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FCH FAMILY AND COMMUNITY HEALTH: PREVENTIVE MEDICINE YL6 COMPILED NOTES BY TOPE VELASCO FCH SOCIAL AND BEHAVIORAL HEALTH Biopsychosocial Perspective Bhutan was successful in pandemic control and action...

FCH FAMILY AND COMMUNITY HEALTH: PREVENTIVE MEDICINE YL6 COMPILED NOTES BY TOPE VELASCO FCH SOCIAL AND BEHAVIORAL HEALTH Biopsychosocial Perspective Bhutan was successful in pandemic control and action Biological Psychological Social - Immediate response - 2 month late vaccination, but still effective Genetics, Behavior, mental, Family, - Colab with med anthropologists variation, cognition, community, work, - 90% of pop was inoculated in 2 weeks bacteria, virus motivation, housing, - 66% coverage emotion ethnicity, class - Even though their between China and India, it was a success because of of their low pop Bioecological Model Brofenbrenner’s Bioecological Systems: looks at indicating Bhutan Vaccination Program levels from within that change thru time; systems grow Involved: Royal Monastic Body, Ministry of Health, Zhung larger and more complex as we move outwards Drastang (traditional leaders), medical anthropologist - Individual: own person - Cultural Brokerage: bridging gaps between - Micro: one interacts with program implementers and community - Meso: one does NOT interact with, but still affects - Being considerate and respectful of culture individual - Macro: global health Subfields of Anthropology Archeology: artifacts (material used by humans) - Materia medica: materials required for med practitioners Linguistics: language Biological/Physical: aka medical anthropology - Genetics, evolution, health Applied: colab of diff disciplines, debatable Critiques about epidemiology Four Aspects of Ecology Micro: dyads, triads, parent-child Meso: relation among systems Exo: settings you do not participate in, but influence you Macro: influence behavior and development, organization of social institutions 1st Critique Social Ecological Model - Epi: biomedical, statistical - Both: patterns of pop, social context 2nd Critique - Epi: (-) too computer based and numbers - Epi: (+) looks at systems pov, flexible 5th Critique - Medicalization: normal life stages are medicalized and defined as risky Social Determinants of Health Three main tiers affecting vaccine uptake: WHO Definition - Individual, interpersonal, structural - Conditions born, grew, and lived with - Structural is critical because not everything is acc - Circumstances from money, power, resources, to indiv’s fault (why we don't want to victim blame) national local levels - Look at larger cultural ideas - Social determinants → health inequities - Dont’t question what an individual does Social determinants of health may include but rather how people should conceive rape - Gender, Race, Sexuality, Disability, Geography, Age, Education, Circumstances FCH Sustainable Livelihood framework Health Behavior Modification Looks into: - Transforming Process: looks at diff aspects to see Opportunities for PH what would change things Challenges include: - Differential Exposures: looks at vulnerabilities - Unhealthy lifestyle, fast food, pollution, AIDS, poverty - Evidence-based science and technological Cultural Ecology advances help in addressing these challenges Relationship of human and environment - Globalization, industrialization, and inequalities Humans are very species-centric: deter/discourage advances in medicine and health - Species at the center of things promotion - Do no think too much about health of environment Adaptations: changes modifications enabling for survival Theory Definitions Systems Approach: recognizes complexity Principles: based on history or research; basis of hypothesis - No single cause of disease Models: draw on multiple theories to understand a problem - Environment = physical and cultural environment Paradigms: create boundaries Social Health Health Education and behavior PH: science of prevent disease, prolong life, and promote Logical positivism, Logical empiricism: reconcile extremes physical health thru sanitation, control of infection, and of induction for verification or confirmation education - Can verify some standards from past studies - Enable citizen to realize birthright and longevity Constructive paradigms: rely heavily on induction International Health: health, practices, policies, systems - Process of discovery - Stresses countries' differences than similarities - Ex. social construction theories, ethnography, Global Health: issues that concerns many countries phenomenology, grounded theory - “Global” refers to scope of problems Meta-Theory: understanding interrelationships between individual and social environment Four Social Theories 1. Unintended consequences of purposive action COMMON THEORETICAL MODELS - Requires routine evaluation to do no harm Transtheoretical Model (TTM/change stages) - Ex. Vaccination programs to make sure they do no - Aka stages of change model harm - Core: stages of change, process of change, decision 2. Social Construction: acknowledges variation balance, self-efficacy - Tensions in global policies and local reality 3. Social Suffering TTM Stages of Change - How could the poor afford drugs Precontemplation: no action in next 6 months - Focused on ignored and unreachable pop Contemplation: action in next 6 months - Suffering is not limited to individual but extends to - Awareness of process and cons family/social network Preparation: action in 30 days - More risk in urban slums - Pros and cons have been weighed 4. Biopower - There is intention Action: some behavior steps had been taken over or overt Political Economy behavior has been changed Critical medical anthropology Maintenance: working to prevent relapse (6 months-5 years) Focused on health inequities Termination: no temptation to relapse - Poverty and its effects to ill-being Stages of change are NOT always linear World Population Ph is 13th in world pop TTM process of change Globes carry capacity: 9-10 billion Defined as the covert and overt activities people use to progress through stages Conscious raising: on causes, consequences, and cures Dramatic relief: increase emotions then reduced effect Self re-eval: values clarification, role models, imagery Environmental re-eval: personal affects social environment - Documentaries, family intervention Self-liberation: commit, change to require will power - New year’s resolution, going public) Social liberation: increase in social opportunities FCH - Advocacy, empowerment, policy changes Occupational Environment Counterconditioning: learning healthier behaviors Facts - Relaxation, assertion, desensitization, nicotine 1. Ph Occupational injuries at 138k from 2015-2019 replacement, positive self statements - Majority from manufacturing sector Stimulus control: remove cues for unhealthy habits - ~40k cases per year - Environmental reengineering, self help groups - ~295k cases of diseases Contingency Management: provides consequences 2. Total Deaths in 2019: 310 ppl - Punishment, rewards 3. Compliance to occupational health and safety Helping relationship: trusts, openness and acceptance standards is legally mandated - Rapport building, therapeutic alliances, counselor - 1987 Ph Constitution: State shall protect and calls, buddy systems promote the right to health - Labor Code (PD 442): set and enforce mandatory Other Concepts occupational safety and health standards Decision balance: weighing pros and cons 4. Work accidents are costly Self-efficacy: confidence on coping with relapsing Temptation: common examples - negative effects positive social situations, emotional distress (stress eating), craving Legal Basis Rule 1000: general provision - protect every worker from Health Belief Model dangers Used to understand why ppl RA 11058: strengthening compliance to occupational safety 5 levels of influence are - Employers must be responsible for upholding safety 1. Intrapersonal/individualistic of workers 2. Interpersonal Dept Order No. 198: Implementing RA 11058 3. Institutional - Outlines OSH program 4. Community RA 9165: drug free workplace 5. Public policy RA 11036: mental health services in workplace RA 8504: HIV prevention HBM Key Constructs Susceptibility: likelihood of getting the disease Two major types of economic costs when OSH is neglected: Severity: feelings of seriousness of contracting the illness 1. Direct costs Benefits 2. Indirect costs Barriers: impediments to behaviors Three major fields of OSH HBM on mammography 1. Occupational health: promotion, prevention, protection, - Older African American: think that their and placing susceptibility is low 2. Occupational safety - Asian American Women: modesty was a barrier 3. Industrial hygiene Concepts of SCT Occupational Medicine: Outcome expectations: beliefs about likelihood Centered on prevention and management of work-related - main determinant of SCT injuries Reciprocal determinisms: environmental factors influence Traditional Role of Physician: conduct medical consultation individuals and groups and treatment; dispenser of medicine; administrator for APE; Self-efficacy: personal ability to perform behaviors that issues fitness cert