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GEO 210
Larry Fullerton

GEO 210 FINAL EXAM NOTES QUICK TERMS  Life expectancy: average number of years to live from date of birth  Risk: probability of danger happening  Hazard: built- in danger  Everything we do exposes us. How we do things influences risk  Group fear: sense that large magnitude events happen infrequently  Major problem of perception. Do the facts and statistics line up with perception? MORTALITY & MORBIDITY  Mortality: number of deaths in a given time or place, proportion of deaths to the population, number lost or rate of loss/ failure o First nation mortality rates are almost twice Canadians  Both genders, more so for young adults o Males have higher mortality rates than females  Due to: more men smoke, drink (#’s evening out), females have more doctor visitors  Micromort: on- in- a – million chance of dying  Morbidity: relative incidence of disease, rate of sickness o Specific mortality due to a disease can droop while morbidly increases  Exposure: genetic disposition, behaviours, life (living, working, playing) when (time of day, moth, year, timing with other events)  Large scale map: more detail, local level 1:25,00  Small scale map: more area, less detail 1: 4,500,000  Hazard zones are shown on maps can show average annual loss of disaster pollution POLLUTION  Leads to pneumonia, asthma, cardiovascular/ heart disease, cancer, dementia  Single biggest health risk (more deaths than anything) Perception of fear:  we have perceptions of race, class, gender  link to certain places  we make associations without knowing  when ideas are imposed on us we exaggerated fear  when it’s our own choice, we underestimate fear VIOLANCE BY STATE  causes: terrorism, executions, battle, refugee problems, concentration camps  war kills but illness is also high during war  violence is a common characteristic of all societies at all times  Landmines o Easy to use, cheap, effective o Sometimes designed to injure and not kill to use up resources o 70 countries still have mines, 100 million unexploded o Ottawa treaty to ban landmines (not all have signed) o Will remain in ground forever o Now civilians are trying to clean them with metal detectors  Live in fear, don’t use certain fields and war areas  85% causalities are civilians o Laying mines has decreased since 2003 VIOLENCE AND THE INDIVIDUAL  Canada not in risk for state violence  Gun violence (U.S) o No restrictions on the number of guns with gun permits in US o Us is the number 1 in the world of hun ownership o More gun in US than people nd o 2 amendment- right to bear arms o It’s the attitude that hasn’t gotten rid of guns  Familiarity, religions, feel safer, media & celebrities o Gun ranges in urban areas, largest in Las Vegas o There are higher murder rate in countries with less guns  Highest gun related murders in Mexico o No US federal legislation, registration, not ownership o Highest homicide rate levels of developed world in turkey & US o 60% of all homicides are by firearms CANADA  Reduction of homicide by long guns reduced by firearms registry  High cost for treating gun shot victims  Highest gun violence in Winnipeg, Saskatoon, Edmonton TORONTO  Crime is decreasing, gun violence always jumps around  Very low risk of involvement in gun related incident  8 safest city in the world, 1 in north America  Highest concentration: Keele area, Entertainment district. Moss park, Scarborough o More in working & service class areas o Often purposeful “sacrifice zones”, less voice in government SUICIDE AND GUNS  Greater rate than homicides (greatest rate in US)  Link with higher gun membership  US gun deaths > any death rate reason in Canada TERRORISM  80% of all concentration are in 5 countries  Concentration: Iraq, Pakistan, Afghanistan, Africa, India, Syria  Fewer attacks than fatalities (death toll is decreasing)  In the middle east, attacks have more fatalities  Total fatalities in Us by terrorism by American- Muslims :50 o Yet 200,000 murders by everyone else (guns kill> terrorists)  Tactics: bombing & explosives  Increase in terrorism linked to conflict events o Assassination of Bin Laden, Syria Civil War  Food illness is as bad as terrorism in US  Babies with guns killed more than terrorists  US population fears do not line up with reality CANADA  More likely to be killed by a moose  National crime rate has been decreasing since 1990  We aren’t afraid of terrorists as much as money, health, jobs PERSONAL TRANSPORT  1 vehicle death per 25 seconds globally  Concentrated: India, Africa, Middle east  80% traffic deaths in middle oncome countries (where