BBH 316 EXAM 1

Health definition

“The state of being free from illness or injury”

Wellness definition

“The state of being in good health, especially as an actively pursued goal”

• focus on balancing many aspects increasing adoption of health enhancing conditions+ behaviors instead of trying to minimize conditions of illness

emotional wellness

• understand and express emotions, cope with stress and trauma, adjust to emotional challenges

physical wellness

• appropriate healthcare, good physical habits (diet, exercise)

occupational wellness

• participate in meaningful and purposeful activities (including employment)

social wellness

• relationships, support system, caring about wellbeing of others

spiritual wellness

• meaning and purpose,balance, peace

intellectual wellness

• lifelong learning, application, sharing knowledge

environmental wellness

• being + feeling physically safe, access to clean air food and water,

financial wellness

• sense of control + knowledge, stability, create budget

health promotion definition

• educational, political, environmental, regulatory, organization approach that support actions and conditions of living and are conductive to the health of individuals, groups or communities

• apply to groups and communities

• allow people 2 engage in different parts of wellness to become healthier

why health promotion?

• prevention focused

• hollistic patient care

• behavior change knowledge

• personal and professional well being

prevention focused

Teaching behaviors to create healthy lifestyle choices, focuses more on prevention methods to better reduce your risk for chronic diseases prior to diagnosis

hollistic patient care

• Having a better understanding on factors influencing the dimensions of wellness to better understand the complexity of health and the factors affecting their behaviors and health

behavior change knowledge

• Learning how to change people's behaviors in order to improve their health

Personal and professional well-being

You will be learning first hand how to change your own behaviors and in doing so will be able to emphasize with patients in the future with their own struggles

health promotion programs

• Aim to improve or maintain the health and wellness

• Focus on a target population/priority population

• Provide planned, organized and structured activities to help people improve their health behaviors across a variety of settings

• Promote policy, environmental, regulatory, organization & legislative changes

What is public health

• Health is very individualized to each person

• As a human, are you the only influence on your health and health outcomes? NO!

• Public health examines external conditions that affect the health of the whole communities, not just one person = population level

similarities Health promotion vs Public Health

• Both have a population-level focus BUT health promotion has a narrower target population approach 

• Both focus on improving health and prevention of disease

differences between health promotion and public health

• Public health aims to:

  • Create conditions where

  • Monitor

  • Help detect health issues early and respond 

Early Concepts of Disease

• Early humans hunted & gathered – their eating and activity was MUCH different

• How did this lifestyle impact health & disease?

  • Much more active

  • Many died from starvation

Latin Engineering

• Romans built aqueducts, public bathes, sewer systems, drainage system & public toilets 

  • Access to hygiene had a profound impact on individuals health

Middle ages

• Fall of the Roman Empire left public health largely in the hands of local communities

• The bubonic plague (black death) was a major event during this time 

• The use of quarantine and isolation first used as a public health strategy to prevent the spread of communicable disease

quarantine vs isolation

• Q: think may have disease, so stay away from others

• I: you have the disease, so need to stay away from others

The Enlightenment (1700-1850)

• Natural sciences (physics and chemistry) rapidly advanced which provided a rational scientific basis for many areas of medicine 

  • Handwashing!

  • Understanding how the body works and how diseases work

Industrialization & Urbanization

• The Industrial revolution led to massive population growth:

  • Job and Labor Opportunities

• How did this growth impact health

  • Overcrowding, inadequate drainage & sewage = diseases spread easily

  • Death rates rose due to tuberculosis, typhus, cholera 

• These conditions prompted sanitary reforms 

• Field of epidemiology arose – spread of cholera via water pump (John Snow)

Bacteriologic Phase of Public Health

• Louis Pasteur: pasteurization, principles of vaccination; developed the germ theory of disease

• Robert Koch: discovered bacteria responsible for several diseases that killed many at the time (anthrax, cholera, tuberculosis); provided significant contributions to germ theory

Public Health in the US: 1700’s

• Smallpox spread widely in Boston but inoculation will smallpox led to immunity

• Efforts to provide care for service members – congress passes the act for Relief of Sick and Disabled Seamen

• First medical school/hospital was opened

Public Health in the US: 1800’s

• Continued advancements

  • Great sanitary awakening (Industrial Revolution)

  • First true vaccine

  • The use of statistics to track health (hospital discharge information)

  • Forced quarantine at port to minimize spread of communicable diseases

  • All immigrants must have a health exam upon entering the United States 

Public Health in the US: 1900’s

• MANY advancements in health during this time, a few notable achievements:

  • Founding of:

    • NIH

    • FDA

    • US Public Health Service 

    • First School of Public Health

    • OSHA

    • Mine Safety and Health Administration

Current State of Public Health in the US

• Estimates show we have gained significant life expectancy

  • Public health initiatives, policies, programs 

• Current challenges we still face:

  • Encouraging vaccines

  • High levels of obesity 

  • Opioid epidemic 

  • Mental health

  • Vaping  

• Despite much progress in many areas of health, some have gotten worse

  • Deaths from Diabetes and Cancers have increased

Health inequality:

• measurable differences or disparities in health outcomes or access to healthcare services between groups. 