bring desired outcomes Roles of OH physician: occupational health service program; Collective efficacy: ability of a group to work together and establish proper med supervision; periodic PE bring desired outcomes Scopes of OH Functions: medical knowledge, training, labor Action Theory law awareness, compliance, familiarity, technical knowledge Two indicators of work effectiveness 1. Accountability Diseases in workplace 2. Perception of workplace empowerment 1. Occupational: affects working pop exclusively, factors in Social Psychological Theory of Empowerment: predictor of the work environment productivity 2. Work-related: occupational + environment + performance 3. General: disease in gen pop which workers are equally susceptible to FCH Occupational Safety Physical hazards Accident: unexpected event that lead to damage Noise: acute (sudden - 140-160dB) or chronic (long term exposure >85dB) Iceberg Theory - Temporary threshold shift (auditory fatigue): Direct Costs: medical expenses, equipment damage, wasted temporary hearing loss; recovery w/in 16-48 hrs raw materials, insurance - Ex. long radio after starting a car - Permanent threshold shift: irreversible hearing Primary causes: unsafe act and unsafe condition loss - 88% due to unsafe act VIbration: mechanical oscillations by regular and irregular - 10% due to unsafe condition periodic movements Unsafe Act: human action that departs from standards - Whole-body: whole body vibration via the feet or -due to improper attitude, physical limitations, lack of seat (truck drivers) knowledge or skills - Segmental vibration: only part of the body; most Unsafe condition: physical or chemical property of material, common is hand-arm vibration (HAVS) machine or environment that results in injury - It is people making unsafe conditions Illumination Recommended illumination levels: the more fine the nature, Industrial Hygiene the higher the minimum lighting level Definition: focus on anticipation, recognition, eval, and control on environmental factors Heat: there should be acclimatization starting w/ 50% of Hazard: any source of potential damage working time in hot environment Risk: chance/probability of harm when exposed to hazard - The greater the heat load, the longer the cooling period Occupational Hazard 4 Major Groups: Biological, Ergonomic (most common), Radiation Chemical, Physical Routes of entry to the body: inhalation, ingestion, skin contact Classification of Toxic Effects Lead and concrete can prevent x-ray penetrations Three basic rules for external radiation protection: - Time, Distance, Shielding More Hazards Biological hazards: virus, bacteria, fungi, parasite, plants Main target of OSH program Ergonomic hazards Forceful exertion: overcome weight, resistance - Lift, push, pull Posture Movement: extreme and repetitive movements 4 levels of control Classification of Chemicals 1. Elimination/SUbstitution: most effective - Health (blue), fire (red), specific hazard (white), 2. Engineering: targets source reactivity (yellow) 3. Admin: limit the time of exposure, policies; targets path - MSDS: Material Safety Data Sheet 4. PPE: least effective, targets receiver FCH Disasters and Health Health Response Team - Medical, PH, Water Sanitation and Hygiene, Nutrition in emergencies, Mental Health - WASH: Safe water, sanitation, and hygiene Concepts and Definitions Hazard: natural or man-made event - Typhoons, earthquakes Exposure: state of being put in a dangerous situation Vulnerability: predisposition to suffer damage due to external events Risk: possibility that something bad will happen - Risk = Hazard + Vulnerability + Exposure - Risk reduction is decreasing all factors Disaster: disrupts normal condition causing suffering that exceeds capacity of adjustment - Occurs when hazards and vulnerability meet Vulnerability: susceptibility + lack of coping capacities + lack of adaptive capacities Susceptibility: state of being easily affected Coping capacities: means when people organize resources and skills to face disaster - Factors influencing the ability of a community to prepared and recover from a natural hazard Coping: capacity to deal with disaster when it occurs Adaptation: decision making process and action undertaken to current or future predicted change Resilience: adaptability, capacity to recover National Framework for Disaster and Risk Reduction and Management (DRRM) Legislative Framework: Ph Risk Reduction and Management act of 2010 (RA 10121) Local Level: all operations take place at this level Key Result Areas 1. Risk reduction 2. Preparedness and response 3. Build back better FCH