HEALTH Illness Injury

1. Chapter 4 HEALTH Illness & Injury

2. The Bio-psycho-social Model Biological: body, brain, genetic factors Psychological: Lack of self-control, emotional turmoil, negative thinking/emotions, emotional stress Social: social, economic, technological, religious aspects of cultures

3. Influences on Physical Growth & Health � Infectious Diseases 70% of deaths in children under age 5 are due to infectious diseases 99% are in developing countries and are related to malnutrition Most death due to diarrhea can be prevented by oral rehydration therapy (ORH)

4. Influences on Physical Growth & Health � Infectious Diseases Developing Countries Malnutrition Lack of immunization Lack of sanitation Diarrhea, dehydration Lack of health care High rates of infant mortality, childhood death

5. Children�s Health � Foci of Prevention Immunization Meningitis, measles, rubella, mumps, chicken pox, polio Accidents Poisonings, falls, drowning, choking Poverty Good medical care, nutrition, living conditions

6. Immunization Immunization has caused a dramatic decline in childhood diseases in the industrialized world 24% of American preschoolers lack essential immunizations (40% in poverty)

7. Immunization Decision Factors 1. consequences of the disease 2. likelihood of contracting the disease 3. possible consequences of the immunization 4. likelihood of those consequences occurring Examples: smallpox MMR & autism

8. Injuries in Early Childhood Leading cause of childhood mortality in industrialized countries. Motor vehicle collisions are the most frequent source of injury at all ages & the leading cause of death among children over 1 year old Auto accidents, drownings and burns are the most common accidents of early childhood

9. Injuries in Middle to Late Childhood The rate of injury fatalities increases into adolescence with rates for boys rising considerably above those for girls. MV accidents are still the leading cause of death, with bicycle accidents next. Parents often overestimate children�s safety knowledge and behavior

10. Influences on Physical Growth & Health, Illness � Otitis media 70+% of American children have had at least one bout by age 3 Xylitol may be a preventative Tubes remain controversial Child-care settings should control infection May cause problems in language development due to hearing problems

11. Health - Middle to Late Childhood This is generally a healthy time The most common vision problem (25%) is myopia (nearsightedness), which progresses more rapidly during the school year. Otitis media becomes less prevalent.

12. Asthma 19% of N.A. children have chronic diseases and conditions Asthma accounts for 1/3 of chronic illness and is the most common reason for school absence Incidence has increased dramatically, 8% of U.S. children�boys, low SES, parents smoke, born underweight most at risk

13. Adult Health Immune System Capacity declines after age 20, partially due to thymus and inability to produce mature T cells Stress and depression can also weaken the immune system

14. Adult Health - Reproductive System The 20�s are ideal for reproduction. Risks of miscarriage and chromosomal disorders are reduced. First births to women in their 30�s have increased in the past two decades Dramatic rise in fertility problems in the mid-thirties (14 to 26%)

15. Adult Health - States of Mind Western stereotype: deterioration is inevitable In one study, people with positive self-perceptions of aging live 7 � years longer More optimistic elders are about capacity to cope with physical challenge, better they are at overcoming threats to health Low SES elders are less likely to believe they can control their health, to seek medical treatment, or to follow doctors� orders.

16. Middle Adulthood: Illness & Disability Cancer & cardiovascular disease are the leading causes of death. Cancer alone among women. Motor vehicle collisions decline, falls resulting in fractures & death nearly double. Personality traits that magnify stress, especially hostility and anger, are serious threats to health.

17. Cardiovascular Disease First detected factors may be high blood pressure, high cholesterol, and atherosclerosis (a buildup of plaque in the coronary arteries). Heart attack: blockage of blood supply to an area of the heart (50% die before reaching the hospital, 15% during treatment) Other conditions include arrhythmias and angina pectoris

18. Cancer � Middle Adulthood The death rate multiplies tenfold from early to middle adulthood. Lung cancer has dropped in men (fewer smoke) and increased in women. Cancer occurs when a cell�s genetic program is disrupted, leading to uncontrolled growth. Damage to the p53 gene is involved in 60% of cancers. This gene stops defective DNA from multiplying. Having the BRCA1 or BRCA2 tumor-suppressing gene is protection against breast cancer.

