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HSCI130 > FINAL EXAM > Flashcards

FINAL EXAM Flashcards

1
Q

Stress

A

State of mental or emotional strain or tension from adverse or very demanding circumstances

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2
Q

Hans Selye

A

Hungarian born Canadian endocrinologist working out of McGill. He was a pioneer of biological effects of stressful stimuli

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3
Q

Selye definition of stress

A

The non-specific response of the body to any demand” & “That which produces stress”

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4
Q

General adaptation syndrome (GAS):

A
  • Alarm: Body recognizes a stressor and is in state of alarm (activation of flight or fight)
  • Resistance: Follows alarm reaction, it is a removal or disappearance of symptoms
  • Exhaustion: As a result of chronic stress the body’s resources are depleted and unable to function properly
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5
Q

SAM system (3):

A
  • Sympatho-adrenal-medullary pathway
  • Perceived through the sympathetic nervous system of the autonomic nervous system
  • Increases secretion of epinephrine and norepinephrine
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6
Q

Consequences of the SAM system (5):

A
  • Suppression of cellular immune function
  • Increased blood pressure and heart rate
  • Variations in normal heart rhythm
  • Sweating
  • Neurochemical imbalances
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7
Q

HPA system (4):

A
  • Hypothalamic-pituitary adrenal pathway
  • Hypothalamus sends message to pituitary
  • Anterior pituitary gland secretes ACTH
  • This activates adrenal cortex to produce cortisol and glucocorticoids
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8
Q

Consequences of the HPA system (3):

A
  • Cognitive decline
  • Immuno-suppression
  • Insulin resistance
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9
Q

Cortisol

A

Steroid hormone that the adrenal glands produce and release

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10
Q

Ways stress can be measured (5):

A
  • Schedule of recent experiences - self report checklists
  • Age specific checklists
  • Life events and difficulties scale
  • Interviews
  • Difference in biographical circumstances
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11
Q

Problems with measuring stress via checklist (3):

A
  • Memory and recall of life event
  • What constitutes a life event; people interpret descriptors in very different ways
  • Other factors influence how people respond (eg. Culture, gender, age)
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12
Q

Cognitive appraisal theory:

A

Originated in sociology/psychology. It was developed by Lazarus to describe and explain individual differences in adaptation

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13
Q

Theories of cognitive appraisal theory (3):

A
  • Individuals constantly evaluate their relationship with the environment
  • Behavioural and emotional responses determined by meaning attached to situation
  • Psychological stress occurs when individuals appraise an interaction between themselves and the environment as greater than resource
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14
Q

3 types of stress appraisals:

A
  • Harm or loss
  • Threat
  • Challenge
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15
Q

Life stress can lead to… (9):

A
  • Asthma
  • Rheumatoid Arthritis
  • Anxiety
  • Depression
  • Cardiovascular disease
  • Chronic pain
  • HIV/AIDS
  • Stroke
  • Cancer
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16
Q

Animal research

A

Stress contributes to initiation, growth and metastasis of tumors

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17
Q

Human research

A

Stress contributes to antiviral defenses, DNA repair and cellular aging

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18
Q

According to Association of Dispositional Mindfulness with Stress article, what is the most common causes of stress among undergraduate students

A

Academic activities

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19
Q

Examples of academic stressors (5):

A
  • Workload
  • Too much information
  • Studying
  • Pressure to make friends when moving abroad
  • Stress from living on residence
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20
Q

Psychological well-being (6):

A
  • Autonomy
  • Self-acceptance
  • Environmental mastery
  • Personal growth
  • Purpose in life
  • Positive relations with others
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21
Q

Cortisol levels at night vs morning

A

Low overnight and increase progressively during morning

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22
Q

Mindfulness

A

Awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment

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23
Q

Dispositional mindfulness would be associated with (4):

A
  • Lower perceived stress
  • Lower physiological stress
  • Higher psychological well-being
  • Greater perceived stress = disrupted cortisol secretion, lower well-being
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24
Q

Stress-elicited endocrine responses (2):

A
  • Hypothalamic-pituitary-adrenocortical axis (HPA)
  • Sympathetic-adrenal-medullary (SAM)
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25
Q

Cortisol

A

Primary effector of HPA activation. It regulates a broad range of physiological processes like anti-inflammatory, metabolism, and gluconeogenesis

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26
Q

Catecholamines

A

Effector of SAM activation. Exerts regulatory effects on cardiovascular, pulmonary, hepatic, skeletal muscle, and immune systems

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27
Q

Repeated activation of HPA and SAM interferes with..

