Population, Health and Place

Geography
What is health and what is the problem with this definition?
Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. However, this definition is not easily applicable and health it is often measured by the absence of disease.
What is the difference between a disease an illness, and a sickness?
Disease refers to a medical conception of pathological abnormality which is indicated by a set of signs and symptoms diagnosed by a medical professional while an illness is the subjective experience of a disease for the patient. A sickness is the social role attached to the health problem by society.
What is the difference between mortality and morbidity?
Mortality refers to death while morbidity refers to sickness, including both disease and illness.
What does geography study?
Geography studies spatial processes, patterns, differentiation and organization of human activity, the environment and their relationship. It uses the concepts of space, place, time, distance, scale and environment. Within geography, the techniques used include mapping, location & spatial analysis and qualitative work.
How are health and geography linked?
Health and geography are linked by the spatial differences found in health (space, scale), the environmental effect on health, the spatial variation in health care availability, the role of distance in health care access, the spread of disease, migration and mobility, the role of place on health and the role of health on place.
What is medical geography?
Medical geography is a branch of geography that uses the concepts and techniques of geography to study health.
What are epidemiology and geographical epidemiology?
Epidemiology is the study of disease in populations while medical geographical epidemiology is the study of how disease is distributed in geographical space.
What are medical demography and medical anthropology?
Medical demography is the study of the demographic aspects of health and health care since health and mortality affect population change. Medical anthropology studies the medical experiences of people and societies.
Provide 5 examples of how geography can be used to study health.
Geography was used to study AIDS in Uganda. AIDS incidents were mapped and it was found that some areas had high levels and others low. The military, transport routes and migrants were found to play key roles.
Geography was used to study childhood accidents in the UK. People’s accounts of daily behaviour were analyzed as children were more likely to have accidents in poorer areas. Middle class people considered their areas safe while the lower class did not.
Geography was used to study racial segregation due to Malaria. Mosquito breeding pools were mapped and the British created a “hill station” to separate themselves from the locals.
Geography was used to study women with multiple sclerosis. Micro geographies were taken of the women and they were found to be handicapped by the disease and by society, and had to renegotiate with their space.
Geography was used to study 19th century asylums and how they were excluded from society and tightly structured to promote order.
Explain the two sub disciplines of medical geography.
The two sub disciplines of medical geography and geographical epidemiology and health care geography. Geographical epidemiology is concerned with disease and mortality and studies the relation between ill-health and environment. Health care geography addresses the location, accessibility, and utilization of health services.
What roles did Hippocrates and John Snow play in health geography?
Medical geography has been said to have its origins in Hippocrates’ treatise On airs, waters, and places. In his work, Hippocrates pointed out that for the study of medicine one must consider the effects of seasons, winds, water, ground, as well as the life and lifestyle of the inhabitants.
John Snow mapped cholera in London and was one of the first to map disease.
What does geographical epidemiology focus on? Define the frameworks of human disease ecology and disease diffusion.
Geographical epidemiology focuses on the spatial variations, spread and diffusion of disease and how it interacts with the environment. Human disease ecology is concerned with the ways human behaviour, in its cultural and socioeconomic context, interacts with environmental conditions to produce or prevent disease among susceptible people. Disease diffusion studies are interested in the spatial structure and spatial form of disease patterns.
What is the new geography of health?
The new geography of health emerged out of a dissatisfaction with approaches and methods in classic medical geography. It is characterized by: the adoption of sociocultural theories, a more critical perspective and the quest to develop critical geographies of health, a renewed sensitivity to place, the use of qualitative approaches, attention to individuals’ subjective experiences and a greater attention to the body and an interest in corporeality.
What is public health?
Public health is preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organization, public and private, communities and individuals.
What are the 3 consequences of disease?
The 3 consequences of disease are impairment, disability and handicap. Impairment is a defective or missing body part and effects people on the organ level (missing leg). A disability is an inability to perform an activity and effects people on a personal level (blindness). A handicap is prevents the fulfilment of a role and effects people on a societal level (poorly designed buildings).
What is the difference between an acute and a chronic disease?
An acute disease has rapid onset and progression, short duration and direct causation, like an asthma attack. A chronic disease has slow onset and progression, long duration and complex causation, like asthma.
What is the difference between infectious and non-infectious diseases?
Infectious diseases are communicable from one person or species to another and are caused by pathogens like viruses or bacteria that invade the body (influenza). Non-infectious diseases are non-communicable (heart disease).
What are the 3 groups of diseases?
Group one includes communicable diseases and maternal, perinatal, and nutritional disorders. Group two includes non-communicable diseases. Group 3 includes injuries both intentional and unintentional.
What are endemic, an epidemic and a pandemic?
Endemic refers to the normal level of a disease in a population. An epidemic is a sudden outbreak of a disease in a particular area or population which spreads rapidly and affects large numbers of people, occurring at levels beyond normal expectation. A pandemic is a worldwide epidemic.
What are: Absolute mortality, Crude death rate, Mortality by age, Age-standardized mortality, Mortality by cause, Life expectancy and Potential years of life lost (PYLL)?
