CHS 4 Flashcards
Population Health
Definition: Identifying health outcomes of a population group and equitably sharing those outcomes
Population groups: Defined by ethnicity, geography, nation, province, territory, community, or setting
Approach: Broad perspective, considers health as a resource influenced by determinants of health
Goals: Improving health status of a targeted population, addressing health inequities through material and social balance reductions
Benefits: Extends to building a sustainable, integrated health care system
Embraces broader definitions of health and wellness, incorporating holistic concepts
Integrates public health initiatives like health promotion and disease prevention
Public health transforms recommendations into action, funded and implemented by governments, involving collaboration with health care providers, industry, and community agencies
Social media’s role: Platform for campaigns, distribution of health information, and improving health outcomes
Population health vs. public health: Differences explained in Box 6.1
The Lalonde Report, 1974
Created by Marc Lalonde, minister of National Health and Welfare in 1974
Introduced the concept of population health to Canada
Document titled “A New Perspective on the Health of Canadians” or Lalonde Report
Acknowledged health determined by more than biology; proposed improvements through changes in environment, lifestyle, and health care organizations
Alma-Ata Conference, 1978
WHO convened the conference in Kazakhstan
Focused on global health cooperation and reform
Promoted the slogan “Health for All—2000”
Primary Health Care Definition (from Conference):
Emphasizes care for individuals and communities
Includes essential medical care at primary, secondary, or tertiary levels
Involves cost-effective, comprehensive, and collaborative care
Purpose of Alma-Ata Conference
Key elements of primary health care
Emphasis on community involvement in care
Goal of reducing global health inequities
Focus on a team approach in delivering care
Alma-Ata Conference Declaration (10 Points)
Stated health as a fundamental right
Emphasized the highest priority for health
Advocated for community involvement in healthcare planning
Challenged governments to enhance primary health care
Declaration’s focus on health as a fundamental right
Priority placed on achieving optimal health
Emphasis on community participation in healthcare planning
Call for government strategies to improve primary health care
Ottawa Charter for Health Promotion, 1986
Expanded on Alma-Ata proposals
Introduction of “health prerequisites”
Emphasized collaborative approach
Outlined five key principles
Broadening of health factors as “prerequisites”
Reinforcement of collaborative approach
Involvement of all government levels in health promotion
Emphasis on individual responsibility for health
Community-level strategies for health enhancement
The Epp Report, 1986
Epp Report by Jake Epp, 1986 Ottawa conference: Focused on reducing inequities, managing chronic diseases, preventing diseases, proposed financial support from all government levels
Public Health Program Initiative
Public Health Program Initiative: Reviewed determinants of health, analyzed impact on Canadian population’s health, assessed health care system efficiency and effectiveness; completed in 2003
Emphasized link between determinants of health and health outcomes
SES Gradient: Disparity in health outcomes among similar groups; reasons for varied impacts despite common denominators; research continues on health equity in Canada despite universal health care access
First Report on the Health of Canadians, 1996
Released by federal health minister David Dingwall and Ontario health minister Jim Wilson in September 1996
Recommendations aligned with proposals from Canadian Institute for Advanced Research (CIFAR) in 1989
Recognized and incorporated determinants of health into findings and recommendations
Acknowledged Canadians among the healthiest populations globally; emphasized need for intensified collaboration among government levels, industry, and private sector to improve Canadian health
Box 6.4: Lists strategies from the report to improve or maintain Canadian health, supporting population health approach principles
National Forum on Health, 1994–1997
Initiated by Jean Chrétien
Gathered public input nationwide
Released two final reports in 1997
Emphasized evidence-informed approach
Key recommendation for health improvement initiatives
Contributed to a united population health approach
Followed by subsequent health reports focusing on Canadian health with a population health approach
Determinants of Health
Linear perspective on health: Genetics, biology, disease; awareness of health promotion, disease prevention, behavioral risks
Profound effect of socioeconomic factors and other health determinants:
Education
Employment, income level
Built environment (work, living, recreation)
Climate change
Early child development (nutrition, exercise, family dynamics)
Social support networks
Health reliant on combination of these factors
Effect beyond genetics, biology, disease; interconnectivity among determinants
Public Health Agency of Canada (PHAC) identifies 12 determinants of health
Income and Social Status
Significance: Major determinants of health
Research link: Strong correlation between income, social status, and health (PHAC, 2013)