A

Control of other physiological systems resulting in increased risk for physical and psychiatric disorders

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28
Q

Friedrich Engel’s study - The Condition of the Working Class in England:

A
  • Examined and observed differences in mortality rates in suburbs of Manchester
  • Observed death rates correlated with quality of housing and quality of streets
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29
Q

Rudolf Virchow*

A

Sent to Poland to investigate an epidemic of typhus in 1848. He found that feudalism, unfair tax policies and lack of democracy leads to poor living conditions, inadequate diet, and poor hygiene = typhus

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30
Q

Virchow recommendation

A

Preserving health and preventing disease requires full and unlimited democracy and radical measures rather than mere palliatives

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31
Q

What makes people healthy (traditional) (3):

A
  • Biomedical model
  • Pathogenesis-origins of disease
  • Emphasis on personal factors/consciousness raising
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32
Q

What makes people healthy (alternative) (3):

A
  • Upstream approach, emphasizes social determinants of health
  • Salutogenesis-origins of positive health
  • Emphasis on structural factors
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33
Q

What makes people healthy (individual) (4):

A
  • Lay health beliefs
  • Self health management - self care capacity/coping skills
  • Biology and genetic endowment
  • Health protective behavior - personal health practice/lifestyle
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34
Q

Public Health Agency of Canada - 12 determinants:

A
  • Social status
  • Support networks
  • Education
  • Employment
  • Social environment
  • Physical environment
  • Personal health practices
  • Skills
  • Healthy child development
  • Biology
  • Health services
  • Gender
  • Culture
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35
Q

Statistics of Canadians sick from their life, health care, genetics, and environment

A
  • 50%, 25%, 15% and 10%
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36
Q

Social inequality

A

Relatively stable differences between individuals and groups of people in the distribution of power and privilege

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37
Q

Social inequity

A

Unfair, avoidable differences arising from poor governance, corruption, social exclusion, discrimination

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38
Q

Social gradient

A

Graded association between the indicator of socioeconomic status and population health

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39
Q

Socio-economic position (SEP)

A

Social and economic factors that influence what position individuals and groups hold in the social structure of a society

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40
Q

SEP individual level measures (4):

A
  • Occupation
  • Income
  • Education
  • Wealth
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41
Q

Traditional tips for better health (5):

A
  • Don’t smoke. If you can, quit. If you can’t quit, cut down
  • Keep physically active
  • Follow a balanced diet with fruit and vegetables
  • If you drink alcohol, do so in moderation
  • Manage stress by taking time to relax
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42
Q

Social determinants perspective tips for better health (4):

A
  • Don’t be poor. If you can, stop
  • Practice not losing your job
  • Don’t live in a neighbourhood with high crime rates
  • Don’t belong to a visible minority
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43
Q

Social determinants of health

A

The conditions in which people are born, grow, live, work and age. The circumstances are shaped by distribution of money, power, and resources at global levels

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44
Q

Salutogenic model:

A

Developed by Antonvosky that highlights importance of improving living and working conditions to provide a health-protective environment and the health and wellness of population

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45
Q

Pathogenesis

A

Origins of disease

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46
Q

Salutogenesis

A

Term used to encourage researchers to explore factors that protect and enhance good health (rather than what contributes to ill health)

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47
Q

Personal determinants

A

Individual level (eg. Genetics, beliefs, attidues, personal health practices)

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48
Q

Structural determinants

A

Societal level (eg. Rates of employment, living and work conditions, health care)

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49
Q

Lalonde major determinants of population health (4):

