Prior To Midterm 1 Flashcards
The meaning health changes between…
….cultures
-for example schizoprenia and weight loss or gain
Scientific era
Health is a lack of disease
Environmental health
People, and the experiences you are surrounded by
-house state
-relationships
Occupational health
Work and life balance, financial stability
-chemical safety
-meaningful purpose
Social health
Interactions with people
-friends
-connections
Spiritual health
Personal reflection, belief in a higher power or freedom in who/what you believe
Health compared to wellness
Health- state of being
Wellness- state of optimal wellbeing
Disease compared to illness
Disease- objective state of ill health
Illness- subjective, socially constructed
Signs compared to symptoms
Signs- objective, observable (temp or blood pressure)
Symptoms- subjective, not observable (stomach ache)
Acute compared to chronic
Acute- short term
Chronic- long term
Disability
Loss or abnormality
Impairment
Restriction or lack of ability
Impairment
Restriction or lack of ability
Disability as seen in the Medical model
-a personal tragedy
-adjustment for people
-need care
-individual problem
Disability seen in the Social model
Social oppression
-rights
-society needs to adjust
-social problem
Conceptualizations of health
-stability
-actualozation
-resource
-unity
Models of health
-medical
-holistic
-wellness
-social ecological
Medical model of health
Disease
Holistic model of health
All parts of the person
-balance
Wellness model of health
Process
-wide range of factors
Social ecological model of health
Many factors that effect health
-complex
Actualization
Ones true self
-optimal human health
Salutogenic
Difficult situations help people to cope
-creation and maintenance of good health
-meaningfullness
Factors of sociology
-historical
-cultural
-structural
-critical
Church and medical times
Medicine was prayers
-illness was sin
-reliant on deities for health
Louis Pasteur
Germ theory of disease
John snow
Found the cause of chorea outbreak
Fallacy of specific ethology
Diseased caused by one thing
Objectification
Person is seemed as their issue or brokeness
Medical scientism
Science is the most superior form of treatment
Reductionism
Not considering social aspect, just the microscopy of the disease
Biological determination
Ones biology determines health status
Victim blaming
Blaming the person rather than social determinations of sickness
Dr Thomas mckeown
Recognized that agriculture and better living a part of health
Social production
Distribution and location
Social construction
Definition health and illness
Social organization
Healthcare and public policies
Two types of Grand theories
Structural functionalism
-symbolic interactionisms
Structural functionism
Society is a system of integrated parts
-every person has a specific role
-conservative
Parsons sick role
Being sick is a form of deviancy
-exempt from your role in society
-adher to doctors, you must get better
-good health and medical care is essential
Symbolic interactionism
Microlevel: what human beings do in a society
-reality based on interactions with each other (meanings to change)
-health illness are social constructions (can change)
Medicalization
Something that was not medical that now is
-medical marjuana
Post modernism
Claims on word is socially constructed by their viewpoint
-subjective
-there isnt ‘one’ truth
-may different kinds of treatments
-power shifts
Four conflict theories
-marxism
-feminism
-race
-post colonialism
Marxism
Controlling group and an oppressed group
-macrolevel
-value comes from physical wellbeing and worldly possessions
-exploitation leads to disease and lack of safety
Feminism
Socially constructed power differences between men and women
-a lot of biological research done on men, affects accuracy of health on women
-abortion as an act against patriarchy and control
-diversity of females in medical field
Race
Sociopolitical construction of power over the Other
-patients dying due to racism
-health equity
-impact day to day
Post colonialism
The impact of colonialism
-the Other
-indigenous health (systemic structured racism causes lower life expectancy)
Social marketing
Commercial marketing techniques in a way that benefits society
-poverty or children foundations
Education in social marketing
Influences behavior by new ideas
-not sufficient
Policy
Influences choice
-don’t want control
The four p’s of social marketing
-product
-price
-place
-promotion
P-roduct
Tangible- must wear helmets to bike
Practice- immunizations
P-rice
Measured in time and effort
-old habits affect wanting to oblige
P-lace
How it reaches consumer
-like bathroom signs
P-romotion
Motivate to try and continue
Purse strings
Where does the money come from
Policy
Creates a push
Partnership
Working with
Public
Internal and external groups
Life course perspective
The full view on a persons life, beginning with an event history
Cohort
Group of people born at same time and experience particular social changes
Life event
Significant change and disruption
Trajectory
Multiple turning points
-long term event
Turning point
Major change that has lasting changes in ones life
-more obvious after time passes
Transition
Occur with trajectories
-changes in roles or status
Can a transition be a turning point?
