HEALTH & SOCIETY CLO-1 /dainayesuraj OBJECTIVES 1. Understand BMI and obesity. 2. Explain hyperlipidemia, hypercholesterolemia. and 3. Explain how plaque develops and how it leads to atherosclerosis. Ever wonder… • How to maintain a healthy weight? • Define being “healthy”. • Name 3 health problems caused by being overweight. BMI = Body Mass Index = is a measure of your weight relative to your height; it correlates with body fat. What is a healthy body weight??? 1. An acceptable BMI 2. Body composition with an acceptable amount of body fat 3. Fat distribution that is not a risk factor for illness 4. Absence of any medical conditions that suggest a need for weight loss (such as Diabetes or Hypertension) ➢ OBESITY = Body weight that greatly exceeds the recommended guidelines. ➢ OVERWEIGHT = Body weight that exceeds the recommended guidelines for good health. ➢ An estimated 650 million people (13% of world population) are obese!!!!!!!!!!!!!!!!! BODY FAT = essential + storage body fat…. Essential body fat is necessary to maintain life and reproductive functions. • Vital for hormone function. {or else detrimental….} Ways of measuring Body Fat. (Accurate but expensive methods) 01. Weighing person under-water (immersion OR hydrostatic weighing) 02. Using special type of X-ray (DXA) to scan Fat, Muscle and Bone Ways of measuring Body Fat. (Less accurate and reasonable methods) 01. Skin-fold measurement OR Caliper testing 02. Bioelectrical Impedance Analysis Where you carry your body fat, also determines your disease risk!! Fat around waist = Abdominal Fat OR Visceral Fat OR Central Obesity Greater than 40 inches (102 cm) for men. Greater than 35 inches (88 cm) for women…. Waist circumference associated with increased health risk. The underrated problem of Underweight..! CHOLESTEROL is a lipid that travels through the blood on a protein named LIPOPROTEIN. https://www.heart.org/en/health-topics/cholesterol/hdlgood-ldl-bad-cholesterol-and-triglycerides • Two types of lipoproteins carry cholesterol. • 1. LDL (Low-density lipoprotein) = Bad Cholesterol = makes up most of the body’s cholesterol. High levels of LDL cholesterol raise your risk for heart disease and stroke. • 2. HDL (High-density lipoprotein) = Good Cholesterol = absorbs cholesterol and carries it back to the liver. The liver then flushes it from the body. High levels of HDL cholesterol can lower your risk for heart disease and stroke. Above condition is linked with fatty buildup within artery walls, which increases risk of heart attack and stroke!!! TRIGLCERIDES ARE THE MOST COMMON TYPE OF FAT IN THE BODY. They store excess energy from your diet. Video links 1. Heart attack – https://www.youtube.com/watch?v=zEzDcElrYgs 2. Stroke – https://www.youtube.com/watch?v=pcmrgwNCPwM FAT = Accumulation of lipoproteins + phospholipids + cholesterol ATHEROSCLEROSIS = Hardening and stiffening of arteries due to buildup of fats, cholesterol, cellular waste products, calcium, and other substances in artery walls. STAGES OF ATHEROSCLEROSIS: 1. Damage to the inner lining (by tobacco smoke, high BP or infection). 2. Creation of a lesion, where a fatty streak can form. 3. Fatty streak = accumulation of lipoproteins, phospholipids and cholesterol. 4. Lipoproteins accumulate within artery wall → undergo chemical changes → trigger inflammatory response → attract WBC’s → take up the altered lipoproteins & clear the lipids → leave the site. 5. BUT……………. If blood lipoprotein levels are too high → more lipoproteins accumulate → more WBC’s die within the lesion → More lipid-rich material is deposited → fatty streak is formed. PRACTICE QUESTIONS EPIDEMIOLOGY AND PUBLIC HEALTH 1. A disease or condition present among a population at all times is called? A. epidemic B. pandemic C. endemic D. cluster 2. Epidemiologists use a model for studying infectious disease and its spread that involves the microbe that causes the disease, the organism that harbors the disease, and the external factors that cause or allow disease transmission. This is also known as? A. host, vector, and transmission B. transmission, host, and environment C. host, agent, and environment D. organism, transmission, and environment 3. Define “Epidemiology”. 4. The main focus of public health is on the A. Livability of environments B. Preventative health services C. Health of populations of people D. Health and wellness of individuals within communities. 5. Why is Covid-19 disease called a pandemic and not a cluster? 6. What is the standard acceptable p-value in statistics? 7. Malaria is present in Africa at all times because of the presence of infected mosquitoes. Therefore, Malaria is a ________________ in Africa. (Choose from the following terms: endemic, pandemic, epidemic, cluster) 8. A disease occurrence among a population that is in excess of what is expected in a given time and place is called? A. endemic B. epidemic C. cluster D. pandemic 9. All of the following illustrate the purpose of epidemiology in public health, except A. identifying populations who are at risk for certain diseases B. assessing the effectiveness of interventions C. providing treatment for patients in clinical settings D. determining the importance of causes of illness 10. State two reasons why epidemiology is so important. 11. Choose the correct scientific term for the passing of a disease from one organism to the other? a. catching b. vector c. transmission d. infecting 12. Define a confounder. 