Health Studies 201 Introduction to Human Health (II)

Study Guide

Unit 1: Introduction to the Determinants of Health

Objectives

After completing this unit you will be able to

  1. Define the determinants of health.
  2. Discuss how the determinants of health impact the health status of individuals and populations.
  3. Identify the leading causes of death in Canada, and how the determinants of health may impact them.

Introduction

Do you feel your health is influenced mostly by your own choices or by other things outside of your control?

Consider the following situation, taken from the Canadian government’s public health website.

Eight‑year‑old Jason hasn’t shown up for school for a few days, so the teacher phones his mom. Jason has been in the hospital with a bad infection in his leg. Jason’s teacher asks, “Why does he have an infection?” His mom answers that he got a cut on his leg and it got infected. “Oh dear, where did he cut himself?” asks the teacher. Jason’s mom pauses, embarrassed, and says “he was playing in a junk yard next to our apartment and fell on some sharp, jagged steel there.” The teacher, thinking this is just another example of poor parenting, asks, “Well, why wasn’t he being watched?” The mom starts to cry. “All the kids in the neighbourhood play there, there is no playground you see. I am pregnant and lost my job because I have been so sick and can’t leave the house. Jason’s dad works away from home because he doesn’t have much education and couldn’t find a job here. We can barely make ends meet, and we don’t know how we are going to pay for the ambulance ride to the hospital. We already got our monthly hamper from the food bank, and if I pay for the ambulance we won’t be able to eat at the end of the month. They wanted me to bring Jason home on antibiotics, but I just haven’t gone back to the hospital because I can’t afford the medicine and figure if I leave him there, they will give him what he needs. When they call I am just not answering the phone. We have no family here and I have no friends, I am at the end of my rope, I just don’t know what to do.”

Now answer the question above from Jason’s point of view.

Is his health mostly influenced by his choice to play in the junk yard unsupervised (i.e., personal choice) or by factors outside of his and his parent’s control (i.e., income, education, employment, physical environment, social support networks, and health services)?

Key Terms

As you work your way through this unit, write definitions for the terms and concepts below. Be sure you understand their significance before proceeding to the next unit.

  • World Health Organization (WHO) definition of health
  • Determinants of health
  • Health equity
  • Health disparities
  • Health‑adjusted life expectancy
  • Health related quality of life
  • Chronic disease

Learning Activities

  1. Read What is health? on the Public Health Agency of Canada’s website and What Makes Canadians Healthy or Unhealthy?. Now list the 12 determinants of health in Your Learning Journal.
  2. Spend half an hour to an hour watching this learning module for health professionals, Social Determinants of Health and complete the online activities (except for memorizing the cultural competence framework). Not all slides may seem relevant if you are not a health care provider but think of yourself as one with a future role to play in promoting health. Note: The terms “social determinants of health” and “determinants of health” are interchangeable (i.e., they mean the same thing).
  3. Read the table Health‑adjusted life expectancy, by sex on the Statistics Canada website and complete the following questions
    1. What is your life expectancy, based on whether you are male or female and the province in which you live? Does your gender affect your life expectancy?
    2. How is health‑adjusted life expectancy different than life expectancy at birth? Hint: Read the definitions at the bottom of the graph. (For more information on quality of life, refer to the Centers for Disease Control and Prevention website.)
    3. What is your health‑adjusted life expectancy?
    4. Draw a concept map like the one below. Circle the determinants of health you think may negatively impact your life expectancy. Why did you choose these determinants? (You can upload the map into Your Learning Journal as attachment).

  4. Read The 10 leading causes of death, 2011 and answer the following questions
    1. What are the top four main causes of death in Canada? (Table 1)
    2. Are these four causes different for men and for women? (Table 2) If so, what is different?

Assignment 1, Part I of 3

Do Assignment 1, Part I of 3 now, but do not submit it until you have completed Unit 3.

Study Guide

Unit 2: Income and Social Status

Objectives

After completing this unit you will be able to

  1. Define income inequality and social status.
  2. Discuss how income and social status impact the health status of individuals and populations.
  3. Identify how income and social status may impact the leading causes of disease in Canada.

Introduction

Rank your income compared to the rest of Canada.

Now compare your income to the rest of the world.

Reflect on how this may impact your health status compared to people in Canada and internationally. Type your answer in Your Learning Journal.

Do you think government transfers and taxes should be used to reduce income inequity in Canada?

Key Terms

As you work your way through this unit, write definitions for the terms and concepts below. Be sure you understand their significance before proceeding to the next unit.

  • Income inequality
  • Gini coefficient
  • Causal relationship
  • Cross‑sectional association
  • Correlational association
  • Social gradient and social status

Learning Activities

  1. You should now read the Conference Board of Canada’s report, How Canada Performs on Income Inequality. While you read, answer the following questions.
    1. Using the income per capita figure, what is the average income in Canada approximately?
    2. Is income inequality in Canada increasing or decreasing? What is the cause of this change?
  2. Read Income inequality and health: A causal review by Pickett & Wilkinson.
  3. Read Income inequality is killing thousands of Canadians every year by Raphael Dennis & Bryant.

