BPK 140 Final CH 1 - 2 Flashcards
Examples of Contemporary Health Issues
- Nutrition and Health
- Obesity
- Infectious Diseases
- Medical Assisted Death
- Opioid Crisis
- Legalisation of Cannabis
Life Expectancy
The average number of years men and women expect live to
How did life expectancy increase
Public health achievements like the invention and use of antibiotics and vaccines
Life expectancy and IMR are both measures of population health T/F
True
Life Expectancy is the same as Life Span T/F
False
Lifespan
The number of years that we as a species are biologically wired to live, about 120 years
Men are expected to live longer than females T/F
False
Leading causes of Death in Canada
Cancer
Heart Disease
Stroke
Accidents
Chronic Lower Respiratory Disease
Alzheimers
Influenza and Pneumonia
Self Harm
Kidney Disease
What does it mean to be healthy?
Longevity
Healthy eating
Physical Health and fitness
How our bodies respond to stress
Spiritual or religious life
Relationships
Mindful activities
What does it mean to be unhealthy?
Unhealthy relationships with food
Non-active, sedentary
Malnutrition
Mental Health Problems
Smoking and Drugs
Having an unhealthy relationship with exercise
What is health?
The overall condition of the body or mind, the presence or absence of illness or injury
What is Health according to the WHO
A state of complete physical, mental, and social well being and not merely the absence of disease or infirmity
Former definition of health
Absence of disease
Old Medical Model of Health
You see your doctor when you have signs or symptoms of disease, the doctor is responsible for your health which is achieved through prescribed treatment
Signs
Something you can see
Symptoms
Something you feel
Goal of Medical Model of Health
Prevent Morbidity and Mortality, focused on the disorder rather than on the person
Health as a Linear Continuum
Health on one side, morbidity/mortality on the other. When one develops signs or symptoms, doctors prescribe treatment until they are in neutral position
What is the new Medical Model of Health
Health Promotion (1970s), Health through prevention
Definition of the new medical model
Empowerment, community support, healthy public policy, supportive environments, knowledge translation, identification of risk factors
What is different about the new model?
Focused on prevention instead of treatment, allowed the individual to be more responsible for their health
Health through prevention of illness Levels
Three levels : Personal, Community, health care provider
Personal Level of Preventing Illness
Responsibility of the person to change their health behaviours to reduce risk
Community Level of Preventing Illness
Health Promoters can target high risk groups and focus on prevention and/or early detection
Health Care Provider Level of Preventing Illness
Physicians can act as a resource to raise awareness and impart knowledge of risk factors
Health Behaviours associated with living longer
Not smoking
Moderate Drinking
Staying Active
5 fruits and vegetables a day
Framingham Study
People who didn’t smoke, moderately drank, were physically active and ate 5 servings of fruits and vegetables a day lived about 14 years longer
Social Determinants of Health
Income
Education
Job Security
Early Childhood Development
Food Insecurity
Housing
Social Exclusion
Social Safety Net
Health Services
Indigenous Status
Gender
Ethnicity
Disability
Strategies to improve social determinants of health
Social inclusion, reducing injustice
High quality public education and affordable post secondary education
Full employment, job security, health working conditions
Reduced Income Disparities
Universal Health Care Access
Adequate housing and food security
Empowering individuals to make informed health related decisions
What is Wellness?
Optimal health and vitality, encompassing all the dimensions of wellbeing.
What is wellness determined by?
Decisions you make about how you live, whether or not you exercise or eat healthy foods
What is enhanced wellness?
Controlling risk factors that contribute to disease or injury, like smoking and drug abuse, physical inactivity
7 Dimensions of Wellness
Physical
Emotional
Intellectual
Interpersonal
Spiritual
Environmental
Financial
Physical Dimension of Wellness
Overall wellbeing, positive mental health, getting good sleep, being active, eating nutritious food
Emotional Dimension of Wellness
Being aware of our pleasant and unpleasant emotions, practicing resilience and self compassion, finding support to enhance your emotional health, self confidence
Intellectual Dimension of Wellness
Openness to new ideas, ability to think critically, be curious, creativity, motivation to master new skills
Interpersonal Dimension of Wellness
Communication skills and ability to establish and maintain satisfying relationships
Spiritual Dimension of Wellness
Compassion, forgiveness, joy, caring for others
Environmental Dimension of Wellness
Having abundant, clean, natural resources, maintaining sustainable development, recycling, reducing pollution and waste
Financial Dimension of Wellness
Having financial security that can contribute to your peace of mind as you worry less about daily expenses and focus on personal interests, having a comfortable living and financial situation, spending within one’s means, saving for the future
The Wellness Continuum
Recognises the importance of disease and treatment but each individual should strive to achieve a high level of wellness, which isn’t a state, but a process of living
Changing behaviour
In order to reduce the risk of health issues, one must identify and change negative health behaviours
How does one change their behaviour
They need to really want and adopt the new behaviour, be ready to change, and have the right resources to do so
Stages of Change
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Termination
Relapse
What is Precontemplation
Not yet thinking about change
Contemplation
Thinking about change
Preparation
Commitment and planning to the change
Action
Putting the plan into action and making the changes
Maintenance
Keeping to the plan and sticking to it
Termination
Reaches a point where they fully recover and never fall back on their bad habits
Is termination always certain?