13. Which of the following is a confounding variable in this study? a. Exercise b. Lung capacity c. Smoking or not d. Occupation 14. Pick the choice that best completes the following sentence. If a relationship between two variables is called statistically significant, it means that the variables are A. related in the population represented by the sample. B. not related in the population represented by the sample. C. related in the sample due to chance alone. D. very important. 15. Which of the following best describes a confounding variable? A. A variable that is manipulated by the experimenter. B. A variable that has been measured using an unreliable scale. C. A variable that affects the outcome being measured as well as, or instead of, the independent variable. D. A variable that is made up only of categories. 16. Epidemiologists learn about A. the causes of diseases and how to cure or control them B. the frequency and geographic distribution of diseases C. the causal relationships between diseases D. all of the above 17. Why does epidemiology as a science do observational studies rather than performing laboratory studies? 18. (a) Define “epidemiology”. (b) Design an epidemiological experiment to find the effects of smoking on heart disease. Your study should not be biased, must include measurable variables and 2-3 confounders. (Your answer should have a minimum of 75-90 words) 19. Epidemiology is the study of patterns, occurrences and control methods of ________. A. deadly diseases B. deadly epidemics C. epidemics D. diseases 20. Epidemiologists are interested in learning about ____________________. A. the causes of diseases and how to cure or control them B. the frequency and geographic distribution of diseases C. the causal relationships between diseases D. all of the above 21. Which of the following is when a disease affects a predictable number of people within a given population? A. epidemic B. endemic C. epidemic and pandemic D. pandemic 22. Choose the best response. If you are looking for specific healthcare data and you cannot find what you are looking for, you: A. Ask your instructor for assistance B. Look for reference clues on reliable webpages C. Randomly search for other options D. Start working on another project to make up for lost time 23. Epidemiologists use a model for studying infectious disease and its spread that involves the microbe that causes the disease, the organism that harbors the disease, and the external factors that cause or allow disease transmission. This is also known as, A. Host, vector and transmission B. Host, agent and environment C. Transmission, host and environment. D. Organism, transmission and environment 24. In the definition of epidemiology, “distribution” refers to: A. Who B. When C. Where D. Why 25. An epidemiologist is conducting a study on the sleep patterns of university students but does not provide any intervention. What type of a study is this? A. Qualitative B. Observational C. Experimental D. None of the above 26. Which of the following health differences is NOT a disparity? A. Low-income groups have a worse health status than high-income groups. B. Older people have a worse health status than younger people. C. Jonathan has a worse health status than his brother, Greg. D. Blacks have a worse health status than whites. Epidemiology and public health 1. Epidemiology Definition: Study of the distribution and determinants of health-related states among specified populations and the application of that study to the control of health problems. 2. How do you become an informed consumer of health information? a. Developing Health Literacy: i. Evaluating health information from the Internet b. Understanding Medical Research studies: i. Basic Medical Research ii. Epidemiological Studies iii. Clinical Studies 3. Measuring what a lot of people are exposed to and trying to work out what the connections are between these exposures and their health form a big part of epidemiology. 4. Just because someone was exposed to something and they got sick, does not mean that the two events are related. The exposure may not have caused the sickness. 5. Epidemiology is crucial for making public health decisions and improving the well-being of people because: a. Makes better healthy lifestyle recommendations b. Reduces health-care bills c. Increases productivity of tons of millions of people 6. Epidemiology Purposes in Public Health Practice: a. Discover the agent, host, and environmental factors that affect health b. Determine the relative importance of causes of illness, disability, and death c. Identify those segments of the population that have the greatest risk from specific causes of ill health d. Evaluate the effectiveness of health programs and services in improving population health 7. Epidemiology Key Terms a. epidemic or outbreak: i. disease occurrence among a population that is in excess of what is expected in a given time and place. b. cluster: i. group of cases in a specific time and place that might be more than expected. c. endemic: disease or condition present among a population at all times. d. pandemic: i. a disease or condition that spreads across regions. e. rate: i. number of cases occurring during a specific period; always dependent on the size of the population during that period. 