Assignment #12

There are many different determinants that can affect an illness or public health problem. These determinants can be classified into biological, social, environmental, economic, and political. The biological determinants of anorexia are much more important than many people think. A person with a family member that has anorexia, whether a parent or sibling, are at an increased risk of 12 times to develop anorexia and these biological factors contribute to approximately 56% of the increased risk. Social determinants are arguably the largest category of determinants because the pressures to be thin come from social pressures. Often parents pressure their children to be thin and be the best they can be if they participate in activities such as ballet, gymnastics, or modeling. It can also come from parents who criticize their children or their children’s looks. Social pressures of school can also have a large impact on anorexia. A need to want to be the best and be perfect often leads teenagers down the road to anorexia. Stressful events such as a parents’ divorce, a breakup, or the onset of puberty can often trigger anorexia or push a teen over the edge into anorexia. Ethnicity also matters although it is not a large factor. Indian girls and Caucasian girl are more likely to be anorexic than African-American girls. It does affect African-American girls although it is much less common.

Environmental determinants often depend on where and how a person was raised. If a person was raised in a wealthy city environment then they are exposed to the other factors that I mentioned earlier. If they are raised in a lower class family that lives outside the city they are much less likely to be exposed to these factors and therefore at a lower risk for anorexia. Economic determinants also play a role in anorexia, but they are very closely related to the environmental determinants. The more money a person has the more likely they are to be exposed to these factors. But if a person has more money they are also much more able to pay for treatment after a person has been diagnosed and are also more likely to get a diagnosis in the first place. Treatment for anorexia is very expensive and often very difficult to pay for and if you are wealthy you are able to afford these expensive treatments. But this can also be a problem because people who are anorexic are often in denial and will deny treatment and forcing them into treatment can be to the dislike of the patient. Political determinants are very few because there are very few laws concerning anorexia and laws do not affect anorexia. Social factors are much more prevalent than political factors in this case.

http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=11748&cn=46

http://helpguide.org/mental/anorexia_signs_symptoms_causes_treatment.htm

Assignment #11

In anorexia surveillance is extremely difficult because the people with anorexia do not believe they need help and they deny it and often fight it if it is given to them. It is an extremely psychological illness that makes surveillance very difficult. The best way this is done is through outside sources such as the parents or friends instead of the people with the illness. Also the majority of people with anorexia still have problems with their weight throughout the rest of their lives. The fact that only 10% of people with anorexia seek treatment makes it extremely dangerous as extreme malnutrition can be extremely dangerous for the body and can result in death. Because of this reason anorexia is the number one killer in psychological illnesses. Anorexia usually takes effect around 17 which is another reason it has a higher mortality rate than any other psychological illness. Teenagers do not seek help and they often only seek help if their parents force them. Up to 5% of all female teenagers are anorexic. This is approximately one in two-hundred women. This is a very rough estimate because people who are anorexic don’t seek medical help and many go untreated. But it is also true that 50% of teenage girls think they are overweight and 40-60% of teenage girls constantly diet. These are the first steps to becoming anorexic and at least 50% of teenage girls are taking them.

There are many direct indicators of anorexia, but indirect indicators are much more difficult to use when dealing with anorexia because of the fact that people deny they need help and deny they are anorexic. The average age of death for anorexic patients is 34 which means that they struggled with the illness since they were teenagers. This is often very difficult to tell because they may seem as if they have recovered but many anorexic patients often have relapses and the majority is still very cautious of what they eat. Also many of the deaths related to anorexia are suicides which is often counted as a different cause of death.

http://www.state.sc.us/dmh/anorexia/statistics.htm

Assignment #10

I have decided to change the topic of my paper to anorexia instead of obesity because obesity was covered in class and I find anorexia to be a much more interesting topic. It might not be as pressing of an issue because it affects a much smaller number of people, but it is still large enough to be a public health issue. Obesity affects many people and causes some of the most devastating diseases that are currently a problem, but anorexia is a more devastating illness for the person and for the family.

Problem Definition: Anorexia is currently a serious problem in females between the ages 12 and 25 that has both psychosocial and physical effects on the person affected.

When a person has anorexia it is a very serious disorder and affects the family as well as the patient. But the person affected is not always a patient because they do not always seek medical attention. When a person has anorexia he or she is usually in denial and will not accept the fact which makes it hard for medical attention to become part of the process. My report is mainly going to focus on anorexia in females because about 90% of the people that have anorexia are females. My report will also focus on the ages between 12 and 15 because 95% of anorexic cases occur between those ages. It is a very important issue for teenagers because it is the third most common chronic illness among teenagers.

