E study Guide
Need to build community that meets the needs of the people: more green space, walk-ability, etter access to healthy foods. Coproduction Framework: (Ex epa came into do study of environmental stuff, tried to say north eastern diet.. found out people were fishing in east? river which was deadly.. ) – working with communtiy members to identify the problems, work with researchers and analyze data together.
Community needs to be connected with these processes ad there imput needs to be taken into account: importance of “local knowledge” Unnatural Causes (movie) Understand the following terms and concepts covered in Unnatural Causes and be ble to describe their implications for community health: Social determinants of health: income, SES, race/ethnicity, home ownership, “power”, design of communities (ex: types of food markets, # of fast food around¤‚¬:) Latino immigrants–> arrive have best health outcomes but longer they are here their health declines b/c they have a social networks/ stronger religious communities.
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Asian immigrants–> lower incidence of liver disease in immigrants here than in asia. Gradient of health: this is seen in the whitehall study (Marmot): Showed it is not as simple as “have” and “have nots”. Inequalities in health follow the trend of your social status- the more money you have, the better your overall health will be. Chronic stress: Stress hormones is Cortisolif causes premature aging of the body, high blood pressure, has a weathering effect and compromises our immune system. Everyone endures stress but where you fall on the social ladder dictates how negatively the stress will affect you.
Role of medical care: Our health care system focuses on treatment and not enough on prevention; many problems with access to health care facilities and affordability. of SES, race, and place. The lower your SES level, the worse off your health is. The higher your SES, the better off your health is. Race: Social discrimination DOES effect our biological health. If whites & blacks have same income and Jobif blacks will still have poorer health. Place: Where you live has a big impact on your health.
Place influencesif your level of physical activity (do you feel safe being physically active outside), what you eat (proximity and access to supermarkets or fast food chains), the air you breathe (how clean is your air/ toxins) Rose Article: Sick Individuals & Sick Populations From the Rose reading, be able to differentiate between studying sick individuals (causes of cases) and sick populations (causes of incidence). When studying sick populations, need to study characteristics of the population rather than characteristics of the individual. ex: why is hypertention absent in Kenyan population but present in London) The determinants of incidence are not necessarily the determinants of cases. Explain why widespread exposures make it harder to detect “causes of incidence” using methods and measures designed to detect “causes of cases. ” Causes of incidence refer to sick populations; causes of disease refer to sick individuals. Individual centered approach looks at relative risk: The risk of exposed individuals relative to the risk of non-exposed individuals.
If it is a wide spread exposure, everyone is equally exposed and therefore the uniform exposure cannot be identified as a risk factor. The distribution of cases is then determined by individual susceptibility. The cause of incidence, the wide spread exposure, on a population level is being overlooked. Explain how shifting population distributions of health can make a greater impact han targeting at risk segments of the population: The attempt is to control the determinants of incidence on a population level, so that we can lower the mean level of risk factors.