Introduction to Health Flashcards
What is Disease Prevention and what is its goal?
” preventive medicine”
Emphasizes the identification and management of early indicators of risk
Goal- prevent illness, delay onset, lessen the severity
What are the 3 levels that disease prevention is divided into?
Primary, Secondary and Tertiary (bottom)
What is Primary Prevention?
Actions/behaviours designed to prevent health problems from arising - target the whole population
E.g. immunization, safe sex, healthy eating
Prevention of disease before it develops. correlates with the Reduction of risk factors
What is Secondary Prevention?
Early recognition and intervention to eliminate or reduce symptoms before a more serious illness develops - targets “at-risk individuals”
E.g. diet intervention for increased blood sugar, smoking cessation
Early detection and intervention correlate with the screening
What is Tertiary Prevention?
Treatment or rehabilitation efforts aimed at limiting the effects of disease - targets patients
Prevent further development, progression, and complications
E.g. chemotherapy, bypass surgery
Treatment of established disease correlates with the Prevent deterioration
What is Health Inequality?
Race/ethnicity: higher risk of illness and adverse outcomes
Gender: differences in disease risk, variation in symptoms
Socioeconomic Status (SES)
Disability: physical and mental health
Access to healthcare, resources
Sexual orientation
The spectrum of Inequality?
gender, geography, sexuality, socio-economic group ,disability, age, ethnicity
What does choosing health behaviours equal?
Immediate benefits
Improved ability to meet developmental tasks
Long-term rewards
Examples of Healthy choices?
Adequate sleep
Healthy eating, regular physical activity
Healthy body weight
No smoking
Limiting alcohol intake
Safe sex
Maintain oral hygiene
Wear your seatbelt
Monitor your health: self-exams, medical checks
What are some Health Promotion Strategies?
Educational supports: promote learning (knowledge is not enough)
Organizational supports: programs/services to encourage participation
Environmental supports: rules, policies governing behaviours, supporting behaviour change
Financial supports: financial incentives motivate healthy choices
How do we stop the spread of COVID-19
Public Health:
Vaccination (doesn’t cure, lessen effect) - prevent disease before it develops
Personal health behaviours (washing hands)
Public spaces
Workplaces, schools, stores, restaurants, etc.
· testing, isolation and contact tracing - early detection and intervention
Medical Intervention:
· Therapeutics, hospitalization, breathing support - treatment if established disease
What are the benefits of Optimal Health?
Individual level:
- Improved life expectancy, and quality of life (QOL)
- Improved physiological function, energy
E.g. stronger immune system, improved cardiovascular endurance
- Improved physical appearance
- Improved self-esteem, positive outlook
- Enhanced relationships
- Improved ability to manage stress
- Improved capacity to cope with life’s challenges
Global level: personal health choices contribute to global health or the global burden of disease
- Decrease direct medical care costs
- Decreased indirect costs, associated with poor health
□ Lost productivity, absenteeism, disability
- Which agency came up with the landmark of health in 1947?
World health organization
- In the early 1900s, the leading causes of death were:
Infectious diseases
What is health promotion
process of enabling people to increase control over and to improve their health” (WHO, 2013)
Policies and programs that promote behaviours known to support good health * creating optimal conditions
Efforts beyond a focus on individual behaviour
□ Wide range of social and environmental interventions
Goal: empower individuals and communities to achieve the highest possible levels of well-being
What is the Social-Ecological Model of Health Promotion?
Bottom to top:
Individual - attitudes, beliefs, knowledge and skills
Interpersonal - family, friends, social groups
Institutional - work, school, organizations
Community - relationships between neighbourhoods, towns, cities
Public Policy - national, provincial, and local laws and regulations
What are some Action areas to achieve health:
Public policy, supportive environments, personal skills
Strategies:
Advocate (individual and social action to get political will), mediate( between multiple state holders), enable (partnership)
What is Health?
Can be seen as a capacity of resource for a vital and meaningful life rather than a state
“To realize aspiration, to satisfy needs, and to change or cope with the environment… a resource for everyday life” (Ottawa Charter, 1986)
the dynamic, every-changing processes trying to achieve individual potential in the physical, social, mental, occupational, emotional, environmental, and spiritual dimensions
What is one of the ways we go about defining health?
impact ex. Trauma vs Camesha
Wellness?
achieving one’s potential in each of the health components
Health and Wellness Continuum?
