Lecture 9:5 Health and Health Info
Transcript of Lecture 9:5 Health and Health Info
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Health and health determinants
Readings: Chapter 1Jenna DeRieu
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What is health?Health is a state of complete physical, mental and social
well-being and not merely the absence of disease orinfirmity.
Definition from World Health Organization, 1948
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Dimensions of Health:
Physical
Physical - Presence/ absence of disease
- Body size, shape, and function- Activities of Daily Living (ADL)
- Physical fitness
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Dimensions of Health:
Mental (Psychological) Health
Mental- Mental wellness/illness
- Emotional well-being
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Dimensions of Health:
Social
- Social Environments
- School, Church
- Personal relationships- Family, work, romantic, team, etc.
- Social Networks
Breadth and depth
real or virtual
Social
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Models of Health
Medical Model
Focus: Individuals biology
Physiology, organ function
Cause of Disease
By an agent (virus), malady (something bad happened
to them), or malfunction (birth deformity)
Treatment of Disease Remove the agent or repair the malfunction
Health=absence of disease
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Models of Health
Public Health Model
Focus: Contextof individual and interactions
Environment
Behavior
Biology
Prevention of disease
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Models of Health
From the medical model we get
Disease treatment or management
Surgery
From the public health model we get
Disease prevention
Environmental and behavioral interventions
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Disease Prevention
Disease prevention Actions or behaviors designed to keep people from
getting sick
Reduce or eliminate factors causing illness or injury
Examples Vaccines
Anti-smoking campaigns
Health promotion
Policies and programs that promote behaviors tosupport health Identify risk factors and people at risk
Frequently focus on environmental change
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Healthy People 2020
Set of goals and objectives with 10 year
targets
Guide national health promotion and disease
prevention efforts
Measure progress for health issues
Goal: Improve health of all people in the
United States
Attain high quality, longer lives free of preventable
disease, disabilities
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Healthy People 2020
12 Topic areas
Access to health services
Clinical preventative services
Environmental quality
Injury & violence
Maternal, infant, child health
Mental health
Nutrition, physical activity, obesity
Oral health
Reproductive and sexual health
Social determinants Substance abuse
Tobacco
Measurements
Persons with medical insurance
Measures of health (BP, BG)
Air quality index
Fatal injuries
Infant mortality, pre-term birth Suicide
Meet PA guidelines, BMI
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WHAT DETERMINES HEALTH?
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Health determinants
The array of critical influences that determine
the health of individuals and communities
Surgeon General
Biology
Behavior
EnvironmentAccess to health care
Policy
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Health Determinants: Biology
Family health history
- Genetics
Age
Gender, race/ethnicity
Personal history with illness/injury
Biological aspects are non-modifiable
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Health Determinants: Behaviors
Responses to external or internal stimuli
Actions and reactions
Intentional actions
Modifiable
Of the the ten leading causes of death 4 of them
are modifiable determinants responsible for
chronic diseases
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Health Determinants: Behaviors
1. Lack of physical activity/inactivity disease risk and early death
overweight and obesity risk
2. Unhealthy dietary intake High saturated fat, high sodium, high calorie Heart disease, obesity
3. Excessive alcohol consumption cardiovascular disease & other conditions, accidents
4. Tobacco use Blood pressure and cardiovascular disease
Cancer
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Health Determinants: Social
Environment
Social environment
Interactions with family, friends, co-workers, neighbors
Social institutions: Schools, Church, worksite
Social services: Law enforcement, transportation,counseling
Socioeconomic status
Important social and economic health determinant
Education Income
Social/ cultural background
Type of job/career
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Health Determinants: Physical
Environment
Built environment
Anything created or modified by humans in thecommunities and areas we live, work, and travel in
Roads, buildings, transportation
Pollution and infectious agents
Environmental hazards or quality
Exposure to: toxins, radiation, irritants Direct or indirect
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Health determinants: Policies and
Interventions
Local and national policies
Smoking bans
Seatbelt laws
Helmet laws
Water safety
Vaccinations
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Health Determinants: Health Care
Access to health care specifically
45.4 million Americans do not have health care
Access to quality or consistent health care
AFFORDABLE HEALTH CARE
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Mortality
Occurrence of death
Mortality rate: number of deaths in a populations
in a given period of time
Usually expressed as a ratio
Population assessments
All-cause mortality
life-expectancy
Infant mortality
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Top 10 leading causes of death in the
United States, 2008 (Heron,2012)
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Leading Causes of Death Among
Americans Ages 15-24 (2007)
Rank Cause Number Percent
1 Accidents
TransportNon-transport
15,897
10,9284,969
46.8
32.214.6
2 Homicide 5,551 16.3
3 Suicide 4,140 12.2
4 Cancer 1,653 4.8
5 Heart disease 1,369 4.0
National Center for Health Statistics, 2010.