No, some might stay in maintenance forever
Relapse
When one slides back into their bad habits, typically happens between action and maintenance. Not always your fault, try and get back on track ASAP
SMART Goals Definition
Behaviour change starts with a goal
Specific
Measurable
Attainable
Realistic
Time frame specific
SMART Goals Definition: Specific
Avoid vague goals, state objectives in specific terms
SMART Goals Definition: Measurable
Recognising your progress is easier to track if the goals are qualifiable, give goals a number
SMART Goals Definition: Attainable
Set goals within your physical limits
SMART Goals Definition: Realistic
Manage your expectations when you set goals
SMART Goals Definition: Time frame specific
Give yourself a reasonable amount of time to reach your goals, state the time frame in your behaviour plan, try to meet the goal within that time frame
Factors that Improve the Likelihood of Behaviour Change
Self-Efficacy
Internal Locus of Control
Self-Talk
Support
Identify and Overcome Barriers
Self-Efficacy
Belief in one’s ability to achieve a goal
Internal Locus of Control
Reliance on internal rather than external sources of motivation
Self -talk
Ability to coach one’s self towards a goal
Support
Can include many sources; friends, family, groups, and community
Identify and Overcome Barriers
Don’t let past failures or occasional relapses discourage you
Assessing Credibility of Health Information
If it is too good to be true, it probably isn’t true
Hierarchy of Evidence
Experimental
Epidemiological
Clinical
Personal
Anecdotal
Evidence Research: Experimental
Uses scientific method and a well-designed research study
Evidence Research: Epidemiological
Find relationships between variables by looking at trends within populations via observations
Evidence Research: Clinical
Evidence from health care professionals and clinicians
Evidence Research: Personal
Something you experienced personally
Evidence Research: Anecdotal
Something someone else experienced and told you about
Scientific Method
Experimental evidence starts with a hypothesis
What is in the ultimate study design
A randomised study group
Double binding and placebo
Cross Over
Double Blinding and Placebo
There are two groups, control and experimental.
Control group gets the real drug and the experimental gets a placebo
The participants NOR researcher knows who is in the control or experimental group
Placebo Drug
Contains all the elements of the drug except the drug itself. Looks, smell, tastes like the drug but doesn’t have the drug itself. Done to check if one would have the same psychological effects as if they took the real drug
Cross Over
Control Group A and Experimental Group B
Then you flip so A because experimental and B becomes control
Who came up with the first epidemiological study
Dr Snow in proving cholera
Epidemiology: Correlation
The difference between correlation and causation, certain criteria needs to be met
The use of population data without intervention, doesn’t necessarily imply cause and effect, observational only
Epidemiology: Causation
Our ability to ascertain cause and effect depends on several factors
depends on strength of association, dose response, consistency, temporally correct, specificity, biological plausibility
Strength of Association
EX: is smoking strongly associated with lung cancer? yes, weak or strong association
Dose Response
EX: Does the risk for lung cancer increase the more cigarettes one smokes? yes
Consistency
EX: Are they many studies linked to smoking and lung cancer? yes
Temporally Correct
EX: Is the timing right? yes, lung cancer doesn’t develop overnight, but it takes years or decades to develop
Specificity
EX: is the increased risk specific to smokers? yes
Biological Plausibility
EX: Is there a mechanism that could explain the cause and effect? Yes
Clinical Evidence
Experience from clinicians, consistent with scientific evidence
Other forms of evidence
Personal and Anecdotal experience
Personal Evidence
Something you have experienced yourself
Anecdotal Evidence
Something someone else tells you happened to them
Assessing Credibility
What is the source?
How often is the site updated?
Is the site promotional?
