HLST 3010 Final EXAM Notes PDF

Preview

Summary

Notes for final exam. ...

Description

HLST 3010 FINAL EXAM NOTES

Lecture 1 - Sept 10-16 What is health? - Well-being of an individual - Being mentally and physically healthy - A balance between being mentally and physically healthy - It depends on the context and person and a lot about perspective. What determines whether you are healthy or not? - Disease - Stress - Social status - Access to health care - Living conditions - Education - Environment - Many more!! What should you do to support your health? - Eat well and exercise - Check-ups - drinking/smoking - Doing all of these things is about health promotion What should governments be doing to maintain the health of Canadians? - Providing access to health care - Minimum wages - Social assistance - Education of health Acces is not equal in this country- it is proven that education on health shows greater health outcomes. We will further explore this. It is not just about the biomedical outcome it is the social determinants of health, we will look at the scandinavian countries to see their good example What is health? - It depends on the context and person, a lot about perspective. The view of health that is adopted within a jurisdiction or by an agency will strongly influence the manner in which health supporting policy is defined, developed, and Implemented.

HLST 3010 FINAL EXAM NOTES

4 Broad approaches to health: These approaches lead to different definitions of problems, different strategies, different target groups, and different people responsible for the activities of promoting health.

1. Medical (Traditional) Health Concept is biomedical, absence of disease and/or disability Leading Health Problems defined in terms of disease categories and physiological risk factors such as physiological deviation from the norm: CVD, AIDS, diabetes, obesity, arthritis, mental disease, hypertension, etc. Principal Strategies: surgical interventions, drug and other therapies, health care, medically managed health behaviour change (diet, exercise, patient education, patient compliance), screening for physiological and genetic risk factors Target: high risk individuals General Approach: Individualized Actors: physicians, nurses, allied health workers -

At its core, if you talk to a physician it is different than a societal approach. People might self-inflict these There is sympathy from people when someone of middle class has cancer but none for the non exercising smoker The biomedical model will target high risk individual Where do Dr.s put their money?Research and development, marketing for people with: chronic diseases, lifestyle drugs, viagra. No money towards rare diseases and people in 3rd world countries

2. Behavioural (Lifestyle) Health Concept is individualized, health as energy, functional ability, diseasepreventing lifestyles Leading Health Problems defined in terms of behavioural risk factors: smoking, poor eating habits, lack of fitness, drug abuse, alcohol abuse, poor stress coping, lack of life-skills, etc. Principal Strategies: health education, social marketing, advocacy for public policies supporting lifestyle choices (e.g. smoking bans, low fat meat production, bicycle paths, ad bans) Target: high risk groups, children and youth General Approach: individualized, elements of societal focus as related to public policy

HLST 3010 FINAL EXAM NOTES

Actors: public health workers, illness-related advocacy groups (e.g., Cancer Society), governments 3. Socio-Environmental (Societal) Health Concept is a positive state defined in connectedness to one's family/ friends/ community, being in control, ability to do things that are important or have meaning, community and societal structures supporting human development Leading Health Problems defined in terms of psychosocial risk factors and socioenvironmental risk conditions: poverty, income gap, isolation, powerlessness, pollution, stressful environments, hazardous living and working conditions, etc. Principal Strategies: small group development, community development, coalition building, political action and advocacy, societal change Target: high risk societal conditions General Approach: societal, focussed on organization of communities and society, development of just political/economic policies Actors: citizens, social development and welfare organizations, political movements and parties 4. Political Economy Health Concept is related to equitable distribution of resources within a society and the organization and exercise of political and economic power by various institutions and class groupings Leading Health Problems defined in terms of inequity in the distribution and control of economic and social power. Of particular interest is dominance by the wealthy and the influence of multinational corporations over the economic and social life of a society at the expense of the health of the population. Principal Strategies: political action by organized labour and social democratic political parties, regulating business and promoting influence by labour and the general population, establishing health supporting public policies associated with the welfare state Target: influence of the wealthy and powerful General Approach: structural, focussed on the political and economic organization of society and political institutions Actors: political movements and parties Black Report: 1. What are the societal factors (e.g., income, education, employment conditions, etc.) that shape health and help explain health inequalities? (#3 see above)