A
  • Human biology: genetics that could lead to susceptibility of disease/hereditary disease
  • Lifestyle: personal factors such as smoking, drinking, eating and physical activity
  • Environment: immediate surroundings like air, water, soil, and food
  • Use of formal health-care services: Focuses on individual health rather than population health so it is not well equipped to deal effectively with major health challenges like preventing occurence of disease and enhancing health
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50
Q

What is considered the leading cause of health problems

A

Life style problems - Tobbaco use, poor diet, physical inactivity

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51
Q

Types of environmental factors:

A
  • Natural environment: Housing, workplace
  • Built environment: Planning and design of our cities
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52
Q

Sprawl

A

Term that means that people must drive greater annual distances and navigate more complex roads which increases risk of traffic accidents

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53
Q

Education

A

Important health determinant because it improves people’s ability to access and understand complex health related information about effective selfcare

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54
Q

Health literacy

A

The ability to access, understand, evaluate and communicate information as a way to promote, maintain and improve health

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55
Q

WHO definition of population

A

Powerful and transforming demographic force. As the proportion of older people increase, there is a rise in prevalence of chronic diseases

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56
Q

3 types of support:

A
  • Emotional support: Feelings of being cared for and valued
  • Instrumental support: Vital practice assistance with activities of daily living
  • Informational support: Knowledge about health related matters
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57
Q

Primary determinants*

A

Household income, education level, employment status

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58
Q

Secondary determinants*

A

Daily behavioural practices and psychosocial wellbeing

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59
Q

Horizontal structures*

A

Immediate factors that shape health and well-being (eg. Family, work, living conditions)

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60
Q

Vertical structures*

A

Distant factors that indirectly influence health (eg. Social, political and economic policies)

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61
Q

Life course perspective

A

Theory that suggests that each life stage influences the next. Thus, experiences from childhood impact how our life unfolds and so on

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62
Q

Pathogenic approach goal

A

Discover origin and nature of disease for treatment and has an illness-avoidance orientation. Focuses on biophysical aspects for risk factors in micro-organisms

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63
Q

Salutogenic approach goal

A

Discover origin and nature of good health to promote health protective behavior. Focuses on psychosocial aspects of health status to search for good health in social environment and lifestyle

64
Q

Sex (3):

A
  • Multidimensional biological construct
  • Premised on biological characteristics enabling human reproduction
  • Encompasses anatomy, physiology, genes, hormone
65
Q

Gender

A

Structure of social relations that centres on the reproductive arena and the set of practices that bring reproductive distinctions between bodies into social processes

66
Q

Things are gendered when:

A
  • Characterized as masculine or feminine
  • Prescribes or exhibits patterns of difference by gender
67
Q

Individual level of gender (6):

A
  • Sex category
  • Identity
  • Display
  • Marital & procreative status
  • Sexual orientation
  • Personality
68
Q

Structural level of gender (6):

A
  • Gendered statuses
  • Divisions of labour
  • Kinships and family rights
  • Personalities
  • Social control
  • Ideology
  • Imagery
69
Q

Differences in health due to gender (5):

A
  • Women live longer than men
  • Gender differs in major causes of death
  • Women diagnosed as suffering from more ill health than men
  • Women make more frequent use of formal health care than men
  • Differences in the social determinants of health
70
Q

Major causes of death (gender)

A

Unintentional injuries from motor vehicle accidents and suicide more common in men. Breast cancer and lung cancer from smoking more common in women

71
Q

Health care differences (gender)

A

When women and men present the same complaints or medical diagnoses, women are given prescription more often

72
Q

Role-accumulation hypothesis*

A

Suggests that women taking on multiple roles leads to positive health effects

73
Q

Role-strain hypothesis*

A

States that women taking on multiple roles are harmful to health

74
Q

Social acceptability hypothesis*

A

Suggests that women have been socialized into accepting the sick role

75
Q

Risk taking hypothesis*

A

Suggests that men engage in risky behavior, because they are socialized to do so

76
Q

Transgender/transsexual

A

Gender identity does not match their physical body (sex)

77
Q

Trans people discrimination

A

They experience discrimination and violence. 73% in Ontario experience ridicule, half experience depression, and 43% attempted suicide

78
Q

The international Classification of Diseases:

