health and place final

Human ecology

interaction with ecological, social and biological environment

public health

making people health depending on the environment

what is environment?

it is a man-made environment

natural environment

the landscapes such as forests and alkes which contain pathogens harmful to human health

built envionment

urban areas where agents of diseases are present in built environment such as overcrowding and pollution

health definition (WHO)

• a state of mental, physical and social wellbeing, not just agents of disease

• a human right

• key health outcome is wellbeing

• is multi-dimensional and dynamic

Biomed/germ theory vs wellbeing model

germ theory

• linear (Cause and then cure)

• positivist (focuses on facts and is objective)

• quantitative

• ignores social factors such as poverty and racism

• all disease has a pathogenic cause that can be controlled by removing that cause

hollistic/wellbeing model:

• post-positivist (beyond just facts)

• qualitative

• understands health as being socially constructed

health promotion model

• many things affect health

• levels of influence —> individual, family, community, system, society

• solutions —> build public policy, personal skills, reorient health services

• social determinants of health at the front —> income, support, environment, genetics

• how we collect data: research, experience and evaluation

• values and assumptions shape everything

what causes antibiotic resistance?

• bacteria changes to resist antibiotics

• due to agricultural practices and human/animal interactions

aral sea, what was the change in environment here?

• 4th largest sea

• desertification and salination

• due to cotton production (agriculture and intense pollution)

• dams increases= less sa and volume of water

• led to cancer, disease, tuberculosis

what are the benchmarks of a mega city?

• depending on standards (can be 5m, 10m, 15m): 10m is the most common benchmark

what are microplastics (size and cause)

• small plastics (>5mm) that are caused by the development and breakdown of larger plastics

• caused by roads, emissions, landfills, and urban centers

air pollution, causes for indoor vs outdoor?

indoors: low income due to soild fuels for gas

outdoors: low to middle income due to industrialization and economic development

what is dengue?

• a viral flu-like infection

• spread through mosquitos (vectors that get it from feeding on humans)

• humans are bit by mosquitos

what are examples of other viruses

• Zika: fever, rash, birth defects —> small head and brain

• chikungunya: fever, joint-pain rash

what is lyme disease?

• spread through ticks which are vectors

  • ticks prefer dry and decidious land

• resoirvoirs are small animals

• signs: circular rash, nervous system disorder, heart issues

how was leprosy spead?

colonization, migration, slave trades

• more prevalent in the GS than the GN” poverty, infrastructure

what is plasmodium falciparum

• the main cause of malaria

• present in africa

  • spread through humidity and monsoons

what are threats to vector-control?

• insecticide resistance

• resistance to anti-malarial resistance

• spread of vectors have also increased due to climate change creating more favourable conditions for the aedes mosquitos

what are the leading causes of death?

• cancer and heart disease

  • both are relatively preventable

what is the most common cancer in men and women

• most common is lung then correctal

what are some social detriments of health

• age, income, gender, culture, genetics

what the differences in heart disease in men and women

• women are diagnosed less

• men are diagnosed in younger ages

what are the #1 social detriments of health and why?

• income and social status

  • higher income individuals have a higher degree of control

  • stress/coping mechanisms

  • higher income have more social and material resources

how much less do low income individuals live than higher income?

• 11.3 years less than high income people

what are coping strategies

promote self-care and self-reliance

5 personal areas that need improvement for people in health practice?

• personal life skills

• stress

• culture

• social belonging

• sense of control

how is culture a SDOH?

• marginalization

• stigma

• language barriers

• culturally appropriate healthcare

what are some geographical risk factors

• lifestyle

• healthcare

• environmental conditions

• genetics

what is the main cause for children’s clustered death?

• lack of immunization

• lack of neonatal/maternal healthcare

• mainly in the global south

alziemhers is most prevalent where and why?

• in the global north

  • They live longer, so they mostly get diagnosed

• highest lifespan in Japan: due to lifestyle, such as diets and passion

where is cardiovascular most prevalent?

• highest in the buckle belt like minnesota

• highest levels of poverty and fried food here

Aasthma causes and how has higher rates?

• mainly air pollution

• normally in megacities

• higher rates in women than men

obesity, where is it getting higher, why?

• especially high in the north but getting higher across Canada

• Food is hard to transport to the north of Canada

• Fat cells are also hard to remove from the body, so if you are overweight as a child you will also be in the adult

what is the cost of hospice/when is it cheaper

• hospice is a hollistic approach that is hardly available

• expensive but cheaper is used for longer

• also cheaper is diagnosis is earlier

• muscular disease, cardiovascular and diabetes are the most expensive

environmental changes of adaptation

• dry climate and sparse plants caused dietary changes

biological changes of adaptation

• larger brains for hunting actions

• smaller colon to digest meats

physiological change

• changes in energy conservation

• insulin needed to process meat and fatty acids

• energy stores in muscle, fat and liver cells

what is the modern impact of these adaptations?

