Beruflich Dokumente
Kultur Dokumente
Health psychology
Health sociology
Health economics
Health ethics
Health law
Historical development of health
problems and Public Health actions
Time Health Problems Public Health
Actions
-1700 Infectious diseases, epidemics Isolation, quarantine
Psychological
Mental
Environmental
Economic
Holistic
Categories of definitions of
health (2)
Positiveconcepts of health
Negative concepts of health
Professionalconcepts of health
Lay concepts of health
Holistic health definition
Healthis a state of complete
physical, mental and social well-
being, and not merely the absence of
disease or infirmity.
AGENT ENVIRONMENT
Case study
Judy, a small, three-year-old child, was playing with her
siblings outside her home in a small, semi-urban, slum area.
While chasing her older brothers she trod on a nail. Her mother
washed the wound and bandaged it. The wound remained red
and ‘angry’. Over a week the wound did not heal, the area
remained red and ‘angry’, with flaring up the leg. Judy began
to complain that she had pain in her groin, she became weak
and febrile. Judy was taken to hospital when her mother could
not control her fever and she died within a few days of
admission.
What are the possible determinants of Judy’s death?
The (possible) determinants of
Judy’s death
Septicaemia (diagnosis)
The nail (environmental – proximal)
The environment – no playground (environmental, social – proximal
and distal)
Lack of footwear (social – distal)
Poverty (social – distal)
Poor housing (social – distal)
Poor wound management (biological – proximal)
Poor knowledge about wound management (social – distal)
Lack of education of parents (social – distal)
Poor health care facilities (social, environmental – proximal and distal)
Lack of antibiotics (biological – proximal)
Determinants of health and
disease
Enviroment
20%
Biological
factors
20%
Behavioral
factors and
Health care
lifestyle
services
50%
10%
Behavioural factors and lifestyle
Smoking
Alcohol abuse
Drugs
Nutrition
Physical activity
Stress
Etc.
Factors influencing lifestyle
Knowledge
Attitudes, beliefs
Habits, skills
(Bartly M, 1994)
Social environment:
unemployment
Cause of death RR with 95% CI
Lung cancer 1.43 (1.12-1.85)
Acute myocardial infarction 1.36 (1.18-1.56)
Other ischemic heart disease 1.77 (1.44-2.17)
Cerebrovascular disease 1.54 (1.21-1.96)
Other circulatory diseases 2.08 (1.59-2.72)
Diseases of respiratory system 3.32 (2.14-5.13)
Alcohol related diseases 5.24 (4.21-6.52)
Suicide 1.92 (1.62-2.27)
Traffic accidents 1.88 (1.47-2.40)
Alcohol poisonings 4.62 (3.59-5.95)
Other accidents and violence 3.01 (2.54-3.56)
■ Human resources
■ Technologies
Behavioral indices
C. Everett Koop