HLTB03 All Lecture Notes

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Health Studies
Dan Silver

HLTB03 EXAM REVIEW: Lecture 1: Introduction Structural Functionalism  framework for building theory that sees society as a complex system, parts work together to promote solidarity and stability. Looks at society through a macro-level orientation, which is a broad focus on the social structures that shape society as a whole, and believes that society has evolved like organisms Conflict Theory  perspectives in sociology that emphasize the social, political, or material inequality of a social group, that critique the broad socio-political system, or that otherwise detract from structural functionalism and ideological conservativism. Conflict theories draw attention to power differentials, such as class conflict, and generally contrast historically dominant ideologies. It is therefore a macro level analysis of society. Symbolic Interactionist/Interpretive Theory  focuses on the analysis of the patterns of communication, interpretation and adjustment between individuals. The theory is a framework for understanding how individuals interact with each other and within society through the meanings of symbols. Feminist/Anti-Racist/Intersectionality Theory  collection of movements and ideologies aimed at defining, establishing, and defending equal political, economic, and social rights Lecture 2: Women’s and Men’s Health Facts about the body that differ by gender… • On average women say 7,000 words per day. Men say over 2,000 on average. • Women burn fat more slowly than men, by a rate of about 50 calories a day. • Women's hearts beat faster than men's. Women’s Health Smoking  Smoking rates among men tend to be 10 times higher than women.  However, women generally have less success in quitting the habit, have more relapses than men, and nicotine replacement therapy may be less effective among women.  Increase in young people smoking  Men more likely to leave the house and engage with others and smoke  Women have a harder time quitting HIV  Of all adults living with HIV in sub-Saharan Africa, 61% are women  In the Caribbean, the proportion of women living with the virus is 43%  Though lower, the numbers of women living with HIV in Latin America, Asia and Eastern Europe are also growing.  Easier for a women to contract from a man, from both physiological and statistical perspective Abuse • Between 15% and 71% of women around the world have suffered physical or sexual violence committed by an intimate male partner at some point in their lives • As many as 1 in 5 women reports being sexually abused before the age of 15 Environmental Exposure • In most countries women tend to be in charge of cooking o When they cook over open fires or traditional stoves, they breathe in a mix of hundreds of pollutants on a daily basis. 1 o During pregnancy, exposure of the developing embryo to such harmful pollutants may cause low birth weight or even stillbirth. Health Care • Across the world and at all ages, women have a significantly higher risk of becoming visually impaired than men • Many women do not have equal access to health care to treat eye diseases often due to o their inability to travel unaccompanied to health facilities, and o cultural differences in the perceived value of surgery or treatment for women Obesity Risk Factors: Consequences: • Physical Inactivity • Type 2 Diabetes • Diet • Psychological Issues • Socioeconomic factors • High Blood Pressure • Heredity • Osteoarthritis • Some cancers and Gallbladder disease • Limited Life Expectancy • Limited Quality of Life Pregnancy • Women who graduate university tend to be older at the birth of their 1 child • Risk factor: downs syndrome Benefits of Breast Feeding  Baby • Protective factor to gastrointestinal infections • Prevents respiratory illnesses • Decreases in SIDS (sudden infant death syndrome) • Higher IQs Controversy with all of those studies  Mother • Decreased risk of pre menopausal breast cancer and ovarian cancer • Less likely to have factures if they develop osteoporosis • Helps the uterus to contract • Convenient Women Get Sicker  More older women than men are afflicted by Alzheimer’s disease, osteoporosis & arthritis  Women experience more minor health conditions compared to men  Women are more likely to visit the doctor Men Die Quicker • Premature girls more likely to survive than boys • Women develop cardiovascular disease about 10 years later than men • WHY? • Testosterone surge – manifests riskier, more aggressive behaviours • Mens bodies are bigger – more that could possibly go wrong • Jobs and habits – i.e. war, alcohol, cigarettes Gender Affects Health 2  Cardiovascular disease tends to appear about 10 years later in women than