Week 2 Flashcards
Four categories of influences on health
- Biology and genetics
- Health care services
- Individual Behaviours
- Social determinants
how to develop effective health promotion interventions
health promoters should consider all of the determinants of health and focus on the most significant
how do we know the most significant determinant of health
measuring health outcomes and status
why do health outcomes need to be measured?
to assess if implemented health promotion intervention have effectively addressed the health status
5 ways differences in social determinants lead to differential health outcomes:
- Behaviour/lifestyle
- the life course
- psychosocial factors
- material conditions
- access to healthcare services
Key determinants of health (textbook) Broad > Narrow
-General socio-economic, cultural and enviornmental conditions
-living and working conditions
-social and community networks
-individual lifestyle factors, sex, age & genetics
General Socio-economic, cultural and environment conditions
- influences all of the determinants
-people and populations that live with lower standards demonstrate poorer health compared to people in other societies
Living and working conditions
- education, housing, availability of healthcare
- significantly contribute to individual and population health
- increasingly the target of health promotion interventions
social and community networks
- relationships and connections communities have with other communities, the larger society and government
-better connections = better health
-health promotion may focus on improving relationships, adovocting for communities, or supporting communities as they advocate for themselves
Individual Lifestyle factors, age, sex ad genetics
- individual habits/behaviours that influence health
-traditional target of health eduction/promotion
-inheritable determinants NOT targeted for change, though thay can indicate who is in need of promotion
list the social factors of health
- Income
- Housing
- Employment
- Gender
- Race
- Place
social factor 1: income
- those with more income experience better health
- reasons:
- access to clean water food and medical services,
- different rates of stress/anxiety
- different ability to buy goods and services
social factor 2: Housing
physical dangers, inadequate heating/cooling, dampess, overcrowding, poor quality, environmental toxins
social factor 3: employment
- determines income, housing
- affects self esteem
- direct effects through exposure to hazardous substances, stress and occupational norms
- occupations with high demands, low control over work and work decisions and low social support all negatively affect health
social factor 4: gender
- women tend to be healthier than men
- b/c more likely to report illness, visit doctor and engage in healthy behaviours and avoid unhealthy ones
- women are socialized different than men leading to health differences
- transgender are particularly disadvantaged when it comes to SDoH and have poorer health on average than cisgender
- b/c stressors and social determinants that arise from the stigma and discrimination
social factor 5: Race
- associated with health status
- “white” are privileged and generally have best health outcomes
- race is strongly correlated with social determinants of health
- other explanations for health outcomes include: effects of stress, availability and quality of health services or attitudes towards health and medicine
- closely tied to ethnicity and culture, affecting health-influencing factors like health behaviours or social/physical environment
social factor 6: place
affects health by distribution of social determinants of health by geographic area, the makeup of physical and social environments or shared norms, or traditions rooted in ethnicity/culture
what measure of class/status can sometimes have greater influence on health
subjective over objective
what did the monkey study show
changing position on the social ladder changed their immune system; Biological embedding of status
Biological embedding of status
lower ladder levels meant increased stress hormone cortisol - elevated cortisol can weaken the immune system
who is at more risk for developing mental illness?
- People with lower household income have the highest risk for developing mental illness and those with high income have lowest risk
geneder effect of mental illness
- gender effect is consistent; men have smaller risk of mental illness than women
objectives proposed by Fair society, Healthy Lives (UK expert commission) as the most important for health promotion:
- Give every child the best start in life
- Enable people to maximize their capabilities and control over their lives
- Create fair employment and good work for all
- ensure healthy and sustainable places and communities
- strengthen prevention
cetrgories of intervention
structural, community & individual
structural intervention: Determinants targeted
general socio-economic, cultural, and environmental conditions
structural intervention: examples of health promotion interventions for diet
trade policy, food-labelling regulations, food fortification
Local/community intervention: determinants targeted
- social and community networks
- living an d working conditions
Local/community intervention: example of health promotion for diet
-food gardens
-free fruit and vegetables in schools
-food outlet availability
individual/family intervention: determinants targeted
individual lifestyle factors
individual/family intervention: examples of health promotion for diet
-nutrition education in school/during pregnancy
-mass-media campaigns aimed at influencing individual behaviour
how is a mass media campaign an example of individual intervention?
although it may be focused on a community, it is considered individual level intervention because it aims to change individual behaviour
purpose of Measures of mortality
-used to compare health statuses of countries as they are readily available
-may suggest where health promotion is most needed
measures of mortality
- death rate
-standardized death rate
-perinatal death rate
-neonatal death rate
-infant death rate
-life expectancy
death rate
deaths per 1000 people per year (unadjusted)
standardized death rate
death rate after adjustment for population characteristics
Perinatal death rate
number of stillbirths and deaths in first 7 days after birth per 1000 live births
neonatal death rate
number of deaths occurring in the first 28 days after birth per 1000 live births
infant death rate
number of deaths occurring in first year after birth per 1000 live births
Life expectancy
the average age a person can be expected to live, based on birth year
what does measures of mortality NOT account for
QoL
health measures that account for QoL
- years of healthy days of life lost (or gained)
- Quality-adjusted life years
- Disability-adjusted life years
Years of healthy days of life lost
combines morbidity and mortality as quantitative measure of loss from disease or gain from intervention
Quality-adjusted life years
years of survival weighed for quality of life people may be expected to have in the context of different states of health and illness
Disability-adjusted life years
combines years of healthy life lost from disability and premature death; incidence and duration of disabilities weighed according to the severity of the disability and its impact