Anorexia is very much a psychological problem because people with anorexia often have internal problem with confidence and feeling worthless. They seem as if they have to do everything they can to be perfect and impress others while inside they feel inadequate. This inadequacy comes from the fact that they think that if they are not perfect they have failed. This has an effect on the family as well. The parents are often very controlling and want their children to be perfect and the children are obedient and strive to be everything their parents want them to be. It is not always their parents who want them to be perfect but there is usually a figure that pushes them to the limit, but it is usually the parents or sometimes an athletic coach.

The physical effects of anorexia are far more obvious because they can be seen as the illness becomes more serious. The deprivation of food leads to a severe lack of calories which leaves the body no choice but to begin consuming itself for calories. This is only the beginning of the illness and once enough weight is lost the illness begins to take severe and long lasting tolls on the body which can last a lifetime. Medical treatment of anorexia can be very difficult because many are being treated against their will because they have a fear of food and gaining weight. This makes it extremely difficult for them to gain weight and continue with a healthy lifestyle.

Assignment #9

The problem that I am going to address in my final paper is obesity because I think it is the largest health issue in America and is one of the solvable problems. Reducing obesity is so important because it is causes so many other problems such as heart disease and diabetes. Obesity may not be eradicated very easily or even ever but reducing the amount of obesity and overweight people will still have a drastic impact on the overall health of the population. People who are overweight and obese have a very increased chance of many problems, many of which are life threatening. There are many studies and many assessments that have shown how large of a problem this actually is. There are many simple solutions to this problem that could have enormous impacts on society. The problem is getting people to follow these simple plans until the results are apparent.

This topic has never been more relevant than now and is now being called one of the largest public health problems in America. This problem needs to be stopped as soon as possible because it is only getting worse. The problem has been developing for decades and is now getting out of control because of the marketing and accepted social norm in which people eat unhealthy and exercise rarely. With the average BMI above 28 which is very unhealthy. The amount of Americans that are overweight in amazing and there are also many that are obese and a much higher increase of certain illnesses. This problem is also very relevant because heart disease is the number one cause of death in America and diabetes is also high on that list. Reducing obesity rates would change these statistics and lower the rates of death due to those two illnesses and many other problems.

I think that this is a very interesting topic because it is so easy to avoid yet it is such a large problem in our country and it is becoming a larger problem around the world. This problem has been developing and now it is time that it is solved through any means necessary. In my paper I will come up with a solution that I would use in trying to solve this problem. There are currently many people who are trying to fix this problem, but they are fighting a losing battle as of today. This needs to be reversed, but many people are unsure of how to do this and there are many different ideas being proposed and tried. Some are successful but it is very hard to apply these plans on a large scale. The scale that these would need to be applied would have to be enormous because of all of the people who are having problems with their weight. Overall this problem needs to be addressed thoroughly and needs to be solved as soon as possible before it before even more serious than it is currently.

Assignment #8

Throughout the first half of class I have realized what a large issue public health is at a global level. Before taking this class I assumed that treatment was much more important and effective than prevention, but now I realize the large impact prevention can have a population and the amount of money it can save. I enjoyed the guest lecturers and the topics they brought to the class. I thought that each guest focusing on a certain area was very effective and helped specify that area and make the class realize the impact that area can have on a population.

The most interesting area that was covered in the first half of the class in my opinion was obesity because of the enormous impact it has on our society and the fact that it is still a rising problem. I realized this was a problem before this class, but now I realize all the problems that can come from it and that it is actually a larger problem than I had assumed. The fact that two thirds of Americans are overweight is a shocking fact and in my opinion one of the largest public health issues today. The fact that it is only getting worse is even more shocking.

What I found most surprising about public health is the enormous range of people that it tries to effect and the enormous effect it has on our everyday health. I did not know that public health affected my life so drastically and many of the things I take for granted are actually provided through public health innovations. The majority of the things I can do safely are provided through public health innovations. The clean water that I drink ever day multiple times is provided because of public health.

In my initial blog post I talked about my Pre-Med course that I plan on taking and how I thought that this course would help me. This course has helped me, but now that I have re read my initial blog post I realize how ignorant I was about the entire area. I thought that public health was a more medical field while I realize now that it is much more focused on prevention and that if the third step of public health, treatment, is reached it is the last resort. I have now learned that public health is a much larger area and has a much larger goal than I originally thought.