A

Developed by the WHO to classify the global population’s experience of disease and illness

79
Q

What is the greatest cause of ill health according to WHO

A

Z59.5 (extreme poverty)

80
Q

Structures of inequality (4):

A
  • Class
  • Gender
  • Ethnicity
  • Age
81
Q

Social exclusion

A

Process of marginalization reflecting unequal power relationships between groups in society and involving unequal access to social, cultural, political, and economic resources

82
Q

4 dimensions of social exclusion:

A
  • Exclusion from civil society: limitations due to legal constraints or systemic discrimination
  • Exclusion from social goods: limited access to resources or services like housing
  • Exclusion from social production: Limited opportunities to contribute through employment or education
  • Economic exclusion: Limited opportunities for acquiring adequate material conditions: living in high crime neighbourhood
83
Q

Socioeconomic status

A

Refers to an individual’s relative social and economic position in society based on income, occupation and education

84
Q

Life expectancy in Sierra Leone and Japan

A

47.5 years in Sierra Leone and 84.6 years in Japan

85
Q

Demand control model:

A
  • The psychological demands on the working person
  • Degree of control the person has over work schedules and job conditions
86
Q

Effort reward imbalance model

A

Emphasizes importance of social reciprocity in our work lives. Health is affected if the time and effort devoted to work are not matched by rewards, incomes, opportunities

87
Q

Michael Marmot

A
  • British epidemiologist and researcher of social gradient
  • Investigator of Whitehall studies
88
Q

Whitehall studies

A

Studies social gradient in mortality from CHD among British civil servants

89
Q

Approaches that explain health inequality:

A
  • Materialist and neo-materialist explanation
  • Cultural behavioral explanation
  • Psychosocial explanation
90
Q

Materialist

A

Emphasizes the material conditions under which people live and characterizes aspects of the social structure such as differences in socioeconomic status

91
Q

Differential exposure hypothesis

A

A materialist explanation. States that people exposed to positive and negative exposures over the life course and outcomes in adulthood are indicators of advantages, disadvantages and differences in exposure to stress influence biological factors that influence health outcomes

92
Q

Cultural behavioural explanations

A

How we learn to behave in society

93
Q

Differential vulnerability hypothesis

A

Argues that we all have stressors in our daily lives that our position on the social gradient can help to alleviate or make worse

94
Q

Wilkinson’s income inequality hypothesis:

A

Suggest a greater inequality income distribution within proper population increases social problems

95
Q

Income influences on children health (3):

A
  • Low birth weight
  • Injury related mortality (eg. fire and homicide deaths)
  • Developmental problems (eg. Hyperactivity, psychosocial problems, delinquent behavior, delayed vocabulary
96
Q

Neo-materialist

A

Health is affected not only by differential access to social and economic resources, but also by the level of funding invested in social infrastructure

97
Q

Psychosocial explanation

A

People’s interpretation of their standing in the social hierarchy matters. Sense of relative deprivation can generate feelings of low self-esteem, shame, envy

98
Q

Medical Care Act 1966

A

Implemented in 1968. Federal government share the costs 50-50 with the provinces for all medical services provided by a doctor outside of hospitals

99
Q

When was medicare adopted in all Canadian provinces*

A

1971-1972

100
Q

First province to implement medicare

A

Saskachewan

101
Q

Canada Health Act

A

Principles and criteria for provinces to receive federal support; prohibitions of extra billing and user fees added to existing components

102
Q

Five principles of Canada Health Act:

A

CUPPA
- Comprehensiveness: All medically necessary services should be provided by hospitals medical practitioners and dentists working in hospitals
- Universality: Providing service on uniform terms and conditions
- Portability: When people move between provinces, emergency healthcare is provided. Travel insurance not acquired
- Public administration: Has to be operated on a non-profit basis by a public authority who is accountable to the provincial government
- Accessibility: Reasonable access without financial or other barriers

103
Q

Key features of the Canadian Health Care System (6):*

A
  • Health care delivery is the responsibility of the provinces
  • Privately delivered and publicly financed
  • Private providers and public not for profit hospitals
  • Fee for service funding and global budgets
  • Choice of practitioner
  • Universal coverage applies to less than 1/2 of total health care expenditures
104
Q