Absolute mortality is the number of deaths. Crude death rate is the number of deaths over the average population for a specific period. Mortality by age is the rate of specific age groups such as infant mortality and maternal mortality. Age-standardized mortality controls for different age-specific population structures. Mortality by cause is the cause-specific mortality rate. Life expectancy is the average (remaining) N of years people are expected to live based on current age-specific mortality rates. Potential years of life lost is the index of premature mortality.
What is health adjusted life expectancy and disability adjusted life years?
The average number of years in full health a newborn can expect to live based on current rates of ill-health and mortality. Disability adjusted life years is the number of life years lost due to early death, ill health, or disability. It is the number of years of life lost (YLL) due to premature death and years lived with disability (YLD).
What are the 10 facts on the global burden of disease?
1) Around 10 million children under the age of five die each year
2) Cardiovascular diseases are the leading causes of death in the world
3) HIV/AIDS is the leading cause of adult death in Africa
4) Population ageing is contributing to the rise in cancer and heart disease
5) Lung cancer is the most common cause of death from cancer in the world
6) Complications of pregnancy account for almost 15% of deaths in women of reproductive age worldwide
7) Mental disorders such as depression are among the 20 leading causes of disability worldwide
8) Hearing loss, vision problems and mental disorders are the most common cause of disability
9) Road traffic injuries are projected to rise from the ninth leading cause of death globally in 2004, to the fifth in 2030
10) Under-nutrition is the underlying cause of death for at least 30% of all children under age five
How are diseases / morbidity in a population measured?
Diseases are measured according to hospital admissions, self-assessed health, incidence and prevalence. Disability is measured according to activities of daily living.
What are incidence (incidence proportion and incidence rate) and prevalence?
Incidence is the number of new cases occurring in a population during a specified period of time. Incidence proportion is cumulative incidence (the new cases divided by N of individuals at risk at beginning of period). Incidence rate is incidence density (the new cases divided by N of person-years at risk). Prevalence is the proportion of cases in a population at a particular point in time.
Indicate 3 differences in the current health status between developing and developed countries. Refer to either the percentage of deaths, the age pattern of dying, the cause-specific mortality, or the burden of disease.
Child mortality is a good indicator of the health of a population. In developing countries child mortality is much higher than in developed countries. For example in high income countries the number of child deaths per 1000 children is close to 0, but is close to 40 in Africa. In high income countries (developed) the majority of deaths are from those over 60 years of age. In Africa the smallest percentage of deaths come from those over 60. In developed countries life expectancy is in the 70s, while in many developing countries it is much lower, around 50 in many parts of Africa.
What patterns does the relationship between life expectancy and economic growth show?
In countries like Asia and Latin America, there is increasing in life expectancy with increase in economic growth. In some countries like the Russian Federation there is stagnation of life expectancy with increase GDP. In Africa both GDP and life expectancy stagnated as the countries face corruption, weak security, and internal conflict as fragile states.
How does health expenditure affect health?
In much of the world the health sector is often underfunded. Lower income countries generally allocate a smaller proportion of their GDP to health than high income countries, while their GDP is smaller to start with and they have higher disease burdens. High healthcare expenditure is associated with better health outcomes.
What is epidemiological transition theory? Describe its propositions and stages.
The theory of epidemiologic transition focuses on the complex change in patterns of health and disease and on the interactions between these patterns and their demographic, economic and sociologic determinants and consequences. The theory has 5 propositions: 1. Mortality is a fundamental factor in population dynamics, 2. There has been a shift in mortality and diseases patterns (infectious => degenerative) (3 stages), 3. The most profound changes are among children and young women 4. Earlier shifts associated with modernization; later shifts associated with medical progress 5. Variations show three basic models. The 3 stages are: The age of pestilence and famine (high and fluctuating mortality, high infant death rate, influenza, smallpox, etc.), the age of receding pandemics (progressive decline in mortality, communicable disease but less epidemics) and the age of degenerative and man-made disease (mortality stable at lower level, more degenerative diseases, man-made and stress related). There are 2 new stages: The age of declining CVD mortality, ageing, lifestyle modification, emerging and resurgent diseases and the age of aspired quality of life with paradoxical longevity and persistent inequalities. Instead of the age of man-man disease, in developing countries the 3rd stage is the age of the triple health burden, with old and new problems and lagging health care.
What are the 3 models of epidemiological transition?
The 3 models are the western model, the accelerated model and the delayed model. In the western model there is a gradual passing through all 3 stages due to modernization. Stage 2 is in the late 18th century and stage 3 in the 20th century. In the accelerated model the decline in mortality and fertility start later, over a short period (Japan). The delayed model characterizes developing countries and shows a fast decline of mortality (due to medical knowledge) that has slowed down.
What are the trends in disease patterns after 1960?
The development trends of developing countries are more diverse. The roles of lifestyle changes are now taken into account and there are new IDPs. There is an overlap of years in the transition and changes do not fully take place. There is epidemiologic polarization with different experiences within subgroups. There is a new stage termed the hybristic stage that deals with the epidemic of heart disease. People feel invincible and their personal behaviour and life style choices affect their health. There were delayed degenerative diseases that postponed death (cancers, chronic disease).

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