Lower socioeconomic status linked to poorer health, earlier death
Higher socioeconomic status associated with better health; health proportional to socioeconomic position
Social Support Networks
Stress relief and enhanced well-being
Sources: Family, friends, community
Diverse affiliations contribute
Influenced by age, sex, gender, culture
Men’s evolving engagement
Cultural impact on sharing
Effects on marginalized individuals
Loss of control and mental trauma for marginalized/bullied individuals
Education and Literacy
Literacy and education’s impact:
Higher education leads to better jobs, social status, stable income
Financial security offers various opportunities for individuals/families, such as organized sports, recreational activities for children
Benefits of higher education: Widens knowledge, enhances logical thinking, problem-solving skills; motivates community engagement, satisfaction
Success despite lower education levels: Individuals thrive, children succeed, overcome challenges, graduate from colleges/trades
Influence of success: Higher education doesn’t solely mean university degree; community skills, trade graduates find diverse employment opportunities
Disparity in wage earners despite high school graduation rates (90% in 2015), post-secondary education (66% continued) - 2016 Health Status Survey (HSS)
Employment & Health
Impact of underemployment/unemployment
Higher mortality & morbidity rates
Stressors on families
Lack of health care benefits
Unemployment rates among Indigenous Peoples
Gender wage gap statistics
Economic inequality faced by women
Effects of contract employment on health
Social Environment
Components:
Individual behavior, relationships, community ties
Attachment, social comfort, sense of belonging
Gender, culture, ethnic group
Education, workforce roles
Living conditions, community context, self-perception
Influence on health and life expectancy, overlapping with other determinants
Similar social environments lead to similar values, outlooks, thinking patterns
Impact of community cohesion: Stronger, more involved communities tend to have better health
Variation in community impact: Diverse community structures, involvement in different activities
Challenges in various community setups: Social isolation, especially for new Canadians adapting to a new culture
Volunteerism: Enhances well-being, promotes compassion, harmony, and cohesiveness; volunteers tend to live longer, experience less depression, heart disease
Support resources in communities: Government-sponsored child care, resources for older Canadians; reduces stress, financial burden
Positive impact of social stability: Fosters positive relationships, cultural diversity acceptance, unified communities fostering confidence, value, support, and reduced health risks
Physical Environment
Natural environment: Includes food, water, air quality, living spaces
Manufactured/built environment: Homes, schools, workplaces, roads, recreational areas
Impact on health: Built environment structure affects health status; e.g., sick building syndrome, Legionnaire disease
Current environmental concerns: Drinking water infrastructure, air pollution, environmental/global warming, agricultural land pollution, natural resource depletion
Challenges in Indigenous communities: Issues with drinking water, faulty purification systems, multiple advisories (130) in 85 Indigenous communities as of November 2017 (Health Canada)
Responsibility: Building, maintaining structures falls under Indigenous and Northern Affairs Canada
Personal Health Practices and Coping Skills
Personal health practices: Linked to self-imposed risk behaviors, health beliefs, behaviors; influenced by self-esteem, sense of control, confidence, life experiences
Influence of life experiences: Example - rejecting the link between smoking and health problems due to family experiences, adverse reactions to immunization affecting future decisions
Coping skills: Help individuals manage situations, influenced by genetics, socioeconomic factors
Varied ability to cope: Some handle stress, challenges better despite socioeconomic difficulties like family disharmony, financial insecurity, marginalization
Challenges for new Canadians: Cultural differences affecting health beliefs, practices, expectations; socioeconomic influences in new environment impact adjustment and coping
Impact of support during transition: More support leads to positive outcomes in confidence and coping abilities for families transitioning to life in Canada
Healthy Child Development
Commencement: Healthy development starts pre-birth, influenced by maternal health practices (e.g., nutrition), risks (e.g., drinking, smoking, drug use)
Adverse effects of maternal behaviors: Fetal alcohol syndrome, drug use, smoking, and concerns about cannabis use during pregnancy; warnings by Health Canada due to potential adverse effects on fetus and child
Determinants affecting child development: Range from employment insecurity to family stressors, disharmony, breakdown
Health Canada’s focus: Emphasis on healthy child development, ongoing research; Canadian council on Social Determinants of Health formed Healthy Child Development Task Group (2014–2017)
Task Group’s objectives: Innovate research methodologies, collaborate with stakeholders, formulate evidence-based plans
