Fall 2010: Topic 2 Lecture Notes This includes all the information for the notes in "first principles of health research and practice" including changes in health status, causes of changes in health status and bringing aobut changes in human health status

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Wednesday September 15, 2010
Topic two: First principles of health research and practice
1. Changes in health status
Evidence from history
a. PALEOLITHIC ERA
- 40 000 to 10 000 years ago
- Hunters, gatherers
- Life expectancy of 40
- Cause of death to be under nutrition (from environment change),
injury (trauma), septicaemia (improper wound closure), parasites
from food and water
- Births equalled deaths therefore small growth rate ( each woman
had 6 children, however most died)
b. NEOLITHIC ERA
- Represents beginning of agricultural revolution (growth of food
began)
- Surplus of food (more food available than needed)
- Domesticated animals increased risk of infectious diseases from
microorganisms
- Growth of communities occurred resulted in a spread of infectious
diseases (constant presence of death)
- Slow growth of populations as birth rate is less than death rate in
cities (immigration from country)
c. INDUSTRIAL REVOLUTION
- Increase in urban population
- Post enlightenment rights of man
- Economical, intellectual, political revolutions (affairs of man under
human control)
- Increase in international trade increases exposure to foreign
pathogens
- Improved living condition and nutrition for some
- Birth rate increases
- Attempts to study and control health occurs
Hygiene, infrastructure, proximity, immunization (Jenner
heard of immunizations from immigrants of other countries,
brought the idea to Britain, and got the credit)
- First time separation between mortality rates or upper classes
- By 1800s the population had begun to increase at a rapid rate
- Migration to the city increased for more opportunities and jobs
- Immigration to city offset benefits of the city, there was no increase
in the life expectancy in the city (cities were growing rapidly)
d. THE EPIDEMIOLOGIC TRANSITION AND THE MODERN ERA
- 1840 to 2000: same maximum life expectancy, it hasn’t changed
- There has been 2 changes:
1. mortality rates decreased
Approach the ideal “Rectangle”
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Increase in the average life expectancy
Decrease in mortality in all ages, especially
infant and child mortality rates
2. Change in the nature of diseases
1840: infectious diseases contributed to the
greatest proportion of deaths
These include tuberculosis, diphtheria, cholera,
puerperal sepsis
The onset of infectious diseases can occur at
any age (point onset disease: occur at any
point)
2000: chronic diseases contribute to the
greatest proportion of deaths
These include CVD, cancer, diabetes, arthritis,
emphysema, cirrhosis
These are late onset disease; usually occur after
the age of 50 (“lifestyle” diseases: occurs slowly
over a period of time)
2. Causes of changes in health status
Changes have occurred in the past 160 years due to the decrease in
infectious disease rates
This may have occurred due to...
a. SOCIOLOGICAL DEVELOPMENT
- In the 1800’s, there was an increase in activism
Therefore, working conditions improved
Labour laws increased which improved overall health
Increased education
These reduced inequality
- How does socio-economical status affect health?
Increase nutrition, increase in public health
b. IMPROVED NUTRITION
- Malnourishment increases mortality rate from a disease
- Measles, diarrhea, tuberculosis
- Irish potato famine led to great increase in typhus and dysentery
rates from malnutrition
c. ADVANCES IN PUBLIC HEALTH
1. Improved sanitation
- “the germ theory of disease” put a scientific basis behind the need
for proper sanitation
- Hospitals had a huge impact with their use of antiseptics
Increase in maternity post-op survival
Increase in infant survival
- There was pressure on the government to make certain changes
Water supply needs to be separate from sewage (Cholera)
2. Legislation improved public health
- Government legislated to increase the control over sanitation
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Document Summary

Topic two: first principles of health research and practice. Wednesday september 15, 2010: changes in health status. Cause of death to be under nutrition (from environment change), Life expectancy of 40 injury (trauma), septicaemia (improper wound closure), parasites from food and water. Births equalled deaths therefore small growth rate ( each woman had 6 children, however most died: neolithic era. Represents beginning of agricultural revolution (growth of food began) Surplus of food (more food available than needed) Domesticated animals increased risk of infectious diseases from microorganisms. Growth of communities occurred resulted in a spread of infectious diseases (constant presence of death) Slow growth of populations as birth rate is less than death rate in cities (immigration from country: industrial revolution. Economical, intellectual, political revolutions (affairs of man under human control) Increase in international trade increases exposure to foreign pathogens. Attempts to study and control health occurs.

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