Lectures for Exam 2 - Lecture 12 Lecture 12 CAUSES of...

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Unformatted text preview: Lecture 12 Lecture 12 CAUSES of Mortality CAUSES of Mortality Reduction Reduction Technophysio Evolution & Social Conditions Overview Overview ! Exam 1 ! Next 1/3 of Course ! McKeowns legacy, Link & Phelan ! Finch & Crimmins ! Fogel Exam 1 Grades: Avg. = 84% Exam 1 Grades: Avg. = 84% Exam 1: Threw out Exam 1: Threw out ! #1: To estimate the 2009 U.S. life expectancy ! #13 (B): Which of the following statements about urbanization is false? Review of 1/3 of Course Review of 1/3 of Course ! Overall point? ! Themes? Section Focus: Causes Section Focus: Causes ! UN (1953) 1. Public Health Reforms 2. Advances in Medical Knowledge/Practices 3. Improved Personal Hygiene 4. Rising Income and Standards of Living 5. Declining Virulence of Pathogens (1973) McKeown: 1955-1972 McKeown: 1955-1972 ! Historical improvements due to broad-based improvements in standards of living ! Medicine? No, declines started before ! Public Health? No, addressed only water (@ the time), which accounted for small fraction ! Declining Virulence? No, biologically implausible ! Still a role for human agency? Fundamental Cause Fundamental Cause Perspective Perspective ! McKeown and Link & Phelan ! Are public health aims better served by targeted interventions or by broad-based efforts to redistribute social, economic, and health resources? ! Controversial ! Overall levels or Disparities? Link & Phelan Link & Phelan ! Fundamental Cause Theory ! When a population develops the wherewithal to avoid disease/death, individuals ability to benefit from that wherewithal is shaped by resources of knowledge, money, power, prestige, and beneficial social connections. Fundamental Cause Theory Fundamental Cause Theory ! Human agency + RESOURCES 1. directly shape individual health behaviors by influencing whether people know about, have access to, can afford , and are supported in their efforts to engage in health enhancing behaviors Fundamental Cause Theory Fundamental Cause Theory ! Human agency + RESOURCES 2. shape access to broad contexts such as neighborhoods, occupations, and social networks that vary dramatically in associated profiles of risk and protective factors. ! As new knowledge/technologies develop, resources shape access & use Examples Examples ! Gortmaker & Wise (1994) ! The First Injustice ! Frisbie et al. (2004) ! Respiratory Distress Syndrome ! Chang & Lauderdale (2009) ! Cholesterol and Statins Caution Caution ! Dramatic improvements versus incremental improvements ! What is McKeown talking about? ! What is Link & Phelan talking about? " In what setting? But What Applies, But What Applies, Regardless? Regardless? 1. Persons and/or groups of people with superior resources will use those resources to garner health advantages 2. Specific mechanisms change from place to place and from time to time SOCIAL CONDITIONS AND TECHNOPHYSIO EVOLUTION Lecture 13 Causes of Mortality Reduction Review ! McKeown ! Social Conditions ! Nutrition ! Link & Phelan ! Fundamental Cause Fundamental Cause and Resources...
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Lectures for Exam 2 - Lecture 12 Lecture 12 CAUSES of...

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