Extra Blog

I am going to discuss the flooding that is taking place in the North Eastern parts of the United States and the public health issues that are related to this event. The majority of public health efforts happen after the disaster has occurred because natural disasters are very hard to prevent, but some measures are taken to prevent them. There were sandbags that were put in place when it was apparent that there would be flooding although the massive amounts of rain that they received was not predicted so there was little preparation and the flooding caused massive amounts of damage. There are entire cars underwater and a large number of houses and businesses that are underwater. This is going to have an enormous impact on the economy of the places the flooding occurred. The majority of the flooding occurred in Rhode Island where there is already a poor economy and the flood will ruin many people’s businesses and boost an already higher-than-average unemployment rate. The amount of rain has broken records and rain in those amounts has never been seen all at one time. The rivers are overflowing and covering cities and making life unsafe for all in its path.

The results of the floods are people not having places to live, unclean water, and sewers overflowing which results in unsanitary conditions. The people who have been exposed to the water are urged to wear long sleeves and wash their hands as often as possible to avoid bacteria and illness from the water. People are also urged not to go in the water because of its contamination. Many of the wells in Rhode Island have been contaminated and drinking water in short supply. This is one of the largest issues because clean drinking water is essential for human survival. Many people have been evacuated dude to loss of living conditions and water has to be conserved because there is a very limited supply until clean water can be guaranteed.

Much of the problem with this disaster is economic, but there are also health problems related to the disaster. The health problems will most likely be minor as they are still emerging, but clean drinking water is currently the most pressing issue. In the aftermath of the floods the economic costs of the flood will be enormous for a place that is already under economic stress. The citizens have been given extra time to pay their bills and extra money is being given to the victims. In my opinion they are doing the right thing by evacuating the people who need to be evacuated because it is dangerous. The best plan is to wait for the water levels to subside and assess the damage and then take actions from that assessment.

Assignment #7

Obama’s healthcare reform is centered on the idea of government sponsored healthcare which would provide a much many more people with health insurance. There are currently around 46 million people who do not have health insurance and this is the problem Obama is trying to fix. The average amount of money spent per person is $6,714 which is much higher than other countries with global healthcare such as France ($3,449). This program would be similar to the government run Medicare which is for citizens who are 65 or older. His goal is to provide healthcare for everyone at an affordable price. Providing quality healthcare to so many people will obviously be difficult and expensive. Many people ask where he is going to get the money to provide healthcare for so many people at a lower cost. The answer he has for this is that he will find the money in eliminating waste and fraud in Medicare and Medicaid and he will repeal the tax reductions that are currently in place for high income citizens. Many people already have insurance that they receive from their employer and under the reform they would be able to keep this insurance, but the Republicans have a different idea of what will happen. They proposed that many employers will stop providing private health insurance and will switch to the less expensive government alternative. This type of insurance would most likely be less costly but would also be lower quality. There are also many people who have pre-existing conditions who have had trouble getting insurance in the past. Under the reform no insurer would be able to deny someone because of a pre-existing condition.

Obviously the majority of democrats are in favor of the bill because they say that there are hidden costs that come from the massive amount of uninsured people which could be fixed by spreading out the costs. This will supposedly lower costs and improve health insurance for all. The republican stance is that the bill impedes the freedoms of the citizens. People who are lower on the socioeconomic ladder are generally in favor of the bill because it provides them with an easier way to get health insurance. People who are wealthier or small business owners are generally not going to be in favor because they are the ones who are going to be paying for the people who could not previously get health insurance. One of the most important groups of people the bill will affect is doctors because it is directly affecting the way they practice medicine and their salaries. Most doctors will not be in favor of the bill because it is affecting their rights and more importantly their lifestyle.

I am not in favor of the health bill because it impedes on the freedoms that all Americans have enjoyed up until this point. The freedoms regarding healthcare are being taken away from us and being dictated by the government. Some of the freedoms that are being taken away are the freedoms to choose what you want in your healthcare plan, rewards for healthy living, high deductable coverage, and the ability to choose your doctors. These are all essential freedoms regarding healthcare and they are being taken away. I am currently pre med and this will greatly affect my medical career. There are many instances where Medicaid cannot cover the actual amount of money that the medical care costs. The doctors often end up losing money on Medicaid cases because they need more money to treat the patients than is available. There are some hospitals that refuse to take Medicaid patients but the government will most likely force everyone to take these patients which will case many problems for doctors.

Assignment #6

The article outlines the current situation regarding healthcare and talks about how it has developed over the past few years and what is going to happen to it over the next few years. These statistics say that the amount of money spent on healthcare is increasing. There are different types of healthcare and both public healthcare, which includes Medicare and Medicaid, and private healthcare have increased and are continuing to increase. Public healthcare has increased more and is expected to increase more due to the increasing enrollment in Medicare and Medicaid. The increase in enrollment is due to the again of the baby boomer generation.