How do we finance health care:

A
  • Tax
  • Health insurance premium
  • Out of pocket expenditures
105
Q

Total amount of money spent on health care in Canada*

A

$228.1 billion

106
Q

3 main categories of health that funds go to

A

Hospitals, drugs, physicians (Physicians had a 4.5% growth in cost since 2007)

107
Q

Year of establishment for Canada Health Act

A

1984

108
Q

CIHI Report

A

Stated that the rate of growth in health spending has barely kept pace with the rates of inflation and population growth combined

109
Q

WAHRS

A

Aboriginal organization who represent Aboriginal peoples who use illicit drugs and or illicit alcohol

110
Q

Method for research in Determinants of Health: Discrimination and Social Exclusion

A
  • Talking circles limited to ten participants
  • Interviewed 30 individuals from 19-70 years and shared experiences about access to healthcare services
111
Q

Most prevalent colonial discourse against Aboriginals

A

That they like narcotics

112
Q

Egalitarianism

A

Particularly appealing, pervasive and powerful discourse in healthcare that perpetuates the assumption that people are treated the same regardless of social, ethnocultural or gendered locations

113
Q

Ethnicity

A

A complex and multi-dimensional phenomenon that includes culture, ethnoculture, ethnic ancestry/origin, ethnic identity, language, religion, and race

114
Q

Culture

A

General term that denotes a complex collection of values, beliefs, behaviors and material objects shared by a group and passed on from generations

115
Q

How are health and ethnicity similar

A

They are both multi dimensional concepts that can be measured in several different ways

116
Q

Two common measures of ethnicity in population health:

A
  • Ethnic ancestry/origin
  • Ethnic identity
117
Q

Ethnic ancestry/origin

A

Refers to place where an individual or ancestors were born

118
Q

Ethnic differences in health (5):

A
  • Aboriginal people have poor health outcomes because of social exclusion and racism
  • “Healthy immigrant effect” that deteriorates over time
  • Ethnic differences in perception and understanding of symptoms
  • Ethnic differences in health care behaviour
  • Ethnic differences in the social determinants of health
119
Q

Median income for aboriginal women and men vs non aboriginal in 2005

A

The median income for aboriginal women was $16,079 and $22,386 for aboriginal men, compared to $21,765 for non-aboriginal women and $33,214 for non-aboriginal men in Canada

120
Q

2 most prominent sources of health inequity in Canada

A
  • Aboriginal identity
  • Socioeconomic status
121
Q

Leading cause of death among aboriginal infants

A

Respiratory ailments, infectious/parasitic diseases and accidents which are indicators of inadequate housing, unsanitary conditions and poor access to medical facilities

122
Q

Intergenerational trauma

A

Negative emotional effects stemming from an initial terrible experience felt throughout life course and reproduced through generations

123
Q

Intercultural care

A

a one size fits all approach to health care that harms the safety and effectiveness of medical care offered to those with diverse backgrounds

124
Q

Cultural sensitivity

A

Emphasizes awareness that doctors and nurses understanding patients who may come from different cultural backgrounds

125
Q

Cultural safety

A

Allows patient to judge whether a particular health-care professional or treatment is, in fact, culturally safe

126
Q

Medicine wheel

A

The indigenous way of understanding health and wellness. Seasons are associated with four elements of wellness ranging from physical, emotional, mental and spiritua

127
Q

Explanations for the deterioration of the healthy immigrant effect (3):

A
  • Converging lifestyles (eg. Smoking, alcohol abuse, bad diet)
  • Resettlement stress (eg. Social exclusion, unemployment)
  • Differential access to health care (eg. Language and cultural barriers, and lack of access to formal health-care services and family physicians)
128
Q

Healthy immigrant effect

A

Term given to the phenomena of immigrants arriving to Canada with stronger health than Canadian borns. However, immigrant health experiences a steep decline over time since migration to reach the Canadian-born population’s health levels or lower.