• thrifty gene: individuals used to be able to store energy for famine but now we are always in feast mode

  • the body stores energy but it isn’t actually used since there is no famine

  • leads to obesity, insulin resistance, and type 2 diabetes

  • especially common in indigenous communities that were hunters a they were more prone to famines

diabetes types

type 1: lifestyle based, body makes insulin but can’t use it properly

type 2: body makes little to no insulin

gestational: body cannot make insulin during pregnancy but goes away after

what does diabetes do?

is damages blood vessels, kidneys and circulation

genetic variations

skin colour: lighter skins migrating to sunny climates (e.g., Australia)

vitamin d deficiency: dark skinned individuals move to higher latitudes such as south asians in northern europe

where is skin cancer most common?

skin cancer: highest in the global north (specifically women and low income communities)

• aesthetics

• outdoor work

• less education

age standarized data

• removes influence of age structure so differences can be removed

• disability adjusted life years: # of years lost due to a disability

• mortality rate: avg # of deaths per 1000 or 10000 etc. (typically within a year)

UVR zones in Canada?

• lower latitudes have highest UVR exposure

• southern and maritime regions

• water reflects light so it has double the exposure

lactose retention and disease

• migration to less sunny places causes decrease in calcium and vitamin D

  • which favours lactose intolerance

  • gradient in europe

what was the bubonic plague?

• bubbles in grion, armpits and neck which oozed blood and pus

• skin and tissue damage: until dark spotches appeared

• death in 4-7 days

• still seen in north america and europe: seen in california in 2020

• spread through rats: cooler climates, trades and political wars

types of diffusion

• contagious

• hierarchial

• relocation

what were the consequences of black plague

• high death

• decreased trade

• villages abandoned

• beginning of fuedalism

what is agrarian change

rapid diffusion, irrigation of crops and disturbed ecosystems

what is the industrial sea?

• rapid industrialization

• higher concentration of people + poor sanitation mean spreading of disease

what are some diseases of affluence

• heart disease

• cancer

• type 2 diabetes

• obesity

• substance abuse

• neurological disorders like alziemher’s

• psychological disorders like depression

what are some individual level causes of diseases of affluence

• physical inactivity, diet, sedentary work and stress

what are some population level causes of diseases of affluence?

processed foods, urbanization, energy-intensive tech for food production…

what are a type of heart diseases and what are their causes?

• heart attacks, heart failure, hypertension

• alcohol, inactivity, diet etc.

• also heart disease is more prevalent in the summer

Heart disease- natural experiment example- explain

• in poland the level of butter consumption decreased and fruit consumption increased

• this reduced heart disease and plaque build up

• a natural experiment is something that happens unintentionally **

how many more people died from heart disease than covid in 2020? how many canadians died from heart disease?

• 4x more people

• 1/5 canadians died from heart disease

what cause of death is heart disease (number) in canada

2nd

what are the most important risk factors for cancer?

• tobacco and aging

• but sun exposure, alcohol, obesity are also ones

environment and cancer relation?

• cancer is dependent on genes

• genes can change due to environment

• environment includes smoking and pollution

• certain groups are more at risk such as south asians and black groups

what is a cancer cluster?

an area that has higher than expected numbers of cancer in a specific group/region

what is the criteria for a cancer cluster

• # of specific cancer rates

• several rare cancer types

• cancer type is not commonly seen in that group

  • for example: children getting a cancer that is mainly common to adults

example of cancer cluster: Fort Chipewan

• an indigenous lake (lake athabaska) in fort chipewan located near oil sands

• residents use water for fishing, drinking and fur

• residents using water had high levels of liver cancer as well as lymphoma, leukemia and lupus

  • levels similar to a major city

• no real cause identified but residents believe it is from the water

camp leguene (another example of a cancer cluster)

• contaminated water which was high in TCE and PCE causing rare cancer rates to rise

shannon, quebec

transporting well water filled w/FCE

Exporting diseases of affluence- tanzania example

• Tanzania has high levels of communicable and non-communicable diseases, but NCDs are more deadly here due to a lack of preparedness in healthcare

  • rapid urbanization

  • and due to lifestyle changes such as increased tobacco use

what does the “marlboro man” mean?

• Marlboro man= smoking culture

• Companies spread smoking culture worldwide

• Companies use trade agreements, media, and global marketing

• An example is indonesia= new marlboro countries

• Tobacco advertising is 81x more in low-income countries than in high-income countries

CIF (comparative incidence figure)

• ratio of age-standardized incidence of smaller area compared to a larger area

CMF

• ratio of age-standardized mortality of a smaller area to a larger area

what can diseases of affluence also be called?

diseases of urbanization