HLST 3010 FINAL EXAM NOTES

2. What are the societal forces (e.g., economic, social, and political) that shape the quality of these societal factors? Some SDoH are: ● Indigenous status ● disability status ● early life ● Education ● employment and working conditions ● food security ● health services

● ● ● ● ● ● ●

gender housing income and income distribution racism social exclusion social safety net unemployment

Do you think government is actively addressing the

SDofH? What should governments be doing to maintain the health of Canadians? - Providing access to health care - Minimum wages - Social assistance - Education of health Acces is not equal in this country. It is proven that education on health shows greater health outcomes. We will further explore this. It is not just about the biomedical outcome it is the social determinants of health, we will look at the scandinavian countries to see their good example

Why do you think there is such a delay in addressing the SDofH? What is the single most important SDofH?

Lecture 2 - Sept 17-23 What are the societal factors (e.g., income, education, employment conditions, etc.) that shape health and help explain health inequalities? What are the societal forces (e.g., economic, social, and political) that shape the quality of these societal factors? See Black Report from Lecture 1

HLST 3010 FINAL EXAM NOTES

Theme1: Empirical Evidence of the Importance of the Social Determinants of Health

Empirical Evidence in Health ● Empirical evidence is info acquired by observation or experimentation. Scientists record and analyze this data. The process is a central part of the scientific method. ● Empirical evidence is information that verifies ● the truth (which accurately corresponds to reality) or falsity (inaccuracy) of a claim. In the empiricist view, one can claim to have knowledge only when based on empirical evidence ● Ex. pharmacies How to do get to empirical evidence? - In science, empirical evidence is required for a hypothesis to gain acceptance in the scientific community. Normally, this validation is achieved by the scientific method of forming a hypothesis, experimental design, peer review, reproduction of results, conference presentation, and journal publication. - That’s when we deem it valid scientific evidence. This has gone through scholars in the same field and if they sign off on this it gets published All of our medical interventions go through some form of empirical research in order to be valid. With vaccines we started to test results See the same in the more basic things like death causes Early Modern Mention of SDOH see charts on slides

The Materialist Approach The materialist approach explains health inequalities through differences in an individual's socioeconomic position. The basic idea is that different social hierarchical positions in socioeconomic stratification are linked to differential exposures to the material world, which can be either conducive or unconducive to health (e.g., noise, pollution, material working conditions). Various authors stressed that factors referring to the public infrastructure may determine the private resources available for health production and should also be considered as (neo-) material factors What does the state provide you with should be considered as well: schools, hospitals, parks etc influence how people can be healthy Pathways (Clyde Hertzman) ● Latent: Specific biologic or developmental factors at sensitive periods that have a lifelong effect regardless of later circumstances. ● If these are impacted it is almost unchangeable. Ex. abuse will last your whole life ● Pathway: Experiences that set individuals unto life trajectories that affect health,

HLST 3010 FINAL EXAM NOTES

well-being and competence over time Ex. shitty school, set them up for a trajectory, not graduate, not go to post secondary etc ● Cumulative: Accumulation of advantage or disadvantage over time involving addition of latent and pathways effects a totality, look at this much later, Ex. Patients w a cumulative shitty life adds up in the end

Psycho-social approach -

-

lower socioeconomic backgrounds experience more negative life events, less social support, less autonomy at work, less job security and therefore suffer from poorer health. Results in STRESS Leads to other physiological factors such as: depression Makes people more vulnerable to many things such as: neuroendocrine (cortisol, testosterone, insulin), autonomic metabolic (cardiovascular function, respiratory, fat metabolism), immune (white cell counts, lymphocytes, cytokines)