8. A Public Health Approach: a. Surveillance b. Risk Factor Identification c. Intervention Evaluation d. Implementation PRACTICE WORKSHEET INTRODUCTION TO HEALTH AND SOCIETY 1. Exercise is mainly a component of _____. A. intellectual wellness B. emotional wellness C. spiritual wellness D. physical wellness E. interpersonal wellness 2. Which of the following provides the BEST example of someone with spiritual wellness? A. Barbara recycles and cuts waste by reducing consumption B. Bob maintains several friendships and is close with his extended family. C. Janet works out several times a week and tries to eat healthy foods. D. Tim takes the time to think critically about issues he is presented with in his daily life. E. Sam dedicates his life to helping those who are less fortunate than himself. 3. Tara is a school counselor who loves helping children navigate the stresses of childhood. Her feelings about her job are a sign of _____. A. occupational wellness B. physical wellness C. intellectual wellness D. interpersonal wellness E. emotional wellness 4. How might someone demonstrate intellectual wellness? A. Through religion B. Through critical thinking C. Through muscularity D. Through social connections E. Through emotional control 5. Choose the RNA sequence transcribed from the DNA sequence: TAC-CGA-TGA-TTT-CTC-ATA A. AUG-GCU-ACU-UUU-GAG-UAU B. AUG-CGA-ACU-AAA-GAG-UAU C. AUG-GCU-ACU-AAA-GAG-UAU D. AUG-GCU-ACT-AAA-GAG-UAU 6. Tom is someone who is confident and exhibits a good sense of self-esteem. These characteristics mark Tom as someone with _____. A. intellectual wellness B. interpersonal wellness C. physical wellness D. spiritual wellness E. emotional wellness 7. The process of enabling people to increase control over their health and its determinants and thereby improve their health is known as: A. Risk Factors B. Health Promotion C. Disease Prevention D. Lifestyle Choices 8. Stacey has made the decision to drink eight, 8-ounce glasses of water each day and to eat a fruit or vegetable at every meal. This is an example of a _____. A. resolution B. health promotion C. disease prevention D. lifestyle choice 9. Which of the following health determinants is directly related to the structure of the medical care system? A. Biological and genetic determinants B. Behavioral determinants C. Social determinants D. Access to health services 10.Use base pairing rules to transcribe the following sequence of DNA: TAC-AAA-GTG-ACG-ATC A. AUG-UUU-CAC-UGC-UAG B. AAG-AAA-CAC-AGC-AAG C. AUG-UUU-CTC-UGC-TAG D. AUG-UUA-CAC-UGC-UAG 11.Studies show that individuals who experience racial discrimination are more likely to develop stress-related health issues. Racial discrimination is an example of which of the following health determinants? A. Physical determinants B. Biological and genetic determinants C. Behavioral determinants D. Social determinants 12.Access to neighborhood sidewalks is an example of which of the following health determinants? A. Biological and genetic determinants B. Social determinants C. Behavioral determinants D. Physical determinants 13.”I refuse to quit smoking! There is absolutely nothing wrong with what I am doing” 14.This most likely describes an individual who is expressing which of the following stages in the Transtheoretical Model? A. Contemplation B. Pre-contemplation C. Action D. Preparation 15.Which RNA sequence would be transcribed from the following sequence of DNA? TAC-CTT-AGA-CCA-TCT-ATT A. ATC-GAA-TCT-GGT-AGA-TAA B. AUG-GAA-UCU-GGU-AGA-UAA C. UAC-CUU-AGA-CCA-UCU-AUU D. AUG-GAA-UCU-GGT-AGA-TAA 16.Which of the following is a stage of change within the Transtheoretical Model? A. Decision making B. Reluctance C. Maintenance D. Optimism 17.The mRNA code that results from a DNA sequence that reads TAC-GCA-TATAGG-CTA-ATT would read: A. ATG-GCA-ATA-TCC-GAT-TAA B. AUG-CGA-AUA-ACC-GAU-UAA C. AUG-CGU-AUA-UCC-GAU-UAA D. AUG-CGA-UAU-UCC-GAU-UAA 18.In physical fitness, which of the following would be an example of a person’s behavior in the preparation stage of the Transtheoretical Model? A. The person travels to the gym three days a week. B. The person meets with a nutritionist and creates a food log. C. The person sees no problem with eating unhealthy and not exercising. D. The person takes a break from attending all exercise classes. 19.Of the following examples, which one best demonstrates a perceived threat, as related to the Health Belief Model? A. If I get a vaccine against meningitis, it might help, but I do not like waiting in the doctor’s office, and I hate needles. B. I live in a dorm at college, where multiple cases of meningitis have been confirmed. I have not received my inoculation for meningitis. I think I am at risk. C. If my college offered free meningitis inoculations, I would have gotten one, but I am not going to pay for it myself. D. I know that the college health department says there are confirmed cases of meningitis here at my school, but I do not believe them. 20.The Health Belief Model assumes that decision-making occurs when the following three elements take place: A. Perceived susceptibility, perceived threat, and perceived reward B. Assumed susceptibility, assumed threat, and assumed reward C. Perceived susceptibility, perceived threat, and perceived benefit vs. barriers D. Assumed susceptibility, assumed threat, and assumed benefit