HLTC02H3 Lecture Notes - Ecological Study

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22 Mar 2012
HLTC02 Lecture 1
Jan 09, 2012:
Definition of Health. What is Health?
What do you think health is? Not just absence of disease and illness but physical,
mental, emotional state of well-being.
What determines whether women are healthy or sick? Being able to do daily functions,
social support, social status, access to resources, SES
What should women do to support their health?
What should governments do to maintain the health of Canadians in general and
Canadian women in particular?
The view of health that is adopted within a jurisdiction or by an agency will strongly influence the
organization and delivery of health care services and the manner in which health policy is defined
and implemented.
What are the dominant views of health and women’s health?
Biomedical approach: hierarchical as health physician diagnoses the illness or disease and
then recommends treatment for it. Emphasis is on the physical. This is an individualized
health approach and involves medical interventions.
Behavioral (Lifestyle/Public Health) approach: includes physiological risk factors such as
blood pressure, cholesterol levels that could be maintained through prevention or change of
risk behaviors such as alcohol consumption or unhealthy diet. The health physician oversees
the change but this method is not as reliable. Principal strategies include health education,
public health departments, exercise people, no alcohol consumption and publishing in
newspapers such as talking about obesity in the New York Times. How obesity is a risk factor
for Type II diabetes and cardiovascular diseases. Most of the at risk groups are the target
How do the media, government and in other domains define women’s health?
FOUR main concepts of health:
1. Medical (Traditional/Biomedical)-absence of illness
Health concept: biomedical, absence of disease and/or disability
Leading Health problems: defined in terms of disease categories and physiological risk
Principal strategies: surgical interventions, drug and other therapies
Target: high risk individuals
General approach: individualized
Actors: physicians, nurses, allied health professions
2. Behavioral (Lifestyle, Public Health) diet, activity, tobacco and alcohol use, etc- Risk behaviors
Health concept: individualized, health as energy, functional ability, disease-preventing lifestyles
Leading health problems-defined in terms of behavioral risk factors
Principal strategies- health education, social marketing
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Target- high risk groups, children and youth
General approach: individualized elements of societal factors as related to public policy
Actors: public health workers, illness, related advocacy groups, governments
3. Socio-Environmental (Societal)living/material conditions
Health concept: positive state defined in connectedness to one’s family, friends or
community. Population-based, community level at risk
Leading Health Problems: Psychosocial risk factors and socio-environmental risk conditions
Principal strategies: small group development, community development. Social support
provided (e.g to elderly or non-profit agencies for supporting single women). In other words,
making lives easier but may not lead to policy changes. So for those living in poverty, this
approach will not change that as poverty is associated with policy changes.
Target: high risk societal conditions
General approach: focused on organization of communities and society and changes in
Actors: Citizens, social development and welfare organizations,
4. Political Economy (Structural Critical) - organization and distribution of societal resources.
INEQUALITIES affect the health of a population. Roles of the governments and political power in
bringing changes for example occupy movement and attention towards that. Population level. How
can we strengthen it? By maintaining health of population by addressing employment needs and
unemployment benefits (for example EI) by having a broader understanding of health
Health concept: related to equitable distribution of resources within society and the
organization and exercise of political and economic power
Leading Health Problems: Inequity in the distribution and control of economic and social
Principal strategies: political action by organized labor and social democratic political
parties. Political parties and movements establish health supporting public policies and do
not look at it as a problem of the self
Target: influence of the wealthy and powerful
General approach: structural, focused on political and economic organization of society and
political institutions
Actors: political movements and parties
Defining health: The medical definition: the normal physical state i.e the state of being whole and
free from physical and mental disease or pain, so that the parts of the body can carry on their
proper function.
WHO definition of Health: state of complete physical, mental, and social well-being and not merely
the absence of disease and infirmity
Epidemiology and Health issues:
Epidemiology- study of diseases and illnesses in a population. Identify causal effects of single
variables on health outcomes. Focus on observable and measureable (biomedical paradigm).
Quantifiable. Focus on the etiology (cause) of disease or causes/determinants of disease. Looks at
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