Research outcomes: Insufficient awareness of social determinants’ impact on brain development in children aged 0–3; more research needed on poverty, food insecurity, neglect, lack of stimulation, and their impact on child development
Potential interventions: Improved understanding for implementing screenings, assessments, and interventions based on cause-effect relationships between determinants and child development
Biology and Genetic Endowment
Definition: Attributes inherited from parents influencing vulnerability to specific diseases, health issues
Genetic studies: Aid in understanding disease risks (e.g., Huntington disease, cystic fibrosis, certain cancers, Alzheimer’s); helps assess risks of passing conditions to offspring; individuals’ varied preferences in accessing this information
Influence of socioeconomic factors and environment: Impact on biology; ideal conditions promote better physical, mental health; healthy, active lifestyle in older adults with robust social networks and accessible medical care may prevent chronic diseases, musculoskeletal decline
Health Services
Components: Diagnosis, treatment (maintain/restore health), disease prevention, health promotion; integral to population health approach
Impact on population health: Type, delivery of health services affect overall population health; availability of primary care, health promotion, disease prevention programs crucial for healthier population
Key services: Immunizations, preventive care (e.g., breast screening, prenatal care, well-baby initiatives), community and long-term care services
Challenges in Canadian health services: Financial, logistical, and human resource constraints; cost restraints affecting prompt access to diagnostics, physicians, procedures; inadequate staffing in hospitals (e.g., nursing shortages)
Inequities in isolated communities: Issues with access, treatment; shortage of human health resources, especially primary care providers in rural/isolated areas
Gender Identities
Definition: Personal expression beyond biology or sexual orientation; includes a range of self-identified social/cultural differences, lifestyle, and sense of self
LGBTQ2: Acronym encompassing various identities—Lesbian, Gay, Bisexual, Transgender, Transsexual, Queer, Questioning, Two-Spirit
Definitions of identities within LGBTQ2 umbrella (e.g., lesbian, gay, bisexual, transgender, transsexual, queer, questioning, two-spirit)
Challenges as determinant of health: Acceptance/rejection impact well-being; employment obstacles due to societal stigma; lack of gender-sensitive care in the medical community
Transitioning challenges: Long waits, assessments, uncertainty about procedures covered under public health plans; criteria based on World Professional Association for Transgender Health standards
Genital surgery facilities in Canada: Only two facilities conducting genital surgery—private clinic in Montreal and Women’s College Hospital in Toronto; conditions include good mental/physical health, hormonal treatment, living in desired identity for at least a year
Culture and Ethnicity in Health
Definitions: Culture as a way of life; ethnicity linked to race, origin, language, religion
Influence on Health: Impact on health beliefs, behaviours, and lifestyle choices
Challenges for Different Groups: Minorities facing inequities, isolation, and socioeconomic issues; influence of larger group’s cultural environments on minorities
Barriers in Health Care: Fear, language difficulties, family non-involvement; support from family, friends, or community crucial in navigating the health care system
Refugee Challenges: Newly arrived refugees face health challenges requiring specialized care; support from government, individuals, or private groups varies; financial insecurity due to unemployment affects daily living
Language Barrier: Access to language learning programs provided but attendance challenging; decisions on attending classes may affect family dynamics
Other Barriers: Religion, dress, climate, regulations, community acceptance, health care practices pose additional challenges
Overlooked Refugees: Illegally arrived refugees await immigration hearings, lack support networks, rely on limited assistance, and face mental, emotional, and physical risks.
Alma-Ata Definition of Primary Health Care
Core Attributes: Essential, practical, scientifically sound, and socially acceptable health care methods and technology
Universality: Available universally to individuals and families within the community
Community Involvement: Emphasizes full participation of the community
Accessibility: Ensures accessibility at every stage of development
Affordability: Provided at a cost that the community and country can sustain
Ideals: Embodies the principles of self-reliance and self-determination
Socioeconomic Status (SES) Explained
Definition: Measurement combining education, occupation, income, social status, and sometimes geography
Purpose: Positions individuals/groups on a socioeconomic gradient for health studies
Levels: Categorized as low, medium/average, and high
Health Correlation: Higher SES often correlates with better health outcomes; lower SES linked to poorer health
Exceptions: Individuals from lower SES backgrounds can enjoy good health and productivity
Research Focus: Studies examine multiple population groups to identify health gaps and necessary interventions
Indigenous Communities: Often situated at lower SES levels, facing poverty, unemployment, and poor living conditions