Now do you think government transfers and taxes should be used to reduce income inequity in Canada?

Assignment 1, Part II of 3

Do Assignment 1, Part II of 3 now, but do not submit it until you have completed Unit 3.

Study Guide

Unit 3: Social Support Networks and Social Environments

Objectives

After completing this unit you will be able to

  1. Define social support networks and social environments and discuss how they differ from each other.
  2. Discuss how social support networks and social environments impact the health status of individuals and populations.
  3. Identify how social support networks and social environments may impact the leading causes of disease in Canada.

Introduction

Do you think the amount of social support you have from others and in your community makes a difference to your health?

Rate your social support for changing eating habits using this Social Support and Eating Habits Survey.

Now rate your social support for exercise.

By adding your two scores up, you can identify how much support you get for these behaviours from family and friends. (If you chose “8” you have to score this as a “1.”)

For the eating habits survey,

  • Add up your scores for items 1–5 for family and then 1–5 for friends. This is your encouragement score.
  • Add up your scores for items 6–10 for family and then 6–10 for friends. This is your discouragement score.

For the exercise survey,

  • Add up your scores for items 11–16 and 20–23 for family and then 11–16 and 20–23 for friends. This is your family and friend participation score.

Looking at the scores from these surveys gives you an idea about how much social support you have for these health habits. Studies have demonstrated that those who have higher scores for encouragement and family participation, and lower scores for discouragement, are more likely to successfully perform these health behaviours (Sallis et al. 1987).

Now answer the introductory question again.

Do you think the amount of social support you have from others and in your community makes a difference to your health?

Key Terms

As you work your way through this unit, write definitions for the terms and concepts below. Be sure you understand their significance before proceeding to the next unit.

  • Social support networks
  • Social environments
  • Social capital

Learning Activities

  1. Read the Conference Board of Canada’s report on Social Network Support. While you are reading, answer the following questions.
    1. How many Canadians feel they have a social support network?
    2. How does Canada rate for social support compared to other countries?
    3. How was social support measured in this article? Do you think this could be improved on? If so, what other measures should be examined to measure social support networks?
  2. Read Martin Turcotte’s report, Trends in Social Capital in Canada. Answer the following questions as you read.
    1. How is social capital defined for individuals (i.e., social support networks)?
    2. How is social capital defined for communities (i.e., social environments)?
    3. Look at Table 1. How does social contact change as people get older? Hint: Look at the no close friends columns. How do these changes affect the health of seniors?
    4. In Your Learning Journal, answer the question about your social contacts.
    5. Look at Tables 10 and 11. What factors were linked to the size and diversity of social support networks?

    6. Look at Table 12. What are the major trends in civic engagement and volunteerism and how has this changed from 2003 to 2013? In Your Learning Journal, answer the question about your volunteer activities. How does your response compare to other Canadians?

    7. In Your Learning Journal, answer the question about trust. How does your response compare to other Canadians?
    8. Look at Table 13. How have levels of trust changed in those aged 15 to 24 from 2003 to 2013?
  3. Watch the 15‑minute Tedx Talk, The Power & Science of Social Connection.
    1. What are the consequences of low social connection?
    2. What are the results of high social connection?
    3. How can you increase social connection?
  4. Read Social and emotional support and its implication for Health to help you with your assignment.

Assignment 1, Part III

Once you have completed Part III, it is time to submit Assignment 1.

Reference

Sallis, J.F., Grossman, R.M., Pinski, R.B., Patterson, T.L., & Nader, P.R. (1987). The development of scales to measure social support for diet and exercise behaviors. Preventive Medicine, 16, 825–836.

Study Guide

Unit 4: Education and literacy

Objectives

After completing this unit you will be able to

  1. Define education and literacy.
  2. Discuss how education and literacy impact the health status of individuals and populations.
  3. Identify how education and literacy impact chronic disease in Canada.

Introduction

How often in a week do you read a book, newspaper, or magazine?

On page 13 of Health Literacy in Canada: A Healthy Understanding 2008, read through the suggested dosage recommendations for the product “Tempra” (acetaminophen) and then answer the following question to test your health literacy.

How many 80‑mg tablets of Tempra can you administer to your 2‑ to 3‑year‑old child in a 24‑hour period?

Key Terms

As you work your way through this unit, write definitions for the terms and concepts below. Be sure you understand their significance before proceeding to the next unit.

  • Basic participants
  • Mainstream participants
  • Advanced participants
  • Literacy
  • Health literacy

Learning Activities

  1. You should now read Education and Skills. While you are reading, answer the following questions.

    1. On what education indicators does Canada score the highest (an “A” ranking)?

    2. On what education indicators does Canada score the lowest (a “C” or “D” ranking )?

    3. What are the goals for basic participants in education and skills performance?
    4. What are the goals for mainstream participants in education and skills performance?
    5. What are the goals for advanced participants in education and skills performance?

