Unit 11: Social Determinants of Health and Chronic Conditions

Question 1

Determinants of Health

Answer 1

• Biology and Genetics
• Social and physical factors
• Health services
• Policies
• Individual Behaviors

Question 2

Grade A

Answer 2

Based on consistent, good quality, patient-oriented evidence such as systematic review or meta analysis showing benefit, Cochrane review with clear recommendations, high quality, patient oriented randomized control trial

Question 3

Grade B

Answer 3

Based on inconsistent or limited quality patient oriented evidence

Question 4

Grade C

Answer 4

Based on consensus usual practice, opinion disease oriented evidence

Question 5

Grade 1

Answer 5

Least harm
-Poses little risk, if any, harm
Ex. Eating more veggies, increase exercise, encouraging healthy social connections

Question 6

Grade 2

Answer 6

Moderate Harm

Potential to cause reversible side effects or interact in a negative way with other therapies

Question 7

Grade 3

Answer 7

Most Harm

-Has the potential to result in death or permanent disability

Question 8

Coronary Artery Disease: Cardiovascular Disease

Answer 8

Remains #1 cause of premature death and disability

• Triggers can be both genetic and environmental, inherited metabolic include dyslipidemia and diabetes
• Environmental and lifestyle factors include nutritional imbalance, smoking, sedentary lifestyle, stress and depression

Question 9

Lifestyle and Therapeutic Review: Coronary Artery Disease: Cardiovascular Disease

Answer 9

• Nutrition (A): most powerful tools or lifestyle changes (Mediterranean diet)
• Exercise (A): 30 min/day walking or 3x a week mod intensity aerobics. resistance training at least 30 min/wk
• Smoking Cessation (A)
• Lipid management (A): LDL (niacin, statins) HDL (exercise, weight loss, decreased carbs, niacin) Triglycerides (exercise, weight loss, reduce carbs, fish oils, vibrates)
• Stress and Anxiety Reduction (B): Meditation and Cognitive-behavioral therapy
• Weight loss (A): If indicated

Question 10

Breast Cancer

Answer 10

Associated with non modifiable risk factors such as family history (genetic mutations) which can double risk for cancer
-Environmental factors and lifestyle are known to be modifiable risks in prevalence of cancer including: food choices, alcohol consumption, weight control, postmenopausal estrogen/progesteron, toxins (radiation and pesticide)
Based on evidence: Not smoking, BMI less than 30, 3.5 hours of exercise or more a week, plant based diet can reduce risk of cancer by 36%; Sleep is also helpful

Question 11

Type 2 Diabetes

Answer 11

Considered preventable
-Lifestyle intervention
-Risk factors: Smoking, obesity, sedentary
Lifestyle choices: Exercise 30-60 min mod intensity exercise on most days of the week, diets incorporating “healing pyramid” which indicates the healthier options (vegetables, grains, legumes, healthy fats, dairy, and lean meats) mindfulness and sleep hygiene are supported by evidence as well

Question 12

Osteoarthritis

Answer 12

• Slow, progressive degeneration joint disease
• Breakdown in physiologic pathways of bone, cartilage, synovium and ligaments
• Presently most common reported chronic condition
• Integrative med is supported by evidence
• Anti-inflammatory diet
• Weight loss
• Exercise
• Mind Body Therapies
• Physical Modalities
• Supplements