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HLTH 101

Lecture 1Saturday October 01 2005220 PM Lecture 1The Public Health Model Working DefinitionsHealthoDefinition state of complete physical mental and social wellbeingoThis is an idealistic goal which can never really be reachedoSometimes this definition can be used in politics to maintain the status quo because radical decisions can be criticized on the basis of the effect they would have on the current state of health in the countryIllnessoDefinition unwanted condition in ones person or self body mind soul or connection to the worldoNote that this is subjective because one person could want the same thing which is unwanted by another personthus a value judgment subjective assignment of value is involved hereDiseaseoDefinition a fall or lowering of an individuals ability to functionoIt is now somewhat more objective although subjectivity remains because ability to function may differ by time and place for example homosexuality is accepted now but before it used to be considered as a psychological disorderoDiseases can be classified based onAnatomy what part of the body does it affectPhysiologybiochemistry ie the flu is characterized by increased mucus secretion in the upper airwaysso this is a physiological thingalsodiabetes is characterized by altered physiology and biochemistryHistopathology the study of microscopic anatomical changes in diseased tissueie hepatitis is a disease which is characterized by pronounced changes in the livers tissue structureEtiology it means the originsourcecausative agent of the diseasethus we can classify diseases by saying bacterial disease or viral disease etcoInfectious Diseases the 3 Main CriteriaWhat is the disease agentwith infectious diseases these are mostly microbialWhat is the host the individual organism in which the infectious agent lives and produces the disease stateWhat is the environment where these interactions are allowed to occurWhere do conditions exist which allow the disease to occurImportantwith only a few exceptions the environment always plays a large roleEither social or physicalThus the biological processes are necessary but not sufficient for infectious diseases to occur Paradigms of Health and DiseaseBiomedical ModeloCharacteristics of the biomedical modelMechanisticwe seek to discover how it workswhat the mechanisms of it areReductionisticwe break down the processes into their simplest observable partsPositivist orientationwe form hypotheses which are testableBiopsychosocial ModeloCharacteristics of the biopsychosocial modelIt is broader than the biomedical model because it includes social and behavioral determinants which affect healthIt incorporates positivist and normative perspectivesIt is patientcentered rather than populationcentered hence the psycho part of the modelSocialecological ModeloCharacteristics of the socialecological model We believe that a persons health results from his interaction with theenvironmentWe look at his relationships on a micro level individual meso level community and macro level societyWe focus on things which result in dysfunction in these relationshipsalthough sometimes we cant do anything about it because the factors are so largePublic Health ModeloCharacteristics of the public health modelThese are societal efforts to protect promote and restore peoples healthMuch of the efforts are analytical and organizationalwe want to identify health problems in the population and how to improve prevent and control themNote that this can be controversial because people disagree on what constitutes healthso we are not free of value judgments History of Public HealthFactors which shaped modern public health systemsoIncrease in scientific knowledge of sources and means of controlling diseaseoPublic acceptance of disease control as a possibility and responsibilityHistorical contextoEarly 19th Century Sanitary awakeningWe started to care about public water and sewage control especially in urban settings such as Toronto and LondonoMid to Late 19th Century Age of Bacteriology and Kochs PostulatesBacteriology is the study of bacteria and how infectious diseases are causedit was founded by Robert KochKoch formulated hypotheses for determining whether a parasite was the cause of some diseaseThe organism must be found in all animals suffering from the disease but not in healthy animalsThe organism must be isolated from a diseased animal and grown in pure cultureThe cultured organism should cause disease when introduced into a healthy animalThe organism must be reisolated from the experimentally infected animaloEarly 20th Century Personal hygienesanitationoMid 20th Century Expansion of role of government in personal healthoLate 20th Century Crises in care and health care financingPublic health programs were starting to struggle because they werent being given enough funding Missions and Content of Public HealthAssessmentoThis involves surveillance of a population to identify disease patternswe look forFrequencyGeographical dataAnd so onPolicy development and planningoWe need to identify goals and make decisionsAssuranceoHere we are discussing the implications of the policies we put in placeie kids cannot buy cigarettes restaurants are subject to healthsafety inspectors etc
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