    6. Where do you see yourself fitting in the education and skills performance diagram?

    7. What do you need to do to become or remain an advanced participant?
    8. Why do you think the financial gains for education appear lower in Canada? Is this association real or is there another factor making it look lower than other countries?

  2. Read this Government of Canada site, Learning – Adult Literacy.

    Consider that Level 3 literacy or above is needed to function fully in society. Level 1 is the equivalent of grade 5 reading and comprehension skills; Level 2 is grades 5 through 7 (US Department of Transportation, 2012). Now answer the following questions.

    1. How have literacy rates changed in Canada from 2003 to 2012?
    2. Make a list of all the other factors that affect literacy and state in what direction (i.e., higher or lower) they affect literacy.

Assignment 2, Part I of 3

Do Assignment 2, Part I of 3 now, but do not submit it until you have completed Unit 6.

Reference

U.S. Department of Transportation, Federal Highway Administration. (2012). How to Engage Low‑Literacy and Limited-English-Proficiency Populations in Transportation Decisionmaking. Retrieved from https://www.fhwa.dot.gov/planning/publications/low_limited/lowlim04.cfm

Study Guide

Unit 5: Employment and Working Conditions

Objectives

After completing this unit you will be able to

  1. Define employment and working conditions.
  2. Discuss how employment and working conditions impact the health status of individuals and populations.
  3. Identify how employment and working conditions impact chronic disease in Canada.

Introduction

Complete the online survey about workplace stress.

Add up your answers.

What is your total workplace stress score?

If you scored higher than 30 you may find the OSH Answers Fact Sheet helpful. It describes workplace stress, provides another assessment tool, and offers practical solutions to help you deal with workplace stress.

Key Terms

As you work your way through this unit, write definitions for the terms and concepts below. Be sure you understand their significance before proceeding to the next unit.

Learning Activities

  1. Read the Employment and working conditions section in the Chief Public Health Officer’s Report on the State of Public Health in Canada, 2008.
    1. As you read this report, make a list of the specific factors that affect employment and working conditions (e.g., the second paragraph mentions unemployment).
    2. Make a list of the determinants of health associated with occupational injury.
    3. Make a list of the determinants of health associated with job stress.
  2. Now read the Conference Board’s report on the unemployment rate and answer the following questions.
    1. What was the unemployment rate in Canada in 2013? Use the unemployment rate graph to see how unemployment has changed from the 1980s in Canada. What was highest unemployment percentage in this time period? What was the lowest?
    2. What has affected the unemployment rate in the Eurozone and in Norway?
    3. Look at the unemployment rate graph of the Canadian provinces for 2013. What two provinces have the highest rate of unemployment? Now read Health – Mortality from Leading Diseases. Based on the “Regions” section, are the patterns of death from chronic disease similar to rates of unemployment? Why or why not do you think this might be the case?

Assignment 2, Part II of 3

Do Assignment 2, Part II of 3 now, but do not submit it until you have completed Unit 6.

Study Guide

Unit 6: Physical Environments

Objectives

After completing this unit you will be able to

  1. Define physical environments.
  2. Discuss how physical environments impact the physical activity and food behaviours of individuals and populations.
  3. Identify how physical environments impact chronic disease in Canada.

Introduction

In this unit we will do something different by focusing on two health behaviours: eating and physical activity. We first explore how physical environments can influence physical activity, then how physical environments may impact the food choices people make.

We are also going to learn about ecological models and frameworks. These models try to explain why health behaviours may or may not happen, and use physical environments to explain physical activity and food behaviours.

Now, you are going to calculate the Walk Score of where you live. This is one measure of your physical environment. If you live in North America, type your address into the “Get your Walk score” box in this format: Street Address, City, Province/State to calculate your score. (If you do not live in North America you can use the Athabasca University office address: 345 6 Avenue, Calgary, AB.) After you have done so, use the “How Walk Score Works” table to interpret it. Enter your score here to compare it with others in the class.

According to the Walk Score.com, the following aspects of a physical environment make a neighbourhood walkable.

  • A center: Walkable neighborhoods have a center, whether it’s a main street or a public space.
  • People: Enough people for businesses to flourish and for public transit to run frequently.
  • Mixed income, mixed use: Affordable housing located near businesses.
  • Parks and public space: Plenty of public places to gather and play.
  • Pedestrian design: Buildings are close to the street, parking lots are relegated to the back.
  • Schools and workplaces: Close enough that most residents can walk from their homes.
  • Complete streets: Streets designed for bicyclists, pedestrians, and transit.\

Do you want to live in a walkable community?

Key Terms

As you work your way through this unit, write definitions for the terms and concepts below. Be sure you understand their significance before proceeding to the next unit.