129
Q

Thrifty gene biological hypothesis

A

Unproven explanation for high rates of diabetes among aboriginals by putting focus on biological factors and minimizing the environmental and lifestyle factors like age, stress, lifestyle

130
Q

Ethnic density effect

A

Refers to health benefits associated with living in a neighbourhood with a high concentration of others from one’s own ethnic group

131
Q

Myth buster 1 summary (IMG’s are the solution to the doctor shortage in underserviced areas)

A

There is a greater demand for healthcare in rural and remote communities because they experience higher rates of chronic disease, traumatic accidents, and poor mental health than urban but there aren’t enough health workers especially doctors. Therefore, many international medical graduates were recruited for temporary placement but many ended up leaving these communities after receiving their full license due to personal and social problems, so the problem for underserviced communities still remained in place without a solution. To fix this, the best hope is to encourage people who are already from rural areas to apply for medical school which would hopefully want to make them stay at the job

132
Q

Myth buster 2 summary (User fees ensure better use of health services)

A

Article that debates whether user fees ensure quality of health services, while minimizing unnecessary hospital visits, and the answer was no, they do not. In fact they affect those who are chronically ill very negatively. It basically just obstructs access to needed care especially for those who cannot afford it and was not necessarily effective unless you had a higher income. And they ran up an experiment by the RAND Health Insurance, and found that user fees cause people to forego necessary treatment. So for example an elderly started taking less medicine and the conditioned worsened, so there was increase in patients ending up in hospitals

133
Q

Primary health care services

A

Provides direct provision of first-contact health care services and coordinates patients’ health care services. May include prevention and treatment of common diseases and injuries or referrals to other units

134
Q

Secondary health care services

A

Services may be provided in the home or community (mostly long-term or chronic care)

135
Q

Palliative care

A

Approach of service providing counselling and management on those nearing death and their families wanting emotional support. Delivered at hospitals, long-term care facilities, home

136
Q

Supplementary health care services

A

Prescription drugs outside hospitals, dental care, vision care, medical equipment and appliances and services of other professionals like physiotherapists

137
Q

Iatrogenesis

A

Term used to describe sickness and injury caused by the health-care system

138
Q

3 types of iatrogenesis

A
  • Clinical
  • Social
  • Cultural
139
Q

Ivan Illich

A

Argued that modern medicine is the major threat to health in medical nemesis

140
Q

Clinical iatrogenesis

A

Illness or injury caused directly by the health-care system

141
Q

Social iatrogenesis

A

When people become dependant on medical interpretations of reality

142
Q

Cultural iatrogenesis

A

Increasing medicalization would eventually compromise people’s abilities to look after their own health without professional health

143
Q

Toward a Healthy Future (TAHF)

A

Produced by the federal/provincial/territorial advisory committee to address health inequalities

144
Q

6 chapters of TAHF:

A
  • Socio-economic environment
  • Healthy child development
  • Physical environment
  • Personal health practices
  • Health services
  • Biology and genetic endowment
145
Q

Results of research article: News media, health literacy and public policy in Canada

A
  • Significant difference in focus between health influences identified in policy statements and newspaper coverage of health stories
  • More people focused on traditional healthcare
  • Newspaper failed to discuss issues like housing, child development, education, working hazards
146
Q

Public health model

A

Approach that sees the causes of death and injury as preventable rather than inevitable

147
Q

Framing theory

A

Cues learned from the media can also be used to make sense of our experiences and social situation

148
Q

4 functions of frames:

A
  • Define problems
  • Diagnose causes
  • Make moral judgements
  • Suggest remedies
149
Q

Episodic framing

A

Led people to attribute responsibility to individuals

150
Q

Thematic framing

A

Led people to attribute responsibility more to societal causes

151
Q

What was the research article: Testing the effect of framing and sourcing in health news sources about

A

Experiment to see whether public health framing and rich sourcing had a causal effect on peoples’ attitudes towards health problems

152
Q

First factor of article

A

Framing (public health/traditional)

153
Q

Second factor of article

A

Sourcing (rich/poor)

154
Q

Repetition factor of article

A

Four health topics (obesity, diabetes, immigrant health, smoking)

155
Q

43%

A

BC budget spent on health care

HSCI130 (7 decks)

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