Terms (Midterm 1) Flashcards
Biomedical Definition of Health
The overall condition of body or mind and the presence or absence of illness or injury.
Recent Definition of Health
A resource for living, not the objective of living.
Social Determinants of Health
1) Income and Income Distribution
2) Education
3) Unemployment and Job Security
4) Employment and Working Conditions
5) Early Childhood Development
6) Food Insecurity
7) Housing
8) Social Exclusion
9) Social Safety Net and Network
10) Health Services
11) Indigenous Status
12) Gender
13) Race
14) Disability
Risk Factors
Conditions that increase a person’s chances of disease or injury.
Health Promotion
A process of enabling people to increase control over and improve their health. A vehicle for achieving wellness.
Dimensions of Wellness
1) Physical
2) Emotional
3) Intellectual
4) Interpersonal
5) Cultural
6) Spiritual
7) Environmental
8) Financial
9) Occupational
Infectious Diseases
Diseases that can spread from person to person. Caused by microorganisms such as bacteria and viruses.
Chronic Diseases
Diseases that develop and continue over a long period such as heart disease or cancer.
Lifestyle Choices
Conscious behaviours that can increase or decrease a person’s risk of disease or injury such as eating a healthy diet, smoking, exercising, and others.
Sex
The biological and physiological characteristics that define men and women. Also includes intersex people.
Gender
How people identify and feel about themselves rather than the body parts and sexual organs they have.
Genome
The complete set of genetic material in an individual’s cells.
Genes
The basic units of heredity, sections of genetic material containing chemical instructions for making a particular protein.
Behaviour Change
A lifestyle-management process that involves cultivating healthy behaviours and working to overcome unhealthy ones.
Target Behaviour
An isolated behaviour selected as the subject of a behaviour change program.
Self-Efficacy
The belief in your ability to take action and perform a specific task.
Locus of Control
The figurative place a person designates as the source of responsibility for the events in their life.
Internal Locus of Control
People who believe they are in control of their own lives.
External Locus of Control
People who believe that factors beyond their control determine the course of their lives.
Wellness
Optimal health and vitality.
Disease
Underlying pathology that is biologically defined. The practitioner’s perspective.
Sickness
Social and cultural conceptions of this condition. Cultural beliefs and reactions impact how the patient reacts. Also covers what is considered a disorder suitable for medical treatment.
Illness
A person’s subjective experience of their symptoms (what the patient brings to the doctor).
Reductionist
Abnormal structure or function of cells, organs, and systems.
Epidemiology
The study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems.
Infectivity
The ability of the pathogen to go pass the immune system.
Agent
Cause (virulence, infectivity, addictive qualities, etc.).
Environment
Determinants (public health sanitation, social context, availability of health care, etc.).
Host
Risk Factors (genetic susceptibility, resiliency, nutritional status, motivation, etc.).
Risk Factor
A variable associated with an increased statistical probability of contracting a disease, injury, or infection. Tend to be more “proximal” to the individual.
Determinants
Upstream factors that correlate with increased risk. Tend to be more “distal” and occur at the population level.
Intersectionalities
Social determinants interact with each other.
Individual Factors
1) Age
2) Sex
3) Biological/Hereditary Factors
4) Lifestyle/Behaviours
Hippocrates (460 BC)
“Father” of Western medicine. Believed disease was caused by something physical.
Hippocratic Corpus
Disease caused by an imbalance of man with the environment also by imbalance in humours/fluids: melancholy (mental health), phlegm, bile, and blood.
Miasmas
Vapours from swamps or cesspools.
Vectors
Spread infectious diseases to humans.
Reservoirs
Where the infectious disease lives.
Dr. John Snow (1813-1853)
A physician in London. Considered to be the father of epidemiology. There were large epidemics of cholera in Europe and America in the 1800s. He systematically studied outbreaks in London. Data supported theory of the source of the outbreaks.
Cholera
Diarrheal disease caused by bacteria Vibrio cholera.
