Lecture 5 - Part 2

Question 1

What makes people sick?

Answer 1

It is an interaction between:

1. Host
2. Agent: e.g. microorganisms
3. Environment: location and quality of environment

And this interaction is influences by social determinants of health

Question 2

What makes Canadian’s Sick? % attributable to…

Answer 2

1. Your Environment 10%
2. Your Biology 15%
3. Your Healthcare 25%
4. Your Life 50%

Question 3

What are health inequalities?

definition

Answer 3

“The presence of a significant difference in the overall rate of disease incidence, prevalence, morbidity, mortality, or survival rates in the population [in question] as compared to the health status of the general population.”

Question 4

What is the difference between equality and equity?

Answer 4

Equality = everyone gets exactly the same thing

Equity = everyone gets what they need (even if some need more than others)

-> think of diagram of taller and shorter people standing on boxes to reach apples

Question 5

Describe the difference between health inequality and inequity

Answer 5

Inequalities are facts about disparities (e.g. women live longer than men on average)

VS

Inequity is concerned about whether the unequal distribution is “fair”, which involves a value judgment. (e.g. Should rich people have more health coverage than poor)

Question 6

How should inequality be reported?

Answer 6

Both absolute and relative inequality should be reported together as complementary measures of inequality

Question 7

When are relative measures particularly useful?

Answer 7

Relative measures are unit-less

-> Useful when making comparisons between indicators with different units

Question 8

What is your social context?

What does different social context lead to?

Answer 8

Your age, your economic development and your urbanization (who you are and where you live)

Different social contexts lead to -> differential exposure which leads to-> differential vulnerability which leads to -> differential outcomes

Question 9

What type of mosquitos carry zika? what other diseases do they carry?

Answer 9

Aedes Aegypti

Dengue, Zika and Chikungunya

Question 10

What are the characteristics (when do they bite from, what temps do they like) of Aedes Aegypti

Answer 10

Bite from 5am to 8pm and like temperatures between 25-38 degrees

Question 11

How many cases of Dengue every year?

Answer 11

390 million new cases/year

Question 12

In 2015 how many cases of Dengue were reported in the Americas?
How many severe?
How many deaths?

Answer 12

2.35 million cases reported
10,200 severe and
1,181 deaths (Americas alone)

Question 13

How many cases of Zika every year?

Where do 70% of cases occur?

Answer 13

230,000 cases

70% in brazil and colombia

Question 14

How many cases of Congenital Zika Syndrome every year?

Where do 87% of cases occur?

Answer 14

3,700 cases

87% Brazil & Colombia

Question 15

What % of the world population is a risk of Dengue?

Answer 15

50%

Question 16

How often is someone admitted to the hospital with Dengue?

Answer 16

Every minute

Question 17

How many people are hospitalized with severe Dengue every year (globally)?

Answer 17

500,000

Question 18

How often is a lift lost to Dengue?

Answer 18

every 20 mins

Question 19

What is the death rate from severe Dengue without experienced medical care?

What could this be brought down to with early diagnosis and quality care?

Answer 19

As high as 20%

could bring it below 1%

Question 20

What are the Health System Determinants of health that determine who dies from Dengue?

Answer 20

Health System Determinants

• Access to health care
• Opportunity for receiving attention
• Qualified attention
• Health staff knowledge

Question 21

What is an issue with the vaccine for Dengue?

Answer 21

The vaccine is not safe.

If you had the disease once already and you are vaccinated after, your risk of hospitalization following the vaccine increases (second infection more severe)

Question 22

What are the 4 phases of near-miss framework?
(causes of death and risk factors that distinguish those who had the risk factors that died vs those with the same risk factors that survived)

Answer 22

Phase 1: Recognizing the need to seek care for first symptoms and warning signs
Phase 2: deciding to seek (preventative) care
Phase 3: identifying and reaching facility that provides necessary care
Phase 4: receiving adequate treatment

Question 23

Why were girls being admitted to hospitals less for Dengue in Vitenam?

Answer 23

They did a study thinking that it was maybe because of fees for hospital would lead parents to focus resources on boys

Their intervention of making admissions free did not work and they determined that it was probably because girls complain less about symptoms

Question 24

Who is more at risk of being bitten by a mosquito?

Answer 24

House: bite women and young children

In apartment mosquitos are less prevalent (don’t go above a certain amount)