Category: What is health

Disability

A disability is when a person’s condition makes it more difficult to complete certain tasks throughout the day. Disabilities can affect the mind or the body. Examples of disabilities include those that affect: movement, vision, hearing, learning, communicating, mental health and others. According to the Census Bureau, nearly 43 million people in the US had a disability in 2021.

Map titled Share of US population with disability by state: 2021. The map shows that the highester % of disability in states is 17 or more in OK, AR, MS, KY and WV. The lowest % is less than 11, in Utah.
Data source: US Census Bureau https://www.census.gov/library/stories/2023/06/disability-rates-higher-in-rural-areas-than-urban-areas.html

People who are older, who live in the South and rural areas, who are of the American Indian/Alaskan Natives ethnicity are more likely to have a disability. People with disabilities tend to earn a lot less than those without. Read more facts about Americans with disabilities here: https://www.pewresearch.org/short-reads/2023/07/24/8-facts-about-americans-with-disabilities/.

The Disability Rights Movement in the 1960’s and 1970’s led to the passage of the Americans with Disabilities Act (ADA) in 1990 which provides for accommodations for persons with disabilities to be able to participate in society. There are limitations to this law, but it has expanded the access of persons with disabilities in many ways, like allowing for service animals in places of business, funding the creation of curb cuts for wheelchair accessibility, encouraging closed captioning for media, providing school accommodations for students with learning disabilities, and so on.

It is important to consider this population when it comes to health. People with disabilities can live healthy and fulfilling lives if their needs are met and they have accommodations available for school, work and everyday life. However, they tend to face discrimination, including medical discrimination, and thus are a special population that may need legal and societal protections.

Common chronic diseases

Many people will live with a chronic illness eventually. Some of these diseases affect one body system, and some may affect multiple. The medical and health professions may still be learning about some of these groups of conditions.

Cardiovascular diseases – these are diseases that affect the heart or blood vessels. The most common of these is coronary artery disease caused by the narrowing or blockage of the arteries which supply blood to the heart. Others include: heart failure, high blood pressure (hypertension), arrhythmia, congenital heart disease, and even cerebrovascular disease or stroke. Learn more here. https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease.

Autoimmune disorders – this is a group of several different disorders in which the immune system of the body attacks its own cells. The symptoms may vary based on which cells are being attacked. Some examples include Type I diabetes, multiple sclerosis, lupus, and others. Women are more at risk of having these disorders. https://www.healthline.com/health/autoimmune-disorders

Respiratory disorders – these diseases affect the respiratory system and can include things like asthma, chronic bronchitis, chronic obstructive pulmonary disease and so on. In some cases, these disorders may be triggered by environmental factors – this includes infectious diseases like flu and RSV, as well as tobacco smoke, allergens, occupational exposures and so on. https://www.healthline.com/health/common-respiratory-diseases#common-respiratory-diseases

Diabetes – there are several types of diabetes, including type I and II, as well as gestational. In general, these diseases happen because of too high blood sugar, though causes vary from type to type. Treatments are available for diabetes, and in some cases, it can be prevented if detected in the early stages like prediabetes. https://my.clevelandclinic.org/health/diseases/7104-diabetes

Chronic kidney disease – this disorder results from damage to the kidneys, which will be unable to filter the blood effectively. It can result from people having other chronic diseases like hypertension, diabetes, or family or personal history. When the kidneys no longer function properly, people may need to get regular kidney dialysis. https://www.kidney.org/atoz/content/about-chronic-kidney-disease

Alzheimer’s disease – this disorder is the most common form of dementia. The biggest risk factor for developing it is advanced age. Common symptoms include memory loss, difficulty completing familiar tasks, and changes in mood, personality, and behavior. https://www.cdc.gov/aging/aginginfo/alzheimers.htm

HIV – infection with the human immunodeficiency virus has become a chronic disease. Many people live long healthy lives while HIV positive. There are medications available to suppress the virus to very low levels, as well as prophylactic medications people can take to prevent infection. https://www.cdc.gov/hiv/about/index.html

What is health?

How would you define health? There are several interconnected and related
dimensions of wellness that are dynamic – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508938. We can describe them as physical, emotional, mental/intellectual, social, spiritual, environmental, financial, and occupational.