Left to right:
Irreversible disability and/or death
Chronic Illness
Signs of illness
Neutral Point
Signs of health/wellness
Improved Health/wellness
Optimal wellness/ well-being
What are the 7 dimensions of Health?
Physical
Social
Intellectual
Emotional
Occupational
Environmental
Spirtual
Physical Health?
body size, shape, functioning, susceptibility to disease, ability to perform ADL (activities of daily living/day-to-day activities)
Social Health?
Capacity for satisfying relationships, successful interactions, and communication.
Intellecutual Health?
ability to learn from mistakes and successes, ability to thinking clearly reason, objectively and make responsible decisions
Emotional Health?
self-efficacy, closely related to self-esteem, mental health, ability to express emotions effectively and appropriately, self-esteem, and trust.
Occupational Health?
satisfactions from career, career development, and work/life balance.
Environmental Health?
should also include personal environment + external environment ex. organized desks space, and people you surround yourself with, appreciation of one’s external environment, and concern for preserving protecting and improving.
Spiritual Health?
having a sense of meaning and purpose in one’s life, strength and hope.
What is life expectancy?
The number of years a person can be expected to live based on the year of birth
→ varies slightly with each successive cohort
varies as a function of gender, place of residence
Is female or male expectancy always higher and wide?r
female
2021 (without all of the COVID-19 waves)
Females: 84 years
Males: 80 years
Factors decreasing life expectancy (2019-2021)?
- Rising rates of overweight and obesity
Life expectancy for the next generation is lower than parents- Global pandemic
5 months reduced as a result of the first 2 waves of COVID-19
- Global pandemic
Morbidity?
the measure of sickness, co-morbidity is the presence of multiple conditions ex. Having diabetes and cancer, another term for illness and disease
Mortality?
another term for the death rate
How are mortality and morbidity similar?
Both often give rates
- Example: infant mortality
◊ Number of infant deaths (<1 year) per 1000 live births(excluding stillbirths)
Referred to the health care system
Referred to pre/post natal care
States help improve areas of healthcare
◊ 2020- 4.5 deaths/1000 births (Stats Can, 2022)
4.5/1000 X 100 =0.45%
Incidence?
Number of new cases of a specific condition in a specific population within a specific time period
Likelihood of being diagnosed with a specific condition in a specified time
Prevalence
Total numbers of cases of a specific condition existing in a specific population within a specific time period
Incidence rate?
number of newly diagnosed cases in the specific time period, divided by the number of personas in the population
What is the pre-1900 Medical model?
focus on the individual (absence of disease, biological aspect if human physical)
What is the post-1900 Public health model:
focus on the individual’s interaction with the environment- aka “ecological model”
What occurred in 1900?
> 30% of deaths occurred among children <5 years
- Infectious disease - the leading cause of these deaths
- TB, pneumonia, influenza
sanitation, vaccines and antibiotics
- Life expectancy dropped dramatically
- Leading cause of death shifted to chronic diseases
What are the leading causes of death in Canada?
malignant neoplasms
disease of heart
cardiovascular diseases
chronic liver respiratory diseases
accidents
What are Infectious diseases?
Caused by pathogenic microorganisms, such as bacteria, viruses, parasites or fungi. Can be spread, directly or indirectly, from one person to another
- E.g. Hepatitis, malaria, STIS
A chronic disease that can be infectious
- E.g. HIV, ATOS
What are Non-infectious or Non-communicable diseases?
medical conditions or diseases which cannot be transmitted from person to person
E.g. heart disease, stroke, cancer, chronic respiratory diseases, diabetes, osteoporosis
What are the classifications of disease?
Acute and Chronic
Acute disease?
symptoms appear and change or worsen rapidly as in a heart attack
Chronic disease?
develops and worsens over an extended period of time as in atherosclerosis
Are all chronic diseases non-infectious?
