KNES 400: Foundations of Public Health
KNES 400: Foundations of Public Health KNES 400
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This 3 page Class Notes was uploaded by Victoria Dassing on Saturday September 24, 2016. The Class Notes belongs to KNES 400 at University of Maryland taught by Shannon Jette in Fall 2016. Since its upload, it has received 53 views. For similar materials see Foundations of Public Health in Kinesiology at University of Maryland.
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Date Created: 09/24/16
Expanding Epidemiology (III): An Embodied Approach Monday, September 19, 2016 11:17 AM I Problems with the Socioeconomic Model In-Class Discussion a Overlapping between groups b Linear progression c Emphasizes stereotypes II Upstream and Downstream Logic a Diseases are attributable to many causes, located outside and inside the body i The social lies in the realm of the distal (upstream) ii The biological (psychological) belongs to the proximal (downstream) b The distal and proximal are connected by levels i Societal, community, individual b A separation of the biological and the social i THE SOCIETY INDIVIDUAL Downstream Upstream Proximal Distal Biomedical Social model model b Conflation of level and time? i What is more distal in terms of level is also distal in terms of time ii Ex. The right to abortion 1 Once the law was passed, there was a direct influence on women's health ii Static, linear understanding of determinants II Ways Forwards a Instead of separating the biological and social, EMBODIMENT covers it all i Environment plays a role on genetics 1 Ex. Decorations are added onto the genes, and they can also be passed down like family decorations ii Embodiment as a: 1 Construct (or idea) a There are social and genetic contributions that lead to risk of disease 2 Process a Temporal aspect b Changes in the body over time c Conscious or unconscious 2 Reality a Data shown through research b There are typically multiple pathways of embodiment contributing to disease distribution i Exposure to social and economic deprivation ii Exogenous hazards 1 Toxic substances, hazardous conditions 2 Ex. Toxic substances can lead to obesity ii Social trauma 1 Discrimination and other forms of mental, physical, and sexual trauma 2 Ex. Increased levels of stress increases cortisol in body which can lead to problems like diabetes ii Targeted marking of harmful commodities 1 Tobacco, alcohol, food ii Inadequate or degrading healthcare b Embodiment Example i Barker's Hypothesis - Developmental Origins of Health and Disease 1 Found a relationship between babies born with low birth-rate (LBW) and coronary heart disease and type 2 diabetes 2 Women with inadequate diet during pregnancy, have lighter babies which are at an increased risk of coronary heart disease (CHD) and type II diabetes 3 During pregnancy, the combination of lack of nutrients causes the fetus to "choose" which body parts will fully develop ii Developmental Plasticity: one genotype can give rise to a range of different physiological or morphological states in response to different environmental conditions during development b EMBODIMENT DEFINITION: "An important integrating concept that describes the sculpting of internal biological systems that occurs as a results of prolonged exposure to particular environments become internalized or get 'under the skin'". c Structured Contingencies i Because they are: 1 Specific, stable dimensions 2 Exist external to individuals 3 Exist CONTINGENT in the sense that contexts within each dimension are varied 4 Likely to affect patterns of risk depending on personal, community, and historical processes b Risk Regulators i Type of variable that shapes health outcomes in populations, but in more indirect ways 1 Difficult to prove casually related to health outcomes using current epidemiological methods ii Phenomenon that impose constraints and opportunities that shape behavioral risk factors that cause disease, and shape the factors that protect against exposure and delay disease progression iii They are not themselves risks but the conditional that regulate or control exposure probabilities to those distal behaviors that lead to disease Optional Class Wednesday, September 21, 2016 11:13 AM I Axis of Nested Hierarchy a Above water -- dotted line because it is not directly linked b Under water c Embodiment: helps associate both levels II Ways Forward… Static and Linear understandings of determinants a Above water factors? RISK REGULATORS/SOCIAL i Include: 1 Racism 2 poverty b Below water factors? BIOLOGICAL/PSYCHOLOGICAL i Include: 1 Health issues 2 Determining factors 3 Direct contributing factors a Can think of them in terms of nested hierarchies, or just "above water" and "below water" b Can also think of above water factors as "risk regulators" i They don’t qualify as causal -- hard to prove as direct causes ii But they shape health outcome iii They regulate the risk factors (ex. Inactivity, hypertension) that cause disease 1 Ex. Racism 2 Ex. Poverty - living in an area without resources -- risk factor for inactivity I Assignment 1 : Due October 16th a Choose a population that faces challenges in engaging in PA i A disadvantaged population with health risks b Using journal articles, identify and discuss 2 above water factors and 2 underwater factors that show to shape physical activity behaviors and embodiment c Incorporate at least one transgenerational element that could i Ex. Discriminatory housing policies ii Ex. Exercise history
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