Age of Reason and Enlightenment (1650-1800 AD)
Scientific reasoning and birth of modern medicine.
William Harvey (1578-1657)
An English physician who did animal dissections. First to hypothesize that mammals reproduce via fertilization of an egg by sperm.
Small Pox
A virus that infects blood vessels of the skin.
Edward Jenner
An English physician. Famous for his cowpox experiment in 1796 where he used cowpox to build immunity against smallpox.
Louis Pasteur
In 1862, he disproved theory of spontaneous generation (that living things just pop up) and published his “Germ Theory”. Responsible for pasteurization (saved the wine industry). Created vaccinations against anthrax and rabies (coined the term “vaccine” in honour of Jenner). In 1888, he became the Head of Pasteur Institute in Paris (started the institute).
Robert Koch
In 1882, he discovered that tuberculosis bacterium and in 1883 he identified the bacterium that causes cholera. Came up with Koch’s Postulates that prove that a specific microbe causes a specific disease.
The Enlightenment and Science
Ideals of democracy, reason, rationality, citizenship, and social value of intelligence.
Utilitarianism
“It is the greatest happiness of the greatest number that is the measure of right and wrong” (Jeremy Bentham). Reducing mortality and improving health is better for the economy. Importance of good government, health, and social policies.
Edwin Chadwick (1842)
An English social reformer. Published a report that described how filth in the environment contributed to spread of disease in urban areas and exposed poor working conditions and child labour (1/2 of child labourers died before 5th birthday). The report led to reforms in sanitation and treatment of the poor and working class.
Grosse Île
A tiny island in the middle of the St. Lawrence in Quebec was the site where many immigrants from Ireland arrived during the Great Irish famine of 1847.
Lalonde Report (1974)
Former federal health Minister Mare Lalonde. Looked beyond individual to improving the health of the population. Started Population Health Movement. Health field concept model with 4 fields, Human Biology, Environment, Lifestyle, and Health Care Organization.
Ottawa Charter for Health Promotion (1986)
The result of first international conference of health promotion held in Ottawa. Reduces inequities, ramped up prevention, and empowered individuals.
Ottawa Charter for Health Promotion
1) Building healthy public policy
2) Creating supportive environments
3) Strengthening community action
4) Developing personal skill
5) Reorienting health services
7 Prerequisites for Adult Health
1) Peace
2) Shelter
3) Education
4) Food
5) Income
6) A Stable Eco-system
7) Sustainable Resources
Epidemiological Transitions
First proposed by Abdel Omran in 1971. Dramatic shifts in the patterns of mortality and disease as countries develop economically. 4 transitions/stages.
1) The Age of Pestilence and Famine
2) The Age of Receding Pandemics
3) The Age of Degenerative and Man-Made Diseases
4) Age of Delayed Degenerative Disease
The Age of Pestilence and Famine
- Most of human history
- Low life expectancy (20-40)
- High infant mortality
- Majority of deaths caused by malnutrition or infectious disease
- Can’t sustain population growth
- Sub-Saharan Africa
The Age of Receding Pandemics
- Late 1800s to early 1900s in developed countries
- Increased food availability and safer food supply
- Public Health sanitation measures
- Better prenatal and postnatal care
- Introduction of immunization programs and antibiotics
- Deaths from infectious diseases and malnutrition decreased
- Life expectancy increased (50)
- Infant mortality decreased
- Some parts of Latin America and Southeast Asia
The Age of Degenerative and Man-Made Diseases
- Mid 20th century
- Chronic disease deaths > infectious disease deaths
- Life expectancy (60)
- Peak in cardiovascular disease (CVD) and cancer rate (>50% of deaths due to CVD)
- Some parts of Central Asia, Middle East, North Africa, and Urban parts of India
Age of Delayed Degenerative Disease
- Mid-1960s to present
- Decline in CVD mortality
—> Prevention (smoking facts, tobacco control policies, and regulations)
—> Technological Advances (blood pressure medications and coronary artery bypass surgery)
—> Public health education around healthier lifestyle, better nutrition, and promotion of physical activity - Life expectancy (82)
Health Inequality
Systematic difference in health between groups of people due to biological differences and/or lifestyle, socio-economic status, and differential access to healthcare.