The increase in healthcare spending can either mean that people are actually getting sick more often and they need more healthcare or it can mean that healthcare is becoming more expensive because healthcare providers are boosting their prices due to the recession and many other less significant reasons. One of the obvious reasons is that there are more people and therefore more money needs to be spent on healthcare to cover the increasing population. These numbers aren’t necessarily bad because it could only be that the population is growing and nothing more, but population growth is unfortunately only a smaller factor in the increase in spending. The increase in public healthcare is clearly partly due to the increase of people, but the article does not state as to what the reasons for the increase in private healthcare are. My guess is that the increase is due to the increase in prices of healthcare with other factors such as population growth. The system is clearly subject to change and is influenced by the economy, but there are many implications that it will continue to grow as it has even through the recession.

If I could change one thing it would be that the healthcare system be more focused on public health related issues such as prevention of sickness instead of treatment of sickness. With this shift we could spend less money and have a much larger impact. The prevention method is much more effective than the treatment method because it prevents people from ever getting sick at a much lower cost than if they were to get sick and use much more money on treatment. For example the prevention of obesity alone would have the most enormous impact on healthcare that this country has ever seen. If obesity is eliminated then the treatment money of all the problems that obesity causes is nonexistent. This among other large scale changes would have the largest impact on the healthcare system and decrease spending drastically. One of the articles we read earlier this year listed the top ten most important public health improvements in the past century and in my opinion those had more of an impact on the healthcare system than changing any one thing in the healthcare system could ever have. The integration of public health into the healthcare system should be made the number one priority for the changing of the healthcare system instead of the newly proposed global healthcare.

Assignment #5

Even though there is an enormous amount of money being poured into developing countries the overall public health of these countries seems to be declining. This is due to many different factors such as the money having strings attached and the money not getting to the actual countries for aid. In Ghana where corruption is particularly widespread 80 percent of the funds that are donated do not actually reach their intended destination or purpose. There are many donors that specify how their money must be spent and these large donations are often not very efficient because they are spent on things that are not as helpful to the overall public health. There are also very large donations that are triggered by emotional responses; the most recent of these is the earthquakes in Haiti and Chili. Those two are minor problems compared to the largest problem which takes the form of the lack of health personnel. The majority of the doctors that are being trained in these developing countries are leaving due to financial reasons. They are being offered more money to go and work in other developed countries such as the U.S. or England. The massive amount of money that is being poured into these countries is being spent on drugs or items that will help the sick, but the fact of the matter remains that there aren’t any health personnel to distribute the drugs or take care of these patients because they are all leaving the country.

The two most important factors in determining the overall public health of a country are increased maternal survival and increased overall life expectancy. If these two things are rising then that means that the health of the population is increasing. But if just the elimination of diseases is focused on and these rates do not go up the massive amounts of money that are being used to aid developing countries is all for nothing. If the maternal survival rates are rising then more mothers are surviving childbirth and their children are healthier. This has a huge impact on a society and if this rate is rising then the overall health care is doing very well. Maternal survival rates also have a large impact on the overall life expectancy. If children are surviving past the age of five then they have a much higher chance of making it to adulthood. The deaths from diseases in adults do have an impact on life expectancy but nowhere near the impact that’s dying infants have on the overall expectancy.

In some cases the diseases are actually worsening because of the lacking of good hospitals and good healthcare that’s can help the victims of these diseases prolong their lives. One thing that is mentioned is the reuse of needles for patients. This is obviously very dangerous and can lead to the spread of multiple diseases. This is only one of many unsanitary practices that could take place. Others include improper cleaning of surgical utensils and improper testing of blood in blood-banks. Another failure is that many people are given HIV treatment but do not complete the treatment which just boost the resistance to antibiotics. They are then susceptible to many other types of sicknesses due to a weakened immune system and have a resistance to antibiotics which is a deadly combination.

Assignment #4

In this article Miss Kirk was quarantined in her house because she had been afflicted with leprosy. In this instance she was still allowed to live in the city even though she was afflicted with leprosy. The board of health wanted to move her out of the city into the pest house which was located near the city dumping grounds and was a very unpleasant place. She wanted either to stay quarantined in her house since she had made no effort to violate the quarantine or have a cottage erected for her isolation instead of staying in the pest house. The difference between her quarantine and her isolation is that when quarantined she is still living in the city and if she was isolated she would be moved out of the city to the pest house. The definitions of quarantine and isolation say that quarantine is for a person who has been exposed and isolation is for a person who has been infected.