Neo-materialist theory - Societies major income inequalities will have more poor people -> more low health. Poor people have worse health bc of: negative exposure to material world and lack individual resources bc of the social infrastructure - This inequality is a result of: cultural, political, and economic processes. - Influences availability of private resources - Determines nature of public resources such as: education, health care services, transport, control of the environment, availability of food, quality of housing, rules and regulations in the workplace Neoliberalism as a water balloon (video) - Neoliberalism is the belief that the government should be less involved in people’s lives. Why should the rich have to suffer and pay more taxes? - Leads to tax cuts - This makes the bottom of the balloon sag below the poverty line, which is comprised of minorities - Things that used to be public are now private because the social safety net was loosened - Bc of lower overall incomes ppl cant buy as much stuff like they used to - The solution to businesses losing this profit is: deregulation- loans and credit - The economy will keep expanding till it explodes Globalization - Businesses operating on a national scale - Reshaping society

HLST 3010 FINAL EXAM NOTES

-

It changes the political outcome of a welfare state bc of the powerful corporate influence Increases the unemployment rate Factors in Globalization - Institutional - Economic Infrastructure - Culture - Population - Social Infrastructure - Health Policies - Development - Trade - Environmental - Health Services Discussion Questions -

Do you think government is actively addressing the SDofH? (Biological, empirical) Why do you think there is such a delay in addressing the SDofH? What is the single most important SDofH? What experiences have you or someone you know had of people receiving different qualities of SDoH? Did these have obvious health impacts? Which models would be most useful for influencing policy-makers and the public in improving the SDoH? Why aren't these models in the media? How can we fix this?

HLST 3010 FINAL EXAM NOTES

Week 9 (fill in the blanks only) Food Security & Insecurity: · a determinant of life, health, dignity, civil society, progress, justice, and sustainable development · food security: defined as the state that “exists when all people at all times, have physical and economic access to sufficient, safe and nutriciouss food to meet their dietary needs and food preferences for an active and healthy life · Food insecurity: “the inability to acquire or consume an adequate diet quality or sufficient quantity of food in socially acceptable ways, or the uncertainty that one will be able to do so” à mostly a policy problem; Canada doesn’t have a food security policy (slide fill in the blanks) Stages of food insecurity: · food anxiety · qualitative compromises · quantitative compromises · physical sensations à at it extreme, it’s food deprivation ******difference between inequities that are unfortunate and those that are unjust *******: unfortunate (widespread poverty, everywhere is the same) VS unjust (being wrong b/c the rest of society can provide food and is rich, but there are still people starving) unjust à avoidable because of result of inequitable distribution of social conditions

Food Soverignty security is a goal while sovereignty is how to get there: -food sovereignty is rooted in grassroots food movements Food Deserts - food deserts are defined as parts of the country… Hunger defines as: **** Hunger has 3 elements: **** important for exam*** 1) it is about suffering 2) in slide 3) in slide

HLST 3010 FINAL EXAM NOTES

What has caused this problem? · Mid 21st century- increase in poverty resulting in the emergence of food insecurity

Impacts of Food insecurity in Canada · more than 1.1 households (9.2%) · 99.3 percent increase food-bank use since 1989 · food insecurity escalates as the adequacy of household income declines What is the face of Hunger in Canada? · lone mothers were 8 times more likely…. · 22.6 % of families that report hunger, report persistent hunger. · people of Aboriginal descent are the only group that had significantly higher hunger rates Implications of Food Insecurity · chronically low intakes of nutrients may heighten individual’s risk of major chronic diseases Nutrient Intake: · particular hazard for individuals with heightened dietary needs including pregnant and lactating women, as well as children and adults suffering from dietrelated chronic diseases What action is being taken? · food supplement and coupon programs

Week 10 Notes: Education and Health Literacy Education Education as a SDoH · Education – low education levels linked w/ poor health, more stress and lower selfconfidence · Canada ranks high (advanced education); 66% of Canadians having completed some form of post-secondary education · Yet youth from low income Indigenous and visible minority background continue to be poorly represented at PSE (post-secondary education) levels

