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Chapter 1-3

HLTH 101 Chapter Notes - Chapter 1-3: Fetus, Numeracy, Neuroplasticity


Department
Health Studies
Course Code
HLTH 101
Professor
Elaine Power
Chapter
1-3

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Social Determinants of Health Textbook
How We Understand Threats to Our Health
-Some succumb to disease, disability, and death where others remain healthy and vital much
longer due to an individuals genes and personality or choice
-Some threats to health are behavioural and examples that increase our risk of bad health
outcomes are smoking or riding a bike with no helmet
-Other risks are environmental and those include air pollution, food contamination and
airborne pathogens
-Health behaviours can be changed through education, persuasion and treatment regimes
-Environmental risks can be changed through public health intervention
-Our genes determine our level of susceptibility in the face of various threats (ie. Breast cancer)
-Risk factors may be health behaviours or environmental factors
Pgs. 256-260- Models of Health
Health in biomedical understanding is the absence of disease, whereas ill health arises
from interaction of host characteristics of age, sex, genes with environmental variables
and health behaviours
The behavioural model shifts attention to lifestyle understood as choices the individual
makes
Health in the behavioural model is functionality, choosing more exercise than less and
better foods over worse etc.
The behavioural model constructs health relevant behaviour as chosen by the individual
These two individual level models are approaches to improving health through health
care services, health education and efforts to modify health-relevant behaviour through
incentives, regulation and so on
Good or bad health arises from the interaction among determinants that one has over the
other
A multi level approach has important implication, it has policy and political implications
The biomedical approach calls for reducing the incidence of diabetes by placing people on
blood sugar medication and instructing people to change dietary choices away from bad
foods to good foods
The behavioural approach calls for strategies to incentivize physical exercise and high
energy foods, the two approaches are compatible with each other
Ideology: a system of beliefs and values that justifies a particular outlook and approach to
social and political issues
Risk Factors: Variables that contribute to the probability of an adverse health outcome
Biomedical thinking is heavily conditioned by the marketplace in health care
Billions are at stake with the sale of compounds that purport to modify risk factors and
health outcomes
In united states the health care market is less regulated than in Canada, Britain and
Australia
Behavioural thinking aligns strongly with liberal ideology which aligns with the nature of
the market economics of the Anglo-American world
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Liberal societies led by US emphasize liberty above all else and characterize individuals
who are not compelled to do something as at liberty to choose whatever is in their best
interests, key defence for having a less regulated market in goods, services and labour
The Anglo-American world is characterized by faith in free markets, suspicion of
governments, low taxes and a low level of public services and there is a rise of
consumerism and neo-liberalism
Neo-liberalism: An ideology that emerged in the 1970's and 1980's that holds
governments should minimize tax and regulatory burden on individual's and corporations,
reduce public services in favour of for-profit corporate services, and promote economic
growth through encouraging trade and consumerism
Solidarity: A perceived community of interest that gives rise to the sense that one's own
social position, success or failure is linked to that of others in ones society
Europe embraces a solidarity principle
Liberal, individualist market driven societies (especially ones dominates by health care
corporations) will be hostile to collective models of health, whereas more solidartisitc
societies will be scared by the fact that health arises from personal and individual effort
Health is ultimately a personal responsibility!!
Chapter 1: Thinking about Individual and Population Health
OBJECTIVES
Distinguish between individual and population levels of analysis
Understand how a shift to a population- level of analysis changes our perspectives on
o Treating people for disease
o Modifying individual behaviour
o Preventing bad health outcomes through screening and early intervention
o Evaluating health programs and services
Appreciate how broader features of society such as its level of affluence affect the
population
Level of Analysis
When talking about being healthy we need to specify discourse
Individual level healthy might focus on regular exercise, or chosen diet, regular use
seatbelts in a car and bike helmets
Population level -> healthy -> effective regulation ensuring safety of food and water,
effective public services and environmental protection
Relevant health factors of an individual include age, sex, genetic inheritance and risk
factors from behaviour and the environment
Individual Level Analysis of Health and Disease
Individual-level model of health and disease often referred to as risk factor model:
2 variants:
o Biomedical variant which focuses on interactions host and agent
o Behavioural variant which emphasizes health behaviour (lifestyle factors)
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Risk factors -> individual characteristics
Behavioural -> dietary choices, activity level, use of alcohol and drugs
Social factors -> support from others, incomes, stress
Host Characteristics: Age
Age is used as a signifier of how healthy a person is and how much longer they live
Age isn't a precise predictor of health because....
o Substantial variation in health, resistance, susceptibility
o Variability in potential for healthy living
o Differences in health and life expectancy at different ages in different populations
Depends on the life they led, their lifetime exposures and current health
Host Characteristic: Sex
Sex is a significant determinant of health and life expectancy
Sex isn't precise predictor of health because....
o People have blends of male and female hormones
Two females will differ as much in health as male and female
o Second, sex is confounded with gender-> the social expectations placed on a person
and the roles that person adopts
Men take more risks -> more behavioural based
Gender is partly sexually determined, structured and supported by physiological and
hormonal differences
Physiological and hormonal differences
Vitally important to recognize the interaction between sex and gender -> risk factors with
sex, behavioural with gender
Host Characteristics: Genetics
Genetic knowledge will inform us of who needs treatment
Individuals will tell us their precise susceptibilities as well as how the individual biological
mechanism
The study of gene expression comprises the rapidly growing field of epigenetics -> tells us
that the correct answer to the "nature vs nurture" argument is "neither"
Genes nor environment decisively determines how healthy we are
Biological entities adapt to the conditions in which they find themselves
o Ex. Genes for tallness -> person may not become tall if under lots of stress, opposed
to a person with some gene eating healthy, under little stress
o Environmental and social conditions modify genetic expression, in which genes are
active and how active each is
So many other factors besides potential genetic variability
Behaviours Portrayed as Individual Risk Factors
Health relevant actions are largely chosen
Behaviour is a straight forward function of individual choice
Behaviour is largely context dependent -> rarely see implications
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find more resources at oneclass.com
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