Learning Activities

  1. Read the Alberta Centre for Active Living’s Physical Activity for All and answer the following questions.
    1. Define physical activity for adults aged 18 to 64.
    2. What factors do you think control a person’s ability to be active?
    3. What factors do you think are outside of a person’s control when it comes to being active?
    4. Read the “The Physical Environment” section.
    5.  What factors in the physical environment control a person’s ability to be active?
  2. Now watch the video Designing Healthy Communities and answer the following questions.
    1. What factors in the physical environment impact our health? List them.
    2. Life expectancy for us has increased by about 30 years from those in the early 1900s. How many of these years are due to enhancements in medical care? What are the other factors responsible for this increased life expectancy?
    3. When the presenter shows the picture of a building (minute 20:05) and asks what it says about the most important thing, what is the answer?
    4. What are some of the solutions he proposes to improve health?
  3. Read Determinants of health for healthy eating in Canada, by Kim D. Raine. (We will refer to it again in other units.) For this unit, please read the introduction on pages 1–2 and the subsection, “Physical environment as a determinant of healthy eating” on page 3 (as numbered in the PDF).
    1. Why are ecological approaches beneficial to the promotion healthy eating?
    2. How does the physical environment impact healthy eating?
    3. How have changes to the physical environment impacted Aboriginal populations in Canada?
    4. Why might the physical environment impact people who are low‑income to a greater extent than those with a higher income?

Assignment 2, Part III

Once you have completed Part III, it is time to submit Assignment 2.

References

Walk Score. (2016). Walkable Neighborhoods. Retrieved from https://www.walkscore.com/walkable-neighborhoods.shtml

Sallis, James F. (2002). Neighborhood Environment Walkability Scale (NEWS). Retrieved from https://sallis.ucsd.edu/Documents/Measures_documents/NEWS_sample.pdf

Study Guide

Unit 7: Personal Health Practices and Coping Skills

Objectives

After completing this unit you will be able to

  1. Define personal health practices and coping skills.
  2. Discuss how personal health and coping skills impact the physical activity and food behaviours of individuals and populations.
  3. Identify how personal health and coping skills impact chronic disease in Canada.

Introduction

It is very difficult to know how to improve your personal choices and coping skills if you don’t know what you are supposed to be doing better. In this unit you will assess your weight, physical activity, and eating patterns to identify some goals for yourself to improve your health.

First, answer the online question

Time to do a quick assessment of your fruit and vegetable intake.

Unit 7 Fruit and Vegetable Intake Survey.

How did you score?

  • If you scored 23–30: You are doing great! You likely eat enough fruits and vegetables.
  • If you scored 8–22: You likely need to start eating more fruit, vegetables, and fibre.

Report here if you are eating enough fruits and vegetables

Now let’s figure out your average physical activity level compared to the rest of this class: Unit 7 Physical Activity Survey.

Canadian Physical Activity guidelines for adults (ages 18–64 years) of 150 minutes of moderate and vigorous activity per week.

Report here if you are meeting Canadian Physical Activity guidelines

Answer the following question to assess your sitting time

Key Terms

As you work your way through this unit, write definitions for the terms and concepts below. Be sure you understand their significance before proceeding to the next unit.

Learning Activities

  1. Read the following scientific statements for the Canadian Physical Activity Guidelines and list how each of the physical activity guidelines positively impacts development, health, and chronic disease.
  2. Read the following scientific statements for the Canadian Sedentary Behaviour Guidelines and list how reducing sedentary time positively impacts development, health, and chronic disease.
  3. Read Sedentary behavior: understanding and influencing adults’ prolonged sitting time by Neville Owen and answer the following questions.
    1. How much sedentary time is listed as causing negative metabolic consequences?
    2. Look at Figure 1. Where is the majority of daily time being spent for adults and how many hours?
    3. How much does every hour of TV time diminish lifespan after the age of 25 years?

  4. Read Determinants of health for healthy eating in Canada. (We saw it in Unit 6). For this unit, please read the section, “Personal food choices: Individual determinants of eating behaviour” on page 2.

    What are the five individual determinants of healthy eating listed in the article?

  5. We will now look at Canadians in general. Please read the information on current smoking, current drinking, leisure‑time physical activity, and fruit and vegetable consumption. (When you click on each behaviour, the statistics for that behaviour will appear.)

    Answer the following questions.

    1. Are smoking rates in Canada going up or down?
    2. What percentage of males and females in all age groups are daily or occasional smokers?
    3. What happens to smoking rates as people age?
    4. What province or territory is prevalence of current smoking the highest in Canada and where is it the lowest?
    5. Are heavy drinking rates in Canada going up or down?
    6. What percentage of males and females in all age groups are heavy drinkers?
    7. What happens to heavy drinking rates as people age?
    8. What province or territory is prevalence of heavy drinking the highest in Canada and where is it the lowest?
    9. What percentage of males and females in all age groups are physically active?
    10. How do these physical activity rates compare to the class results?
    11. What happens to physical activity rates as people age?
    12. What province or territory is prevalence of physical activity the highest in Canada and where is it the lowest?
    13. Is fruit and vegetable intake in Canada going up or down?
    14. What percentage of males and females in all age groups eat 5 or more servings of fruit and vegetables a day?
    15. What happens to fruit and vegetable rates as people age?
    16. What province or territory eats the most fruit and vegetables and where is consumption lowest?
  6. Read about drinking in Canada. Note the recommendations for alcohol consumption for men, women, and in pregnancy. Now read about the costs of substance abuse in Canada, and answer the following questions.
    1. Why do you think people underestimate the seriousness of alcohol, illicit drug, and injection drug use when reporting them at the local level?
    2. What substance is perceived as the most serious problem in Canada?
    3. What is the cost of substance abuse per every adult Canadian?
    4. What substance has the highest level of cost?
    5. Why is alcohol abuse seen as less serious than other substances but is actually responsible for a much higher social cost?
    6. What are some of the institutional and socio/cultural factors that affect how drinking alcohol is perceived by Canadians?