in men  Cardiovascular disease manifests itself different in women than in men  Smoking among teenaged girls now exceeds smoking rates among teenaged boys  The death rate from suicide is at least four times higher for men than it is for women  However, women are hospitalized for attempted suicide at about one and a half times the rate of men  For Aboriginal women, the rate of diabetes is five times higher than it is for all other women in Canada; for Aboriginal men, the rate is three times higher Major Diseases/Illnesses that Target Women • Cardiovascular diseases are 8 times more likely to kill women than much-feared and much-publicized breast cancer • Lung cancer has recently surpassed breast cancer as the leading cause of death due to cancer in women • 1 in 9 women will be diagnosed w breast cancer in the course of her life • The incidence of breast cancer has risen steadily over the last decade • Mortality rates have declined • Cervical Cancer • Incidence rates rise sharply round 40 years of age • est.,. Predict that up to 90% of cervical cancer could be prevented by regular Pap Smear testing • Human papillomavirus (HPV) has recently been identified as being responsible for the large minority of cervical cancer Canadian Women & HIV/AIDS  12.1% of positive HIV test reports among adults  24.8% of AIDS cases among adults  Women represent an increasing proportion of reported HIV cases in Canada  The proportion varies considerably by age and is highest among young women (15- 29 years old)  Aboriginal and Black women have also been identified as vulnerable populations Preventative Measures • Have regular mamograms • Get regular checkups and screenings – Early detection is important for treating breast, cervical, uterine and ovarian cancer – Plan for pregnancies - Nutritional needs – folic acid (3 months before pregnancy) • While you are pregnant see your healthcare provider regularly Men’s Health • Many of the health conditions that affect men can be prevented or treated with early diagnosis Colour Blindness • Approximately 8% of men are colorblind • Approx. 0.5% of women are colorblind Lung Cancer • The leading cause of cancer deaths among men – Mostly due to cigarette smoking Prostrate Cancer • The third most common cause of death from cancer in men of all ages 3 – It is rare, but more deadly, in men younger than 40 Colon Cancer • Cancer of the colon or rectum • Caught early, it is often curable • It is more common in people over 50, and the risk increases with age Heart Disease • There are many different forms of heart disease – The most common cause of heart disease is narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the heart itself • The main ways to prevent heart disease include: – Controlling blood pressure – Lowering cholesterol – Avoiding smoking – Getting enough exercise Unintentional Injury • The leading cause of fatal accidents among men is motor vehicle crashes • Driving to fast, more haphazardly compared to women • No seat belts Suicide • Intentional injury • Men more likely to commit suicide General Trends • Men tend to smoke and drink more than women • They tend not to seek medical help as often as women • Some men define themselves by their work, which can add to stress Preventative Measures • Don't smoke or use other tobacco products. Avoid exposure to secondhand smoke • Eat a healthy diet rich in vegetables, fruits, whole grains, fiber and fish. Cut back on foods high in saturated fat and sodium • If you have high cholesterol or high blood pressure, follow your doctor's treatment recommendations • Include physical activity in your daily routine Preventative Measures – cancer • Don't smoke or use other tobacco products • Avoid exposure to secondhand smoke. • Include physical activity in your daily routine. • Consult your doctor for regular cancer screenings. • Reduce exposure to potential cancer-causing substances (carcinogens), such as radon, asbestos, radiation and air pollution. Preventative Measures – Unintentional Injuries • Wear your seat belt. • Follow the speed limit. • Don't drive under the influence of alcohol or any other substances. • Don't drive while sleepy. Lecture 3: Health Care Systems Desirable Qualities in a Health Care System • Cost containment • Efficiency • Equity • Universality 4 • Comprehensiveness • Responsiveness Ways of Financing • General taxation • Social insurance • Private insurance • Out-of-pocket payment Canadian Health Care System • Canada has a publicly financed system of public health care insurance – Known as “Medicare” – Medical and hospital care – Provides universal coverage – No direct out-of-pocket costs – Publicly administered – Publicly financed but privately run – Non-profit – Single payer  There is not a single Canadian