  • Examples? lifespan from country to country

Health inequity

• unfair, avoidable and unjust differences in health that results from social, economic, or political conditions. These differences are rooted in structural disadvantage. 

  • Examples? language barrier 

Health equality

everyone receives the same support, does not address inequalities

Health equity

everyone has a fair and just opportunity to be as healthy as possible, each person gets the support that they need

Justice

everyone deserves equal rights & opportunities; ideally addresses the causes of inequality

Health Disparities

are differences that exist among specific population groups in the attainment of full health potential; preventable and unjust.

causes of health disparities

• biological

• gender

• geographic

• access to healthcare

• SDOH

SDOH

conditions in which people are born, grow, work, live, and age

• economic stability

• Social & Community Context

• Neighborhood and Environment 

• Health Care

• Education

ex. zip code more important then genetic code

How does poverty lead to health disparities?

• Food insecurity

• Housing instability and homelessness

• Higher rates of no health insurance, inability to afford medical care

• Higher chronic illness, stress, and poorer health outcomes

How does race lead to health disparities?

Race is a social construct and structural racism has created

How does education lead to health disparities?

• Lower education →

• Health literacy gaps worsen

How does Gender and Sexual Orientation lead to health disparities?

• Women: earn

• LGBTQ+ Populations: societal

How does Geographic Location and Environment lead to health disparities?

• Where you live shapes access to:

  • Healthy

  • Environmental

How does healthcare access lead to health disparities?

• High cost, lack of providers, lack of cultural humility to care =

• U.S spends more on healthcare than any other country, but has worse health outcomes 

• 2019: ~30 million uninsured despite ACA expansion

How does access to the internet lead to health disparities?

• Affordability, availability and digital literacy impact

• Lack of access to the internet:

• Rural residents, minorities, older adults, and low income populations most impacted →

Health promotion programs often aim to improve health equity and reduce health disparities – how?

• Goal: shift from equality → equity → justice

What are the current health challenges that are some of the primary causes of death in the United States?

• Heart disease

• cancer

• obesity-related diseases such as type 2 diabetes

How is Obesity Defined?

• Body Mass Index (BMI)

• A measure of body fatness, calculated by dividing body weight (kilograms) by the square of height (meters)

Standardized cutoff points for BMI

• underweight: below 18.5

• healthy: 18.5-24.9

• overweight: 25-29.9

• obese: 30 or higher

why do we use BMI

• Strong evidence: high BMI = higher risk of chronic disease and early death

• Current Obesity Rates in the US + How does this present A National Security Risk to the country

• 40-43% 

• It restricts the pool of eligible military recruits and degrades combat readiness

Behaviors Associated with Obesity and Chronic Disease

• Diet/Nutrition 

• Physical Activity

• Smoking

• Alcohol Consumption

• Stress

• Sleep

Dietary Guidelines

• Follow a healthy dietary pattern at every life stage 

• Customize and enjoy nutrient dense foods and beverage choices to reflect personal preferences, cultural traditions and budgetary considerations

• Focus on meeting food group needs with nutrient dense foods and beverages to stay within calorie limits

1. Follow a Healthy Dietary Pattern

• Variety of vegetables from all the subgroups: dark green, red & orange, legumes, starchy & other

• Fruits, especially whole fruits

• Grains, at least half from whole grains

• Fat free or low fat dairy

• Variety of protein (seafood, lean meats, poultry, legumes, nuts, seeds, soy products)

• Oils

2. Nutrient Dense Foods

• Nutrient Density: food items that are high in nutrition in proportion to their calorie content 

  • Examples: Fruits & Vegetables and other whole foods

• Calorie Dense: food items that contain considerable calories but are of little nutritional value

  • Examples: cake, cookies, doughnuts, candy

• People should focus on nutrient dense foods that meet their individual needs and preferences

3. Meeting Food Group Needs

• Food Group Needs: My Plate 

• Calorie limits: how do you know how many calories you should consume in a day?

  • It depends! Factors that influence are age, gender and activity level.

4. LIMIT Calories from the following

• Saturated Fats – Consume less than 10% of calories per day from saturated fats

• Added Sugars – Consume less than 10% of calories per day from added sugars

• Sodium – Consume less than 2,300 mg of sodium per day

• Alcohol – up to 1 drinks per day for women, 2 drinks per day for men

Louis Pasteur:

• pasteurization, principles of vaccination; developed the germ theory of disease

• cholera

Robert Koch

discovered bacteria responsible for several diseases that killed many at the time (anthrax, cholera, tuberculosis); provided significant contributions to germ theory

Public Health in the US: 1700’s

• Smallpox spread widely in Boston but inoculation will smallpox led to immunity

• Efforts to provide care for service members – congress passes the act for Relief of Sick and Disabled Seamen which establishes the first public health agency in the US

• First medical school/hospital was opened in the US (Penn)