Voting question 7.5

Voting question 7.6

If you answered yes to either of these questions you may be drinking in a way that harms your health. To find out if you may have a problem with drinking, please see the following link: https://sbir-diba.ca/screening-and-assessment/screening-and-assessment-protocol

Assignment 3, Part I of 3

Do Assignment 3, Part I of 3 now, but do not submit it until you have completed Unit 9.

Study Guide

Unit 8: Healthy Child Development

Objectives

After completing this unit you will be able to

  1. Identify key transition periods and contributors to healthy child development.
  2. Discuss how healthy child development is impacted by other determinants of health.
  3. List different factors that influence healthy child development.

Introduction

Read about Breastfeeding Trends in Canada.

Were you breastfed for more than one week as a baby?

Were you given formula in the first six months of life?

Do you think being breastfed can positively impact healthy child development?

An important part of healthy child development is being breastfed. The current recommendation in Canada is to offer only breast milk for the first 6 months of life and then to continue breastfeeding for up to two years or more. The benefits of exclusive breastfeeding (breastmilk only, no formula) are strongest in the first six months of life. For the baby these include

  • Optimal eye and brain development
  • Protection against infectious diseases
  • Protection against death from sudden infant death syndrome (SIDS)
  • May protect against obesity

Most Canadian women (around 89%) start breastfeeding their babies at birth. However, only 26% are still feeding only breast milk after the first six months. The most common reason mothers stop breastfeeding is because they think they have a low milk supply. This is actually very rare but sometimes if women are putting the baby on a feeding schedule, or giving formula or other foods, the supply of breast milk can go down because the baby is breastfeeding less.

Knowing the importance of breastfeeding, would you give formula or other liquids or solids to your baby before 6 months of age?

Key Terms

As you work your way through this unit, write definitions for the terms and concepts listed below. Be sure you understand their significance before proceeding to the next unit.

  • Healthy child development
  • Adverse childhood experience (ACE)
  • Toxic stress
  • Complex trauma
  • Executive function
  • Resiliency
  • Attachment
  • Self‑regulation

Learning Activities

  1. View this 30‑minute Training Module on Building Brain Architecture and answer the following questions.
    1. What year of life builds the most brain circuits?
    2. Why does learning new things take more effort as you grow older?
    3. What is “serve and return” interaction? Provide an example.
    4. If a child “serves” and the interaction is not returned, is this a negative or positive experience for development?
    5. What implications does this have for the popular practice of parents allowing their very young child (1 month old +) to cry for extended periods of time? (It may be called “sleep training” or “letting them cry it out.”)
    6. What effects can the prolonged activation of the stress response have on a child with no supportive adult to help them?
    7. What are the three types of stress? Provide an example of each.
    8. Calculate your ACEs score. You do not need to report it. Please answer the following question in Your Learning Journal.
    9. How does stress (i.e., ACEs) relate to childhood development?
    10. What can help buffer children from toxic stress?

  2. Read Growing Healthy Canadians and answer the following questions.

    1. What are the four developmental transitions in the lives of children and youths?
    2. Who are the major contributors to the healthy development of young people?
    3. Look at the left side of the page. You will see the two sections, “Life Transitions” and “Contributors.” Work your way through them to provide yourself with evidence‑based knowledge of how to promote the well‑being of young people.

    On the contributors pages, you will find a series of tables giving positive outcomes for optimal child development for each contributor. List each positive outcome in the table and specify the relevant age group. For example, under “Family,” we see that families support a successful transition in the first year through promoting physical health, secure attachment to caregivers, the ability for children to develop emotional control and feelings, and help children get ready for language and learning. Pick one of these positive outcomes, read the information on it, and list beside it what determinants of health are related. (This will help you with Assignment 3).

    The physical health of the child is influenced by a healthy pregnancy. Healthy pregnancies are influenced by personal health choices and coping skills, social support networks, employment and working conditions, social environments, income, culture, and health services.

    For each contributor (i.e., family, schools, workplaces, community, government) there are four tables, so you will need to write 16 statements (one about each table).

Assignment 3, Part II of 3

Do Assignment 3, Part II of 3 now, but do not submit it until you have completed Unit 9.

Study Guide

Unit 9: Biology and Genetic Endowment

Objectives

After completing this unit you will be able to

  1. Define how biology and genetic endowment affects health.
  2. Discuss how biology and genetic endowment impacts other determinants of health.
  3. Identify how biology and genetic endowment impacts chronic disease in Canada.

