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Western University
Health Sciences
Health Sciences 2000A/B
Leichelle Little

What Is Health?  When Is Health Unhealthy? Disagreements about the meaning of health are common because health can have medical, social, economic, spiritual, and many other components Learning Objectives Apply the four models of Health to a real life example Compare the different models: including benefits and limitations to each Recognize the fundamental objective of the World Health Organization, and how it relates to the individual and society Evaluate key components of health involved with the four models Theorize how different perceptions of health and wellness are influenced by technology Explore the importance of defining health on an individual level and community level Complete Obsession Apotemnophilia – An attraction to the idea of being an amputee Zenomelia – The oppressive feeling that one or more limbs of one’s body do not belong to one’s self Large number of people interested: One discussion group has 1400 subscribers Robert Smith, a surgeon at Falkirk and District Royal Infirmary, in Scotland had amputated the legs of two patients at their request, and he was planning to carry out a third amputation when the trust that runs his hospital stopped him. These patients were not physically sick. Their legs did not need to be amputated for any medical reason. Nor were they incompetent, according to the psychiatrists who examined them. They simply wanted to have their legs cut off. In fact, both the men whose limbs Smith amputated have declared in public interviews how much happier they are Medical Model Definition of Health – Absence of disease or disability Treatment – The body as a machine, to be fixed when broken: restore balance Research – Medical research currently is centered around the medical model (although the newer definitions of health are exerting an influence) Benefits Highly productive in the advancement of the medical sciences and health (Wood 1986) Objective view: easily measured Limitations De-emphasizes prevention Difficulty of adapting it to emotional and psychiatric disorders Disease is more than biological, as social and economic factors must be taken into account WHO Created on 7 April 1948 by the member states of the United Nations Fundamental objective of “the attainment by all peoples of the highest possible level of health” Challenged political, academic, community, and professional organizations devoted to improving or preserving health to be accountable for their work WHO Model Definition of Health – Astate of complete physical, mental and social well-being and not merely the absence of disease or infirmity (United Nations 1984) Prevention – Preventative care is widely practiced, with routine physicals and vaccinations Research – Used in important health studies – more emphasis on the connection between physical and mental health Social Health Individuals as social beings whose health is affected by social behaviour and interaction Alameda County study – First study to look at nature and extent of social networks (marriage, close friends, relatives, etc.) Found that social networks have broad health consequences Collective – Social networks (Berkman & Breslow 1983) Individual – Social participation in activities and interpersonal interactions (Ware 1981) Who Model Benefits Asomewhat comprehensive definition of health Developed more practical norm for mental and social health Limitations Social factors: Independent dimensions of health? (Newhouse & HIEG, 1993; Ware et al. 1981) No consensus on the meaning of well-being in the definition (Bice 1976) Ultimate goal more than a guideline for concrete action Difficult to measure health in a sense that would satisfy usual scientific criteria (Breslow 1972) Wellness Model Definition of Health – Health is greatly influenced by personal feelings – energy, comfort, and the ability to perform (Greer 1986); linkage between mind and body Treatment The wellness model recognizes that very large numbers of diseases are healed by the body itself (Dubos 1979) Health promotion and disease prevention are key elements: Helping oneself in the process, or recovery is slowed Research – Focusing on not only on the whole person but also on promoting the positive aspects of health Benefits The wellness model recognizes the important linkage between mind and body that the practicing physicians may overlook Health promotion and responsibility for ones own health Limitations Numerous difficulties in measuring subjective perceptions Perceptions of wellness vary according to age and cultural context Wellness may expand health into a too broad definition for measurement Happiness and Health Aperson may be perfectly healthy by the medical model but be unhappy and have a low quality of life according to the wellness model Is it our right to be happy or healthy or both? Environmental Model Definition of Health Dynamic equilibrium with the environment and capacity to live physically, mentally, and socially (Breslow 1989) Organism works with its environment successfully and is able to grow, function, and thrive (Abanobi 1986) Treatment and Prevention Self-care and medical care designed to re-establish health balance (Noack, 1987) Prevent imbalance from occurring in the first place through health promotion Research Improvements in physical well-being could include more extensive controlling for the effects of the environment Benefits Emphasis on health promotion requiring supportive environments (Speller, Learmonth, and Harrison 1997) Limitations Measurement problems exist because conceptual definitions are so broad Summary – Models for Defining Health Medical Model World Health Organization (WHO) Model State of complete physical, mental, and social well-being and not merely the absence of disease or infirmity Wellness Model