vs. barriers 21.Choose the correct RNA sequence transcribed from the following DNA sequence: TAC-AGC-GGT-CGC-ATT A. ATC-AGC-CGC-TAA B. AUG-UCG-CCA-GCG-UAA C. ATG-TCG-CCA-GCG-TAA D. AUC-AGC-CGC-UAA 22.The Health Belief Model (HBM) was developed in response to the failure of a free tuberculosis screening program offered in the 1950s. Of the following options, please select the one that best describes the HBM’s goal. A. Explain the impact of a group’s perception on a particular disease and how the group’s ideas affect an individual’s decision-making. B. Explain the impact of an individual’s perception and attitude toward a particular disease and how it impacts their health-related decision-making. C. Explain the difference between a group’s perception and an individual’s perception about a particular disease. D. Explain the overall impact of an individual’s perception on a group’s decision-making, related to a particular disease. 23.Which of the following DNA sequences would produce this sequence of RNA through transcription? RNA: AUA-CCU-GUG-AAG A. ATA-CCT-GTG-TTC B. TUT-GGA-CAC-UUC C. TAT-GGA-CAC-TTC D. ATA-CCA-CAC-AAC 24.All of the following are examples of where to find reliable healthcare data EXCEPT: A. Reviewed journals B. Government websites C. Professional websites D. Advertisements 25.Choose the best response. If you are looking for specific healthcare data and you cannot find what you are looking for, you: A. Randomly search for other options B. Ask your instructor for assistance C. Look for reference clues on reliable webpages D. Start working on another project to make up for lost time 26.Choose the correctly transcribed RNA sequence given the DNA sequence: TAC-AAC-AAG-AAT-TTT-ATC A. ATG-TTG-TTC-TTA-TTT-TAG B. AUG-UUG-UUC-UUA-AAA-UAG C. AUG-TTC-UUC-UUA-UAG D. AUG-UUG-UUC-UUA-UUU-UAG 27.Which of the following is NOT true about limited health literacy? A. Good health outcomes B. Increased use of emergency services C. Higher healthcare costs D. Poor health outcome 28.Which of the following is NOT true about health literacy? A. Health literacy is being able to fill out a medical form. B. Health literacy is your ability to interpret food nutrition labels. C. Health literacy is being able to understand written health information. D. Health literacy is not being able to understand a prescription. 29.Identify the base pairing rule not followed in the transcription example shown below. DNA: GGG-ATA-CTA-AGG-TAA RNA: CCC-AUA-GAU-UCC-AUU A. Cytosine always pairs with guanine B. Adenine always pairs with uracil. C. All base pairings are correct. D. Adenine always pairs with thymine. 30.Identify the base pairing rule not being followed in the transcription example below: DNA: TAC- GCA-TAT-AGG RNA: ATG-CGU-AUA-UCC A. Uracil pairs with adenine. B. Adenine pairs with thymine. C. Cytosine pairs with guanine. D. All rules are being followed 31.Transcription yields the following RNA sequence: GUA-CCA-AAG-UAC Which DNA sequence would be the template? A. CAU-GGU-UUC-AUG B. CAT-GGT-TTC-ATG C. GTA-CCA-AAG-TAC D. GAA-CCA-AAC-AAC 32.Spiritual health suggests which of the following? A. a basic religious education B. participation in an organized religion C. a belief in God D. people’s value system or beliefs 33.What is a genome? A. the complete set of DNA B. the place where the set of genetic instructions is stored C. the bond that connects the two strands of DNA D. one of the building blocks of DNA 34.Health disparities between racial or ethnic groups are largely attributable to which of the following? A. genetics B. public health policy C. national, state, and local laws D. social and economic conditions 35.Health is defined by the World Health Organization as the absence of disease. A. True B. False 36.The RNA sequence GGG-CAU-AUG-GGU was transcribed from which of the following DNA sequences? A. GGG-GAA-AAC-CCA B. CCC-GUA-UAC-CCA C. CCC-GTA-TAC-CCA D. GGG-CAT-ATG-GGT 37.People’s value systems or beliefs can have an impact on their overall health. A. True B. False 38.Which of the following is an example of a disease prevention effort? A. COVID-19 booster shot campaign B. accurate labels on packaged foods C. bike lanes on public streets D. emergency preparedness messages in different languages 39.Backsliding into a former health state is called A. failure. B. relapse. C. avoidance. D. modification. 40.A family health tree is also called a genogram or a genetic pedigree. A. True B. False 41.Commitment to change will successfully carry a person through the process of change. A. True B. False 42.Using base pairing rules (and Chargaff’s rule), calculate the amount of adenine in a DNA sequence that is 29% guanine. A. Adenine will make up 58% of the DNA B. Adenine will make up 29% of the DNA C. Adenine will make up 21% of the DNA. D. Adenine will make up 42% of the DNA 43.The ability to read, understand, and act on health information is called A. health-risk assessment. B. health literacy. C. self-evaluation. D. being an informed consumer. 