No
What is the human genome project?
international effort to identify and describe all genes in the human genome
- Complement of genetic material contained within chromosomes in cells
Current research:
- Genes associated with aging and disease (e.g. telomere shortening)
- Environmental influences
What is Epigenetics?
field of study - influence of environmental factors on gene expression
Some illnesses are strictly genetic… regardless of environment disease will surface
- E.g. cystic fluorosis, sickle cell anemia
What is Penetrance?
likelihood that disease will occur when a particular genotype is present (NCL, 2020)
- In many cases, genetics predispose people to certain diseases, disorders
- E.g. cancer, depression
Genetic predisposition is influenced by environmental factors e.g. health behaviours
What is the activity of genes influenced by?
epigenetics
- Can down/up-regulate them
Incidence and Prevalence diagram?
incidence - faucet
prevalence - water in bathtub
death (mortality) - leak from bathtub
recovery - heat released from bathtub
What are non-modifiable risk factors?
those that cannot be manipulated or changed
E.g. age, gender, mendicity, genetics
Modifiable risk factors?
those we can do something about
E.g. diet, physical activity smoking, alcohol, body weight
3 major chronic diseases?
► Malignant neoplasm/tumour/cancer
► Cardiovascular disease
► Diseases of the heart and blood vessels
Diabetes (a major cause of morbidity NOT mortality)
What are the leading risk factors of chronic diseases?
obesity (body far in the middle increase chance of low metabolism)
alcohol
smoking
In 2019 - in a study population of 2000 healthy Canadian women (48-70 y), 22 were diagnosed with breast cancer. In 2020 another 16 women were diagnosed
- what is the incidence rate of breast cancer in 2019?
22/ 2000 = 1.1%
what is the prevalence rate of breast cancer in 2020?
22 +16=38
38/2000 = 1.9%
In 2021 - 2 women die of breast cancer (diagnosed in 2019) and 11 more are diagnosed
- what is the prevalence rate of breast cancer in 2021?
22+16+11-2/2000-2 = 2.4%
Denominator represents at risk population
What are the determinants of Health?
the range of personal, social, economic and environmental factors that influence the health status
· The Lalonde Report (1974)
Lifestyle, environment, human biology, health services
Determinants of health?
social & economic environment, personal health behaviours, physical environment and biology & genetics
What are the factors of the social & economic environment?
socioeconomic status (SES), ethnicity/culture, social support, health services and public policy
Socioeconomic Status (SES)?
relative economic and social ranking - potent predictor of health, well-being
SES includes income, education & employment lower SES associated with poorer health risk of morbidity and premature mortality
social gradient on health
Why?
poor living conditions, food insecurity → poor nutrition
sedentary lifestyle, increased smoking, decreased breastfeeding
hypertension (high blood pressure), obesity, increased risk of disease increased stress, decreased control, decreased identity/ purpose
Ethnicity/culture?
race, ancestry, religion & customs may associate with additional health risks
linked to lower SES
stigmatization, loss or devaluation of culture
Social support?
support from family, friends and communities is linked to better health
increased social contacts, emotional support
social participation
Health services?
access and use of services that prevent and treat disease influences health
health screening
access to extended healthcare
shift to home care
Public Policy?
a powerful influence on the health of individuals and communities
Smoking bylaws, laws that govern seat belt & helmet use, vaccination programs, mental health services
What are biology and genetics?
Basic biology and organic makeup of the human body - fundamental determinant of health
genetics, gender, prenatal care, child development
What are the factors of biology and genetics?
genetic endowment, gender, prenatal care, healthy child development
Genetic endowment?
inherited predisposition to factors that influence health
abnormality in genome leads to certain diseases
e.g. Cystic Fibrosis, Huntington’s, Sickle Cell Anemia
Gender?
linked to genetics, social roles, attitudes, behaviours, health system practice & priorities
men more likely to die prematurely (CVD, accidents)
women more likely to suffer from depression, abuse
Prenatal care?
critical periods in fetal development
influenced by nutrition, environmental toxins, PA, stress
▪ e.g. folate, nicotine, alcohol, drugs
□ birth defects, fetal alcohol syndrome
□ low birth weight, miscarriage
Healthy Child development?
early life exposures
optimal conditions for child development - first 5 years
e.g. brain development outcomes later in life
What are risk factors of personal health behaviours?
diet
physical activity
smoking
alcohol
coping skills
Diet?
unhealthy eating (e.g. added sugar, sodium)
linked to major causes of morbidity and mortality
▪ obesity, CVD diabetes, many cancers
Physical activity?
physical & psychological benefits
many independent effects of regular PA
some linked to overweight and obesity
Smoking?
responsible for ~25% of deaths (35-84 y)
increased risk of cancer, heart disease
respiratory conditions
effects of secondhand smoke
Alcohol?
effects of blood alcohol
excess intake is associated with liver disease, cancer risk
during pregnancy - fetal alcohol syndrome
Coping Skills
stress management
prolonged exposure to stress:
adverse health effects
What are personal health behaviours influenced by?
