Unit 1: Health, Wellness and Assessing Credibility

Define Health

The overall condition of the body or mind and the presence or absence of illness or injury.

How was health historically viewed?

• A medical model of health predominated where health was viewed as the absence of disease.

• The physician is responsible for your health, which is achieved through treatment.

• The goal is to prevent morbidity and mortality.

What are signs and symptoms?

A sign is something you can see and a symptom is something you can feel.

What is the newer perspective of health (health through prevention)?

• Happened in the mid 1900s to the 1970s with the emergence of the field of health promotion.

• Involves empowerment, community support, healthy public policy, supportive environments, knowledge translation, identification of risk factors.

• Focused on prevention

• Relates the main cause of mortality in a population to known risk factors.

What is health through prevention of illness?

1. At a personal level, it is the responsibility of the person to change their health behaviours to reduce risk.

2. At the community level, health promoters can target high risk groups and focus on prevention and early detection.

3. At the health-care provider level, physicians can act as a resource to raise awareness and impart knowledge of risk factors.

According to Tufts 2008, what are the personal health behaviours associated with living longer?

• Not smoking

• Drinking in moderation

• Staying Active

• 5 fruits and vegetable a day

What was the Framinghan study?

• Large scale epidemiological study

• Showed that people who didn’t smoke, drank moderately, were physically active and ate 5 servings of fruits and vegetables a day lived 14 years longer.

• Wheras, smoking, diabetes, obesity, hypertension significantly reduced liklihood of reaching age 90.

Define Wellness

Wellness involves optimal health and vitality, encompassing all dimensions of wellbeing. It involves controlling risk factors that contribute to disease or injury.

What is the difference between health and wellness? Provide an example

Health can be determined or influenced by factors beyond your control while wellness is determined by the decisions you make for yourself. For example, health care system v going for screening tests.

What are the key social determinants of health?

1. Income; finances shape overall living-conditions, psychological functioning and health-related behaviours.

2. Education; people with more education tend to be healthier.

3. Job security; Being without a job often leads to material and social deprivation, and psychological stress.

4. Early childhood development; experiences have strong, immediate, long-lasting biological, psychological and social impacts on health,

5. Food security; unable to have an adequate diet in terms of quality or quantity

6. Housing; poor quality housing and homelessness increase the risk for many health problems, including associated with overcrowding, unclean water and lack of a safe shelter.

7. Social exclusion; less likely to have access to social, cultural and economic resources which impact health.

8. Social safety net; range of benefits, programs, and supports that protect citizens during various life changes that can affect health.

9. Health services; high quality health care services are considered both a social determinant and a basic wrong

10. Indigenous status; adverse health outcomes experienced by indigenous people are one of the many effects of colonization.

11. Gender; Some people are at a higher risk for adverse health outcomes due to gender-related discrimination.

12. Ethnicity

13. Disability; society providing persons with disabilities with supports and opportunities necessary to participate in mainstream society.

What are some strategies to improve social determinants of health?

1. Social Inclusion - reducing injustice

2. High-quality public education and affordable post-secondary education

3. Full time employment, job security and healthy working conditions

4. Reduced income disparities

5. Universal health care access

6. Adequate housing and food security

7. Empowering individuals to make informed health-related decisions

What are the key dimensions of wellness?

• Physical; body’s overall condition, the absence of disease, fitness level and ability to take care of yourself.

• Emotional; having trust, self-confidence, optimism, satisfying relationships, and self-esteem.

• Intellectual; constantly challenging your mind, never stop learning and having an active mind.

• Interpersonal; the ability to develop and maintain satisfying and supportive relationship.

• Spiritual; Posses a set of guiding beliefs, principles, or values that give meaning and purpose to your life, especially in difficult times

• Environmental; the livability of your surroundings, having a clean and safe surrounding.

• Financial; living within your means and manage money in a way that gives you peace of mind.

What is the wellness model?

A model that recognizes the importance of disease and treatment but understands that a high level of wellness is not a state but a process of living.

What are the leading causes of death in Canada? (2020)

1. Cancer

2. Heart Disease

3. COVID-19

4. Accidents

5. Stroke

Compare life expectancy and lifespan

Life expectancy is the number of years an individual is expected to live based on where and when they are born. Lifespan is the number of years a given organism is biologically/physiologically capable of living.