Introduction

Please complete this survey to identify whether you would be considered at risk of developing type 2 diabetes. Make a note about how biology and genetics (i.e., gender, age, waist size, blood pressure, birthed a baby weighing over 9 lbs, and blood relatives) influence your diabetes risk.

Now report your diabetes risk level here. If you scored at high risk, it would be wise to get your blood sugar tested by your doctor.

Key Terms

As you work your way through this unit, write definitions for the terms and concepts below. Be sure you understand their significance before proceeding to the next unit.

  • Chromosome
  • DNA
  • Protein
  • Alleles
  • Mutation
  • Chromosomal disease
  • Single‑gene disorders
  • Multifactorial disorders
  • Mitochondrial disorders
  • Genetic susceptibility
  • Noncommunicable disease
  • Communicable disease

Learning Activities

  1. Read the World Health Organization’s resource on Genes and human disease. (The “next page” button is located at the bottom of each page in a blue box.) Answer the following questions.

    Page 1

    1. If you want more information on how chromosomes, DNA, and genes work together, watch the video by Scientific American.

    Page 2

    1. What kind of disease is Down’s Syndrome? What causes it?
    2. How does having Down’s syndrome impact overall health?
    3. Read this report on Down’s syndrome in Canada to identify the most established risks for having a baby with Down’s syndrome.
    4. According to Figure 2.1, how many children were born with Down’s syndrome for every 10,000 total births in 2007?

    Page 3

    1. List the different monogenic diseases.
    2. What is the Canadian distribution for haemoglobin disorders per 1000 infants? How does it compare to other countries such as the United States and Central America?
    3. Why do these differences exist between neighbouring countries for blood disorders?
    4. Is Cystic Fibrosis inherited from the mother, father, or both?
    5. Overall, how do monogenic diseases affect lifespan?

    Page 4

    Before you begin answer this question.

    For this section you will also need to use the Chronic Disease and Injury Indicator Framework to examine rates of disease in Canada. (This is an excellent resource with statistics for different age groups and areas of Canada.)

    For more detailed information, look within the searchable data in the “CDIIF Data Tool”.

    For example, look in the Domain (“health outcomes/status”), Indicator group “general health”), and examine the many categories in the Data breakdown drop down menu.

    1. What are noncommunicable diseases? Please give three examples.
    2. What genetics cause cancer? What is a tumour?
    3. Now go to the PHAC’s page on Cancer. How many men and how many women in Canada will develop cancer in their lifetime?
    4. What does this Canadian website say you can you do to reduce your risk of cancer? What determinant of health do these fit into? Can you think of at least one other determinant that may impact cancer risk? Provide an example.
    5. What factors other than personal health choices and coping skills could you add to this list? (The WHO website lists a few additional causes.)
    6. What is cardiovascular disease (CVD)?
    7. Go back to the Chronic Disease and Injury Indicator Framework. Select the specific measure Prevalence of cardiovascular disease, adults (self‑reported), and age group (Life‑course). Click “View Results.” How many people in Canada have CVD? What age groups have a higher prevalence of CVD than the Canadian average?
    8. Now go back to the indicator framework and choose Mortality, Mortality rate due to a major chronic disease, Age Group (Life‑course). What is the total population rate of death per 100,000 for any chronic disease?
    9. Now choose Mortality rate due to cardiovascular disease age group (Life‑course). What is the total population rate of death per 100,000 for CVD? Based on these statistics, what percentage of chronic disease deaths are caused by CVD?
    10. What triggers an asthmatic episode?
    11. Use the Chronic Disease and Injury Indicator Framework to identify the number of adults with asthma in Canada. How many people in Canada have asthma? What age groups have a higher prevalence of asthma than the Canadian average?
    12. Now identify how many children in Canada have asthma. Is this higher or lower than the adult numbers?
    13. Why do you think asthma rates are increasing? Use evidence‑based statements to support your answer and reference them using APA.

    Page 5

    1. List each of the communicable diseases on this page and explain how genetics influence them.
    2. Read this information on HIV infection in Canada. How many people in Canada were living with an HIV infection in 2011? Is this number increasing?
    3. How often does someone in the world die from tuberculosis?
    4. What ethnic group in Canada is most at risk for TB?
    5. According to the Globe and Mail, mosquitos are the “deadliest creature on the planet, killing about 725,000 people per year. By comparison sharks kill about 10 people and snakes 50,000. Around 630,000 of these mosquito deaths are caused by malaria” (Picard, 2014). Can malaria be transmitted in Canada? How might a Canadian contract malaria?

Assignment 3, Part III

Once you have completed Part III, it is time to submit Assignment 3.

Reference

Picard, A. (2014) Why mosquitoes are no joke. Globe and Mail. Retrieved from https://www.theglobeandmail.com/life/health-and-fitness/health/these-little-buggers-are-natures-biggest-killer/article19568720

Study Guide

Unit 10: Health Services

Objectives

After completing this unit you will be able to

  1. Define how the health access to care, quality of care, and health financing affect the health of Canadians compared to other countries.
  2. Discuss how health services interact with the other determinants of health to influence health.