HLST 3010 FINAL EXAM NOTES

Background · by law, children in Canada must attend school starting at the age of 5/6 and continue until they are between 16-18 · Schools in Canada: o start w/ kindergarten and continue to grade 1-12 · it’s up to parents to choose type of schooling o free public schools o paid private schools o at-home education o English or French Schools (in many areas) · In Canada, 3 types of post-secondary schools: o Universities o Colleges o Institutes · Govn’t has processes to make sure the schools and programs they offer meet their standards. · Institutions that don’t go thru govn’t quality control are not officially recognized. · schools that are recognized can grant: o degrees o diplomas o certificates o other qualifications · All students must pay tuition fees for post-secondary studies. Tuition varies depending on the school and program. Usually between $2,500 - $8,000/ year. Students bust also buy course materials such as textbooks and must also pay for: o housing o food o transportation o other expenses · Many depend on programs to help them cover the costs of post-secondary education in Canada. In general, there are 2 types of financial help for students: o student loans from the ban or the government, which you have to repay o grants, scholarships or bursaries, which you don’t have to repay. · both the federal govn’t and the provincial/ territorial govn’t have programs that provide low-cost loans, grants and scholarships for students Canadian Stats · Canada spends ~5.4 of its GDP on education · it invests heavily on tertiary education (more than $20,000/ student)

HLST 3010 FINAL EXAM NOTES

· Recent reports say from 2006 tuition fees of Canadian Universities have increased by 40% · in 2016, > half of Canadians aged 25-64 had either college or uni qualifications, from 48.3% in 2006 (ten years earlier) · Canada Continues to rank #1 among the Organization for Economic Cooperation and Development (OECD) countries in the proportion of college and uni graduates · In 2016, 22.4% of Canadian popl’n 25-64 yrs had a college diploma as the highest educational qualification, compared with an estimated 8% among OECD countries overall. · In 2016, 40.7% of young women aged 25-34 had a bachelor’s deg. or higher, up from 32.*% in 2006. · Young men have responded to job opportunities and earning incentives by moving into the skilled trades sector. · Proportion of young men w/ an apprenticeship certificate ^ from 4.9% in 2006 to 7.8% in 2016. Minority Population Stats · First Nations people, Metis and Inuit all made gains in postsecondary educations at every level. (stats from 2016). · A higher proportion 20.4 % of lone mothers aged 25-64 in 2016 had a bachelor’s deg or higher up from 14.7 % in 2006 · Close to 1/3 (31.5%) of refugees who became permanent residents in Canada upgraded their educational credentials after arriving in the country. Education and Health · as with other SDofH, it plays a major role in one’s overall health and well-being · can affect us throughout our lifetime and has been shown to ^ healthy behaviours and improve health outcomes – including obesity rates · Early ed = sets foundation for life · more education = the longer the person will live · Education à strong predictor of long-term health and quality of life Education & Socioeconomic Inequality as Health Risk Factors · Low S.E.S. + inadequate employment + family fxn + educational attainment = associated w/ compromised health across the entire life span · Low SES alone is one of strongest predictors of poor health and development b/c material deprivation constrains behaviour and lifestyle choices among those living in poverty + neuroendocrine responses to the stress that SES imposes influence psychological well-being Early Learning: a Protective Factor for Lifetime Health · the effects of the early environment (+ve and –ve) are long lasting · close relationship between early life conditions, performance n school, adult literacy, health status and mortality

HLST 3010 FINAL EXAM NOTES

· Appropriate stimulation and positive early experiences have profound impact not only on development of neural systems involved in cognitive, emotional, neuroendocrine and neuroimmune fxns, but also on the expression of genetic factors that modify the effects of hormone receptors and influence an individual’s response to stress throughout life · this helps set developmental trajectories for acquisition of competence and coping skils and regulation of responces to new or challenging experiences Recommendations for Human Development-Oriented Health and Education Policy · One of the best ways for us to improve the health of the whole population is to focus on evidence-based policies that optimize both early childhood development and ...