chapter ten Flashcards
1
Q
Canada’s life expectancy
A
- women = 84
- men = 80
- life expectancy plateaued in the last 5 years due to the opioid crisis thing young peoples lives
- women outlive men because men have higher risk factors
2
Q
life expectancy in 1867
A
- ~47 years
- influenza, or other illness were infectious communicable diseases, including tuberculosis which was the #1 cause of death
3
Q
life expectancy 1867-1925
A
- high infant and maternal mortality
- during or around the time of birth
- due to high rates of infection and lack of understanding/knowledge, lack of doctors and lack of antibiotics at the time
4
Q
life expectancy 1880-1885
A
- 10% plains indigenous population died of starvation
- starved into submission; attempting to force them away from certain land areas
5
Q
life expectancy 1900-1920
A
- infectious/communicable diseases #1 cause of death:
- 1915: 30% of Canadian soldiers had venereal disease and there was no treatments for these at the time
- 1918: ~17% of Canadians had the Spanish Flu; 50,000 deaths attributed to the epidemic after the war
6
Q
public health development in 1920s
A
- sanitation-clean water/sewage management: keeping waste-water and drinking water separate
- hygiene-clean hands and bodies: making the connection between bacteria and infection
- pasteurization-milk: natural bacteria in cows milk + bacteria from machines, storage or equipment and boiling milk to eliminate bacteria
7
Q
early advances in public health
A
- food inspection: educating on proper handling and operations of food, plants and workers
- vaccination programs
- venereal disease education: educate on the symptoms of venereal disease and usage of protection
- travelling nurses: maternal and infant health
- patent medicine regulations: removal of alcohol, cocaine and other ingredients as well as regulating labelling of all ingredients on packaging
8
Q
social determinants of health
A
- aboriginal status
- income and income distribution (rich outlive the poor)
- social exclusion
- health services (access/quality)
- gender
- disability
- housing
- early life experiences
- education
- race
- employment and working conditions
- food insecurity
- social safety net
- unemployment and job security
9
Q
health of Indigenous Canadians
A
- compared to non-Indigenous Canadians, Indigenous Canadians have lower life expectancy and much higher rates of:
- suicide
- trauma
- infant mortality
- diabetes and other chronic diseases
- some infectious diseases
10
Q
social class and health are reported in
A
- The Whitehall Study I (1967)
- The Whitehall Study II (1985)
- The Black Report (1977-1980)
11
Q
Whitehall study I - 1967
A
- two studies designed to evaluate the determinants of health and disease among British public servants
- 1967- 18,000 men
- specifically focused on working men and coronary heart disease
- results determined that male employees in more highly paid, higher-status jobs had better health compared to workers of lower-status, lower-salary positions because risk factors for disease such as smoking, high BP or high BMI are more common in lower employment grade groups
12
Q
Whitehall II - 1985
A
- wanted an explanation for the findings in Whitehall I
- included women this time; 10,000 men and women
- loved at health status, work characteristics, social networks & support, health behaviours, personality test (type A ppl), and stressful life events
- confirmed findings in Whitehall I but added other findings for women
13
Q
Whitehall II findings on women
A
- women were more likely to be living with a typically non-life threatening illness/issue
- isolation
- lower job status more likely unmarried
- obesity more common in lower status workers
- lower job status associated with self-perceived lower health status and resignation to poor health
- lower job status associated with more life stressors
- lower job status: less control over work; more demanding workload and psychological stress at work
14
Q
importance of the Whitehall studies
A
- established the interconnectedness of:
1. socioeconomic position (income)
2. psychosocial factors (stress)
3. health - early support for the biopsychosocial approach to health and illness
15
Q
the black report (1977-1980)
A
- was commissioned by the Labour government in the United Kingdom in 1977 to explore the association between social class and health/disease
- confirmed findings of a socioeconomic gradient in health
- for each improvement in social class, there was a corresponding improvement in health (i.e., lower risk for disease and death with higher employment status)
16
Q
the black report explanation
A
- artefact
- social selection
- materialist
- cultural/behavioural
17
Q
the black report - artefact
A
- the study found this gradient because of its design
- questions the validity of the association by suggesting that the association might be artificially created because of the way that health and/or socioeconomic position were measured
- how does one measure position in a socially stratified society?
- shouldn’t assume that higher status means less stress or financial stability
- e.g. got parents wealth, gambling addiction, etc
18
Q
the black report - social selection
A
- reverse causation; presumption that social class determine health
- research supports a causal relationship (social class as a cause of poor health) with two exceptions: schizophrenia; never attain status they would have if they had not acquired the illness, and indirect social selection; childhood illness may compromise school participation with long-term results
19
Q
the black report - materialist
A
- economic deprivation prevents individuals from obtaining the resources that they need to maintain and promote their own health
- if everyone had access to the same diet and food would these issues and differences in health still exist?
- e.g. can’t afford lean proteins or fresh fruits and vegetables
20
Q
the black report - cultural/behavioural
A
- if policies were enacted to improve the material conditions of living, the authors of the Black Report worried that ingrained patterns of behaviour would persist
- e.g. one may change their living conditions, but not necessarily their behaviour; higher rates of smoking among poor; poor who are lifted out of poverty may still smoke
- psychosocial pathways
- social capital
21
Q
psychosocial pathways
A
- greater attention to one’s sense of place in the social hierarchy, whereby a low status results in increased feelings of powerlessness
- study the powerlessness in relation to health
22
Q
social capital
A
- those aspects of social ties that both provide and produce resources that can be used by individuals and groups within a social network
- social capital is protective
- social connections = social capital
23
Q
present Canadian healthcare system
A
- the present medical care system (socialized medicine) was first implemented in 1972 and started by Tommy Douglas in Saskatchewan
- basic principles of the program:
1. universality
2. portability
3. comprehensive coverage
4. non-profit administration
5. accessibility - privileges biomedicine and physicians
24
Q
universality in the healthcare system
A
if you are canadian you have access to a hospital and healthcare without paying
25
Q
portability in the healthcare system
A
Alberta health care card is portable and useable across Canada
26
Q
comprehensive coverage in the healthcare system
A
- everything that is medically necessary
- this is where some problems arise because certain things aren’t recognized as “medically necessary” my the government but is necessary for individuals to function
- e.g. glasses, psychotherapy for severe depression are not seen as necessary
27
Q
non-profit administration in the healthcare system
A
- the government is not supposed to be turning a profit
- they are meant to be putting the money back into the system
28
Q
accessibility in the healthcare system
A
- added in 1984
- wait list rules saying that people should not have to wait for a surgery for x amount of time based on what they need
29
Q
creeping privatization in the healthcare system
A
- most long-term care institutions are owned privately, not by the state
- most doctors are in private practice
- approximately 70% of health-care funds come from the public sector; 30 per cent are from the private sector
- many costs associated with the use of the allopathic medical care system are not covered, such as taking time off work or the cost to fill a prescription
30
Q
self-reported health status in Canada
A
- self-report health status = A
- life expectancy = B
- premature mortality = B
- mortality due to cancer = B
- mortality due to heart & stroke disease = B
- mortality due to nervous system disease = B
- suicide = B
- infant mortality = C
mortality due to diabetes = C
