Adult Health Flashcards
Case Study:
Mr X = presented to A&E with metacarpal fractures a few weeks ago, here for a check up
Smoking history, VBA about smoking cessation worked
Suffered from mild depression in 2001 - treated with SSRIs for 6 months
Served in the military, but currently unemployed
Two children
Mentions he is ‘stressed’ - cannot find a new job, misses the military and his friends
What are the key social determinants and lifestyle behaviours identified in this case that would be important in taking a holistic approach to this man’s health?
Stress from lack of job
Odd sleep schedule - going back to bed in the mornings for an hour or two
Parent of two children
Used to smoke, but has now quit - hopefully does not relapse from stress
Missing his friends
As the registrar, is there anything you would want to be aware of for your own health in this case?
x
How does Mr. X compare with Alex who you met in 1a- specifically thinking about lifestyle and social factors that will be impacting health?
x
What else might be affecting Mr.X?
Besides health behaviours and the financial worries inherent in unemployment how else might leaving the military be impacting Mr. X?
No longer has a regime/ timetable so can feel derailed
Loss of friends
What stats show there is men’s heath inequality in healthcare?
Males live shorter lives than females
Suffer life-limiting diseases soon
And gap between male and female life expectancy is greater in higher income countries
How do nature and nurture impact men’s health?
Initially thought to be mostly biological differences that led to men leading shorter lives
Now, also thought to be partially due to social constructs about gender and identity
Sex VS gender?
Sex = male or female, biological, assigned at birth
Gender = man or woman, social construct, personal identity
How many years on average do men die earlier than women?
What are the common causes?
5 years
IHD (ischaemic heart disease), road injury, lung cancer, COPD, stroke
Why do men die of CVD and resp diseases more than women?
Oestrogen thought to be CVD protecting
Men = greater tobacco use and poorer diet
Why do men die from injuries more than women?
They take more risks
Work in more ‘dangerous’ jobs - agriculture, industries
What are health seeking behaviours?
Men are 2x as likely to have inadequate health literacy than women
Men are less likely to seek help when they need it
Tend to attribute health concerns to ‘getting old’
Present to doctors with more progressed health issues = harder to treat
Why do men have worse mental health?
Do not seek help
Find mental health to be ‘stigmatising’ - do not talk to friends or GP
Less socially connected as they get older
More likely to substance abuse, alcohol abuse and be homeless
Suicide rate differences between men and women?
Women = more likely to attempt
Men = more likely to complete a suicide attempt
Men = more violent suicide attempts
How can suicide rates be lowered?
Generational change in culture
Work place health initiatives - can influence better health behaviours: better work hours, more efficiency, provide mental health first aid courses, suicide prevention, promote mental health discussions
Social prescribing - ‘Men in sheds’ = men connect shoulder to shoulder = shared connection
What is self-care?
WHO = what people do for themselves to establish and maintain health, and to prevent and deal with illness
What are the 7 pillars of self-care?
- Knowledge and Health Literacy
- Mental wellbeing
- Physical activity
- Healthy eating - high fibre with nutrients, not overeating
- Risk avoidance
- Good hygiene practices - oral, digital, sleep
- Rational use of products and services - responsible use of medications
What is the self-care continuum?
Healthy behaviours ———————> acute conditions and trauma
Daily choices –> lifestyle –. self-managed ailments –> minor ailments –> long-term conditions –> acute conditions –> compulsory psychiatric care –> major trauma
Why is self-care effective?
Lack of self care e.g. unhealthy diet, physical inactivity, tobacco use, excess alcohol
= Raised BP (hypertension), obesity, raised BGL
= Chronic disease = heart disease, stroke, cancer, diabetes, lung diseases
= Higher mortality rates
Also reduces spread of communicable diseases - risk avoidance, good hygiene, awareness and literacy
How can self-care be integrated into daily behaviours?
Activation, incentivisation, nudges, gamification, personalisation
Can be achieved by lifestyle medicine, lifestyle modifications > drugs, person-centred medicine, doctors as coaches, democratisation of self-care, and Health is All Policy (HiAP) approach
What technologies influence self-care behaviours?
eHealth and mHealth Diagnostics Fitness trackers Nudges (notifications) Internet pharmacies AIs BP monitors Sleep apnoea monitors Glucometer Heart rate monitors
etc.
What is the paradigm shift?
Self-care not accessible to all
Poor self care –> government interventions –> Good self care
What can affect self-care?
Inequalities Homelessness Alcohol / substance dependency Suicide Social isolation / loneliness
How can we influence good self-care behaviours?
From a young age - to make self-care behaviours a habit
Starting with workplace interventions