Yes, if it comes with crisis, conflict or no typical age (pregnancy)
Systemic racism
White supremacy imbedded into policies and processes of Canadian institutions
-advantage white
whiteness
Refers to a system that advantages euro Canadians over BIPOC
Institutions
Church, school, government
Why is systemic racism a SDOH
-geographic isolation
-residential schools
-difficulty accessing healthcare
Settler societies
Rooted in western territories
Settler colonialism
Replacement of indigenous populations
-invasive
-false narratives are told of indigenous people
Imperialism
-allowed colonialism to occur
Race of claiming parts of the world for monarchs
How did settler colonialism occur
-scientific justification
-doctrine of discovery
-imperialism
Indian act
Stipulation which controlled indigenous people and worked towards assimilation
Who are the indigenous people in Canada
Aboriginal (First Nations Métis Inuit)
First Nations include
-treaty (status)
-non treaty (non status)
What does it mean to be “treaty” or status
Belong to a First Nations group that has a treaty with the government
Métis
Formed post contact and pre confederation
-self identify, historic ancestry
-connected within the community (acceptance)
Inuit
People in northern Canada arctic
-colonized much later than other indigenous communities due to their geographic location
Treaties
Between the First Nations and governments
-all Canadians have treaty rights and responsibilities
-two sided
First Nations gave: land
Government gave: variety of things like farming, money, clothing
The Indian act
Defines who is allowed to be an ‘Indian’
-pass system: request agent (lots of power) to leave the reserve
Indigenous colonies are actually ……..
Matriarchal
Oka crisis
78 day standoff between Montreal community and Mohawk group
-wanting to expand a golf course on indigenous lands that was a cematary
What was launched against federal governments by residential school survivors
Class action lawsuits
Indian residential school settlement agreement
-common experience payment
-out of court process for resolving sexual abuse claims
Money given to people
Inter generational trauma
legacy of numerous traumatic events a community experiences over generations
Indian hospitals
-segregated hospitals
-thought that indigenous people were an infectious risk for other Canadians
-horrific abuse, sterilization, language barrier, invasive surgery
-creates a distrusted healthcare system for current generations
Determinants of health
-racism
-poor housing on reserve
-educations funds leads to lack of competitive courses
-employment rates
Settler ally
Recognize unearned privilege received from societies patterns and take responsibility
-learning
-working with
Health indicator
Measures health
-Reflects a given situation
-alert potential issues
Rates, vital signs, mortality rates are all..