19. Cancer 40% of people with cancer are cured. Breast cancer is most prevalent for women, prostate cancer for men. Lung cancer is next, followed by colon/rectal cancer.

20. Adult-Onset Diabetes Causes abnormally high levels of blood glucose Incidence doubles from middle to late adulthood Effects 10% of the elderly Inactivity and abdominal fat deposits greatly increase risks Treated with controlled diet, exercise, and weight loss

21. Arthritis Osteoarthritis: most common and involves deteriorating cartilage on the ends of bones of frequently used joints Rheumatoid arthritis: an autoimmune response leading to inflammation of connective tissue, especially the membranes that line the joints Effects 45% of American men and 52% of women over 65. Rises to 70% in women at age 85.

22. Osteoporosis Major age-related bone loss 12 to 20 % of patients die within a year of a major break such as a hip Patients are advised to: Take calcium and vitamin D Engage in weight-bearing exercise Take HRT/ERT Take bone-strengthening medications

23. Health in Older Adulthood Generally a continuation and intensification of problems that began in middle adulthood.

24. Physical Disabilities Cardiovascular illness and cancer increase dramatically and remain the leading causes of death Respiratory diseases also rise sharply Emphysema, mostly from smoking Pneumonia, 50 types Stroke is the 4th most common killer Hemmorage or blockage of blood flow in the brain

25. Chronic Conditions Arthritis Hypertension Hearing impairment Heart disease Diabetes Asthma Osteoporosis

26. Mental Disabilities Normal age related cell death in the brain does not lead to loss of ability to engage in everyday activities. Dementia: a set of disorders occurring almost entirely in old age and leading to impairment of many aspects of thought and behavior

27. Dementias Alzheimers: most common form Close to 50% of people over age 80 are affected Starts with memory loss, faulty judgment, anxiety, aggressive outbursts, reduced initiative, social withdrawal, depression Later purposeful movement may degenerate, may lose speech, lapse into a coma

28. Alzheimer Neurofibrillary tangles: twisted threads from collapsed neural structures Amyloid plaques: deposits of deteriorated protein surrounded by clumps of dead nerve cells Lowered levels of acetylcholine and serotonin (Drugs limiting acetylcholine breakdown reduce dementia symptoms.)

29. Alzheimer Risk Factors Familial: early onset, rapid progress Genes on chromosomes 1, 14, and 21 Dominant Related to Down syndrome Sporadic: no obvious family history Abnormal gene on chromosome 19 leads to excess ApoE4 blood protein that carries cholesterol and is linked to amyloid formation Some have no known genetic markers

30. Suspected or Possible Alzheimer Risks Toxic substances Viruses Defects in the blood-brain barrier Vitamin and mineral deficiencies Excess dietary fat Cardiovascular disease Head injury Elevated aluminum levels

31. Alzheimer Protective Factors Vitamin C and E Anti-inflammatory drugs (aspirin, ibuprofen) Education Active lifestyle

32. Cerebrovascular Dementia 5 to 10% of cases Series of small strokes leaves areas of dead brain cells Risks include high blood pressure, cardiovascular disease, diabetes Also smoking , heavy alcohol use, high salt intake, very low dietary protein, obesity, inactivity, and stress In most cases caused by atherosclerosis

33. Parkinson Disease Subcortical dementia Involves dopamine-producing neurons in the substantia nigra of the brain Symptoms include muscle tremors, slowed movements, and partial facial paralysis Drug treatment is partially successful

34. Reversible Dementia Depression Prescription drugs Surgery Environmental changes Social isolation

35. Unintentional Injury At age 65 and older, the death rate from unintentional injuries is at an all-time high Due to MV accidents and falls Older adults have higher rates of traffic violations, accidents, and fatalities per mile driven than any other age group 30% of people over 65 and 40% of those over 80 have experienced a fall in the last year Declines in vision, hearing and mobility make it harder to avoid hazards and keep one�s balance