Model of determinants of health. In the middle of the image are biological factors, then individual lifestyle behaviors, then social and community networks, then socio-economic, cultural and environmental factors

What makes your health better or worse? All of the factors that influence
your health for better or worse, including your genetic code, your behaviors, and your environment, are called the determinants of health – https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

Social determinants of health – https://www.cdc.gov/socialdeterminants/index.htm

To learn more about how social determinants of health can impact our lives,
watch this movie (this is optional). Go to the BMCC Library website – https://www.bmcc.cuny.edu/library/ and click on Databases. Select Video Databases, then select Kanopy Streaming Videos. If you are not on campus, you will have to log in with your BMCC log-on (the same credentials you use to log into computers on campus). When you are in the Kanopy database, search for Unnatural Causes. Your result will say Collection on it. Watch the movie titled In Sickness and in Wealth.

Is the United States a healthy country? Many studies show that the United States spends a lot of money on average per person, but that health outcomes tend to be worse than similarly economically developed countries around the world. There are also many differences among individuals in health status in the US based on historic and current discrimination. Read more here – https://www.apha.org/topics-and-issues/health-rankings.

Leading causes of death

One way to track the health of the nation every year is with the leading causes of death which can be found here https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm for all ages in the United States. The rate of death is called mortality.

It takes time to fully finalize leading causes of death and the final figure for 2023 is not yet available. Patterns of leading causes of death have been changing with the arrival of COVID-19, which was was the third or fourth leading cause of death in the US since 2020.

We can also see how long people are expected to live – this is called life expectancy. Right now the average life expectancy is 77.5 years according to the CDC. You can also see differences by sex and ethnicity here – https://www.cdc.gov/nchs/products/databriefs/db328.htm.

Generally, life expectancy has been on the rise across most of the world, reflecting advances in medicine. However, in the US life expectancy has declined several years in a row, first as a result of the opiate epidemic, and then because of COVID-19 –https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/.

In the Untied States, there exist health disparities – differences in health status and health outcomes in different groups. One of the missions of HealthyPeople 2030 is to achieve health equity, that is the improve health for all groups and to close the gaps that currently exist between groups. The CDC in partnership with many organizations, both public and private, work to reach health equity – find more information here https://www.cdc.gov/minority-health/racism-health/index-1.html.


Healthy People 2020 and 2030

Our government and many health-related organizations put together a plan every 10 years to improve the health of the nation. This decade’s plan is called HealthyPeople 2030 – https://health.gov/healthypeople/about

Some of the main goals and target areas that Healthy People 2030 focuses on are:

  • Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death.
  • Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.
  • Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all.
  • Promote healthy development, healthy behaviors, and well-being across all life stages.
  • Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all.

From: https://health.gov/healthypeople/about/healthy-people-2030-framework

It is important that we can measure how well the nation is achieving these goals. There are overall health and well-being measures, like life expectancy – https://health.gov/healthypeople/objectives-and-data/overall-health-and-well-being-measures; social determinants of health – https://health.gov/healthypeople/objectives-and-data/social-determinants-health; and leading health indicators – https://health.gov/healthypeople/objectives-and-data/leading-health-indicators.

How can we improve our health?

What are some of the most common behaviors that contribute to the leading causes of death? And is there anything we can do to change our likelihood of death from a particular cause? When a death happens before someone is expected to die, we call that premature death. Some early or premature deaths can be prevented by actions by the individual or the healthcare system.

Some individual behaviors that are responsible for many of the deaths in the United States are: using tobacco, a sedentary lifestyle, drinking alcohol, and an unhealthy diet. A few other preventable causes of death that can be affected by healthcare and social determinants of health are: uncontrolled high blood pressure, opioid overdose, and lack of cancer screenings.

Health behaviors are considered to be modifiable determinants of health – that is, you can change them! But how can people change these common behaviors? The field of health education uses several theories to explain the process of making behavior change.
• Health belief model – http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories2.html
• Theory of planned behavior – http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories3.html
• Social cognitive theory – http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories5.html
• Transtheoretical model or Stages of Change – http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories6.html

Remember, modifiable does not mean easy! Often, changing health habits can be very difficult.

Mortality in 1900 vs. 2010

Mortality in 1900 vs. 2010

Over the last 100 years, there have been many advances in public health and medicine. Read about it here https://www.ncdemography.org/2014/06/16/mortality-and-cause-of-death-1900-v-2010/.