Population health indicators
Self rated health
Extremely reliable indicator or mortality in short rate
Considerations for gathering population data
-well defined
-validity and reliability
-affordable or feasible
-useful to decide makers
Quantitative research
Objective, controlled measurement techniques
-statistically
-numbers
Example: BMI
Qualitative research
Someone’s subjective, personal perception
-descriptions of pain
-life experience
-feelings or emotions
Elements of qualitative
-Purposeful sampling
-exploratory
-interpretative
Epidemiology
Statistical study of patterns of disease in the population
Example of epidemiology
Vaccines
Purpose of epidemiology
-risk factors
-prevent and treat any disease
-health programs and services
-prevention campaigns
Life expectancy
Common indicator of health status
-starting at birth if mortality rates stayed the same
Incidence
number of cases of disease having their onset during a prescribed period of time
Prevalence
Total amount of people who have a disease or sickness in a specific snapshot time
Mortality rate
Death of people due to disease divided by total population
Breast cancer incidence and prevalence
Incidence: amount of new cases of breast cancer in Canada, period of time
Prevalence: number of people living with breast cancer in Canada at a particular point in time
Crude mortality rate
Total deaths from any cause in a given year in a population
Infant mortality rate
How well a country does in terms of overall physical health of a community
-measures human infant death (younger than one year)
Potential years of life lost
Measure of premature mortality providing an estimate of time lived if they would have not died prematurely
(Under age 70)
-want small values
Epidemiological triangle
Assist in figuring out new diseases, how it happened and what to do (Idea is you need to break connection)
-host
-agent
-environment
Agent in epidemiology triangle
What: bacteria, fungi, viruses
-can also be stimulisis : lack of vitamin d
Environment in epidemiological triangle
Exposure to the host
-weather, crowded areas, climate change
Vector in the epidemiological triangle
Something that goes imbetween the host and agent
-bat, like rabies
Paradox of change
Learning better heath habits to better yourself
Health promotion
High level of well being
-art and science of supporting people to make changes in their life
-direct people towards health
Disease prevention
Anything we do to stop disease from spreading
-focus don specific as
Three levels of disease prevention
Primary, secondary and tertiary
Primary level of disease prevention
Protect against a disease before signs and symptoms occur
-vaccines
Secondary level of disease prevention
Promotes early detection of disease
-bloodwork, mamograms, bp screening
Tertiary level of disease prevention
Minimize disability from disease
-physio therapy, cardiac rehab
Health promotion
-Social justice/political (focusing on fairness)
-holistic (whole individual and picture)
-long term perspective
-all sectors (education, industry, environmental)
-empowerment
Empowerment: individual vs community
Individual: ability to make decisions and control over their personal life
Community: acting collectively to gain influencer over the quality of life in their community
HBM health belief model
Model for health protection
-designed to understand the likelihood that someone would perform a health protective behaviour
Self efficacy
Able to do a lot of things
Sociosphychological
Personality
Structural variables
Your knowledge
Critiques to the HBM
-doesn’t take into account habitual behaviours
-behaviours done for non health reasons (Social norms)
-assumes everyone has equal access to information
Transtheoretical model
-based on RESEARCH relative to stopping smoking in adults
Trans (across) theoretical (concerned with the theory, variety of places)
Four key constructs
-stages of change 6
-processes of change (independent variables) 10
-self efficacy
-decisional balance
Premise of transtheoretical
-behaviour change is an ongoing process, not an event
Assumptions of transtheoretical model of change
Individuals have varying levels of motivation or readiness to change
Three assumptions of transtheoretical
-behaviour change is ongoing
-individuals have varying levels of motivation
-individual shave varying information for each stage of change
Spiral pattern
-pre contemplation (no intention of changing)
-contemplation
-preparation
-action
-maintenance
-relapse
Precontemplation
No intention to change
-not aware
-resistant to change
Our action: validate and encourage
Contemplation
Sitting on the fence weighing pros and cons
-can last a long time
-aware of problem but is not committed to fixing it yet
Preparation
Intending to take action in the near future
-not full action
Action
-actually taking action, modifying their behaviour
-requires time and commitment
Maintenance change
-a continuation of change
-attempting to not relapse
Relapse
Resumption of old behaviours
-can come from major change, or loss of support
Experiential process of change
-conscious raising
-dramatic relief
-self revaluation
-social liberation
Behaviour process
-counterconditioning
-contingency management
-self liberation
-stimulus control
Consciousness raising
Increasing information about self and problem
-why its helpful
Dramatic relief
Emotional arousal
-Experiencing and expressing feelings
Self reevaluation
Assessing how one feels and thinks about oneself
Social liberation
Increasing alternative for non problem behaviours available in society
Self liberation
Choosing and committing to act
Counter conditioning