Introduction

The World Health Organization defines health services as the access and use of services that prevent and treat disease (WHO, 2016). Read Five Things Most People Get Wrong about Canada's Health Care System and answer these questions about your perceptions of health services in Canada.

Unit 10 Survey

Key Terms

As you work your way through this unit, write definitions for the terms and concepts below. Be sure you understand their significance before proceeding to the next unit.

  • Health services
  • Mortality
  • Quality care
  • OECD countries

Learning Activities

  1. Read the Chief Public Health Officer's Report on the State of Public Health in Canada 2008 and answer the following questions on health access.
    1. How many Canadians do NOT visit a regular family physician?
    2. What determinants of health impact health access? Provide an example.
  2. Read the Report of the Advisory Panel on Healthcare Innovation and answer the following questions on how Canada compares to other countries for health care spending and health outcomes.
    1. In the Health Spending section, look at Figure 2.1: Total Health Expenditures, Canada 1975–2014 and Figure 2.2: International Comparison of Health Spending. How many billions of dollars has total health care spending gone up from 1975–2013 in “Constant 1997 dollars”?
    2. In Canada, although we have a public health care system, public expenditure on health care per person is $3074 compared to the OECD average for other countries of $2535. How many OECD countries spend more than Canada and how many spend less?
    3. Think over some health areas you have spent your money on over the last year to improve your health. List five examples.
    4. Compared to other OECD countries, what is Canada’s highest expenditure? Why?
    5. Now look at Figure 2.3: Health Status Performance Profile. What health outcomes does Canada score better on than the OECD country average?
    6. In the Quality of Care section, look at Figure 2.6: Nation Summary Scores on Health Systems Performance. What is Canada’s overall ranking for health systems performance?
    7. What are the four components of quality care and how does Canada score out of the 11 countries in the figure?
    8. List the countries from highest to lowest health expenditures per capita, and then write the overall ranking for their health system performance beside them.
  3. Read the OECD’s Obesity Update.
    1. For the 11 countries discussed above, list their obesity rates beside your list.
    2. The OECD reports that obesity‑related costs are responsible for 1–3% of total health expenditure in most countries, and 5–10% in the U.S. What five countries may see more of an increase in health care costs related to obesity?
    3. Why is this concerning for Canada? What is a possible solution?

Assignment 4, Part I of 3

Do Assignment 4, Part I of 3 now, but do not submit it until you have completed Unit 12.

References

WHO. (2016.). Health Impact Assessment (HIA). Retrieved from https://www.who.int/hia/evidence/doh/en/

Statistics Canada. (n.d.). Canadian Community Health Survey (CCHS). Retrieved from https://www23.statcan.gc.ca/imdb/pIX.pl?Function=showStaticArchiveHTML&a=1&fl=https://www23.statcan.gc.ca/imdb-bmdi/instrument/5146_Q1_V2-eng.htm&Item_Id=53430#a26

Study Guide

Unit 11: Gender

Objectives

After completing this unit you will be able to

  1. Define how gender impacts the health status of individuals and populations.
  2. Identify how gender impacts the other determinants of health.

Introduction

Complete the following survey. Only you will have access to your personal results. The results will be saved in Moodle for you to refer to later.

Unit 11 Survey

You will now compare your results to 638 undergraduate students from Ontario.

The following exercise involves searching the library for basic research articles, and is important for the unit. Find the following article in the Athabasca Library ejournals. Search for “JRSH.” Choose one of the full text links for the journal listed below. If you have not already logged in to your library account, do so now.

Dawson, K.A., Schneider, M.A., Fletcher, P.C., & Bryden, P.J. (2007.). Examining gender differences in the health behaviors of Canadian university students. The Journal of the Royal Society for the Promotion of Health 127, 38–44.

Look at Table 1 on pages 40–42 in the article. How did your responses to each question compare with those of other students? You will need to answer some questions about this article for Assignment 4, but won’t be asked to share your personal results.

Key Terms

As you work your way through this unit, write definitions for the terms and concepts below. Be sure you understand their significance before proceeding to the next unit.

Use the Chief Public Health Officer’s Report on the State of Public Health in Canada, 2012 to define the following terms.

  • Sex
  • Gender
  • Gender roles
  • Gender relations

Other definitions

  • Hypertension
  • Postpartum depression
  • Sexual health

Learning Activities

Download the Chief Public Health Officer’s Report on the State of Public Health in Canada, 2012.

  1. Read Chapter 3: Sex, Gender and Health Outcomes and answer the following questions.
    1. How does sex impact hypertension?
    2. How does gender impact hypertension?
    3. In Canada, what gender has higher rates of depression and why?
    4. How do feelings differ in women and men who may have mental health concerns?
    5. Men seek help for mental health issues less often than women. How might men cope with these problems instead?
    6. How does being a lesbian, gay, bisexual, or transgender, or queer (LGBTQ) influence mental health?
    7. Watch this video on postpartum depression and answer the following questions.
      1. What is the difference between baby blues and postpartum depression?
      2. When can postpartum depression occur?
      3. What can relatives, friends, or partners of a new mother do if they think she may have postpartum depression?
    8. What gender is more at risk for a sexually transmitted infection and why?
    9. What is the best way to prevent STIs in people who are sexually active?
    10. Who is more likely to report condom use, males or females, in the past year?
    11. Who is more likely to report having multiple partners, males or females?
      What is one possible explanation for why women have higher rates of STIs than men?

