Transcript AssessmentF16Bx

Health Assessment
Terms
 Definition of Health
 Major Causes of Death 1900 vs. 2010
 Behavioral Pathogen
 Behavioral Immunogen
 7 Healthy Behaviors
 Determinants of Life Expectancy/Health
How to Define Health??
Word Origins
 Indo-European Root: Kailo
 Old English: Hale
 Emphasis on vigor,
strength, whole, uninjured
 Health= absence of
physical disease
WHO Definition
 State of complete physical, psychological, and social well-
being
 Not merely absence of disease or infirmity
 “Health Triangle”: Biopsychosocial Model
Threats to Health
1900 USA: Life Expectancy 47
 Infectious Disease
 Cholera
 Dysentery
 Influenza
 TB
 Occupational Diseases
 Black lung
 Silicosis
 Accidents
2016 USA
Major Causes of Death??
CDC 2014 Data: Life Expectancy 78
 Heart Disease: 599, 413
 Cancer: 567,628
 Chronic Respiratory Disease: 137, 353
 Stroke: 128, 842
 Accidents: 118,021
Major Contributors
 -tobacco ( 400,000)
 -diet and activity patterns ( 300,000)
 -alcohol (100,000)
 -microbial agents like viruses, bacteria, fungi ( 90,000)
 -toxic agents (60,000)
 -firearms (35,000)
 -sexual behavior (30,000)
 -motor vehicles ( 25,000)
 -illicit use of drugs ( 20,000)
 Iatrogenic (doctor or treatment caused)
Causes of Death Demo
Lifestyle and Behavioral Factors
 Behavioral Pathogens:
health-compromising
behaviors
 Behavioral
Immunogens: healthenhancing behaviors
Behavioral Pathogens for Alzheimer’s ?
nine risk factors
 Obesity
 Smoking
 Low Education
 Type 2 Diabetes
 Depression
 High Blood Pressure
 Narrowing of Carotid Artery in Neck
 High levels of Homocysteine
Are certain traits linked to long life
?Carmelo Flores, b1890
 "I was born here in the highlands," Flores told CNN in Aymara,
with his son translating into Spanish. "I was not a mischievous
child. I was rather calm. I arrived as a young man in Frasquia and
worked as herder and farmer. I was very happy with my wife.We never
fought. I never cheated on her and we were both very happy.”
 Flores' wife lived to be over 100 years old. According to
family tradition, the secret to a long life is drinking the water
that flows down the Illampu Glacier, located not far from
Frasquia. Their diet includes no packaged or processed foods,
but locally grown plants like barley and quinoa. They hunt a
local fox that lives in the Bolivian mountains known
regionally as "zorrino."
Importance of Genes
no particular diet, geographical location or kind of water
makes people live longer.
” People who have extreme old age have virtually nothing
in common. They don't share the same religion, nutrition
or exercise routine. They only have one detail in
common: they have relatives who have lived a long time and
children (who) also tend to live a long time," Coles said.
Factors Influencing Life Expectancy
 **Biological/Personal:
 Individual characteristics (genes) and behaviors
 Social/Cultural:
 Economy and society
 Environmental:
 What we do or don’t do
How Much of Cancer is Due to
Lifestyle?
 Just Bad Luck vs. Preventable
Behaviors?
 Song & Giovannucci (2016)
 Data from Nurse’s Health
Study & Health Professionals
Follow-up Study ( 130,00
subjects)
 Filled out medical
data/lifestyle surveys every 2
years; dietary info every 4
years
 Divided subjects into two
groups, based on lifestyle
 Low- Risk Group: (21% total; 12% F; 9% M)
 Never smoked or not smoked for 5 yrs before start
 Not drink alcohol or only moderately ( 1/day women; 2/day
men)
 BMI of at least 18.5 and lower than 27.5
 Engage in at least 75 min vigorous intensity or 150 min
moderate intensity activity/week
 High- Risk Group (79% Total)
 Everyone else
Rates
 Overall USA Cancer Rates per 100,000
 Women: 618
 Men: 425
 Rates in Low Risk Group
 Women: 463
 Men: 183
Main Outcomes & Measures
 Population Attributable Risk (PAR) : Proportion of
cancer cases that would not occur if all individuals adopted
characteristics of low risk lifestyle
 Calculated by comparing incidence & mortality of cancer
between low & high risk groups
 Assessed PAR at national scale by comparing low risk group
with US population
PAR for Cancer Incidence
PAR for Cancer Mortality
PARS Summary
 Overall, about 20-40% of all cancer diagnoses, and about
50% of all cancer deaths can be prevented by lifestyle
changes
 Rates increase to 40-70% in general population
 Individual Cancers:




Lung Cancer: 70-80% deaths avoided by low risk lifestyle
Colorectal: 30%
Bladder-40-50%
Liver- 50-70%
Conclusions
 Lifestyle factors are important factor in cancer incidence &
mortality
 Certain cancers are more influenced by lifestyle factors
 “Need to avoid procrastination”- induced by waiting for new
cures, or idea that cancers are driven only by chance
 Preventability may be higher if diet, occupational factors,
infectious agents, hormone use also included
Behaviors
7 Healthy Behaviors
 Regular Physical Activity
 Eating Breakfast
 Enough Sleep ( at least 7 hrs)
 Never Smoking
 Moderate Alcohol Use
 3 Meals a Day
 Being at or Near Normal Weight
Social Factors
 Marital Status
 Social Groups
Changing Behavior
“When we look at living creatures
from an outward point of view,
one of the first things that
strike us is that they are
bundles of habits”
- William James
James on Habits:
“Any sequence of mental action which has been frequently
repeated tends to perpetuate itself; so that we find
ourselves automatically prompted to think, feel,
or do what we have been before accustomed to think,
feel, or do, under like circumstances, without any
consciously formed purpose, or anticipation of
results”
Characteristics of Habits
 We’re only vaguely aware of performing them
 Act of performing a habit is emotionless
 Repetition produces habituation
 Environments tend to trigger chain of habit behaviors
 Classical Conditioning: e.g. Daily Routines
Implications for Change: Make new habits
“For this we must make automatic and habitual, as early
as possible, as many useful actions as we can, and guard
against the growing into ways that are likely to be
disadvantageous to us, as we should guard against the
plague.The more of the details of our daily life we can
hand over to the effortless custody of automatism, the
more our higher powers of mind will be set free for their
own proper work.”
Don’t Think, Just Do
 Start now- don’t wait till New Years, or special date
 Don’t let the old habit slip in
 Arrange your environment to trigger new habit
 put yourself in conditions that encourage the new way
 Make new behavior incompatible with the old
 Make public pledge
How long does it take to change?
 Depends:
 21 days for some: drink glass of water with breakfast
 84 days, or much longer for others ( exercise)
In Class Activity
 How many of the 7 health behaviors are part of your routine?
 How might you make them habitual, using the techniques
discussed earlier?
Log Entry #4
What is your health belief model?
How do you define health?
What is important to you?
How can you optimize health, minimize illness?
 “We are what we repeatedly do,” Aristotle famously proclaimed.
“Excellence, then, is not an act, but a habit.”
 Don’t have a specific goal, like to lose five pounds
 choose a particular situation and then attach a particular action
to it.
 Example: if you always snack between meals
 Replace cake with apple
 Create new link between that situation and response that you
perform in that situation
 Repeat that over and over again until you do it automatically