PHYSICAL AND MENTAL HEALTH CARE

Dr. Alberto Pimentel Jr

Health Defined

• According to the World Health Organization, health is defined as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”.

• In recent years, mental health has become a larger concern to the medical community.

• In the modern day health care system, a significant percentage of the medical treatments are centered around mental health.

• Mental Disorders: are patterns of mood, thought, or behavior that cause distress and decrease the ability of a person to function.

Health Defined: History of Health Care

• Throughout American history, access to health care has often been viewed as a luxury, instead of a human right.

• The quality of medical care has caused great debates and at times, is associated with an individual social class standing.

• Early medical practice involved little more than folk remedies and home cures…in fact, if you boys aspired to be medical professionals, they would essentially serve as an apprentice for a medical practitioner throughout their teenage years and then, be allowed to practice medicine.

• In the mid-1700’s, American colonies in the North adopted laws and licenses for medical professionals.

• In the U.S, the first medical school was establish in Philadelphia in 1765.

Health Defined: History of Health Care

• In the 18th century, medical science was still based on the notion that the body was a system with balanced amounts of blood, phlegm, and bile (fluid that helps with digestion)…if a person was sick, this meant their was an imbalance.

• Bloodletting, leeches, and forced vomiting were all means for purging the body of impure fluids.

• Example: George Washington was bled and eventually, he died from a loss of blood.

Health Defined: History of Health Care

• Four Different Schools of Thought arose in contrast to the orthodox medical science in the 1800s.

• Hydropaths: believed that the body could be cleansed internally and externally by the use of water, natural foods, good hygiene, and exercise.

• Osteopaths: believed that manipulation of the skeleton would improve health…used baths, massage, and surgery to correct problems in patients…similar to chiropractic therapy today.

• Christian Scientists: believed that all illness was an illusion of the mind and did not really exist…sickness was a spiritual matter and a person could heal oneself by healing the mind.

• Homeopaths: believed orthodox medical practices overmedicated and overtreated people, making them even more ill…insisted that the key to healing could be found in prevention and treatment with small does of medicine that supported the bodies ability to heal itself…still exists today.

Health Defined: History of Health Care

• Evolution of the Hospital:

• Almshouses (places for the poor) were the first hospitals in the colonies.

• The first true hospital for the sick was created in Philadelphia in 1752, built from voluntary donations.

• Most people continued to prefer to be treated at home and hospitals were generally used by those who had no families or were homeless and poor.

• After the conclusion of the Civil War, there was an increase in the number of hospitals being built and as medical training included hospital rotations, hospitals and medical doctors became more important.

Social Epidemiology

• An individual’s health is often connected to their social status.

• Social Epidemiology: focuses on the distribution of diseases and health throughout a population and assesses the social problems that occur.

• How does gender affect childhood illness?

• Do social classes differ in rates of depression?

• The goal is to find links between certain social factors and physical and mental well-being.

Age and Health

• In the United States, death is rare among the young.

• Less than 7 infants die per 1,000 births and the average American can expect to live well into his/her mid-70’s.

• In Nigeria, only 1 of every 3 children will live to be a year old and the average adult lifespan is only 48 years.

• With the improved life expectancy and longevity in the U.S, elderly people face a wide variety of health problems that were not as prevalent in the past.

• Chronic conditions such as arthritis, diabetes, heart and lung disease, and mental illness plague the elderly.

• These conditions limit activity, making work, socialization, and exercise difficult for seniors to pursue.

Age and Health

• Childhood Obesity

• The United States is witnessing a rise in childhood obesity because children are consuming energy-dense foods and drinks combined with a lack of energy expenditure.

• Children and adolescents between 2-19 years old:

• The prevalence of obesity was 18.5% and affected about 13.7 million children and adolescents.

• Obesity prevalence was 13.9% among 2- to 5-year olds, 18.4% among 6- to 11-year olds, and 20.6% among 12- to 19-year olds.

• 25.8% of Hispanics and 22% of African American children suffer from obesity

• 11% of Asian American and 14.1% of Whites suffer from obesity.

• The more educated a parent/guardian is, the less likely a child is to suffer from obesity.

• Children with the lowest socioeconomic standing have an obesity prevalence of 18.9%, middle income children have an obesity prevalence of 19.9%, and the highest income children have an obesity prevalence of 10.9%.

Gender and Health

• The life expectancy for women in the U.S is 80.4 years old and the life expectancy for men is 75.2 years old.

• According to sociologists, men may live shorter lives because they may be more inclined to take risks, abuse alcohol, drive aggressively, and perform a host of other behaviors that can lead to their early deaths.

• Men are also more likely to accept dangerous work and make up a greater portion of the armed forces during wartime.

• Women are generally more concerned with preventive maintenance of their health than men are.

• Women are twice more likely to get regular medical checkups, decreasing the possibility of life-threatening illnesses and health problems.

• Women are also more likely to discuss personal health issues with their doctors.

Social Class and Health

• Social class has a major effect on health in the U.S.

• The quality of health care is often connected to one’s ability to pay for it.

• The lack of access continues to be a serious social problem for the poor.

• There are programs designed to help increase access to health care but many are poorly funded.

• Higher social class means greater access to health care, and having more money allows for more basic needs to be met.

• Lower socioeconomic status leads to a lower likelihood of access to health care and poorer standard of life.

• Studies show that the higher one’s socioeconomic status, the more likely a person is to live longer, healthier, and happier.

Social Class and Health

• People who live in poor neighborhoods generally have less access to health care.

• Neighborhoods that house poor, unemployed, uneducated and single parent households adversely affect the health of people living there.

• Pollution and unsanitary conditions cause major health issues.

• For example, minority children living in the Bronx and Upper Manhattan suffer from a high rate of chronic health problems such as asthma due to living in an area with a high rate of air pollution.

Race and Health

• The average life expectancy for Whites is 78.3 years while the average life expectance for an African American is 73.2 years.

• Infant mortality rates are higher in minority communities.

• Access to quality health care varies between communities that are White and those that are a majority minority.