Determinants of Health and Disease

Question 1

Define a stress

Answer 1

an external factor which exerts a disadvantageous effect on the organism.

Question 2

Define a strain

Answer 2

a reduction in function resulting from a stress.

Question 3

Define adaptation.

Answer 3

changes in function between individuals due to evolution, in order to change (the magnitude of) the response to a stress. Adaptation involves heritable changes in DNA structure.

Question 4

Define Acclimatisation

Answer 4

physiological changes made during the life of the individual due to stresses to ameliorate strain. This is genetically determined but does not cause changes in the DNA.

Question 5

What model is the western medicine centred around?

Answer 5

Western medicine has been centered around the biomedical model.

Question 6

What are healthy and unhealthy people defined as in the biomedical model?

Answer 6

According to the biomedical model, a healthy person is defined as someone free from any disease whereas an unhealthy person is defined as someone with any symptoms of any disease.

Question 7

How does the biomedical model veiw disease?

Answer 7

It views disease as a breakdown of body systems or other bodily function, or caused by specific pathogenic agents being introduced to the body.

Question 8

How does the biomedical model help people with disease?

Answer 8

It examines the body for “broken parts” and aims to restore these parts to function normally by supporting or replacing these functions.

Question 9

What is the methodology of the biomedical model?

Answer 9

The biomedical model therefore focuses more on testing and diagnosing underperforming functions and then treating them.

Question 10

Treatment under the biomedical model falls under three main categories which are:

Answer 10

• Surgery.
  -Generally successful
• Structure restored or reformed
• Antibiotics
• Very successful
• Structure often repaired after pathogen killed
• Pharmaceutical drugs
• Generally do not repair structure/function – so healing does not occur

Question 11

What do pharmaceutical drugs do?

Answer 11

They tend to either replace the function or reduce the symptom.
The result is often that individuals will have to take them for the rest of their life.
They commonly have unwanted side effects.

Question 12

Modes of action of pharmaceutical drugs:

Answer 12

• Physical mechanisms
  e.g. Emollients
• Chemical mechanisms
  e.g. Antacids
• Drug- receptor interactions
  e.g. Insulin
• Drug- enzyme interactions
  e.g. Aspirin
• Drug- channel interactions
  e.g. Calcium channel blockers (some blood pressure medications)

Question 13

Has the biomedical model really helped us to live longer?

Answer 13

Well, an analysis of the mid-Victorian period shows life expectancy at age 5 was as good as or even better than the life expectancy we have today, even though we are more medically advanced, so if anything life expectancy has shortened since this era. Incidences of degenerative diseases was 10% of ours. There level of physical activity was twice ours today. Perhaps factors such as this are the reason why they have a longer life expectancy than us even without the medication. As long as we look after our bodies throughout our entire life, we may no longer need medicines in later years of life (age 60-70). However, medicine CAN keep us alive for slightly longer, but we live in poor health. On average women are now living for 19.1 years in
poor health, compared with 16.1 years for men.

Question 14

What does functional medicine aim to do?

Answer 14

The aim is to restore function by looking at and understanding the root cause of the issue, not just addressing symptoms of it.

Question 15

What are some pre-requisites for human health?

Answer 15

– Peace
* Shelter
* Education
* Food
* Income
* A stable eco-system
* Sustainable resources
* Social justice and equity

Question 16

What are the 5 Approaches to Health Promotion?

Answer 16

1. Medical or preventive
   * To prevent disease
2. Behaviour change
   * To encourage the adoption of healthy lifestyles
3. Educational
   * Ensure people are well informed
4. Empowerment
   * Promote skills and confidence
5. Social change
   * Change Polices and environments

Question 17

What is the medical/preventative approach aimed at?

Answer 17

aimed at reducing premature deaths (mortality) and avoidable diseases
(morbidity)

Question 18

Who are actions targetted at in the medical/preventative model?

Answer 18

Actions are targeted at whole populations. Such as Immunisation for high risk groups.

Question 19

In what order does the medical model prevent?

Answer 19

primary prevention -> secondary prevention -> tertiary prevention.

Question 20

What is primary prevention?

Answer 20

Prevention of the onset of disease through risk education:
* Smoking cessation
* Cholesterol reduction
* Obesity & sedentary life style

Question 21

What is secondary prevention?

Answer 21

• Preventing the progression of disease
• Screening and other methods of early diagnosis

Question 22

What is tertiary prevention?

Answer 22

• Reducing further disability
• Preventing the recurrence of illness
• Patient education
• Palliative care

Question 23

What does the behavioural change approach aim to do?

Answer 23

Aims to encourage individuals to adopt healthy behaviours which are considered to improve ones health.

Question 24

How does the behavioural change approach view health?

Answer 24

This approach views health as the property of the individual

Question 25

What are the assumptions of the behavioral approach

Answer 25

People can make real improvements to their health by changing their lifestyle
If people don’t take responsibility for their actions they tend to blame others for the consequences.

Question 26

What is the educational approach linked to?

Answer 26

This approach is strongly linked to health education.

Question 27

What does the educational approach aim to do?

Answer 27

Aims to provide knowledge and information to individuals so that they can develop the necessary skills to make informed decisions about their own behaviour.

Question 28

What is the empowerment approach also known as?

Answer 28

Also known as the bottom up approach.

Question 29

What does the empowerment approach aim to do?

Answer 29

Aims to help people or communtiies to identify their own health concerns, gain the skills necessary to change and improve their lives accordingly.

In this approach, professionals act as facilitators rather than the expert by acting as a catalyst for change, and supporting individuals and communities to make changes or lobby for changes.

Question 30

What does the empowerment approach increase the ability to do?

Answer 30

Increases the ability of individuals and communities to change their social reality.

Question 31

What does the empowerment approach help to do?

Answer 31

Helping communities to identify general / social concerns and make a programme of action to address the concerns

Question 32

What does the social change approach focus on?

Answer 32

Focuses on the policy or environmental level.

Question 33

What does the social change approach target?

Answer 33

Targets groups and populations. A top down method of working.

Question 34

What method of working is the social change model?

Answer 34

A top down method of working

Question 35

What is the social change approach also known as?

Answer 35

Radical health promotion

Question 36

What are the beleifs of the social change approach?

Answer 36

that socio-economic circumstances determine health status

Question 37

What does the social change approach aim to do?

Answer 37

Aims to bring about physical, social, economic, legislative and environmental changes that will be health enhancing or promoting

Question 38

What is the Social change approach based on?

Answer 38

based on the notion that to promote positive health it is necessary to tackle and diminish social and health inequalities

Question 39

Disadvantage of social change approach?

Answer 39

• Healthy choices may be available, but this may require major structural
  changes