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TOPIC 4.docx

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University of Waterloo
HLTH 101
Glenn Ward

TOPIC 4: USING KNOWLEDGE TO CHANGE HUMAN HEALTH STATUS IMPROVING HUMAN HEALTH  How do we modify and improve human health? o We improve it two general ways: i. We can improve it from a currently poor state (we can make individuals or populations less sick) ii. We can prevent illness and disease from occurring  Either way, we must have an idea of the causes of changes in health before we can implement programs and policies to bring about the desired changes  Recall our 1st principles of health research and practice o We have established that human health status has undergone dramatic changes on at least two occasions: during the transition between the Paleolithic and Neolithic eras, and again during the past 170 years or so o The most recent occasion, the most recent so-called epidemiologic transition, was a major event in that it led to great increases in average life expectancy (if not maximum life expectancy) and dramatically changed the major causes of death  Therefore, if we wish to determine the factors that can bring about major changes in human health status, we can begin by studying the factors believed to be responsible for the most recent major epidemiologic transition  Recall, again, our 1st principles of health research and practice # 3: WE CAN USE KNOWLEDGE TO CHANGE HEALTH STATUS  Now that we have some understanding of the factors underlying the greatest improvement in human health in history, we can begin to understand the justification for the specific approaches used by health scientists to improve human health  In general, we use two broad approaches to improve health, and these are called the basic paradigms i. Basic Paradigms a) Individual Reactive Intervention  In this case, we use our knowledge to react to changes in health of individuals*  The nature of our reaction is to intervene after something is wrong  This paradigm includes biomedical, psychological, and many alternative models of health (those alternative models which are based upon the idea of curing disease)  This approach is very resource-intensive  It is also often not successful, usually because it ignores the broad determinants of health (see the example of the Many Farms experiment, above)  It has had some successes:* o The treatment of traumatic injury o The development of antibiotics o The reduction of morbidity associated with illness (usually be reducing symptoms of disease, if not actually affecting the course of the disease)  Making us feel better  Problems: o Resource-intensive o Often unsuccessful b) Population-Based Approaches  These approaches address prevention of illness and disease at the population level*  Emphasis on prevention  These approaches include health promotion, health education, and public health  Historically, these approaches are believed to have been more successful than the reactive intervention model  Examples of successes include:* o Accident prevention (ex. helmet laws, seatbelt legislation) o Improved nutrition, especially during pregnancy and early life o Preventing epidemics or reducing the scale of an epidemic through infectious disease surveillance  Problems: o multidisciplinary nature (coordination among a lot of people of different disciplines) makes it difficult to carry out o difficult to carry out o greater responsibility (major impact on population if you make a mistake) The Population Health Approach  In Canada, the population health approach has been institutionalized as “official” policy*  This was not accomplished overnight, but developed over the past few decades: 1. 1974: the Lalonde Report, examining the factors that affected the health of Canadians, was released  With this report, the Canadian Government officially recognized that the
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