HSci 215: Midterm 1 Flashcards
What is injury?
Damage to the body caused by acute exposure to physical agents (e.g. mechanical energy, heat, electricity, chemicals, ionizing radiation)
What are some major causes of injury?
Traffic collisions, drowning, poisoning, falls, burns, violence from assault, self-inflicted violence or acts of war
_% of global mortality is due to injury.
9%
_% of global injury mortality is caused by road traffic injuries.
25%
_% of global injury mortality is caused by interpersonal violence.
10%
_% of global injury mortality is caused by self-inflicted violence.
16%
What happens to a large portion of people surviving their injuries?
They incur temporary or permanent disabilities
What are some examples of injury-related impairments resulting in disabilities?
Physical and/or cognitive limitations due to neurotrauma, paralysis due to spinal cord trauma, partial or complete amputation of limbs, limb deformation resulting in mobility impairments, psychological trauma, sensory disability such as blindness and deafness
What is disability?
An umbrella term, covering: impairments, activity limitations, and participation restrictions
What is an impairment?
Problem in body function or structure
What is an activity limitation?
Difficulty encountered by an individual in executing a task or action
What is participation restriction?
A problem experienced by an individual in involvement in life situations
What is health?
State of complete physical, mental and social well-being, and not merely the absence of disease or infirmity (also includes spiritual, emotional, environmental, occupational, intellectual health)
What is physical health?
Ability to perform activities of daily life
What is social health?
Capacity of satisfying interpersonal relationships, interaction with others, adapting to various social situations
What is mental health?
Ability to think clearly, reason objectively, analyze critically
What is emotional health?
Ability to show emotions effectively and appropriately
What is environmental health?
Appreciation of the external environment and the role individual plays to protect, preserve and maintain it (biophilia!)
What is spiritual health?
Deepest, innermost part of you that helps you understand the world and your role in it
What is occupational health?
Satisfaction person gets from their job or stages of career development
What % of the world’s population live with some form of disability?
15% of the world’s population live with some form of disability
Why is the % of people in the world living with some form of disability increasing?
Due to the rise of chronic diseases, malnutrition, occupational injuries, traffic injuries, violence (especially due to domestic violence, war), ageing (and other injuries like falls, AIDS, environmental degradation, etc)
What % of people with disabilities live in low-income countries with limited or no access to basic health services?
80% of people with disabilities live in low-income countries
Who is WHO?
World Health Organization, specialized agency of UN that acts as a coordinating authority on international public health, started April 7, 1948 in Geneva, has 193 members
What are the 6 geographical regions of WHO?
AFR, AMR, SEAR, EUR, EMR, WPR
What does AFR stand for?
African region
What does AMR stand for?
Region of the Americas
What does SEAR stand for?
South-East Asia region
What does EUR stand for?
European region
What does EMR stand for?
Eastern Mediterranean region
What does WPR stand for?
Western Pacific Region
What happens do each geographical region that has been divided?
They are each further subdivided by income level
What are WHO’s goals?
1) Assist countries in DEVELOPING POLICIES on disability (with community involvement, national rehab programmes)
2) Assess and recognize diferent health conditions using ICF (International Classification of Functioning Disability and Health)
3) Ensure EARLY IDENTIFICATION and TREATMENT of disabled, including ASSISTIVE DEVICES and ENVIRONMENTAL MODIFICATIONS
4) Ensure EQUAL OPPORTUNITIES AND PROMOTION OF HUMAN RIGHTS for people with disabilities (especially those who are poor)
What is the ICF?
“International Classification of Functioning, Disability and Health”, WHO’s framework for measuring health and disability at both individual and population levels
What effects disabilities other than the health condition itself?
Contextual factors: environmental factors and personal factors
How have injuries traditionally been known as?
Accidents
How has the understanding of injuries changed recently?
Both unintentional and intentional injuries are viewed largely as preventable events
With a new view on injuries, what has developed?
Preventative strategies, and a decrease in the human death toll due to injuries in some countries
What types of prevention are there?
Primary, secondary, tertiary
What is primary prevention?
Actions designed to stop health problems before they start
What is secondary prevention?
Intervention early in the development of a health problem to reduce symptoms or to halt its progression
What is tertiary prevention?
Treatment or rehab efforts aimed at limiting the effects of a disease after the person has become sick
How is WHO working to prevent injuries and violence and mitigate their consequences?
1) Improve DATA COLLECTION
2) Develop SCIENCE-BASED APPROACHES to PREVENTION, CONTROL, REHAB
3) Distribute proven and promising INTERVENTIONS
4) IMPROVE SERVICES for persons with disabilities, as well as victims and survivors of injuries and violence and their families
5) Enhance TEACHING and TRAINING programmes
What are ways to prevent road injuries?
Seat-belts, helmets, enforced BAC
What are ways to prevent poisoning?
Child-resistant containers and cupboards
What are ways to prevent falls?
Home hazard modification
What are ways to prevent drowning?
Pool fencing, swimming lessons
What are ways to prevent suicide?
Treatment of depression, watching for signs
What are ways to prevent violence?
School-based educational programmes to prevent intimate partner violence, and home visitation programmes to reduce child maltreatment
What are three reasons disability on a global level is on the rise?