    12. Human papillomavirus (HPV) is the most common sexually transmitted disease. Most sexually active adults get HPV at some point in their lives. HPV can go away on its own but can cause genital warts and cancer. When given in the recommended age groups, HPV vaccines protect males and females against some of the diseases caused by HPV (e.g., cancer). All boys and girls aged 11 or 12 years should be vaccinated. It can be given to males up to age 21 and females up to age 26. For gay or bisexual men it can be given up to age 26. Please answer the following questions and compare your response to your classmates.

      Would you get a HPV vaccine?

      If you have some reservations about getting the HPV vaccine what might they be?

  2. In Chapter 4, Section Two: Sex and gender in select health outcomes, you will be directed below to the sections you are to read.
    Promoting Healthy Weights section
    1. In what learning environment do girls learn best? Provide an example.
    2. In what learning environment do boys learn best? Provide an example.
    3. How do sex and gender stereotypes affect physical activity? Provide an example.
    4. Describe one problem someone who is transgender may have participating in competitive sports.
      Promoting Heart Health section
    5. What is the leading cause of death in women over the age of 35?
    6. Why have recent public health campaigns focused on women?

Assignment 4, Part II of 3

Do Assignment 4, Part II of 3 now, but do not submit it until you have completed Unit 12.

Study Guide

Unit 12: Culture

Objectives

After completing this unit you will be able to

  1. Define how culture impacts the health status of individuals and populations.
  2. Identify how culture impacts other determinants of health.

Introduction

Do you think Canada has a problem with racism?

To begin this unit, watch Our Canada: Are We Racist?. Note: This video does have some adult content as it deals with the potential of racism in Canada.

Key Terms

As you work your way through this unit, write a definition for the term below. Be sure you understand its significance before proceeding to the next unit.

  • Cohort analysis

Learning Activities

  1. Investigate cultural competence and communication using the Association of Faculties of Medicine of Canada’s AFMC Primer on Population Health. This reading is a chapter in a virtual textbook on public health concepts for clinicians, but being culturally sensitive will benefit both you and the people you come into contact with no matter where you live, work, or play.
    1. Define the following terms from the reading.
      • Culture
      • Cultural awareness
      • Cultural sensitivity
      • Cultural competence
      • Cultural safety
      • Ethnocentrism
      • Cultural blindness
      • Culture shock
      • Cultural conflict
      • Cultural imposition
      • Stereotyping and generalization
      • Collectivist cultures
      • Individualistic societies
    2. How does culture influence health? Provide an example of each influence and one thing you might do, if you were a health practitioner, to address the issue in a culturally competent way.
    3. What kind of cultural pattern do you come from? Answer in Your Learning Journal.
    4. Goal‑setting is a commonly used behaviour changing strategy for promoting lifestyle change in individuals. Current recommendations to set goals say they should be SMART goals: Specific, Measureable, Attainable, Realistic, and Timely. How might people from different cultures view their health practitioner setting a SMART goal with them?
    5. How did colonization adversely affect Canada’s indigenous people?
    6. How long were residential schools for First Nations open in Canada?
    7. What are some of the differences between western and traditional indigenous medicine? Describe one traditional practice from First Nations cultures.
    8. Watch The Sharing Circle, a YouTube video describing many of the impacts of colonization on First Nations and the Sun Dance ceremony
    9. If you are providing services or care to someone from a different culture but you don’t know much about that culture, what should you do?
  2. We are now going to examine Statistics Canada’s report, Avoidable mortality among First Nations adults in Canada.
    1. What is avoidable mortality?
    2. What risky health behaviours are more prevalent in First Nations cultures than non‑Aboriginal cultures?
    3. What is premature avoidable mortality?
    4. How many more times likely are First Nations men and women to die from an avoidable cause than non‑Aboriginal cohort members?
    5. What were the rates of avoidable causes of death among First Nations male cohort members compared to non‑Aboriginal?
    6. What were rates of avoidable causes of death among First Nations female cohort members compared to non‑Aboriginal?
    7. How did educational attainment and income adequacy impact dying from avoidable causes? How did these hazard ratios for First Nations compare to non‑Aboriginals?
    8. Are First Nations avoidable mortality rates compared to non‑Aboriginals improving or getting worse over time?
    9. What First Nations age group is at the highest risk for avoidable mortality? What are the hazard ratios and confidence intervals for males and females in this group?

After watching the video from the introduction and doing the readings, answer these two questions again in Your Learning Journal.

Do you think Canada has a problem with racism?

Do you personally have a problem with racism?

Assignment 4, Part III

Once you have completed Part III, it is time to submit Assignment 4.