social and economic environment
What is the Physical Environment?
clean air and safe water, safe food, safe houses, healthy workplaces, communities & roads all contribute to good health
□ airborne contaminants, secondhand smoke
▪ asthma, lung, cancer □ contaminated water (drinking, washing) ▪ waterborne diseases □ unsafe food supply ▪ foodborne pathogens (salmonella, E.coli) □ safe housing, workplaces, and communities “built environment” correlates with conditions that promote health
What are the types of diseases in populations?
epidemiology, epidemic, pandemic
Epidemiology?
the study of the distribution and determinants of disease within populations
▪ incidence, prevalence, causal factors
Epidemic?
disease outbreak affecting many people in a community at the same time
Pandemic?
global epidemic
What are multi-causal Determinants of Disease?
most diseases processes are multi-factorial
Interactions of several factors
Modifiable and non-modifiable
Etiology: the cause or set of causes of disease
□ factors which produce or predispose toward a certain disease or disorder
conditions required for infectious diseases to occur:
□ Transmitting agent present
□ susceptible host
□ hospitable environment
What is the
The Epidemiological Triade?
Agent (top of trainagle)
Environment (bottom right)
Host (bottom left)
Disease in middle
What is Preparing for Behavior Change
behaviour change is time-consuming and difficult different approaches work for different people
gradual change may enhance the success
Key steps to behaviour change?
decide what needs to change & why
decide what actions are necessary
explore alternatives, consequences
make a plan → execute → evaluate
maintenance
Make Habits and new behaviours involve?
do more, do new, do different
break habits and change/reduce behaviours include?
do less, do different
What are the 3 factors affecting behaviour change?
predisposing, enabling, reinforcing
What are predisposing factors?
Factors that predispose us to certain conditions and are likely to lead to certain behaviours:
e.g. habits from family
- knowledge
- beliefs
- values
- attitudes p selected demographic variables (age, sex, ethnicity, income, education)
- access to low-cost, high-quality health care
Enabling factors?
Factors that make health decisions more convenient or more difficult: e.g. access to resources
- skills and abilities
- available health resources
- community/government priority and commitment to health
- health-related skills
- physical, emotional and mental capabilities
Reinforcing factors?
Support or lack of support from significant others, situations that shape behaviours e.g. public policy
- family support
- peer support
- teacher support / encouragement
- employer actions/policies
- health care provider costs and access
- community resources
- health education access to information
Is knowledge enough to alter behaviour?
No
you may believe that a certain behaviour has a certain consequence- but that may not be enough
What are we often influenced by?
approval or disapproval (real or imagined) of significant others
support for positive behaviours, negative interference
from family, friends, and others? (coaches, teachers, coworkers)
What are beliefs and attitudes?
regarding the value of your actions (e.g., will it make a difference?)
What are the 6 behaviour change techniques?
- shaping
- visualizing
- modelling
- controlling the situation
- reinforcement
- changing self-talk
Shaping?
developing behaviour in small steps
start slowly, keep steps small and realistic
be flexible but systematic
reward yourself for meeting short and long-term goals
example: healthy eating
Visualizing?
imagined rehearsal
mental practice increases preparedness
example: marathon run
Modelling?
careful observation of other
model behaviour after proven success
example: presentation skills
Controlling the situation?
situational inducement
placement in the right situation or group
example: smoking cessation
Stress inoculation
Reinforcement?
positive incentives
highly individual
tangible rewards, enjoyable activities, social
“manipulative” incentives (if you do this, ill do this)
Changing self-talk?
altering internal dialogue
identify, challenge and replace negative thoughts
“blocking” or thought stopping
self instructions and positive affirmations
Some Benefits of Goal Setting?
Helps to assess if the change is realistic
Helps to organize your thoughts
Helps to formulate a plan
What are SMART Goals?
Specific - 5 whys, Clear and precise!
What exactly do you want to achieve?
Measurable - how will you know when you’re done, Quantifiable method of evaluating
What will you observe? Evidence!
Attainable - Realistic, consider resources, timelines
Relevant - how does this fit into your life now, Why do you want to reach this goal? Fit with lifestyle, and overall goals?
Time-bound - when will you achieve your goal? What’s your deadline? A specific date or timeline
Transtheoretical model?
“Stages of Change”
□ are you ready for a change?