Population ageing, rapid spread of chronic diseases, and improvements in measuring disability
What is key to prevent disability?
Reducing risk factors
What are behavioural risk factors of CVD?
Unhealthy diet, physical inactivity, tobacco use
What are biological risk factors of CVD?
High blood LDL, high blood pressure, overweight
What are prevention strategies for CVDs?
Regular physical activity, avoid tobacco use and second-hand smoke, diet of fruits and vegetables, avoid fatty, sugary, salty foods, maintain healthy body weight
Behavioural risk factors are responsible for _% of CVDs.
80%
What are risk factors of cancer?
Tobacco use, obesity, low fruit/veggie intake, physical inactivity, alcohol use, HPV infection, urbam air pollution, indoor smoke from from household use of solid fuel, exposure to UVB rays
What are prevention strategies for cancer?
Do opposite of risks, vaccinate against HPV and HBV, control occupational hazards, reduce sunlight exposure
What % of cancer can be prevented by avoiding risk factors?
30%
What does “population ageing” mean?
Lives are getting longer (due to elimination of infectious diseases), so we actually have more old people than ever before
What is an RTI?
Fatal or non-fatal injury incurred as a result of a collision on a PUBLIC road with at least ONE moving vehicle
Who are the most vulnerable road users?
Children, pedestrians, cyclists, riders and passengers of motorized two wheelers, elderly
What can survivors, relatives and friends suffer after a sever crash?
Physical, psychological, emotional and economic devastation
How many people die every year due to RTIs?
1.3 million people every year
How many people sustain non-fatal injuries due to RTIs every year?
20-50 million
How many groups of causes is mortality divided into, and what are they?
Group 1, group 2, group 3
What is group 1 of mortality causes?
Communicable diseases, maternal causes, conditions arising in ther perinatal (28wk in gestation-1st week of birth) period and nutritional deficiencies; no longer leading causes of death around world due to health advancements, and more common in low income countries
What is group 2 of mortality causes?
Noncommunicable diseases, predominant around the world
What is group 3 of mortality causes?
Intentional and unintentional injuries
What are the leading causes of death by unintentional injuries?
RTIs, falls
What are the leading causes of death by intentional injuries?
Self-inflicted injuries and interpersonal violence
RTIs and interpersonal violence have higher rates of injury-related mortality in who?
Males (compared to females)
Who do fires most commonly kill?
Females, and then children
Why are non-fatal outcomes measured?
To describe accurately burden of disease due to injury (DALY)
What is DALY?
Disability-adjusted life years, indicator used to quantify loss of healthy life due to disease; years of life lost from premature death plus years of life lived with disability
What is the DALY equation?
YLL + YLD
What does YLL mean, and how do you calculate it?
Years of life lost due to premature mortality; YLL= NxL
- N= number of deaths
- L= standard life expectancy at age of death in years
What does YLD mean, and how do you calculate it?
Years lost with disability due to injury or illness; YLD= IxDWxL
- I= incidence
- DW= disability weight (standardized weight, which is given)
- L= average duration of case until remission or death (in years)
Is DALY internationally accepted?
Yes, because it assumes everyone in the world has the same right to the best life expectancy in the world (Japan takes the lead: 80 for males, 82 for females)
What % of DALY is due to RTIs?
22%
What % of world’s deaths are due to injuries?
9%
What % of world’s DALY is due to injuries?
12%
What region has the highest mortality rate due to injuries?
Lower-income countries in Europe (EUR)
What percentage of people in the world live in lower-middle income countries?
About 82%
How much of the world’s deaths from injuries occur in low-middle income countries?
90%!
What regions have the highest number (not rate) of injury deaths worldwide?
SEAR and WPR
How many people died worldwide from injuries in 2000?
5 million (mortality rate of 83.7 per 100000)
Globally, how does injury mortality compare between men and women?
Twice higher in men, but in some regions, females are the same or higher
What ages accounts for almost 50% of world’s injury-related mortality?
15-44
How does mortality from RTIs and interpersonal violence compare between men and women?
3 times higher in males than in females
What percent of children under 5 account for drowning deaths?
25%
Children under 5 account for how much of fire-related deaths?
15%
What are 3 flaws in the Global Burden of Injury 2000 data?
1) National vital registration was only available for 19% of countries in AFR
2) GBD estimates for 2000 were from info compiled to estimate burden of disease in 1990, so some necessary adjustments were lacking
3) DALY measure doesn’t reflect all health consequences of injuries (like mental health problems from violence and war, STIs resulting from rape or effects of infectious diseases and malnutrition after war
What would need to change in order for suffering to be avoided?
Prevention and emergency rescue services
What age do RTIs kill the most?
15-29 (second is 30-44)
Whats happening from 1990 to 2020?
- RTIs will rise in rank to 6th place as a major cause of death worldwide
- RTIs will become 3rd for DALY
- RTIs will be 2nd for DALY in low and middle-income countries
- RTIs will increase by over 80% in low and middle-income countries, and decline by 30% in high-income
In 1990, what were RTIs ranked for DALY?
9th
Which has the highest number of mortality and DALY due to RTIs?
SEAR
What % of RTIs are in low-middle income countries?
90%