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HLTC02H3 (51)

HLTCO2 textbook notes for the entire year

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University of Toronto Scarborough
Health Studies
Toba Bryant

HLTC02 Staying Alive Chapter 1 Intro epidemiology is the study of health and its determinants in specified populations with the goal of improving healthin the past has mainly been concerned with illness gap bw rich and poor may be a key factor in producing health Early Epidemiology John Snow and cholera in london discovered drinking water was the cause by going door to door and counting the deaths and the homes distance from water sources showed that we dont need to understand all the links bw causes and outcomes of disease prob with lack of concern for improving health once the cause of a disease is identified William Farr at the same time as John Snow recognized that poverty was an important associate to poor health Health as a Concept Differs on the Level Being Considered Cellular level all cells need to be nourished properly with glucose and trace elements to functiondoes not mean that we should stuff ourselves full of food and oxygenobesity it is not right to generalize that what is best for our component parts is best for a community of them Individual Level aka community of cells following the dos and donts such as eating right and exercisingetc is good but not necessarily for the indiv cellcells should be healthy as a by product of this Cant generalize from the indiv level to the communitypopulation levelie Japan has the highest smoking rate but are among the healthiest associations of cells as organs and the factors that produce disease are the primary concern for epidemiologiststhey study the incidence and prevelence of disease risk factor behaviour or other charactersitic that is associated with the condition studiedThe Cause of the Cause need to go back to the source of the prob 3 questions what are the factswhat is the interpretation of the factswhat are the presuppositions that frame a discussionPopulation Health Epidemiology John snow used shoe leather epidemiology disease focused approach requires the knowledge of whether or not someone has the disease and the the gathering of supplemental info to find out what is going on kinds of questions asked depends on the charac of the popa narrow focus and short term behaviourial focused interventions are not the most effective which is often the case the focus on the indiv keeps researchers stuck at the indiv level to get valid results you need to compare indiv of the same ses education wealth etc need to control your reasearchfactor out the importance of a variable in the analysisLearning from Health Data on Populations health state of complete physical mental and social well being not merely the absence of diseaselife expectancy the death rates for ppl and their ages in a given year UNDP from the WHO The US is not the healthiest country despite being the most wealthy and powerful Japan is healthier epidemiologists also look for confounders and other explanations Richard Wilkinson showed that the gap bw the rich and poor in a country appears to be correlated with the populations health association DOES NOT mean causation to be causative we need several studies on diff populations by diff investigators at diff times that all showed the same association need a dose response relationship RELATIVE POVERTY IS BAD FOR YOUR HEALTHbeing lower on the ses ladder is bad for you poorer ppl have diff body chemistry and physiology more egalitarian countries have better average health a dollar at the bottom buys more than a dollar at the top you get sick if you are poor not the other way around there is also biological plausability for diseases it is difficult to demonstrate the impact of medical advances on the health of a whole communityBox 11 Evaluation The Impact of Health Care on HealthBunker looked at curative and preventative care in the US and its effects on life expectancy gain 1 5 yrs 2 used gain based on results of idealized care clinical trials 3 did not consider the efficacy and effectiveness Inequality in Society is Bad for your Health most commonly used measure of inequality is that of income differencesbut it is a flawed measure because of the different redistribution measures in some countriesie sweden has high redistribution and thus has reduced its poverty rate significantly also depends on the social and economic policies in the country the geographical level at which income distribution is measured affects the health outcomea neighbourhood where everyone is fairly similar economically vs a city the rich may be as affected by the gap bw rich and poor as the poor are a study found that mortality rates among both classes are almost the sameBasic Needs the nature of caring and sharing in a society determines its health Nepal life expectancies births and deaths are crude estimateshighest infant mortality rate is found in districts with the most egalitarian structure they have food deficits and everyone is uniformly poorin countries with low GDP life expectancy estimates increase with increasing GDP which indicates that everyone is getting the basic necessities Box 12 Methods Used in Epidemiologyobservational ecological studiescohort studiescross sectional studymulti level modelling Natural Experiments in Population Health Epidemiology Agriculture human health declined with the domestication of plants and animals in hunter gatherer societies sharing was critical itmeant eveyone was given food shelter and safety which was sufficient to maintain health with agriculture there were food surpluses and ppl took more than others declaring themselves a lord leading to a decline in sharingliving in close proximity to animals also lead to human disease Japan at the end of the Second World War japan became the healthiest country in the world because of economic policies resulting from the US occupation demilitarizationdemocratization and decentralization allowed their health to improve dramaticallyall done by General Douglas MacArthur The Former Soviet Union hierarchy that was created led to a massive decline in health the rise in the gap bw rich and poor lead to a decline in health and life expectancy by about 7 yrs Box 13 What Produces Health in a Populationbasic needs are metthe nature of caring and sharing typically measured by distribution of wealth resources income education etcmore egalitarian societies have better average healthWomens Health Chapter 1 Women Gender and Health Research Introduction gender refers to the social and cultural and economic influences that affect women and men sex refers to the biological and genetic characteristics of women and men The History of Womens Health Report of the Royal Commission on the Status of Women set the stage for improving services for women initial approaches to womens health coalesced around a reaction to the health care sys health care professions and societal norms and values that led to negative outcomes for womensome issues included lack of consent information and sexismthis phase was aimed at raising awareness of womens health issueslater approaches became more proactive leading to many womens health enterprises such as
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