44.Use base pairing rules to transcribe the following sequence of DNA: TAC-CCG-ATA-CCT-ACT. A. ATG-GGC-UAU-GGA-UGA B. ATG-GGC-TAT-GGA-TGA C. AUG-GGC-UAU-GGA-TGA D. AUG-GGC-UAU-GGA-UGA 45.During the COVID-19 pandemic, social determinants of health that affected people earning lower incomes included less ability to physically distance, work from home, or take leave. A. True B. False 46.The World Health Organization (WHO) defines health as having several domains, and encompassing multiple dimensions, including physical, mental, emotional, and spiritual. A. True B. False 47. Choose the correct DNA sequence that lead to transcription of the following RNA sequence: CAU-UGA-GUA-CCG A. GAT-TCA-CTA-GGC B. GTA-ACT-CAT-GGC C. GUA-ACU-CAU-GGC D. CAT-TGA-GTA-CCG 48.What term is used to describe ethnic groups based on physical characteristics such as skin color or facial features but which reflects a social category? A. biology B. race C. ethnicity D. culture 49.Using base pairing rules (and Chargaff’s rule), calculate the amount of cytosine in a sequence of DNA that is 15% thymine. A. Cytosine will make up 35% of the DNA. B. Cytosine will make up 70% of the DNA. C. Cytosine will make up 30% of the DNA. D. Cytosine will make up 15% of the DNA. 50.Social health is defined as the ability of an individual to interact effectively with other people and their social environment. A. True B. False GHSO100 Chapter – 1: Revision 1. Of the following, the best type of website on which to research health issues is one that is sponsored by a(n) a. educational institution. b. individual. c. commercial health organization. d. drug company. 2. a. b. c. d. Which of the following best illustrates a public health measure? medical schools competing for research grants promoting a new surgical technique preventing the spread of disease-carrying insects upgrading the local hospital’s dialysis equipment 3. a. b. c. d. What is the major goal of primary disease-prevention efforts? to inhibit the development of diseases to treat a person for particular problems associated with a disease to find a cure for prevalent diseases to detect diseases before they become symptomatic 4. Health is conceptualized as having several domains, such as physical, mental, social, and spiritual domains. a. True b. False 5. Individual choice is the only factor governing a person’s ability to live a healthy lifestyle. a. True b. False 6. Health disparities occur when all people have the equal opportunity to attain their full health potential. a. True b. False 7. Factors such as income level, available health care services, and literacy are examples of social determinants of health. a. True b. False 8. Of our 23 chromosome pairs, 22 are the same for women and men. a. True b. False 9. The complete set of DNA is called a person’s genome. a. True b. False 10. In a person’s complete set of DNA, one pair of genomes is labeled with an X or a Y rather than with a number. Females have two X genomes; males have an X and a Y genome. a. True b. False 11. Genetic mutations can be beneficial or harmful—or neither—to one’s health. a. True b. False 12. If an individual receives a faulty, mutated copy of a gene from his or her mother, that person will most likely acquire a genetic disorder. a. True b. False 13. Most genetic disorders are caused by single-gene mutations. a. True b. False 14. Multifactorial disorders are those caused by the interaction of both environmental and genetic factors. a. True b. False 15. A family health tree is also called a genogram or a genetic pedigree. a. True b. False 16. When evaluating a family health tree, a family member who has a heart attack at age 70 raises more genetic concerns than a relative who develops colon cancer at age 28. a. True b. False 17. Sade’s mother was diagnosed with Alzheimer’s disease at age 50. Courtney’s grandmother was diagnosed with Alzheimer’s disease at age 82. Sade’s mother’s disease is more likely to have a genetic component. a. True b. False 18. The Stages of Change Model emphasizes that change happens not as a one-time event, but as a process. a. True b. False 19. Adam is in the contemplation stage of the (Stages of Change) Transtheoretical Model when he decides that he will stop drinking alcohol at the beginning of next month. a. True b. False 20. In the maintenance stage of the Transtheoretical Model for health behavior change, a new behavior has been in place for a minimum of two years. a. True b. False 21. For some types of behaviors, the maintenance stage of the Stages of Change Model can be an ongoing, lifelong process. a. True b. False 22. Activities such as developing social support systems and establishing goals and rewards help people to move through stages in the Stages of Change Model. a. True b. False 23. A successful behavior change plan will include strategies for dealing with potential barriers to change. a. True b. False 24. For a person to change a behavior successfully, he or she does not need to have a perceived sense of self-efficacy. a. True b. False 25. A signed behavior change contract, with a family member or friend witnessing your new contracted commitment to change, is among the most effective tools for change. a. True b. False 26. When implementing a behavior change plan that involves a long-term health goal, you should strictly avoid setting and rewarding interim goals. a. True b. False 27. SMART is an acronym for Specific, Measurable, Attainable, Realistic, and Time-bound goals. a. True b. False 28. In assessing your health risks, it is important to ignore any emotional reaction you may experience. a. True b. False 29. Scientists typically consider the results of a single study to be conclusive and definitive. a. True b. False 30. The terms disease prevention and health promotion mean the same thing. a. True b. False 31. Community implies an interdependence between people and/or organizations within a defined region. a. True b. False 32. The terms ethnicity and race can be used interchangeably. a. True b. False 33. Race is a term used to describe a community based on common cultural origins and ancestry. a. True b. False 34. The term wellness refers to a relative state in which a person maximizes their physical and emotional functioning to live a full and satisfying life. 35. Interpersonal health is the study of health outcomes in or between groups of individuals such as college students. 