health care insurance system but instead 13 provincial and territorial medical care and hospitalization insurance systems which all receive federal government resources  The Canadian Health Care System has been in constant transition 5 Principles of Medicare – aka criteria to receive funding • Comprehensiveness • Universality • Portability • Accessibility • Public administration Goal • To provide universal coverage for medically necessary health care services • To provide care on the basis of need, rather than the ability to pay Federal Gov • Sets and administers the Canada Health Act • Acts as a focal point for disease prevention and control • Emergency response to infectious diseases • Food safety and nutrition • Regulation of pharmaceuticals, consumer products, pest management • Funding for health research Provincial and Territorial Gov’s • Deliver most of Canada’s health care services • Provide medically necessary hospital and doctor’s services are free of charge • Provide services to workers injured on the job Primary Health Care • Provides direct provision of first-contact health care services Secondary Services • Specialized care may be received at a hospital, long-term care facility, in the home or community The US Health Care System • Health expenditures in the U.S. are the highest among the OECD countries • The majority of health expenditures in the US come from private sources • However, public funding of health expenditures is increasing in the US 5 • Health care facilities are largely owned and operated by the private sector • However, since 2010 provision of health care insurance is largely provided by the government Brazil • 5 most populous country • 1970 – approx 1/3 of the population had piped water in their home – Approx 17% had access to sewage systems – And no one had access to garbage collection • 2010 – over 93% had piped water in the home – 60 were connected to municipal sewage systems – 90% had access to garbage collection • Unified Health System – Established in 1988 – With the passage of the constitution – Federally sponsored and decentralized so states and municipalities administer & provide services – Record vaccinations – Community health workers, family health teams, oral health teams • Unequal care – Urban vs. rural – Race/ethnic issues – 26% of the population has private insurance – The rest have long waiting lists, crowded hospitals & clinics – Public infrastructure is deteriorating – Traditional medicine (African & Portuguese) – Medical tourism resources not used locally Lecture 4: Social Determinants of Health Health Research can be focuses on… • Individual • Community • Health care professionals • Local, national, international levels Social Determinants of Health  The explanations of the inequality–health relationship described above are, collectively, referred to as the Social Determinants of Health.  These social determinants affect the health of both the individual and the population.  Key social determinants of health in Canada today are inequality, food security, poverty, education, employment and unemployment, housing, and neighbourhood. Inequality  Inequality in a country is a significant predictor of the health of the population of the country.  Countries with higher degrees of income inequality tend to have poorer health outcomes. Poverty  Those living in poverty are more likely to experience diseases than those in other social classes. 6  Children living in poverty more frequently have learning disabilities, language delays, and anti-social behaviour. Food Security  Food insecurity is defined as not having sufficient money for adequate nutrition.  Food insecurity is estimated to affect over two million Canadians. Employment and Unemployment  Employment (and unemployment) are significant determinants of health and illness.  While simply being employed rather than unemployed provides some benefit, there is more to employment than merely having a job. Housing and Neighborhood  Neighbourhood characteristics, such as the degree of stability and affluence, have a powerful and independent effect on health status and may be more important than individual social and economic status and health behaviours. Lecture 5: Biological Determinants  Environmental hazards in the air, water, and land have increased tremendously over the last century.  Environmental risks are now ubiquitous and growing.  Like other health threats, environmental hazards are unequally distributed. Air Pollution  Air pollutants can lead to a wide variety of illnesses.  Pollutants in the air can have short-term and long-term negative effects on health.  Radon, asbestos, and second-hand smoke are among the most harmful indoor pollutants Water and Land Pollution  Unclean water is responsible for millions of deaths in the developing world.  