What are SMART goals?

1. Specific

2. Measurable

3. Attainable

4. Realistic

5. Time-frame Specific

What are the stages of behavioural change?

1. Precontemplation; Raising of awareness or consciousness

2. Contemplation; An arousal or intent to make a change.

3. Preparation; made a plan or commitment to take action within a month or may already have begun to make small changes in your behaviour.

4. Action; Outwardly modify your behaviour and environment.

5. Maintenance; maintained your new, healthier lifestyle for at least six months. Relapses are common.

6. Termination; exited the cycle of change and are no longer tempted to lapse back.

Using exercise as an example, what are the stages of behavioural change?

1. Precontemplation; Your friend mentions you should start exercising more

2. Contemplation; Thinking about day to day activity and realize getting more exercise will be beneficial.

3. Preparation; discovering a new gym, setting a goal and practicing visualization.

4. Action; start cycling to work or going to the gym for one hour after class

5. Maintenance; riding bike to work every day or increasing the time you spend at the gym. Not giving up when you sleep in and have to drive to work.

6. Termination; No longer feel the urge to drive to work or miss the gym session.

What are factors that improve the likelihood of behaviour change?

1. Self efficacy; belief in one’s ability to achieve a goal

2. Internal locus of control/reinforcement; reliance on internal rather than external sources of motivation

3. Self-talk; ability to coach one’s self towards a goal

4. Support; friends, family, groups, community

5. Identify and overcome barriers; not allowing past failures or occasional relapses to discourage you.

What are the available sources of health information?

• Health Magazines

• News channels

• Newspapers

• Social Media

What is the hierarchy of evidence?

1. Experimental; uses scientific method and a well designed study, randomized controlled trials.

2. Epidemological; observation studies that seek to find relationships between variables by looking at trends within populations, Framingham Heart Study

3. Clinical; evidence from health care professionals and clinicians, evaluating patient health records.

4. Personal; Something you experiences personally, peanuts cause your skin to flare up.

5. Anecdotal; Something someone else experienced and told you about, a skin product that cleared their acne.

What is the scientific method?

1. Ask a question

2. Do background research

3. Construct a hypothesis that is testable and falsifiable

4. Test hypothesis with an experiment

5. Analyze data and draw conclusions

6. Report your results; was your hypothesis correct?

What does the ultimate study design include?

1. A randomized study group; participants are randomly assigned to an experimental group or control group.

2. Double blinding & Placebo; researchers conducting the study do not know which of the participants are in the control or experimental group.

3. Cross-over; participants receive the same two or more treatments, but the order in which they receive them depends on the group in which they are assigned to.

Who was Dr Snow? Why is he credited as the first epidemologist?

A 19th century English physician who’s credited with proving that cholera spreads through contaminated water rather than bad air. He did so by creating a mind map of victims and relatives of cholera to find the cause which was a common well.

What are epidemiological studies? What is the key limitation?

The study of population data without intervention, for example, tracking the spread of a disease through a population. It can lead to associations that do not necessarily imply cause and effect because the information is observational only.

What are the categories to establish causation?

1. Strength of association

2. Dose-response

3. Consistency

4. Temporally correct

5. Specificity

6. Biological plausibility

What is clinical evidence?

Clinical evidence comes from experience of clinicians. It is often consistent with scientific evidence, however, many clinical procedures have not been tested scientifically.

What is personal experiences as evidence?

Something you have experienced for yourself. For example, taking tylenol on an empty stomach makes you nauseous so you stop taking tylenol without food.

What is anecdotal evidence?

Something someone else tells you happened to them. For example, misinformation on the measles vaccine.

How do you asses credibility of health information?

• Go to the original source

• Watch for misleading language

• Distinguish between research reports and public health advice.

• Anecdotes are not facts

• Be skeptical

• Make choices that are right for you

How do you assess credibility of internet resoures?

• What is the source?

• How often is the source updated?

• Is the site promotional

• What do other sources say?

• Does the site conform to a set of criteria for accuracy?