Health promotion and progress toward higher functioning, energy, comfort, and integration of mind, body, and spirit Environmental Model Adaptation to physical and social surroundings – a balance free from undue pain, discomfort, or disability Future Goals How Health is Defined Impact on how a nation allocates its resources Helps to outline how to measure health outcomes and quality of care Will new concepts of health lead to new methods of measurement which may eventually be useful in overcoming disease and advancing health? Millennium Goals September 2001, United Nations (UN) presented the Millennium Development Goals (MDGs) as a list of common goals for the world community to achieve by 2015 Examples: Reduce child mortality, eradicate extreme poverty/hunger Problems With Millennium Goals? May not be achieved by 2015, as was initially envisioned and are unlikely to be met in the next two decades Should we lower or readjust our expectations? Is the concept of health a deception? Is it even possible to reach a basic level of agreement on the meaning of the world health? Results from Study Individuals answered the question based on WHO definition Would this be different if there was a different definition attached? Should there be a definition attached? Why is this important in research? Perception of Health Although it is a measure of perceived rather than actual health, research has shown that self-assessed health status is a predictor of mortality and morbidity (Gerdtham et al 1999; McCallum et al 1994) There are even data to suggest that perception of poor health is a stronger determinant of mortality than physician assessment of risk (Huppert & Whittington 1995; Benyamini et al 1999; Idler et al 1999) Health care workers: Important to determine how the patient defines good health. In order to help them comply with their treatment plan, we need to know how the patient views what we are doing for them Measuring and Monitoring Is health a construct that can be defined and measured? Can any definition of health be operational? Alameda Study: Although study emphasizes “health” through the WHO definition, most of the analyses reported focus on mortality as the primary criterion index, with this being viewed as one end point in the health continuum (Glenn 1983) The advocates of the medical model view attempts to conceptualize well-being as a departure from objective measures into subjective and short-term indicators As mortality has declined, the scope of the public and private health services has increased and new objectives have been established. The economic and social consequences of illness receive more attention than formerly in evaluating levels of health and the importance of health problems. The chronic diseases have become relatively more important. Their consequences include not only death but reduced productivity, prolonged disability and the need for care These considerations suggested that a more sensitive and informative measure of levels of health might be obtained with an index based on the health characteristics of the living as well as mortality Social Media AHealth and Lifestyle article posted by Time Magazine researched the effectiveness of “health” apps, discovering less than half of the apps available, “directly related to patient health and treatment, meaning that they provided some type of advice and treatment guidance. The rest are spewing forth data that neither doctors nor consumers can use to improve their well being.” Without any guidelines to help you move forward, no improvement is seen in health; technology enables you to stay stagnant in your current state. The article also brings up crucial points explaining why technology aimed at health and fitness products are more for entertainment purposes Healthy Hearing Types of Hearing Loss Congenital (Onset) Conductive (Type) Sensorineural (Type) Progressive (Onset) Symdromic (Type) Non-syndromic (Type) Congenital Hearing Loss Prevalence – 1.1 per 1000 live births Screening brief – Screening infants for congenital deafness Progressive Hearing Loss 5.3% of world’s population with some form of hearing loss 33% of people aged 65 and older have some form of hearing loss Conductive vs. Sensorineural Conductive hearing loss happens anywhere from the pinna to the stapes Healthy Hearing Syndromic vs. Non-Syndromic Example: Alport Syndrome Some symptoms include: Abnormal urine colour Ankle, feet, and leg swelling Decreased or loss of vision Loss of hearing Central Auditory Processing Disorder Normal Hearing Thresholds Difficulty processing sound Affects approximately 5% of school-aged children Hearing “loss” vs. Hearing “impairment” Healthy Hearing Causes of Hearing Loss Noise Aging (prebycusis) Congenital conditions Prenatal conditions, such as fetal alcohol syndrome or conflicting Parental blood types Heredity Disease Repeated ear infections Wax build-up Trauma to the head or hears Tumours (acoustic neuromas) Auto-immune conditions Chemical/toxic damage to the ear (ototoxicity) Abnormalities of the tiny bones of the ears Estimated – Over 50% of HL is due to genetic factors Heredity Hearing Loss Genotype + Environment = Phenotype Heredity Hearing Loss – Noise Induced Hearing Loss Genetic Mutation + Noisy Environment = Hearing Loss How Does Noise Damage Hearing? Healthy Hearing Example of anAudiogram Healthy Hearing Hearing Health Programs Sound Sense Targeted to Grade 4 students Teaches Fundamentals of hearing/types of hearing loss Science behind NIHL Prevention Tips for Conversing with Someone with Hearing Loss Gain attention Maintain eye contact Keep hands away from face Speak naturally Rephrase rather than repeat Healthy Hearing Converse away from background noise 3dB Rule Every 3dB increase – Safe listening time cut in half Interesting Facts Hearing Loss – 360 million persons Vi
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