36. In 1947, the World Health Organization (WHO) broke new ground with its positive definition of health as a state of complete physical, mental, and SOCIAL well-being. 37. The SOCIO-ECOLOGICAL model of health addresses the interrelationships that influence your health. 38. Your health is affected by your BUILT physical environment (including schools, sanitation, and transportation) and your natural physical environment (such as air and water quality). 39. External environmental conditions that can be altered by social and health policies and programs are known as the social DETERMINANTS of health. 40. The series of four bases arranged to form a distinct message, located at a certain location along a chromosome, is called a(n) GENE. 41. The tightly-coiled molecule within the nucleus of a cell that contains an entire set of genetic instructions is called deoxyribonucleic acid, or DNA. 42. The two chains that DNA consists of are joined in a double STRANDED structure. 43. Of our 23 CHROMOSOME pairs, 22 are the same for men and women. 44. Females have two X chromosomes; males have only one. 45. Changes that occur during the process of parents passing genes to their children are called mutations. 46. A single-gene physical characteristic, such as whether earlobes are detached or attached, is determined by either a dominant or a recessive gene. 47. A mutated gene that is not expressed when paired with a dominant or healthy gene is called recessive . 48. A health condition caused by interactions among one or more genes and the environment is called a(n) multifactorial disorder. 49. An illustration of an individual’s family genetic history is commonly referred to as a family health tree. 50. To understand why people make the health choices they do, the Health Belief Model uses the constructs of perceived susceptibility, seriousness of consequences, benefits of action, and barriers to action. RESOURCES (as per syllabus GHSO-100) REQUIRED BOOK SmartBook: Your Health Today: Choices in a Changing Society, Eighth Edition (with extra Supplemental Chapters) ©2020 | Teague, Mackenzie, Rosenthal | McGraw-Hill Higher Education — USA- to be implemented as an E-book in the next semester. Reference HEALTH & SOCIETY CLO-1 /dainayesuraj GHSO100 – LECTURE 1 OBJECTIVES 1. Explain the importance of health awareness in society. 2. Understanding health problems and their social effects. 3. Understand individual individuals. the promotion of health between 4. Explain briefly the determinants of health. global Ever wonder… • why is it so hard to break a bad habit? • how much your parents’ health predicts your own? • how your neighborhood affects your health? AIM OF STUDY: Personal health in the context of social, cultural & physical environment. GOAL: Individuals should take up personal and collective changes. 1947 – WHO – Defined Health … Physical + Mental + Social health = HEALTH (3) ILLNESS (Western) *spiritual domain WELLNESS (7) = continuous, active process to improve health & be satisfied health-wise .. (…+ emotional + intellectual + occupational + environmental) WELLNESS (Other approaches) SALUTOGENESIS* HOW DOES THIS MODEL PLAY OUT IN YOUR LIFE? SOCIAL DETERMINANTS OF HEALTH = Complex, external factors that influence an individual’s and population’s health (income, economic status, educational attainment, literacy, employment status, literacy, employment status, working conditions, housing, transportation, healthcare, social support networks etc..) Environmental Factors Natural Factors Built Factors POPULATION DIFFERENCES create HEALTH DISPARITIES • • • • Geography Ethnicity & race…. well, what’s the diff? Socioeconomic status Educational attainment ………all of these matters…… If these are uniform, then HEALTH EQUITY can be attained!! ☺ PUBLIC HEALTH – It **Remember focusses on healths of : Public populations of people Your Health healthis Health Promotion Community Health Disease Prevention Personal Community Health = interdependence between people & organizations “a society in which all people live long, healthy lives” Your personal health choices HEALTH-RELATED BEHAVIOUR CHOICES…2 useful MODELS on this: Your personal health choices HEALTH-RELATED BEHAVIOUR CHOICES…2 useful MODELS on this: CREATING A BEHAVIOR CHANGE PLAN. 1. Is there a health behavior I would like to change? 2. Why do I want to change this behavior? 3. What barriers am I likely to encounter? 