Bar graph of top 10 causes of death in the USA in 1900 and 2010. In 1900, people died most from pneumonia and influenza, tuberculosis, gastrointestinal infections. In 2010, most common causes of death were heart disease and cancer.

Consider this question: How have the causes of death changed in the last 100 years?

Consider this question: Why have the causes of death changed in the last 100 years?

Even more recently, we have had a resurgence of infectious diseases and COVID-19 has become the third leading cause of death in the US. What health behaviors can mitigate the spread of infectious illnesses? What policies can help to prevent deaths?

What is environmental and neighborhood health?

The environment describes all external factors that affect us – thus environmental health is the idea that these factors can influence our health, for better or worse. There is the social environment, or the people around us, and the physical environment, or all external physical factors that affects us. This can be the air we breathe, the water we drink, the neighborhoods we live in, and even the laws and policies that structure our lives.

How can a neighborhood impact our health? Try this interactive activity to find out – https://unnaturalcauses.org/interactivities_03.php. Do you live in a healthy neighborhood? New York City has been surveying and writing about its neighborhoods for several years – looks up yours here.

The kinds of toxins and pathogens we are exposed to may be a product of our environment. That is, if we live in cities with higher air pollution, or geographic locations where certain animals that carry diseases proliferate, we may be more likely exposed to these diseases. For example, you can look at maps of where cases of West Nile virus happen here – https://www.cdc.gov/west-nile-virus/data-maps/current-year-data.html.

Other environmental factors are built environment – roads, buildings, parks, and so on. Things like availability of bike lanes may help people reach their recommended levels of physical activity. Other things like the presence of lead paint in a home with small children can be detrimental to people’s health – the NYC report on lead levels is here https://www.nyc.gov/site/doh/data/data-sets/lead-pubs.page.

Prevention and wellness

One view of medical care is that if something is wrong, you can go to the doctor to get better. The medical definition of health is often just the absence of a particular disease.

However, there is another view of health and wellness – this is the view that sees wellness as a combination of several dimensions, and sees the interaction of the person and their environment. In this view, we not only want to cure an illness, we want to prevent it from happening if possible. This is the public health model of health.

We can think of prevention as a behavior that eliminates or lowers the chances that a disease will happen in the first place (primary), or behaviors that lead to a disease being discovered early and thus treated early (secondary).

Examples of primary prevention are vaccination, wearing condoms, putting on sunscreen and hand washing. Examples of secondary prevention are Pap smears, mammograms, and other screening tests.

Image of vaccine adminstration

Here are a few more ideas for preventing disease – https://www.nih.gov/health-information/disease-prevention-toolkit.

How does the body work?

Our bodies contain several different systems and are made up of tissues and organs. All the systems work together in a complicated way to break down foods, intake oxygen, expel waste, communicate between each other, process outside stimuli, and more.

Read a short description of what each body system does here https://www.healthline.com/human-body-maps and watch the short video below.

In particular, the cardiovascular and respiratory systems work together to get oxygen out of the atmosphere and move that oxygen to various organs and tissues. The lungs help to oxygenate the blood, the heart then pumps that blood out to the other parts of the body, and blood vessels circulate the oxygenated blood around the body, and bring carbon dioxide to the lungs to exhale.

Organic changes in the cardiovascular system can lead to heart disease – the leading cause of death for most demographic groups in the US. https://www.cdc.gov/heart-disease/about/index.html. One of the most common system-wide changes is atherosclerosis, the narrowing and hardening of arteries throughout the body. This process can lead to heart attacks, pain in the chest, strokes, and other consequences. Heart attacks (myocardial infarctions) usually happen when the blood supply and oxygen are disrupted to a part of the heart and the heat cells begin to die. This tends to happen because the coronary arteries become closed off or narrow.

Similarly, strokes happen either because of a bleed in the blood vessels in the brain, or a lack of blood and thus oxygen to a part of the brain. Both strokes and heart attacks can be fatal or survivable, depending on the size of the damaged tissue.

Another leading cause of death is cancer. Cancer is a name given to several related diseases. In general, when people have cancer, some cells in their bodies divide uncontrolled and spread to other tissues. https://www.cancer.gov/about-cancer/understanding/what-is-cancer Cancer can happen for various reasons, but commonly it happens because of genes inherited from our parents, or exposure to toxins, infectious agents, radiation and others.