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Lecture #5- Feb 8.docx

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Health Studies
HLTH 237
Ron Shore

th Lecture #5- February 8 , 2012 The Ecology of Risk- Why Setting Matters - Average opium user was married females - Morphine users had less availability to prescriptions and turned to black market - First steps towards addiction turning to a criminal activity - Focus now on minimizing hospitalized patients o Person-centred care people controlling their own behaviour and health Ecology of Risk - Why setting matters - Ecology= system in which we live; we like to think we are free-standing but we are integrated into everything around us - Afghanistan; growing heroine as a business vs. safe injection sites (downtown city addicts) movie contrasting health and drug policies - Opium are beautiful flowers and have been used 1000s of years for medicinal pain killers o More recent there is a culture of opium smoking o Drug policy problem now - Integrative thinking: addictive potential (drug policy issue) vs. a medicine (health issue) - We are the formation of our cells; synaptic firing of neurochemicals - Our consciousness is part of our physical being Back to Basics - John Snow; working class physician around 1854 o Cholera outbreak o These are ‘his people’ and he wants to solve the problem o Mapped out deaths of which areas were affected  Birth of public policy  How are they contracting the disease- interconnection of geography and medicine  Found that the deaths were very concentrated with a water pump in the middle- causal connection o Social shift at the time; people were moving into the city where the life expectancy was much lower than the country (26 vs. 57)  Inner city Liverpool o Lesson learned  Prevention strategies can be developed without complete knowledge of biological mechanisms  Geography is important  Change is action-oriented What drugs teach us - We are interconnected to each other and our environment - Perceptions and consciousness are susceptible - We need to promote healthy neighbourhoods not just healthy individuals Risk - The quantifiable likelihood of loss or less-than-expected returns - Derived from Arabic word “to seek prosperity”; need to take risks to gain rewards - Largely replaced the idea of fortune and coincided with the rise of merchant sea trade, commerce - Probability of a negative event - Decision marking in conditions of uncertainty The Effects of Adverse Childhood Experiences - Cognitive risks - 17000 middle class Americans enrolled with Kaiser Permanente HMO (all health care is coordinated to you if you can afford it) - ACE study: analyzing the relationship between multiple categories of childhood trauma, and health and behavioural outcomes later in life - Felitti: we overlook short term benefits of drug use o If you have
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