4. Am I ready to change the behavior? How do you become an informed consumer of health information? Understanding Medical Research studies Developing Health Literacy Evaluating health information from the Internet Basic Medical Research Epidemiological Studies Clinical Studies HEALTH AND FAMILY HISTORY….! DNA – RNA – PROTEIN Mutation: Changes that occur in a gene; “mostly spontaneous” Genetics and Heredity….? ALLELES = alternative forms of a gene OR copy of a gene Examples of Dominant and Recessive traits… Epigenetics and DNA Methylation… • CAUSES OF EPIGENETICS…. RelativeContributionofEnvironmentandGenetics Nature & Nurture CREATING A FAMILY HISTORY TREE….. ➢ A visual representation of the family’s genetic history ➢ Also called genogram or genetic pedigree W hat can you learn from your health tree??? EPIDEMIOLOGY & PUBLIC HEALTH CLO-2 /dainayesuraj Daina Health & Society Lectures OBJECTIVES 1. What is epidemiology and how does it serve public health? 2. Examples and case-study of epidemiological cases. Daina Health & Society Lectures Ever wonder… How do regulators make decision on what we aren’t allowed to do? • Like smoking in public places.. • Or driving air polluting cars? How do health organizations make recommendations on healthy eating? • Like 5 servings of fruits & veggies a day? THESE ARE EXAMPLES OF PUBLIC HEALTH DECISIONS BASED ON EPIDEMIOLOGY. Daina Health & Society Lectures Epidemiology — Defined Study of the distribution and determinants of health-related states among specified populations and the application of that study to the control of health problems Check out this article by NCBI on the “Epidemiology of Covid-19” which was published in the US National Library of Medical Sciences https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364648/ 4 Community Health Centers study epidemiology “a society in which all people live long, healthy lives” Daina Health & Society Lectures How do you become an informed consumer of health information? Developing Health Literacy Evaluating health information from the Internet Daina Health & Society Lectures Understanding Medical Research studies Basic Medical Researc h Epidemiolo gical Studies Clinical Studies 1.In the definition of epidemiology, “distribution” refers to: a. Who b. When c. Where d. Why 2. In the definition of epidemiology, “determinants” generally includes: a. Agents b. Causes c. Control measures d. Risk factors e. Sources 3. Epidemiology, as defined in this lesson, would include which of the following activities? a. Describing the age and marital status of persons with food poisoning in Dubai b. Prescribing an antibiotic to treat a patient with fungal infection c. Comparing the family history, amount of exercise, and eating habits of those with and without newly diagnosed diabetes d. Recommending that a restaurant be closed after it became the source of a hepatitis A outbreak Daina Health & Society Lectures How do we know whether.. Something we do OR Something we’re exposed to …Is harmful or not? … And how harmful is it? …. By doing experiments Daina Health & Society Lectures The only reliable way is … to use science to develop evidence that shows something is bad for health! IN-VIVO = IN-NATURE 1: To do research on animals (in-vivo studies) [Not same effect on humans] e.g. Chocolate is harmful to dogs, Aspirin is toxic to cats, but both are safe for humans OR IN-VITRO = IN-LABORATORY 2: To do research on cells isolated in test-tubes or petridishes in the laboratory (in-vitro studies) Cells out of body behave differently!!! So, we have to be very careful when we apply the effects of these cells on humans. Daina Health & Society Lectures Of course, the most straightforward approach is … to do experiments on real people! BUT WITH A FEW EXCEPTIONS, this is highly unethical. #warning You can’t go around exposing people to potentially harmful substances JUST TO SEE WHAT HAPPENS. Daina Health & Society Lectures OBSERVATIONAL STUDIES THIS LEAVES US WITH OBSERVING THE REAL WORLD!!! 1. Measuring what a lot of people are exposed to? (by a lot means 100s or 1000s of people) ☺ 2. Trying to work out what the connections are between these exposures and their health. (EXPOSURE → → → → → HEALTH?) STUDIES LIKE THIS FORM A BIG PART OF EPIDEMIOLOGY. Powerful way to understand how exposures and behavior potentially affect large groups of people! Daina Health & Society Lectures Just because someone was exposed to something and they got sick, does not mean that the two events are related. THE EXPOSURE MAY NOT HAVE CAUSED THE SICKNESS. Making sense of epidemiology data is OFTEN REALLY HARD!!! So, care needs to be taken so that we DO NOT JUMP TO THE WRONG CONCLUSIONS . Daina Health & Society Lectures While EXAMINING RELATIONSHIPS BETWEEN EXPOSURE and OUTCOME, there is a number of reasons why we might see an association!!! (*confounding = other things interfering with our observation) Daina Health & Society Lectures Confounding = other factors that confuses our interpretation of the exposure. In this case, SMOKING is the confounder. In real-life, there are many confounders!!! Some more obvious than others. Because of this, epidemiological investigations take quite a bit of detective work to figure out what exposures really lead to the health outcomes? And which ones only appear to? Daina Health & Society Lectures WHAT INFORMATION MATTERS? To find what’s really relevant, epidemiologists use STATISTICS. One standard practice in analyzing data = to look at PROBABILITY or p-value. (to determine if findings are likely to be true or simply due to chance) “The lower the p-value, the more likely it is that the results studied represent reality and did not happen