Substituting alternatives for problem behaviours
Stimulus control
Avoiding stimuli that elicit problem behaviours
Reinforcing management
Rewarding oneself or being rewarded by others
Four constructs of transetheoretical
-self efficacy
-decisional balance
-stages of change
-processes of change
Self efficacy
Belief about ones own competence and ability to self regulate
High level: more likely to initiate and maintain the behaviour
Low level: less likely
Decisional balance
Weighing the pros and cons of changing behaviours to help change begin
-more cons, or early on (precontemplation, contemplation and preparation)
-More pros (action and maintenance)
Ethics of behaviour change
-people have their own right to what changes they want
-avoid authoritarian or manipulation
Define social determinants of health
Economic and social conditions shape the health of individuals
-individuals to populations
-societal choices of who gets what
-causes of the causes of health
Causes of the causes
-keep asking questions
-deeper issues
-how far back can we go
Determinants of health 1994
-income and social status
-education and literacy
-employment
Added determinants in 1996
Gender, culture and social environments
Common to date social determinants of health
-employment and working conditions
-food security
-heath care services
-housing
-social exclusion
Lalonde report
Initial notice that something was impacting health other than biological factors
Criticisms for lalonde report
-victim branding
-deflecting attention from one’s environment
Population health approach
Measured by health status indicators
-interventions
-multiple strategies
Determinants of health are all
Interreltated
The aim of population health approach
focusing on reducing material and social inequalities
What do societies need to have health
-food, water, housing
-environment aspects
-accesses to health services
-peace
-rescources
-social justice
-empowerment
the epp report
Health promotion
Dealing with three major health challenges
-Reducing: inequalities
-Improving: prevention
-Coping: enhancing coping
Availability of choices
Causes of the causes
Health of a population is measured by
Health status indicators
Health of a population is influenced by
Social, economic and physical environments
-individual capacity
Affects of education on reserves
-mistrust
-European traditions
-colonial histories
-racism
-undervalued indigenous culture and language
Deterrents to education
-parents who didn’t have education themselves to help
-financial issues
-trauma
-underfunded schools
Initiatives for indigenous education
-developing policies such as TRC calls to action
-curricular reforms
-educating staff/teachers
Low education and low employment levels lead to low…
Socioeconomic status
Indian act as an impact of health
-higher rates of suicide
-lower income
-poorer health
-higher rates of unemployment
Scientific era definition of health
Freedom from disease
Seven multidimensional pieces of health
-physical
-social
-emotional
-spiritual
-environmental
-occupational
-intellectual
-physical
Coneptualizations of health
Health as…
-stability
-actual action
-rescources
-unity
Models of health
-medical model
-holistic model
-wellness model
-salutogenic model
Medical model
Conventional approach
(Absence of disease)
-body as machine
Holistic model
Considers all parts of the person
-alternative
-just recently integrated
Wellness model
-builds on medical and holistic models
-continuously changing
-indivudal is responsible
Social ecological model of health
-broad health conception
-many factors
Salutogenic model of health
Focuses on the origins of postive health
-factors that enhance good health
Health as actual action
-comprehensive
-trying to reach ones potential/ones true self
WHO definition of health
State of complete physical, mental and social well being
-not just absence of disease
Health as stability
Defined as the main tench of
-physical
-logical
-social norms
Health as actualization
Actulization of human potential
Health and wellness interchangeable
Health as aculization and stability
Realization of human potential thru goal directed behaviour
Health as rescource
Capacity to fulfil roles, meet demands and engage in activities of everyday living
Health as unity
Reflecting the whole person, as a process
Lalonde report
Behavioural approach to health
-lifestyle, environment, human biology and organization of health care
Behaviour approach
Places responsibility for health on the individual
Socioenviromental approach
Lifestyle improvements made by
-well educated
-well employed
-higher income Canadians
Ottawa charter
Identified prerequisites for health
Prerequisites for health
Peace, shelter, education, food, income, social justice and equity
What do the Ottawa charter and epp report both reflect
A socioenviromental approach
-health is more than absence of disease
-self efficiency and engaging in meaningful activities
Psychosocial risk factors
Psychological experiences resulting from
-isolation, lack of social support, low self esteem, self blame
Socioenviromental risk conditions
Living conditions
-poverty, low educational or occupational status
-dangerous or stressful work
Population health approach PHAC
individual + collective that determine population health status
Jakarta declaration
-empowerment of women
-social security
-respect for human rights
-social relations
Bangkok charter
Affirmed health as a human right
-mental and spiritual well being
Health disparities
Differences in health status among diff population groups
Health promotion
Directed towards increasing well being and self actualization
Disease prevention
Avoid illness and disease
