Prevention of Illness - PowerPoint PPT Presentation

1 / 31
About This Presentation
Title:

Prevention of Illness

Description:

Dave Akin, Professor, University of Maryland ... Addictive Substances. Smoking & oral tobacco use. Alcohol. Illicit drugs. Environmental Risks ... – PowerPoint PPT presentation

Number of Views:44
Avg rating:3.0/5.0
Slides: 32
Provided by: mmc89
Category:

less

Transcript and Presenter's Notes

Title: Prevention of Illness


1
Prevention of Illness
  • Fundamental Concepts

2
  • Striking a reasonable balance between cure and
    prevention would do a great deal to optimize the
    health status of Canadians.Spending 5 of health
    care dollars on prevention isnt a balance
  • Marions corollary
  • In nature, the optimum is almost always in the
    middle somewhere. Distrust assertions that the
    optimum is at an extreme point. Akin's Laws of
    Spacecraft DesignDave Akin, Professor,
    University of Maryland

3
Why Focus on Prevention?
  • A significant percentage of global mortality and
    morbidity is caused by preventable conditions
  • The WHO estimates that 30 of global mortality
    results from 10 risk factors, all of which are
    preventable (The World Health Report, 2000)

4
  • The list includes
  • Childhood and maternal under nutrition
  • Underweight
  • Vitamin mineral deficiencies
  • Lack of breast feeding

5
  • Other diet physical activity related factors
  • High blood pressure
  • High cholesterol
  • Obesity, overweight, high body mass
  • Low fruit vegetable intake
  • Physical activity

6
  • Sexual Reproductive Health
  • Unsafe sex
  • Lack of contraception
  • Addictive Substances
  • Smoking oral tobacco use
  • Alcohol
  • Illicit drugs

7
  • Environmental Risks
  • Unsafe water, sanitation hygiene
  • Urban air pollution
  • Indoor smoke from solid fuels
  • Lead exposure
  • Climate change

8
  • Occupational Risks
  • Injuries
  • Exposure to carcinogens
  • Airborne particulates
  • Ergonomic stressors
  • Noise

9
  • An American study identifies 9 modifiable risk
    factors that constitute the leading causes of
    death in the US (Mokdad et al. (2000). Actual
    causes of death in the United States, 2000. JAMA
    291(10), 1238-1245)
  • Tobacco (18.1 of total deaths)
  • Poor diet and physical activity (16.6) (soon to
    overtake tobacco)
  • Alcohol (3.5)
  • Microbial agents

10
  • Toxic agents
  • Motor vehicle crashes
  • Firearms
  • Sexual behaviours
  • Illicit use of drugs

11
  • Unfortunately, these lists are not the same
  • Makes direct comparison impossible
  • However, some important themes emerge from these
    two studies
  • What are they?

12
  • One important insight conveyed by these studies
    is that there is more than one way to
    conceptualize causes of death (mortality) and
    illness (morbidity)
  • These studies represent a relatively new approach
    to this subject

13
  • A more traditional approach is reflected in how
    Canadian mortality is generally reported by
    Statistics Canada
  • In 1997 the leading causes of death in Canada for
    both sexes, all ages were

14
  • Diseases of the circulatory system
  • Cancer
  • Respiratory diseases
  • Unintentional injuries
  • Diseases of the digestive system
  • Endocrine diseases
  • Diseases of the nervous system
  • Mental disorders
  • Suicide
  • Genito-urinary diseases

15
  • There are problems with this more traditional
    approach to analyzing mortality
  • 1. It fails to reveal that there are important
    age and sex differences in human mortality

16
  • For example, the leading cause of death for all
    Canadians, both male and female aged 65 is
    diseases of the circulatory system
  • But for 15-19 year old males females, its
    unintentional injuries
  • For 25-34 year old males, its still injuries
  • For 25-34 year old females, its cancer

17
  • An effective approach to prevention requires an
    understanding of the risks to health that affect
    the specific population you are working with

18
  • 2. Traditional approaches tend to focus on
    pathology, not what underlies the pathology
  • This leads research in a particular direction
  • Biomedical
  • Emphasis on individual clients
  • Treatment

19
  • Refocusing on underlying causes shifts the
    research agenda to
  • Prevention
  • Identification of modifiable risk factors
  • Sometimes a focus on lifestyle/behaviour
  • Hopefully also an emphasis on social
    environmental risks to health

20
  • 3. Many underlying causes of mortality
    morbidity have social, economic political
    origins
  • e.g. poverty
  • This reality is not reflected in traditional
    epidemiological approaches to assessing the
    health of populations

21
  • Easier to discern in studies that search for
    underlying causes and modifiable risk factors
  • This course will emphasize risk and how risk can
    be modified at the level of
  • -the individual
  • -the community

22
  • It will place at least as much emphasis on social
    and political change as it does on changing
    individual behaviour

23
Health
  • Health can be conceptualized in many ways
  • How one defines health shapes how one sets about
    attaining it
  • This is the primary message of Chapter 5
    Concepts of Health

24
  • Young Higgins identify two ways to define
    health (and there are many, many more)
  • Medically
  • Systems
  • Each approach leads to a different set of
    conditions that determine health

25
  • Several approaches to the idea of determinants of
    health will be covered in this course
  • Like definitions of health, all tend to highlight
    different aspects of what influences human health

26
Prevention Vs. Health Promotion
  • Theoretical distinctions between these two
    concepts are quite clear

27
Health Promotion
  • Strategies that enable or enhance the achievement
    of optimal health
  • Cause-effect relationship not relevant

28
  • Main characteristics Statchenko Jenicek (1996)
  • Positive, multi-dimensional model
  • Participatory
  • Aimed at and seeks changes in populations
    environment (social, political, physical)
  • Involves a network of issues
  • Uses diverse complementary strategies
  • Facilitating, enabling
  • Multi-sectoral

29
Prevention
  • Interventions that discourage the interaction of
    an individual, group or population with an agent
    known to produce harm
  • Cause-effect relationship known

30
  • Main characteristics Statchenko Jenicek (1996)
  • Absence of disease
  • Medical model
  • Aimed at and seeks change in high risk groups
  • Concerned about specific pathology
  • Often one-shot strategies
  • Employs directive/persuasive strategies
  • Situated primarily in health care sector

31
  • Do these distinctions hold up in practice?
Write a Comment
User Comments (0)
About PowerShow.com