Lecture 11: Social and Environmental Epidemiology

Question 1

Social Epidemiology

Answer 1

• The study of the social distribution and social determinants of health
• identifies socio-environmental factors exposures that influence a broad range of physical and mental health outcomes

Question 2

History of Social Epidemiology

Answer 2

1600s - bills of mortality
1700s - villerne: illnesses across different work classes due to social conditions
1800s - John Snow: Germ Theory
1844 - Engels: disease development in Germany was due to bad working conditions

Question 3

Key Concept of Social Epidemiology

Answer 3

• the bio-psychosocial paradigm
• the population perspective
• use of new statistical approaches such as multilevel analysis
• significance of theory

Question 4

The bio-psychosocial paradigm

Answer 4

• Engel stated that medical thinking was reductionistic and materialistic
• presented a complex view that shows different levels of the bio-psychosocial hierarchy could interact

Question 5

The Population Perspective

Answer 5

Shifting the whole population into a lower risk category benefits more

Question 6

Use of new statistical approaches such as multilevel analysis

Answer 6

Multi-causality in epidemiology – there are multiple factors at different levels that interact to influence health status. How do driving forces in the environment interact with human activities and exposures leading to adverse health outcomes.

Question 7

Theories in Social Epidemiology

Answer 7

• psychosocial (1920s)
• social production or disease and/or political economy of health (60s and 70s)
• eco-social theory and related multi-level frameworks (1994)

Question 8

Pyschosocial

Answer 8

• reconceptualises the host-environment-agent interactions
• takes into account the psychological and social factors that impact health

Question 9

Social Production of disease and/or political economy of health

Answer 9

• social production of disease and illness from political framing
• expands on national and global politics
• immigration policies, racism, race/ethnicity, refugees

Question 10

Eco-social theory and related multi-level frameworks

Answer 10

• social factors in the context of environmental factors; biology, ecology, and social organization, how do they together influence health and well being
• ex. how the physical environment affect health

Question 11

Ecology

Answer 11

interactions between living organisms and inanimate matter and energy

Question 12

Urban Design

Answer 12

• traffic
• noise
• social isolation
• physical inactivity
• prolonged sitting
• unhealthy diets
• air quality
• safety

Question 13

Stressor Influences

Answer 13

• harmed physiological function
• endocrine disruption
• mutations/carcinogenesis
• reduced emotional regulation and cognitive capability
• social isolation

Question 14

Salutary Influences

Answer 14

• reduced physiological stress
• enhanced immune function
• increased physical activity
• attention restoration
• connection to nature
• sense of awe and mystery
• social connectedness
• co-benefits (improved air quality)

Question 15

An ecological approach in epidemiology (core concepts)

Answer 15

• scale
• level of organization
• understanding unique phenomenon in relation to general processes
• mathematical modelling
• dynamic states

Question 16

Toronto’s Vision Zero Plan

Answer 16

• Eliminate fatalities and serious injuries in Toronto’s transportation system
• first adopted in Sweden
• Involves engineering, education, technology, and enforcement measures

Question 17

What are the 6 areas that Toronto aims to tackle in its Vision Zero plan

Answer 17

• pedestrians
• school children
• older adults
• cyclists
• motorcyclists
• aggressive driving and distraction