The overuse of water, namely in the developed world, is also an environmental threat. Food Safety  Food safety has emerged as an important environmental and public health issue in the last two decades, as a result of frequent outbreaks of food-borne diseases.  Food-borne diseases cause approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths per year in the US alone. Occupational Injuries/Illnesses  There were 277,000 workplace injuries or illnesses registered with the Workplace Safety and Insurance Board in 2005.  Workplace injuries or illnesses vary by gender, occupation, and industrial sector.  There are health risks associated with shift work, including cardiovascular disease, hypertension, and gastrointestinal disorders. Additionally, shift work may exacerbate existing health problems.  Almost one-third of employed Canadians work shifts. Public Concern • Silent Spring 1962 – Marine biologist Rachel Carson – Describes the devastating environmental and human health impacts of DDT – DDT: used after WWII to control insect pests Oil Crisis in the 1970s • Real and perceived shortage of petroleum 7 • In October 1973, the members of the Organization of Arab Petroleum Exporting Countries (OPEC) proclaimed an oil embargo in response to the U.S. decision to re- supply the Israeli military; it lasted until March 1974 Chemicals  Chemicals pose major threats to health.  Substances like lead, mercury, polychlorinated biphenyls (PCBs), and nitrates are especially problematic for the most biologically vulnerable around the world, including children, infants, and fetus’. Toxic Body Burden • The bioaccumulation of toxic substances that virtually all human beings have in their bodies • Examples – Pesticide Residue from non-organic fruits and vegetables – Dioxins from waste incinerator or paper mill miles and miles away. • Some toxins remain with us for longer – Arsenic is mostly excreted within 72 hours of exposure. – Chlorinated pesticides, such as DDT, can remain in the body for 50 years. Lecture 6: Child Health Childs Health Around the World  43% of deaths of children under five years old occurred in Africa  Most of these deaths occurred from preventable causes: o AIDS/HIV, o malaria, o respiratory and bacterial infections, o diarrheal diseases o and traffic accidents Pneumonia/Acute Respiratory Infections  Risk Factors - Low birth weight, Malnutrition, Non-breastfed children, Overcrowded conditions  Prevention – Vaccination, Exclusive Breastfeeding  Treatment - Appropriate care by a trained health provider, Antibiotics, Oxygen for severe illness Childhood Diarrhea  Risk Factors - Non-breastfed children, Unsafe drinking water and food, Poor hygiene practices, Malnutrition  Prevention - Exclusive breastfeeding, Safe water and food, Adequate sanitation and hygiene, Measles vaccination  Treatment - Low-osmolarity oral rehydration salts (ORS), Zinc supplements Childhood Obesity in Canada  Obesity rates in children have almost tripled in the last 25 years.  Approximately 26% of Canadian children ages 2-17 years old are currently overweight or obese  Approximately 1/3 of normal weight 20 year olds will become overweight within 8 years  Approximately 1/3 of overweight 20 year olds will become obese within 8 years  Risk Factors o Consume food and drinks that are high in sugar and fat on a regular basis o Are not physically active each day o Eat to help deal with stress or problems 8 o Lack resources or family background that favors healthy eating habits o Genetic disease or hormone disorder such as Prader-Willi syndrome or Cushing's syndrome Theories in Child Development Psychoanalytic Theory • The oldest and most controversial development theory • Sigmund Freud (1856-1939) – Success with hypnosis convinced him some of his patients’ symptoms were psychological rather than physiological – Speculated that the basis of mental illness could be found in early child development • The Conscious Mind – Includes everything that we are aware of – The aspect of our mental processing that we can think and talk about rationally • includes memory, which is not always part of consciousness but can be retrieved easily at any time and brought into our awareness • The Unconscious Mind – A reservoir of feelings, thoughts, urges, and memories that outside of our conscious awareness – Most of the contents of the unconscious are unacceptable or unpleasant, such as feelings of pain, anxiety, or conflict – According to Freud, the unconscious continues to influence our behavior and experience, even though we are unaware of these underlying influences. • 3 Elements of Personality – ID • the only component of personality that
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