because of chance/ random variations” *statistical significant= a fancy way of saying that there is a less than 5% chance of these results being due to random variations. However p-value only tells us whether the outcomes are due to chance or not. It does not help us understand how strong the association is. It DOES NOT tell us how important the health implications are. Daina Health & Society Lectures If statistics aren’t done well, even low p-values can be misleading!!!!! Consider Cancer risks… Red Meat Case – This is extremely low when you consider all the other things you’re exposed to that potentially infect your health. Especially if the chances of getting cancer aren’t high to start with… And this is why, LOOKING AT p-value ALONE ISN’T ENOUGH! Researchers also need to consider how large of a effect the exposure has? = “EFFECT SIZE” Not just whether there is effect or not. Daina Health & Society Lectures Lastly, when making sense of epidemiological studies, it’s important to remember that this science deals with collective health of a lot of people, and not individuals. Because we’re all different & live under different conditions, it is very hard to apply broad conclusions from such studies, to single people. But they are good at indicating what whole communities should do to stay healthy! Daina Health & Society Lectures Bottom line is, it takes a lot of work to conduct epidemiology studies. It takes a lot of work to interpret them correctly!!! Despite, these difficulties, epidemiology is crucial for making PUBLIC HEALTH decisions and improving the well-being of people. It: 1. Makes better healthy lifestyle recommendations 2. Reduces health-care bills 3. Increases productivity of tons of millions of people Daina Health & Society Lectures WHICH IS WHY, EPIDEMIOLOGY IS SO IMPORTANT! 1. A study in which children are randomly assigned to receive either a newly formulated vaccine or the currently available vaccine, and are followed to monitor for side effects and effectiveness of each vaccine, is an example of which type of study? a. Experimental b. Observational c. Clinical trial 2. The Iowa Women’s Health Study, in which researchers enrolled 41,837 women in 1986 and collected exposure and lifestyle to assess the relationship between these factors and subsequent occurrence of cancer, is an example of which type(s) of study? a. Experimental b. Observational c. Clinical trial 3. Indirect transmission includes which of the following? 1. Droplet spread 2. Mosquito-borne 3. Foodborne 4. Doorknobs or toilet seats Daina Health & Society Lectures A Public Health Approach 20 Epidemiology Purposes in Public Health Practice • Discover the agent, host, and environmental factors that affect health • Determine the relative importance of causes of illness, disability, and death • Identify those segments of the population that have the greatest risk from specific causes of ill health • Evaluate the effectiveness of health programs and services in improving population health 21 Epidemiology Key Terms epidemic or outbreak: disease occurrence among a population that is in excess of what is expected in a given time and place. cluster: group of cases in a specific time and place that might be more than expected. endemic: disease or condition present among a population at all times. pandemic: a disease or condition that spreads across regions. rate: number of cases occurring during a specific period; always dependent on the size of the population during that period. 22 A Public Health Approach Surveillance Risk Factor Identification Intervention Evaluation Implementation 23 Sample questions All of the following illustrate the purpose of epidemiology in public health, except A. identifying populations who are at risk for certain diseases. B. assessing the effectiveness of interventions. C. providing treatment for patients in clinical settings. D. determining the importance of causes of illness 24 Sample questions Epidemiologists use a model for studying infectious disease and its spread that involves the microbe that causes the disease, the organism that harbors the disease, and the external factors that cause or allow disease transmission. This is also known as A. host, vector, and transmission. B. transmission, host, and environment. C. host, agent, and environment. D. organism, transmission, and environment. 25 Sample questions Match each term with the correct example. A. endemic B. pandemic C. epidemic A. 1. Malaria is present in Africa at all times because of the presence of infected mosquitoes. Malaria is _____ in Africa. C. 2. The Ebola virus in parts of Africa is in excess of what is expected for this region. This virus is a/an ________. B. 3. HIV/AIDS is one of the worst global diseases in history. It is a/an _________. 26 Sample questions Choose the correct answer. A. distribution B. cluster C. determinant In March 1981, an outbreak of measles occurred among employees at Factory X in Fort Worth, Texas. This group of cases in this specific time and place can be described as a ________________. 27 Sample questions Choose the correct answer from the following choices: A. Qualitative C. Observational B. Experimental C. Observational An epidemiologist is doing a study on the sleep patterns of college students but does not provide any intervention. What type of study is this? 28 Daina Health & Society Lectures