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Sept 19 - Health Related Issue & Behaviours.pdf

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Western University
Health Sciences
Health Sciences 2801A/B
Terry Biggs

Day 2 - HealthRelated Issue & Behaviours Whatare we tryingto promote & prevent? September-19-11 11:40 AM Importance of healthy heart Avoid medical procedures,complications,side-effects of drug therapies Behaviours/Issues Keeps the rest of the body going The importanceof a healthyheart Tool for activitiesof daily life Overview about: longevity Heart functioning Coronary heart disease How the heart functions Heart health & risky issues & behaviours (obesity, stress, family history, smoking) all interrelated Pumps blood to various parts of the body (4.7L/min Cancer Rupturedor obstructedblood vessels can mean O2 deprivation to body parts, death of body part (necrosis) Heart also requires a blood supply, so if coronaryarteries are blocked, Factors & behaviours related to healthy/unhealthy heart heart tissue can die (myocardialinfraction) Obesity & overweight- physical activity& dietary intake B/c arteries that supply heart w/ blood = coronaryarteries, any problem (implicationsfor heart & more) w/ them is called coronaryheart disease(CHD) or coronaryartery disease Stress Heart disease is the #1 killer. It can be hereditary,caused by rheumatic Smoking fever AND a build up of plaque (cholesterol) Heredity - unchangeable Obesity Who has it? What causes it? What is it? What cures & prevent it? What does it cost? Obesity Obesity used to be considered a sign of wealth & prosperity;now not Most prevalent form of heart disease is CHD - a conditionin which the so rare, & not desirable heart is supplied w/ insufficient blood die to cloggingof coronary arteries World-wide, more than 1 billionadultsoverweight,300 millionobese Canada:50% (11.1 million)adultsoverweight,15% (3.3 million)are obese SES & Gender 1/3 children overweight or obese (starting at 2 yrs!) U.S. Study found: London is the 5th fattest city in Canada. St. Catherines is #1 High SES men MORE likely to be obese than low SES men fattest High SES women LESS likely to be obese than low SES women We are not really that much betterthan the US Inverse b/w men & women Unless effective interventionsto reduce obesity are developed, the Low SES women are 2x MORE likely to be obese than low SES men steady rise in life expectancyobserved in the modern era may soon High SES women are LESS likely to be obese than high SES men come to an end & the youth of todaymay live shorter lives than their Not "just"gender or SES, but the interactionb/w the 2 that really parents. This is the FIRST time in history that the current generationis impacts obesity expected to live a shorter life than the previous generation Its the interactionof SES & gender that makes the impact on health Epidemic in developed & developingcountries Considered the "new tobacco" Socioeconomic variation in obesity in Canadian children The odds of a child being overweight: Affecting all socio-economicgroups, all age groups, both genders...but NOT equally! Decreased 3% w/ each $10,000 higher family income Decreased 4% w/ each additional year of father's education Decreased 11% for each additionalsibling Obesity & minorities When income level is the same, minoritiesare still more likely to be obese than white people, males & females So What? The SES & Obesity relationship... WHY? Excess weight places an extra strain on the heart & increases blood cholesterol& BP Grocery storelocations: Disparity b/w # of major grocery store chains in low SES compared to Blood cholesterol:Producedby the body & also found in foods high SES neighbourhoods of animal origin Body stimulatedto produce chol when we eat foods high Wealthier areas have 3x grocery stores than poorer areas, which tend to have more "mom n' pop" stores (7 11 variety stores; you can get in saturated fats candy & bread & milk) Several kinds of lipoproteins,of which low-density lipoproteins(LDL) (want low) & high-densitylipoproteins Access to healthy foods: Better quality fruits & veggies in high SES stores (even when (HDLs, want them high :D ) are the most importantin CHD considering"same" chain) Blood Pressure:25% of Canadianmen & 18% of Canadian women have high BP High SES areas have stores w/ better variety of healthyfoods Get away w/ it b/c these low SES people don't have any more Largely hereditary options PA & healthydiet recommended for those w/ high BP Medicationoften prescribed Society is setting up certain people to have certain health High BP increases risk for CHD by 2-3x Both high & low SES areas have easy access to fast food chains, BUT high SES also have more delis, sandwich shops, etc = CHOICE Eg. Urban planningstudy Transportation& Pricing: Access to stores w/ better variety, higher qualityhealthy foods easier for higher SES folk Pricingof food consistentlyhigher in low SES areas. (captive HP Units 1 & 2 Page 1 Transportation& Pricing: Access to stores w/ better variety, higher qualityhealthy foods easier for higher SES folk Pricingof food consistentlyhigher in low SES areas. (captive audience?) Exercise: Exercise is highly correlatedw/ educationlevel Lower SES folk have lower educationlevel, exercise less, eat unhealthier foods... Overall, an equationleading to obesity as highly probable for lower SES folk Obesity & Overweight postMAJOR risk: Type 2 diabetes Increased risk of premature death What does it Cost? CHD & CVD Over $1.8 billion(in 1997): Hypertension & stroke Decreased QOL Hospital care Gallbladder disease Some cancers Health care workers' services Drugs What is it? Health research Obesity often identified as BMI >30 Significant portion of ALL HC expenditures Human costs: morbidities(diseases) & mortality,low SE, stigmatism Overweight = BMI 25. Obesity = BMI 30+ From 1985-2000, 57181 deaths in Canada were a result of overweight & BMI is weight in kgs divided by heightin meters squared (typically use nomogram) BMI = kg/(height m ) obesity Doesn't distinguish b/w muscle & fat Highest rates in Eastern Canada Rate of deaths due to overweight & obesity2x from 5.1% to 9.3% in 20-64 yo Canadians in 15 years What factors are contributing to the obesity epidemic? Increased consumptionof soft drinks Larger portionsizes **Although_not the "gold standard"for assessing obesity, BMI is Eating out more inexpensive,
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