POPULATION HEALTH, SOCIAL DETERMINANTS AND HEALTH OUTCOMES

POPULATION HEALTH, SOCIAL DETERMINANTS AND HEALTH OUTCOMES

We will be starting our series of Preventive Health Intervention publications whose sole aim is to equip readers with reasonable and useful preventive health information, capable of positively influencing personal behaviour leading to improved health outcomes within and between population groups. This will be a foundational teaching of the entire series.

What is health? We all at some point misunderstood health as being the absence of disease but the World Health Organisation (WHO) in its 1948 constitution defined health as “a state of complete physical, mental and social well-being and not mere the absence of disease or infirmity”. This definition looks at health in totality and the outcomes capable of influencing our decisions, productivity, actions and the overarching effect on our personal health.

Every workplace, every neighbourhood, every settlement, schools and assemblage of people could be seen a population group and it is important to know the healthy population within these groups.

Healthy Population is the health outcomes of a group of individuals, including the distribution of such outcome within the group. When we have more of unhealthy work population, the work distribution term to place more pressure on the healthy population in trying to meet collective goals and this could also throw more people from the health population bracket into the unhealthy population pool. This is the reason why creating health programs and wellness initiatives towards maintaining healthy population have become the new global frontier.

Naturally, people are able to act or take hold of their health concerns within the level of health information at their disposal, this is necessary in reducing man-hour-loss through hospital visits, illness related absenteeism or even most recently presenteeism (physically present at work and not able to produce optimally). This further validates the need to build and develop within capacity in the area of health information and education.

SOCIAL DETERMINANTS OF HEALTH

This is referred to as the need to encourage physical and social environment that promotes health. We cannot isolate this exclusively to the work environment but also includes where we were born, where we live, what we eat, where we learn, where we worship and the effects they have on our functionality and quality of life. As already established in many studies, chronic diseases are fuelled by two factors spanning from these:

Non Modifiable Risk Factor: This is as a result of the inherited gene that each person has by virtue of parental traits. We see people having Type 1 Diabetes even if they fall within the healthy body size category, the Diabetes they have is hereditary and not as a result of their actions or social behaviour. This is the reason why people with diabetic parents are always advised to be mindful of their dietary pattern and social behaviour as alcohol use and frequently check their glucose level to know how well they are doing in this regard.

According to the study on nature-nurture debate on obesity for instance, it was reported that a child with non-obese parents stands 10% chance of being obese, a child with one obese parent stands 40% chance of being obese and a child with both obese parents has an 80% chance of being obese. This is just to illustrate how much parental genes can influence non modifiable health risk in their offspring.

Modifiable Risk Factors: These are all factors within our control and when modified, we just live a more functional and healthy life. Example is people with Type 2 Diabetes, this is the diabetic disease condition that comes not because of genetic factor but as a result of our life style which includes poor dietary pattern leading to overweight and obesity. Obesity is a confounder of diabetes and other cardiovascular diseases which can be controlled by life style modification such as healthy eating, physical activity and informed social behavioural choices capable of restoring functional health. We will leave this for now because there is a complete teaching coming on this issue in the weeks ahead.

It is obvious we all want to be healthy and active but at the centre of this desire is our personal actions which we are only able to take with the right information at our disposal and the level of our personal discipline. We cannot be eating high carbohydrate food at 10.00 pm or midnight with the assumption that it will not have effects on our body weight and overall health functionality. You can be thought all you need to know as it concerns your personal health but taking action is your responsibility. In trying to play your role in this cycle of change, you must have motivation within supported by commitment which Darl Bem propounded in his 1972 “Change Talk Theory”. The 4 types of change talk are represented in the D-A-R-N acronym.

D – Desire to change: There should be that “WILL”. Example, “I will”, “I want to”, “I am longing to run upstairs once I stop smoking”. This is all about desire; it is at the beginning of personal commitment to functional health.

A – Ability to change: This is the expression of that change “ABILITY”. Example, “I am thinking I really should be able to stop smoking because I remember when I was trying to lose weight a few years ago, I worked on it. I thought a lot about it, then I decided finally how to proceed and I actually maintained that. So stopping smoking; I should be able to do that”. Talking about ability to change builds your internal positive reinforcement and motivation.

R – Reasons to change: What drives or motivate us towards taking an action is the perceived benefit. We ultimately want to live healthy lives; we must create a mental picture of the overall benefits. Example, “I am worried that smoking is going to make my health worse. I am still young, I love to smoke with my colleagues but I know that chances are I am not going to feel this way the rest of my life. Maybe I should stop smoking to make sure I am as healthy as possible”. The need to be healthy is the reason for the change.