What do other sources say?
Does the site conform to a set of criteria for accuracy?
How does Canada compare globally health wise?
Canadians make 4x more money
Live ~11 years longer
12/100,000 women die in childbirth versus 210/100,000
Lower under five mortality rate: 5/1,000 vs 51/1,000
Lower Tuberculosis rate: 6/100,000 vs 170/100,000
Higher access to clean drinking water, childhood immunisation, and publicly funded health care
Canadian Health Challenges
3/5 deaths due to cancer or cardiovascular disease
Sharp increase in obesity and type II diabetes
Hypertension affects to 1 in 4
1 in 5 experience a mental health issue
Chronic conditions are a burden
History of Canada’s Health Care System
1948: started by Tommy Douglas who was premier of Saskatchewan, Medical Care Act
1957: Insurance plan for physician services was added to the program
1964: Federal government paid for part of the plan
1972: All provinces joined
1984: Medical Care Act replaced by Canada Health Act
Five guiding principles of the Canada Health Act
- Public Administration
- Comprehensiveness
- Universality
- Portability
- Accessibility
Public Administration
All administration of provincial health insurance must be carried out by public authority on a non-profit basis (Fraser Health, PHSA)
Comprehensiveness
All necessary health services, hospital, physicians, surgical dentists, must be insured
Universality
All insured residents are entitled to the same level of health care
Portability
A resident that moves to a different province is entitled to coverage from their home province
Accessibility
All insured persons have reasonable access to health care facilities
How is our healthcare system excellent
High quality of people, places, equipment
Relatively equal access,
Adequate resources
How is the Canadian health system not perfect?
Longest wait times in developed world
Fewer physicians per capita (2.2 per 1000 population)
Limited services and access in rural areas
Needs more focus on prevention
BC Medical Services Plan
Medicare Protection Act makes it mandatory for residents to enrol in MSP in order to access healthcare services
What MSP doesn’t cover
Cosmetic surgery, regular dental services, eye exams, glasses, prescription drugs
Canadian Physicians
Must have a medical degree from one of 17 accredited Canadian medical schools
An additional 4 year program after a 4 year undergraduate degree
Must obtain medical license
What are examples of Health care providers
MDs
Nurses
Licensed Practical Nurses
Specialists
Podiatrists
Optometrists
Dentists
Who is ultimately responsible for your health?
You are!
Who is ultimately responsible for your health?
You are!
What does the Canadian System operate on?
A welfare state model
Physicians are self-employed
Socialist Model
Universal but all clinics and hospitals are government run and physicians are government employees
Cuba runs on this model
Free Enterprise Model
Health care is a private sector, insurance companies are for-profit
USA runs on this model
Medical Rights
Patients have the rights to access their records and have those records kept private
Receive treatment that provides a reasonable degree of care
Know about potential dangers and benefits of any treatment
Receive competent diagnosis and treatment
designate a person to make decisions if they cannot
Give informed consent for hospitalisation, surgery, and other treatments
Self Medication
Over the counter treatments that are deemed safe to use from Health Canada without a physicians prescription.
Highly effective in relieving symptoms and some are effective in curing illnesses
Generic drugs must meet the same Health Canada standards as their brand name counterparts
Complementary and Alternative Medicine (CAM)
Conventional Western medicine tends to focus on the body, the physical causes of disease and ways to eradicate pathogens, in order to restore health.
Primarily based on science and experimental and clinical evidence gathered in randomised control trials
Tends to focus on the mind, body and spirit and primarily based on healing traditions and accumulated experience
Chinese medicine, chiropractic, naturopathy, homeopathy
Not all have been carefully evaluated for safety and effectiveness
5 domains of CAM Practices
Alternative Medical Systems
Mind body interventions
Biologically based therapies
Manipulative and body based methods
Energy therapies
Alternative Medical Systems
Complete systems of theory and practice that have evolved independently of and often long before the conventional biomedical approach, Traditional Chinese medicine, homeopathy
Mind Body Intervention
Employ a variety of techniques designed to make it possible for the mind to affect bodily functions and symptoms, prayer, meditation
Biologically based therapies
Include natural and biologically based practices, interventions and products, many of which overlap with conventional medicine’s use of dietary supplements, herbal, special dietary
Manipulative and Body Based methods
Includes methods that are based on manipulation and movement of the body, Chiropractic, massage therapy
Energy Therapies
Focuses on energy fields within the body (bitfields) or other sources (electromagnetic fields), Reiki, therapeutic touch