only 52% of world’s vehicles)  #1 cause of death of young people: car accidents  ½ of fatalities are pedestrians, cyclist, motorcyclist  Only 7% of population have adequate traffic laws  Often not enough training, laws, regulation, registration  Distracted driving o Eating & drinking o Visual, manuals, cognitive distractions o Alberta worst in Canada o Highest with teenagers CANADA  High volume of cars  High fatality rates compared to developed countries  60% of fatalities are pedestrians, rarely cyclist  Seniors & alcohol are main causes TORONTO  Worst Canadian city for accidents  Highest cyclist accidents (Spadina Ave. is the worst)  Highest cyclist accidents with young adults and seniors  Number of incidents increasing but fatalities decreasing  Reasons: design of roads o Most accidents when cars turn right (sight lines) o Where bike lanes end o Intersections where major road meets side road EPIDEMIOLOGY  Epidemiology: study of how often diseases occur in different people/ groups and why  No agreement on oldest disease  Used to manage patients and prevent occurrences TUBERCULOSIS  Bacteria usally attacks lung , can go to spine, kidney, brain, can be often fatal o More people died from TB than war during the same period  Treatment still can take up to 2 years  India and china have the highest incidence  4,100 people die form TB everyday  About 1/3 – ¼ of global population have TB  Most cases are missed until its too late  Need $8 million to treat all per year CANADA  Low incidence and mortality  Aboriginal people have 5times the rate, higher on reserves  90% of people ware resistant, more are women BUBONIC PLAGUE- “THE BLACK DEATH”  Spread through infected rats, transmitted by fleas  China -> middle east -> Europe  First germ warfare in, 1345, threw infected bodies INTO TOWN TO SPREAD PAGUE (there was a YouTube video) o Also had rates on the ships of those who escaped town and were travelling back to Italy, this spread it to Europe  Spread by war trade routes, travel  20 million dead o With such a loss, you have to recreate society (total breakdown of society) o At the beginning they boost faith in Christianity  Lullaby: “ ring around the rosy”  Major eruptions o 6 century o 14 century- biggest, highest population density increased morbidity o 17 th o Total deaths 187 million th  (14 century) Starkdin china- about 90% loss of population of one province, kills 2/3 of china’s population (1334) o In Europe: 20-25 million over 6 years (1/4 population) (1348)  Impacts o Agriculture population dies- no one to harvest -> people dies of starvation o Moral behaviour  With 1/3 of the population gone, sex crimes remained constant therefore more people were doing it  Present o Still carried by fleas or rats, when rat died, fleas move on to new host (pets, us) o Can cure bacteria with antibiotics, but starting to show resistant strains in isolated cases o Mostly in mid-west of US o 2000-2014 highest in 2007 and high in 2014 (cases) (US) o Very low rate of death 1 a year, 7 cases per year (US) o Mid Africa, china, India, Indonesia, south Africa SPANISH FLU  Right after WW1 (linked to war) October – November 1918 (spike )  50,000 Canadians  Possibly brought on Parkinson’s later in life  Brought to Canada by soldiers from war  Origins? *China* in 1917, France (trends in war), Kansas (1918) o Chinese helped in background of war  Worldwide pandemic o Rare genetic shift of influenza virus o Trade routes (japan, France, USA (Boston), Africa  Odd: killed young (not very young)  Probably type of bird flu  Name: high spike in Spain (8 million in may 1918) o Spain was only country that published records, everyone else hid  Killed more than all of WW1  Most devastation epidemic (20 – 100 million globally)  4 years of black death= 1 year of Spanish flu  Oddity: o Usually high morbidity but low mortality (<0.1%) with more victim’s elderly and very young o SF: most chances for 20-29-year old’s o Mortality: 2.5%  Reduced workforce, families without wages, orphaned thousands  Indigenous: 85% death rate  Creation of department of health in 1919 Why so deadly?  