The board of health has the right to decide when a person should be quarantined as is what happened in this scenario. Miss Kirk agreed with their quarantine and had not argued it or tried to violate it. The reason she argued was because she did not want to have to live in the pest house which she thought was unfair and unreasonable. In her opinion the isolation was a violation of her rights which is why she argued against it. I think that the board was right to quarantine her because her disease was contagious and it was a public health issue which most likely saved many other afflictions. But as stated in the article the quarantine could not last forever and they were looking to isolate her, but it was unreasonable to have her isolated in the pest house which is why the court granted a temporary injunction.

In this case I think that Miss Kirk was right to take her case to the court and argue that it was unjust to have her isolated in the pest house. The Board of Health was right to quarantine her and should have the responsibility of deciding when to isolate and quarantine people. However the Board of Health was not right in the sense that they tried to put her in the pest house which was a vile place and not a place for a person like Miss Kirk. This was an error in protecting the rights of an individual and in my opinion this is more appropriate than if they were to commit an error in protecting the rights of a community. If they had not demanded that Miss Kirk be isolated and kept the quarantine then she could have infected many other individuals and it could have had a much larger impact on the society. It is more important to protect the rights of the society in public health regards because of the catastrophic repercussions it could have if the disease was to get out of hand. If that were to happen then not only would the rights of the community be violated but the rights of many individuals would also be violated when hundreds if not thousands of people had to be quarantined and isolated instead of a single person like Miss Kirk.

Assignment #3

I thought the most surprising statistic on that list was the fact that the average C-sections per live birth was 25.7 which is drastically higher than I had assumed. I would have guessed that the number would have been closer to 5% in the States, but it turns out that the U.S. has an even higher rate of 31.1 C-Sections per live birth. I was also surprised that countries such as Belgium, Norway, and Denmark had the highest ratings in some of the categories. They mostly dominated the medical staff statistics which I thought the U.S. would have done much better in considering they are the country that spends the most money on health related materials.

I thought the least surprising was obviously the U.S. at the top of the obesity statistic. America has been know and is becoming more known for its obese population which is why we clearly dominate this category more than doubling the worldwide average of 15.1%. Japan seemed to be doing very well in this category which was surprising with only 3.4% of an obese population. The U.S. clearly needs to do something about this obesity problem which is happening, but in my opinion not on a large enough scale. Another surprising statistic was that the life expectancy in the U.S. is lower than the worldwide average by .9 years. I would have thought with the U.S. having such medical technology and being well above the worldwide average in many medical averages the life expectancy would be at least above the average.

In my opinion the greatest impact on public health would be the obesity dilemma because it affects such a wide variety of things that eliminating it would mean eliminating countless other problems. Obesity puts a person at a much higher risk of heart disease, high blood pressure, diabetes, and many other health related problems. Eliminating obesity would eliminate all of these problems and therefore would save hundreds of thousands of lives and millions of dollars. There is nothing healthy about obesity and the problems associated with it are life threatening which makes it one of the deadliest problems in America. Obesity is due to inactivity and poor nutrition. This could be a simple problem to solve if everyone would follow a healthy lifestyle. Daily exercise and a reduction of calories would make an enormous difference in the majority of people and make their overall lives much healthier. This would also help bring the U.S. highest in the life expectancy statistic. My proposal is that we make people aware of the dangers of obesity and also make them aware of all the easy ways that this dilemma can be avoided. With this knowledge people will hopefully make minor changes to their lifestyles that can have a big impact on the overall public health of America.

Assignment #2

This article states that the most important public health achievements have occurred within the last 100 years. These achievements include Vaccination, Motor-vehicle safety, Safer workplaces, Control of infectious diseases, Decline in deaths from coronary heart disease and stroke, Safer and healthier foods, Healthier mothers and babies, Family planning, Fluoridation of drinking water, & Recognition of tobacco use as a health hazard. This list was compiled to show people how much of an impact public health has had over the past century and how much safer it has made our lives. In my opinion Recognition of tobacco use as a health hazard is the most important because it was a rising health problem and now that it has finally been addressed millions of lives are saved each year. This awareness shows people the dangers of using tobacco and prevents many from making the wrong choice and using tobacco. This achievement does not personally affect me, but many of the other ones such as motor-vehicle safety do affect me. A public health advancement that was not mentioned in this list is the chlorination of water which made drinking water safer for everyone in the States and improved sanitation.

Assignment #1

My name is Steven Pope. I am a freshman public health major. I am from St. Louis. I am interested in public health because I am pre-med and this was a major that interested me. In my opinion public health is the act of keeping the general public healthy, safe, and happy. My interests in public health are to use it as a basis for medical school and to be more familiarized with field that coincides with medicine. My initial impression of the first two classes are that it will be a field in which I know little about, but can learn about fast and use in my medical career.