Health Disparity
Systematic inequalities due mainly to social disadvantages.
Health Inequity
A healthy disparity that is deemed unfair (moral imperative to try to correct). Ex. systematic health disparities for Indigenous Canadians.
Institutionalized (Structural) Racism
Material conditions and access to power.
Personally-Mediated Racism
Prejudice and discrimination.
Internalized Racism
Acceptance by members of the stigmatized races of negative messages about their own abilities and intrinsic worth.
Prevention
Covers actions to prevent the occurrence of disease such as risk factor reduction and also to arrest its progress and reduce its consequences once established.
Primordial Prevention
Actions to minimize future hazards to health that addresses broad health determinants. At populations.
Primary Prevention
Prevent the onset of specific disease via risk reduction. At population or individual level.
Secondary Prevention
Procedures to detect and treat pathological changes.
Tertiary Prevention
After a disease has been treated in clinical phase, prevent relapse or decrease impact on patient.
Protection
Reducing threats to population health (primordial and primary prevention activities).
Surveillance
The on-going, systematic collection and analysis of population-level health information in order to guide the design of public health and preventive interventions. May include long-term, passive monitoring of general health trends or active, short-term checking for emergent diseases or outbreaks.
Health Promotion
Focuses on removing negative threats/influences.
Behaviour Change
Moving in the direction of wellness means cultivating healthy behaviours and working to overcome unhealthy ones.
Models and Theories on Factors That Influence Health Behaviours
1) Transtheoretical Model (Stages of Change)
2) Health Belief Model
3) Theory of Planned Behaviour
Transtheoretical Model (Stages of Change)
In order to change target behaviour you must move through distinct stages.
The Transtheoretical Model: Stages of Change
1) Precontemplation (person has no intention for and sees no reason to make change).
2) Contemplation (person has the intention to change target behaviour within 6 months).
3) Preparation (person plans to take action within a month or is already taking small steps to change behaviour).
4) Action (person is already making changes to behaviour which requires time and energy).
5) Maintenance (person has maintained new, healthier lifestyle for at least 6 months).
6) Termination (the new behaviour is adopted).
Health Belief Model
Decisions depend on a certain pattern of beliefs.
Theory of Planned Behaviour
Assumes rational planning by patient. Extension of Health Belief Model that incorporates subjective norms (perceived social pressure to change) and self-efficacy.
Qualitative Research
Generates hypotheses. Answers “why?” and “what does it mean?” questions.
Quantitative Research
Tests hypotheses. Answers “what?”, “how much?”, and “how many?” questions.
Epidemiology
The study of the occurrence of disease in populations. Emphasis on prevention of disease through reduction of risk factors for diseases.
Comparative Discipline
Comparing risk of disease in people exposed to a particular agent to those not exposed to the agent. The ultimate goal is to try to establish whether there is a causal relationship.
Austin Bradford Hill (1965)
Proposed criteria for assessing the causal nature of epidemiological relationships.
Criteria for Assessing Epidemiological Relationships
1) Strength of association (high relative risk).
2) A greater response to a greater dose.
3) Consistency between different studies.
4) A temporal relationship (exposure occurred before symptoms).
5) A plausible mechanism (plausible reason why exposure causes symptoms).
Observational Studies
Researcher observes what happens to people under exposure conditions outside the control of the researcher. Non-randomized design.
Confounding
Occurs when a (third or other) variable is associated with BOTH the exposure and outcome being studied. If this third variable is not taken into account, the relationship between the other 2 variables may be misinterpreted (the other variable is the actual reason for the symptom).
Types of Observational Studies
1) Descriptive Studies
2) Analytical Studies