Lecture 9:5 Health and Health Info

7/29/2019 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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Mental (Psychological) Health

Mental- Mental wellness/illness

- Emotional well-being


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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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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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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?

Documents

Lecture 9:5 Health and Health Info