1880-1900: different flu circulated among young adults o Gained protection against it  People born between 1880-1900 were around 20 with Spanish flu had no resilience  Might explain seasonal flu mortality  If it happened today-> would still kill 62 million people BUT most victims would be in developing world  When global outbreak happens with bird flu it will be in SE Asia and Africa BIRD FLU H5N1  Virus mutates IN BIRDS TO BE DANGEROUS TO HUMANS  WE CAN ADOPT EVENTUALLY TO H5N1 but it can mutate to something were not used to  Defense: wash hands, cover nose, don’t rub eyes  Infectious diseases always cross national borders o Now: airline traffic (increasing international travel *Canada)  Bird flu o Centered in southeast Asia o SARS started from Vancouver and Toronto airports  Huge spending to control the outbreak  Impact on social and economics states o Airline vulnerability  Spreading of disease depends on original location CHOLERA  “cholera” in polish: swear word  Acute diarrhea (infection of intestine)  Probably originated along Ganges river (India)  Get it by drinking/ using infected ater  Epidemic source is usally the feces of an infected person o Need effective water treatment  Symptoms o 1/20 have severe symptoms (high incidence, low mortality)  Diarrhea, vomiting: loosing body fluid -> dehydration/ shock  Can loose 10% of body weight in hours  Mortality depends on treatment  No treatment -> can die in hours of symptoms o Worse with children (already have low body mass)  Exeter, England 1882 o Major epidemic (2 years long) o Dr. Thomas S… arrived -> mapped deaths to home locations  1854 London (before -> they thought it spread with air) o “the great stink” o Sewage system for rainwater off streets o Horse droppings (1000 tons a day) “mud”  Couldn’t get rid of the horse feces o No indoor plumbing (cesspools)  Would clean & dump in Thames river -> “night soil men” or sell to farmers  Flush toilets created -> would add more water, leak more  Outbreak o 600 people in Soho in 10 days o No cure -> panic o They thought it was the plague from 100 years ago DR. JOHN SNOW  Father of epidemiology  Study of distribution/ determinants of health related states/ events  Plus, application of the study to the control of health problems  He knew he had to find source -> mapped 578 deaths o Locations & quantity  Connected survivors to not drinking the city’s water  Link between all deaths and a certain pump o Taking water from ground with leaking cesspools from houses  Solution: take handle off pump th  19 century: biggest project to sewage system under London o 15 year increase of lifespan between 1880-190’s  Untreated :50% mortality  Type O blood: most susceptible  Type A blood: most resistant Treatment  Aggressive re hydration (intravenously)  Las outbreak 1911(N.A)  Average 1 case a week in US (today)  Highest in Africa and south America o Africa is declining recently o SA was low till outbreak in 2010-2012 o Mexico & Caribbean Haiti after 2010 earthquake  220,000 – 316,000 deaths, 1.5 million had no homes  Still living in tent cities -> no sewage systems  Major outbreak (100 years since last case)  Exact same strain in Nepal (UN peacekeeper from Nepal who didn’t have symptoms started it)  770,000 deaths (could be 3X higher)  Hurricane in 2016 made everything worse (lost all crops living conditions) Toronto- 1832  Linked to outbreak In India in 1817  Came from boat with infected people (600 people)  Animals running wild in streets  Sewage system -> flowing down to front street  Would dump manure in Berkley & King area  “cholera pit” no more room for cemeteries -> threw out bodies o Near St. James Cathedral o 200-2000 (maybe 5000) bodies there  Another outbreak in 1834 (1/10 of population died) Chances  Ontario – 1 case a year o Linked to travel (all cases0  World- 3-5 cases a year o 100,000-120,000 a year AIDS (HIV/AIDS)  HIV is a virus on immune system, destroys blood cells, spreads and allows other problems to destruct  AIDS = extreme stage of HIV, state of symptoms  If you can control HIV you can stop AIDS  HIV treated can live to 70  Cases are still growing  60% in Sub- Saharan Africa (1/20) (worst in south) ( also Russia)  34 million in world living with HIV/ AIDS  25 million died since 1981 *locational & populational  Highest in Blacks, Latinos, Islanders  Perception of problem is declining  68 million infected by 2020 (if rates continue)  Globally: 49% - 51% gender gap -> depends on area o Women up than men in Africa o Men up than women in south America o Men up women in Europe & Asia 2014  38.1 million infected, 25.3 million deaths  2.6 million are children  46% don’t know they have it  2002-2.8 million children in Africa compared to 1000 in North America Effect  Get in from infected blood, semen, breast milk, vaginal fluids  Pregnant women can pass to child  Unprotected sex. Contaminated needles, breast milk, mother- child Symptoms  Rapid weight loss, dry cough, fever, tiredness, diarrhea, memory loss, could develop into AIDS  Greater risk of STD  Opportunistic infections (pneumonia, cancers, age effected) What can be done?  