N – Need to change: Until you identify that “NEED” to do something differently, you cannot experience that change. Example, “I have been noticing recently, since I smoke I have troubles running up the stairs, I feel I am more breathless and I cough more, I really need to do something about this”. This is the need to change.

The D-A-R-N Change acronym tells us the role of our personal responsibility in activating the cycle of change towards a positive health outcome which we all crave for. The need to develop personal health plans and setting goals, every goal you achieve no matter how little, be excited about it, appreciate yourself and motivate yourself towards the next goal.

We will continue from here in our next series but before we draw the curtain, we need you to rate your personal health and wellness in a scale of 1 – 10 (1 being the least and 10 being the highest). This is for your personal use, so be honest as much as you can.

How do you rate your personal health and wellness in terms of:

  • Presence or absence of disease
  • Emotional Health
  • Social wellbeing
  • Intellectual health
  • Spiritual wellbeing
  • Physical health
  • Environmental

We will be looking at healthy food and eating behaviour possibly in our next publication.

WORLD HEPATITIS DAY ARTICLE – 28 July 2016

Theme: Know hepatitis – Act now

Viral hepatitis – a group of infectious diseases known as hepatitis A, B, C, D, and E – affects hundreds of millions of people worldwide, causing acute and chronic liver disease and killing close to 1.4 million people every year, mostly from hepatitis B and C. It is estimated that only 5% of people with chronic hepatitis know of their infection, and less than 1% have access to treatment.

On World Hepatitis Day, 28 July 2016, WHO calls on policy-makers, health workers and the public to “Know hepatitis – Act now”.

The Organization urges them to inform themselves about the infection, take positive action to know their status by getting tested, and finally seek treatment to reduce needless deaths from this preventable and treatable infection.

Activities will take place around the world to improve public knowledge of the risk of hepatitis, and enhance access to hepatitis testing and treatment services.

Know hepatitis – Are you at risk?

Viral hepatitis affects 400 million people globally and, given the size of the epidemic, anyone and everyone can be at risk. It is estimated that in Nigeria, 20 million people are infected while 2 million people die of the consequence.

Know hepatitis – Get tested

An estimated 95% of people with hepatitis are unaware of their infection. Hepatitis tests are complex and can be costly, with poor laboratory capacity in many countries.

Know hepatitis – Demand treatment

Globally, lack of awareness and poor access to hepatitis treatment services mean that most people who need treatment do not receive it.

Over 90% of people with hepatitis C can be completely cured of the virus within 3–6 months. Appropriate treatment of hepatitis B and C can prevent the development of the major life-threatening complications of chronic liver disease: cirrhosis and liver cancer.

Let’s look at Hepatitis B

This is about the most common Hepatitis virus amongst us. Studies have shown that 15% – 25% of people with Hepatitis B will die without treatment. So it is important we”

  • Get educated
  • Get tested
  • Join the fight against Hepatitis B

 

What is Hepatitis B?

Hepatitis B is caused by a virus that attacks the liver and causes liver inflammation. The virus spreads through contact with infected blood or bodily fluid, it can be transmitted through:

  • Mother to unborn child
  • Unprotected sex
  • Injection or drug use

What are the symptoms?

  • Nausea
  • Vomiting
  • Fatigue
  • Abdominal pain

However, you may be among the about 30% of people who do not have symptoms when they are infected.

Who is at risk?

  • People with multiple sex partners
  • Injection and drug users
  • Healthcare and public safety workers
  • People who live in same household with some who has Hepatitis B

Types of Infection

Acute: Short term, less than 6 months

Chronic: Long term, more than 6 months and it is mostly a life-long condition and requires a long tern treatment to prevent more damage to the liver. Treatment is important because the damage to the liver could cause serious liver problem called cirrhosis.

Cirrhosis of the liver is the destruction of normal liver tissues, harm and scars left behind will prevent blood from flowing through the liver. Cirrhosis certainly sets a stage for liver cancer. Chronic Hepatitis B is the leading cause of liver cancer worldwide.

Screening and Vaccination

Hepatitis B is a preventable disease, the first step in this direction is to undergo screening and when you are found negative, you quickly commence the vaccine which comes in three-course, 0, 1 and 6.

Non-Negative

When you turn out non negative to Hepatitis B, the Doctor may order more test to check the state of your liver. It is important you see your Doctor often to check the state of your liver to know if treatment is necessary and to see how well your treatment is working.