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Morbidity
Disease occurrence
Morbidity rate: Incidence of disease among
members of a population
Co-morbidities
Diseases or conditions that co-occur with each
other
Example: Obesity co-morbidities Diabetes, asthma, arthritis, cardiovascular disease
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Quality of life
Quality of life Subjective evaluations of the positive and negative
aspects of ones life individualsperception
Encompasses wellness concepts
Influenced by health, environment, living situation,occupation/school
Health related quality of life (HRQOL) Measures of health the directly impact the subjective
evaluation of ones physical and mental well-being
Associated with health risks, functional status, socialsupport, socioeconomic status
Source: http://www.cdc.gov/hrqol/concept.htm
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Morbidity and Mortality: Risk Factors
Risk factors
A condition that increase ones chance of
disease or injury (or death)
Condition any attribute, characteristic or
exposure of an individuals likeliness
Controllable AND uncontrollable
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Risk factors
Controllable
Diet
Physical activity
Smoking status
Substance use and abuse
Coping mechanisms
Compliance with
treatment/medications
Uncontrollable
Age
Sex
Race/ethnicity
Genetics
Physiology/metabolism
Susceptibility to disease
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Evaluating Credibility
Credibility= Believability Confidence in the truth of information AND interpretations
We believe someone is telling the truth
We believe that truth is accurate
Concepts well return to in health sciences research:
Validity: Is it true?
quality criterion degree of accuracy in a studysconclusions Do we believe they found a true association or relationship?
(internal validity)
Do we believe it can be applied to real life? (external validity)
E l ti C dibilit f H lth
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Evaluating Credibility of Health
Websites(the same could apply for books, magazines, etc)
ANYONE can publish on the internet
No review by anyone else
No standards for content
Its up to readers to be sure they are readingcredible information by assessing:
Accuracy
Authority
Bias/ObjectivityCurrency/Timeliness
Coverage
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Evaluating Websites
1. Accuracy
Look for evidence:
- is the info based on scientific research?
- are the sources cited to support facts, claims,
outcomes?
- Are these sources credible?
Assess quality:
How do websites review their info?
Id there an editorial board
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Evaluating Websites
2. Authority
Author Who wrote the article or supports the website?
What are their credentials?
Who are they affiliated with?
Webpage/Website
Is their an editorial board? Is their a policy of mission statement?
What are their credentials?
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Evaluating Websites
3. Bias/Objectivity
Is this information showing just one point of view?
What is the purpose for the website or article?
Is advertising used?
Is that point of view polarized? Or unsubstantiated
This is a miracle fruit!! ORAC is over 3,500 which is
hundreds of times higher than your average fruit This is THE WORST food you can eat!! Your body will
feel its toxic effects for years
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Evaluating Credibility of Health
Websites
4. Currency/Timeliness How recently was the article written or the website
updated?
Do the links still work
Keep in mind:
Medical treatments change as new research iscompletedOld sources may be inaccurate or wrong based onnew information
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Evaluating Credibility of Health
Websites
5. Coverage
Is this info complete?
Do they have links to other sites or info?
6. Privacy
Check for privacy policies
What kind of registration do you need to see thepages
What do they do with this information?
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Evaluating Credibility: My Sources
National Library of Medicine (supported by the NIH)
http://www.nlm.nih.gov/medlineplus/healthywebsurfing.html
National Network of Libraries of Medicine
http://nnlm.gov/outreach/consumer/evalsite.html
Evaluating Web-Based resources:
http://nccam.nih.gov/health/webresources
http://www.nlm.nih.gov/medlineplus/healthywebsurfing.htmlhttp://www.nlm.nih.gov/medlineplus/healthywebsurfing.htmlhttp://nnlm.gov/outreach/consumer/evalsite.htmlhttp://nccam.nih.gov/health/webresourceshttp://nccam.nih.gov/health/webresourceshttp://nnlm.gov/outreach/consumer/evalsite.htmlhttp://www.nlm.nih.gov/medlineplus/healthywebsurfing.htmlhttp://www.nlm.nih.gov/medlineplus/healthywebsurfing.html -
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Five Quick Questions for Evaluating
Health Websites Who? Who runs the Web site? Can you trust them?
What? What does the site say? Do its claims seem too goodto be true?
When? When was the information posted or reviewed? Is itup-to-date?
Where? Where did the information come from? Is it basedon scientific research?
Why? Why does the site exist? Is it selling something?