DETERMINANT FACTORS OF DISEASES

Tatong Hariyanto, dr, MSPH Dept of public health Agust 27 2007 IKM-01-2

STATUS OF HEALTH & DEVIATION OF FUNCTION/STRUCTURE

Level of Health POINT OF NO-RETURN

SUBCLINICAL Reversible CLINICAL HORIZON

CLINICAL Irreversible

Deviation of Functional & Structure from normal

Notes : Subclinical phase create ICE-BERG PHENOMENA

DISEASES CAUSATIONS
MOSTLY MULTIFACTORIALS (> 1 factor) There must be LAG-TIME (time intervals) or Incubation Period, between first-contact with the cause of disease and time of arising objective or subjective sign of functional or structural deviation, 2 THEORY :

EPIDEMIOLOGICAL TRIANGLE MODEL; LA LONDE (Henry L Blum) MODEL.

EPIDEMIOLOGICAL TRIANGLE MODEL

The arising disease, is always a result of total interaction of 3 factors: The Destructive power of AGENT OF DISEASE, as an absolute factor that must be exist as the cause. The Defensive Power of HUMAN HOST as the target of agent of disease, and The Supporting Power of the ENVIRONMENT to destructive power of agent of disease or to protective power of human host

DETERMINANT OF HEALTH EPIDEMIOLOGICAL TRIANGLE MODEL

Destructive power of Agent of diseases

Resistance of Human host against disease

Environment

AGENT OF DISEASES
Physical agent: Temperature, dust, gas, light, noise, radiation, etc Chemical Agent : Acid, Base, metal, Organic compound, food aditive, etc Biological agent : Bactery, Insect, Allergen, Animals bites, etc Intrinsic agent : Gen, hereditary disorders; Psychologial agent : Mental Stress;

DESTRUCTIVE POWER OF AGENT OF DISEASE

DETERMINED BY : Quantity of agents; Duration of contact with agent of disease; Area of contact between agent of disease and body of human host; Basic characteristic of agent of disease : Corosive, Allergen, Toxic, Carcinogenic, Mutagenic, Invasive, etc; Tissue resistance of human host against agent of disease

HOST RESISTANCE
Host resistance against destructive power of agent of disease, determined by :
Genetic factors; Mental & Spiritual stability Nutritional status; Physical fitness; Immunity;

ENVIRONMENTAL FACTORS
EFFECT AGAINST AGENT OF DISEASE : Increase /decrease number of agent of disease, duration of contact, area of contact and destructive power of agent of disease; ex High air temperature lower the body indurance EFFECT AGAINST HUMAN RESISTANCE : Increase / decrease psicho-bio-physical indurance ; ex Food production determine the nutritional status of population.

DETERMINANT OF HEALTH LA LONDE MODEL

PSYCHOBIOLOGICAL ENDURANCE

HEALTH SERVICE PROGRAMS

Health problem
ENVIRONMENT Biological Social

LIFE STYLE

HEALTH PROBLEMS ?
INDIVIDUAL : Functional/ structural deviation of Bio-Psychosocial; ex: Burns; Suicide; Drug abuse; Hypertention; COMMUNITY High prevalence of cases in the community; ex: Epidemi of diarrhea; Increase Number of narcotics; High prevalence of cancer

Lifestyle / Perilaku
Keyword: Habits; An action done without thinking the consequenses; Examples :
Smoking habit; Fitness Exersize; Consume junctfood;

ENVIRONMENT
Physical, Biological, Social
Anithing outside human body.
PHYSICO CHEMICAL; BIOLOGICAL (FLORA & FAUNA) SOCIO-CULTURAL :
Occupations Education; Customs; Law; Mariage

PHYSICAL - MENTAL-SPIRITUALAND SOSIAL INDURANCE

Physical fitness; Mental maturity; Spirituality; Nutritional status; Immunity; Genetics

HEALTH SERVICES PROGRAM

ALL ACTIVITY DONE TO IMPROVE HEALTH: Promote healthy life; Disease prevention; Treatment of disease; Rehabilitation of handicaps;

Epidemics of
DENGUE HAEMORRHAGIC FEVER
Habit Factors ? Environmental factors ?

Physical-mental-social conditions ? Health Service factors:

TERIMA KASIH

Thanks and See You .