Your Doctor may use a variety of test s to check the liver and monitor the amount of virus in your blood. Some of such tests are:

  • HBV DNA test: The Doctor may use this to monitor the amount of virus in your blood and also to measure your viral load.
  • The ALT: This looks at active liver inflammation.
  • Liver Biopsy: This is when the Doctor takes a sample of your liver tissue. This test is used to check the level of damage or liver inflammation.

The Doctor at this point decides what is right for you. If you have high viral load, the Doctor now decides which medication is needed.

High Viral Load

This is a sign of liver damage or you are at risk of liver damage. You may not feel sick but it is important you get treated if the Doctor recommends so. The earlier you treat a disease, the more likely you stay healthy longer. Why there is not cure for chronic Hepatitis B, there are two types of treatment to help:

Antiviral drug: These are to prevent the virus from growing and reproducing in your body.

Interferon: This helps strengthen your body against the virus.

Whether you are taking medication or not, there are things you must do to keep the liver healthy. These include:

Eating right: Eating healthy meals

Rest: Getting enough sleep

Avoid things that may harm your liver such as alcohol, drugs and some herbal medications.

See your Doctor every 6 – 12 months; it is also a part of taking care of yourself. It is only through the Doctor that you can know how the virus is affecting and detect liver cancer.

One of the several things you can do is to learn more about the disease and how to stop the spread of the virus.

This material is a part of publications of Action for Preventive Health Concerns, a Not-For-Profit Social Venture of OHSM

References:

www.who.org

www.yourliveryourhealth.com    You can reach us using ehi@ohsm.com.ng

INTRODUCTION TO OHSM HEALTH INFORMATION DIGEST

 

We, the management and staff of Occupational Health and Safety Managers (OHSM) want to use this opportunity to thank everyone for the co-operation with our medical team in making the Apapa Clinic functional and engaging. We are excited about this and it gives us further boost in our collective desire towards maintaining global best standards in healthcare practice.

The new global approach to healthcare is “right health information for the right population”, which has yielded results across many regions of the world. In our strategy towards upholding preventive health approaches to Medicine, we will be adopting this style by creating health information traffic within the user-group in Apapa Clinic population. The level of health information an individual has at his/her disposal is capable of influencing healthy behavioural decisions and lifestyle changes which ultimately culminate into improved and healthy behavioural pattern leading to good health outcomes capable of reducing hospital visits, absenteeism, increased productivity and personal fulfilment afterwards.

In our series of health information pool, we will be sharing the following content with you in the weeks and months ahead.

  • Healthy population
  • Social determinants of health
  • Making health personal
  • Common food sources
  • Healthy food and eating behaviour
  • Hunger and eating
  • Satiety and factors affecting eating decisions
  • Minerals and functions
  • Physical fitness and health benefits
  • 2008 physical activity guidelines
  • Sedentary behaviour
  • Non-Exercise Activity Thermogenesis (N-E-A-T)
  • Built environment and physical activity
  • Sleep, stress and communication
  • Recommended hours of sleep
  • Inadequate sleep and health risk
  • Improving your sleep environment
  • Sleep diary and tips for healthy sleep
  • How much sleep is enough?
  • Insomnia and dysomnia
  • Sleep and cognition
  • Sleep deprivation
  • Sleep and stress
  • Healthy management of stress
  • Personal Action Plan for Stress (PAPS)
  • Health literacy and importance
  • Media and influence on food choice
  • Healthy weight
  • Prevalence of obesity and overweight in adult and children
  • BMI categories
  • Health implication of excess body fat
  • The concept of energy balance
  • Weight loss strategies
  • Disordered eating and eating disorder
  • Malnutrition
  • Infectious diseases and prevention
  • Risk factors of infectious diseases
  • Reducing risk of infectious diseases
  • Immunity
  • Chronic diseases
  • Hypertension and physical activity
  • Dietary Approach to Stop Hypertension (D-A-S-H) Diet
  • Cardiovascular disease
  • Modifiable and non-modifiable risks
  • Heart failure
  • Diabetes: Types and causes
  • Modifiable and non-modifiable risk
  • Management of diabetes
  • Nutrition and diabetes
  • Dementia
  • Nutrition and dementia

This space hopes to be exciting and we will be coming up with a number of new information on emerging workplace illnesses.

 

Ehi Iden

Chief Executive Officer

 

Safety in the work place

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Health and Safety Matters

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since the 1500s, when an unknown printer took a galley of type and

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