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Lecture 6

HLTB21- Lecture 6- Oct 24.docx

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Health Studies
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R Song

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Lecture 6- Oct 24 Anthropogenesis of Disease  Agriculture…and social classes with differential access to resources  Initiating of social classes: people stratified by what they did, relatively wealth in terms of land, or political influence, their social power, reputation. etc.  that stratification is significant because it means now that different people have differential access to resources  Now, everyone tends to have equal access to resources Social Inequality Armelagos et a. 2005: 756  Concept of macro parasitism to understand the changing pattern of inequality: when organisms appropriate others as continuing sources of food and energy, we can characterize that relationship as parasitism  Social stratification within societies and between them is an evolutionary strategy that we consider ‘macroparasitism’ Urbanization Accompanied by disease  Numerous epidemics in Europe from 16 century onward (influenza, plague, tuberculosis, smallpox, measles, cholera)  Intricately tied to undernutrition, SES, hygiene  Population aggregation  Trade (economic dev.) and travel  Heightened inequality Demographic Transition Picture/Graph – How disease changed over time (refer to reading) We can track overtime the major cultural events (Neolithic revolution) and how we can think of people in relation to the cultural events. We see greater inequality, creation of elites-> they don’t really exist for the city We get a more significant divergence in the wealth The elite level of health suddenly keeps increasing-> they have most access to resources (food, health, etc.) Cities: Toronto has more government jobs so they have higher pay than other cities  Elites in cities: Cities allow, much more so than in rural areas, allow elites to gather wealth-> a lot of stuff going on in cities. Cities are trade.  So we DO have a divergence  Cities are able to accumulate wealth  A lot of inequality in Egypt  Pharaoh on top, Vizier, nobles and Priests, Scribes and soldiers, Craftsmen, Slaves The Second Epidemiological Transition Significant decline in infectious disease mortality within developed countries (coinciding with industrialization, mid-19 thcentury, Europe, N. America) 1.Replacement of the common infectious diseases by non-communicable diseases and injuries as the leading causes of death 2.A shift in peak morbidity and mortality from the young to the elderly 3.A change from a situation in which mortality predominates the epidemiological panorama to one in which morbidity is dominant “Diseases of Modernization” CHRONIC Non-Infectious DISEASES Cancer Hypertension
Heart Disease
Diabetes Mellitus
Obesity (adiposity) Affective Disorders (psychosocial) Diet
Activity level Mental stress Behavioural practices Environmental pollution The Third Epidemiological Transition Persistence of Chronic Non-Infectious Diseases, Newly Emergent & Re-Emergent Infectious Disease Infectious diseases notable for 1) many new diseases causing mortality being detected; 2) increased incidence and prevalence of previously controlled (re-emergent) infectious diseases; 3) many re-emergent pathogens evolving into drug-resistant strains The interaction of:
 1) Social change
 2) Demographic change 3) Environmental change 4) Microbial adaptation “Deliberately Emerging Infectious Diseases” Three categories of Risk for Bioterror Agents: A) Six most lethal agents (top priority): anthrax (bioterror weapon -. Could cataastrophicaly kill mills of people; the concentrated anthrax in powder form which makes is much more dangerous than in its natural form), smallpox, plague, tularaemia, viral haemorrhagic fevers, clostridial botulinum toxin B) and C)
Agents that include food-borne and water-borne organisms that incapacitate but usually do not kill Factors in Disease Re-/Emergence Interaction of: 1. Social/Economic/Technological change (human behaviour) 2. Demographic change 3. Ecological/environmental change 4. Microbial adaptation and change 5. Breakdown in public health measures and medical malpractice These are all Anthropogically created. Anthropogenic Factors in Disease (Lebarbenchon et al. 2008)  Biological change within human hosts  Biological change among non-human hosts (domesticated 
and wild): livestock production, encroachment  Medical interventions (hospital ecosystems, nosocomial infections)  Human contact networks (and parasite transmission-> Tires tend to collect water and mosquitos are breeding in those tires. )... dispersal of microparasites (and associated pathogen evolution through inter-specific hybridization)  Environmental changes favouring transmission (new pathogen environments, including artificial, e.g., cooling towers, A/C units, and new habitats, e.g., resale of used tires and mosquitoes...)  Environmental changes hindering transmission, i.e., via chlorinated water, vaccines....though overuse of vaccines can also select for greater virulence  Global climate change and pollution : Anthropogenically created. We have changed environments Not all anthropogenic factors are bad -> some have helped us to create technologies to get rid of diseases Nosocomial infections: any infection you pick up from a healthcare setting -> i.e. Hospital Newly Emerging HIV/AIDS Evolutionary Ecology  Evolutionary ecology: ecology and evolutionary biology  Study of ecology that considers t
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