□ where are you in terms of readiness?
Decreasing order:
Precontemplation (not even thinking about it)
Contemplation (thinking about making a change)
Preparation (planning)
Action (executing)
Maintenance (committed to the change, avoid relapse)
What is the health belief model?
- explains how beliefs, and perceptions may or may not influence your behaviour
- perceived susceptibility to the health problem
□ evaluation of risk
□ evaluation of the medical or social consequences· cues to action
□ reminders or alerts about potential health problems (any source of reminders of what will happen if I don’t do this)
· assessment of “cost-benefit” tradeoff, barriers?
□ likelihood of preventative action - perceived susceptibility to the health problem
What are the ABCs of Behaviour change?
Antecedent - Events that come before behaviour
* physical events, settings, thoughts,
feelings, actions of others
Behaviour
Consequences - Events that come after behaviour
* outcomes - affect whether
behaviour will be repeated
Examples of Physical Health
fitness and recuperative abilities
performing activities of daily living
susceptibility to disease or disorders
Examples of Social Health
satisfying interpersonal relationships
adapting to various social situations
Examples of Intellecutual Health
responsible decision making
learning from successes and mistakes
healthy curiosity
Examples of Emotional Health
trust and love
self-esteem and self-confidence
Examples of Spiritual Health
meaning and purpose in life
feeling a part of a greater spectrum of the existence
Examples of Environmental Health
working on preserving, protecting and improve conditions in the world
protecting yourself from hazards at work and home
Wellness is a concept that includes:
a dynamic, ever-changing process of trying to achieve maximum potential in each of the dimensions
a way of expressing the complexity of health by recognizing different levels of health depending on the situation at the time
Examples of Individual Behaviour
tobacco use
poor nutrition
physical activity
excessive alcohol consumption
Examples of Biology and Genetics
asthma
age
hemophilia
race
Examples of Social Factors
access to good jobs
educational opportunties
Examples of Policymaking
smoking bans
drunk driving laws
Examples of Health Services
access to health insurance
mental health services
“I never even think about smoking anymore” is which of the stages of the transtheoretical model of behaviour change?
Termination
“I have never been able to quit smoking before, it is just a part of who I am” which of the stages of the transtheoretical model of behaviour change?
Precontemplation
“I have to quit smoking. It is just too dangerous for me and those around me. I’m not yet sure, though, how to do it” which of the stages of the transtheoretical model of behaviour change?
Contemplation
“I have been doing so well for over 7 months now, but I did smoke with my friends at that bar last night” which of the stages of the transtheoretical model of behaviour change?
Maintenace
“I have the money for the education to help me stop smoking and I have my support group ready” which of the stages of the transtheoretical model of behaviour change?
Preparation
“After I formed my plan, I started taking the medication and I have been at two meetings with my support group” is which of the stages of the transtheoretical model of behaviour change?
Action
Your family health history is important because __________.
it may have an impact on your own health status and you can move forward with that knowledge
The following are all ways to get motivated EXCEPT __________.
building an external locus of control
Restructuring your environment is a way to promote behaviour change by altering your surroundings to promote healthy behaviours or reduce temptations. Which of the following is an example of restructuring an environment?
Rahul wants to build his muscle mass, so he bought a set of hand weights for his dorm room.
Which of the following is true about rewards?
Rewards should help you feel good about your progress.
What is an example of an intrinsic reward?
a reward that is inherent in practicing your target behavior
You should reevaluate rewards __________.
if you are not feeling motivated
Which of the following is not one of the dimensions that contribute to your overall health and wellness?
economic health
From the list below, select all of the items that represent modifiable factors which affect the risk for chronic disease.
diets low in healthful foods like fruits and vegetables
tobacco usage
low level of physical activity
From the list below, choose the item that does not accurately describe someone in one of the stages of the transtheoretical model of behaviour change.
Mitchell believes he is at high risk for heart disease because his father and uncles all had heart attacks in their 40s.
From the list below, select all of the actions that will help a person prepare to change behaviour.
anticipating barriers to change
using shaping
setting a SMART goal
Which agency came up with the landmark definition of health in 1947?
World Health Organization
Marta, a physically active young adult, grew up in a family that was very active. They regularly went on hikes and bike rides together when she was a child. This is an example of:
a predisposing factor influencing Marta’s behaviour
The ability to perceive, interpret and evaluate information effectively are characteristic of:
good intellectual health