Early diagnosis  Combinations of drugs  AIDS without drugs: 1 year  AIDS with drugs: 5 years  HIV with drugs:70 years  HAART: multi drug treatment o When introduced: deaths down but infections up (people stopped protecting themselves)  Highest in Switzerland Botswana  3 in the world  First to provide free anti- HIV treatment (money’s running out) o Diagnosis rates have leveled off o Deaths have gone down  Drugs are running out  Young people 50% of new cases Canada  Huge passing of HIV through drugs (highest for women)  Huge also with homosexual sex (50%) (highest for men)  Aboriginals (4 times Canadian average)  Every 3 hours  Women have 25% of cases  AIDS dropped after HAART  HIV more prevalent  Highest for white males (by a lot)  Highest for black and indigenous women  Highest for drug use for indigenous  Highest for heterosexual contact for white men  High in Saskatchewan (drug use)  Canadian average = 5%  Higher in Ontario due to male- male sex Population periods  Double bar graph that looks at age and sex  Males on left, females on right  Verticals axis: age grouings ( based on census info)  Horizontal axis: population #’s ( % or #’s) Advantages  Simplicity  Large differences shown easily  Can predict for later years Disadvantages  Small changes go unnoticed  Not useful for volatile area  Cohort: one horizontal line of a group of people  Decrease cohort: could be o Decrease in birth rates o Specific incident killed off certain age groups o One group left (migrated) o Combination  Age & sex: primary factors o Represents different underlying things  Top age used to be >70 now >95-100  Africa could/ should be most populous place in the world o Isn’t due to disease, poverty (AIDS) WEST NILE AND DENGUE lecture 9 Mosquitos climate & disease  Mosquitoes depend on climate o Can easily be mapped West Nile  Only certain types of mosquitoes  Become infected by feeding on infected birds  Can be transmitted to many animals  No evidence of transmitted from person to person  No evidence of transmission directly from birds  First found in 1937 in Uganda o Spread to Egypt, Israel , south Africa, Asia, Europe  First in North America in 1999  First in Canada 2001  Infection tripling in Canada  80% have no symptoms  <1% have serious form that inflamed the brain, fatal Symptoms. Signs  Flu- like, headaches, fever, mild body aches, rash, swollen glands  5% mortality rate  Not treatment  How we deal: reduce # of mosquitoes, reduce chances of being bitten ( do have treatment from horses)  Concentration in Manitoba  Declining since 2003 across Canada Dengue fever & climate  Most important vector- born diseases (10 million die from vector- borne)  Illness transmitted though blood  1000s of million infected a year Aides Aegyptus  Urban oriented mosquitoes prefer humans to animals  Thrives in pools of standing water (only need a tablespoon)  Warm climate + peak periods of rainfall  No effective treatment  First case 1779- Batavia, Indonesia, Cairo  Pandemics in tropical/ subtropical climates  Same virus family as yellow fever  High in equator band across the world  # surged in 1945 -> greater urbanization  1950’s dengue hemophilic fever and dengue shock syndrome o More extensive issues, fatal  Climate change is increasing risk o If projections of climate change are right: 50- 60% will live at risk eventually  Good supportive care can save lives ZIKA  Symptoms 2-7 days  Not in Canada  1/5 people  No treatment  Illness is mild, death is rare  Most affect pregnancy, birth defects  From Uganda in ZIKA forest 1947 MALARIA AND YELLOW FEVER LECTURE 10 Malaria  First: 2,700 BC old  300 million people per year  600,000 to 1000,000 will die (most are preventable)  “malaria responsible for half of all human deaths since stone age”  USA 1941: 4000 deaths o 2000: 5 deaths -> global issue not local India  1897: 1 million people die  Caused by parasite in blood o Didn’t know how it was transmitted  Dr. Ronald Ross found it through observation o People in open had higher risk than people inside o Mosquitoes activity, dissected stomach of mosquito o Mosquito injects infected saliva into victim DDT  Insecticides  First one in 1940’s  Used to combat malaria. Typhus  Also effective in crop & livestock production, homes & gardens  Quickly created a resistance by may pest species  1950’s-60’s : prohibits due to toxic effects & environmental effect  Doesn’t break down easily, kills levels of ecosystem  Rachel Carson-> start of environmental protection agency  Spraying virtually eliminated in North America  Strong link to poverty and climate  Era of suppression: 1960’s- 1970’s o Roared back in 1990’s o Disease adapts and reacts to treatments  One episode will cost 5-20 days of work -> no money o Might strain on heath care system  No reliable vaccine for any parasite  Bacteria adapts quickly to vaccines & cures  Drugs can kill parasites once person is infected o Very expensive  Head to tail if you have it  Poverty o No windows, screen, no protection  90% of malaria deaths are in Africa (children) o `3.2 billion people in high risk areas Yellow fever  Transmitted by same mosquito as malaria and others  Across Africa & North South America o Endemic  Africa 2013: 84,000- 17,000 cases, 29,000- 60,000 deaths  Very strict concentration areas 1) Stage 1: flue symptoms 2) Stage 2w: remission 3) Stage 3: jaundice (not everyone shows it), shock multiple organ failure  Epidemics: high population & high mosquito concentration  Huge outbreak with creating Panama Canal  Most cases are mild, fever, headache, chills, fatigue, vomiting (disappears later)  Small % go deVere, bleeding from mouth, eyes, “black vomit”  There is a vaccine, safe & affordable! Single dose  2006 -> outbreak in Angola, UN 8,000 vaccination teams, but ran out of doses early so started giving fraction of dose to temporarily save them, this is still dangerous for long term.  End of outbreak February 2017 OBESITY & DIABETES BMI  Define by abnormal fat accumulation that may impair health  BMI: sample index of weight – for- height, commonly used to classify overweight & obesity in adults  Weight/ height  BMI _> 25 overweight  BMI _> 30 obese  Trend: population less obese think majority are obese and vice- versa  Rates have doubled since 19080 (65% obese) o 2.1 billion  42 million children (under 5 years old) are overweight/ obese  More obesity in developed countries  Males have higher rates in Canada & west but less in East  On the rise for lower – oncome countries now (especially with children) Reasons  Energy dense foods that are high in fat  Decrease in physical activity (types of jobs, transportation)  Problem: obesity creating financial burdens (direct & indirect) o Health care costs, (employers’ health care companies) o As BMI increase -> # of sick days’ increases  Cardiovascular (heart disease/ stroke)  Diabetes  Muscular skeletal disorders (osteoarthritis, joint disease)  Cancers (breast, colon)  5 leading cause of death globally  Risk factors: up blood pressure, smoking, diet low in fruit, air pollution, diabetes physical inactivity, diet high in sodium, obesity Childhood obesity  Higher chance of adult obesity  Premature death  Adult disability  Breathing difficulties  High risk of fractures  Hypertension  Psychological effects (stressed) Middle income countries  Infectious diseases  Undernutrition  Obesity & overweight ( can occur together poor diet, fat high, nutrient low)  USA: Mississippi -> fattest, better in West, horrible in mid- east  Dress sized have been made smaller although they are larger o Instead of getting people to be smaller  Canada: lowest in BC, Ontario -> average, highest in Newfoundland & Labrador Diabetes  About 8 of every 10 people with type 2 diabetes are overweight/ obese o Link but not sure their underlying relationship  High in US, India (more about diet), China, Germany  30% undiagnosed in USA, north America o 40% in South America Type 1  Accounts for 5- 10 out of 100 people with diabetes  Starts early in life  Immune system destroys cells that release insulin Type 2  Can develop at any time  Rising in children (obesity link?)  Majority of diabetic people  Insulin resistant and then you become deficient  High blood sugar  Leading cause of blindness & kidney failure, heart disease, stoke, amputations  Can be fatal directly or indirectly (diabetes or heart diseases, stroke) Canada  Diagnosis every 3 minutes  30% of Canadian have it (3.4 million) (5 million by 2015)  Costs us $14 billion a year ( in 10 years -> $ 17.5 billion)  Ontario highest province  Increases with age & higher in males  Way higher for indigenous people o Food availability o Health care  Direct costs o Hospitalization, medication o Diabetes or complications  Indirect costs o Death, disabilities o Diabetes & complications ANIMAL HAZARDS  Fear of animals goes way back  Image of cuteness maybe misleading  Wide range of event, locations, type  Risk as wild animals get more comfortable in urban areas and with people Australia (poster child for animal fear)  Animal conditions due to climate  Buffet of unusual animals and plants  BUT more people die in car accidents than from all animals  Overall risk is actually small o Majority in rural areas (outback)  Top risk: jellyfish, salt war crocodiles, octopus, spiders, snakes, great white shark (#9)
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