Health Indexes

1
Health Indexes

• What is healthy?
• Mortality the number of deaths due to a
  particular cause
• quantity
• Morbidity the number of cases of a disease or
  illness at a given time
• quality

2
Health in general

• Females, Whites, and Asian-Americans live longest
  Males, African Americans, and Puerto Ricans die
  younger (Mortality)
• CHD is the major cause of death in both males and
  females of all races in industrialized nations.
  Cancer is second for all.
• Females and Hispanic-Americans have more
  illnesses (Morbidity)

3
Cardiovascular Health

• CHD clogging of arteries, specific illness
• CVD a general term for all heart related issues
• Males, post-menopausal females (w/o HRT),
  African-Americans and Puerto Ricans have highest
  risk
• low control/high demand job risk

4
Utah Profile Death Rates from CHD 1991-1995
5
Cardiovascular Health

• Symptoms
• Diagnosis
• Recovery

6
Cancer

• African Americans are 9 times more likely to get
  and die from cancer than Whites
• Skin cancer most common for all
• 2) prostate cancer (Males)
• 2) breast cancer (females)

7
Prostate Cancer in males

• What is the Prostate?
• Over 50 of males between 60-70 years old will
  get it in some form
• Diagnosis
• Treatment

8
Rate of Prostate Cancer
9
Breast Cancer in females

• 1 in 9 females will develop BC by age 85
• Nearly 50 diagnosed will survive at least 15
  years
• Treatment
• modified radical mastectomy (MRM)
• modified radical mastectomy with reconstruction
  (MRM w/R)
• lumpectomy breast reconstruction treatment,
  includes chemotherapy (BRT)

10
Eating Disorders

• Obesity an excessive accumulation of body fat
  (in general more than 20 above ideal weight)
• Anorexia nervosa a condition produced by
  excessive dieting and exercise that yields body
  weight grossly below optimal level
• Bulimia a condition produced by alternating
  cycles of binge eating and purging though such
  techniques as vomiting or extreme dieting

11
Anorexia Nervosa

• Danger Signs
• loss of a significant amount of weight
• continuing to diet although thin
• feeling fat, even after losing weight
• intense fear of weight gain
• fainting spells exercising
• exhaustion
• periods of hyperactivity

• Medical Consequences
• shrunken organs bone mineral loss, which can lead
  to osteoporosis
• low body temperature
• low blood pressure
• slowed metabolism and reflexes
• irregular heartbeat, which can lead to cardiac
  arrest

12
Bulimia Nervosa

• Danger Signs
• binging, or eating uncontrollably
• purging by strict dieting, fasting, vigorous
  exercise, vomiting or abusing laxatives or
  diuretics in an attempt to lose weight
• using the bathroom frequently after meals
  preoccupation with body weight
• sore throat
• vomiting blood
• weakness, exhaustion

• Medical Consequences
• dehydration
• damage to bowels, liver and kidney
• electrolyte imbalance, which leads to irregular
  heartbeat, and in some cases, cardiac arrest

13
Role of social norms in eating disorders

• NO CLINICAL DISTINCTION between males and females
  with an eating disorder
• Dieting messages in the media
• Ideal body perceptions study (Demarest, Allen,
  2000)
• Both the men the women misjudged whichshapes
  the opposite sex would rate as most attractive
• African American women had the mostaccurate
  perceptions of what the men found attractive,
  whereas the Caucasian women had the most
  distorted views

14
WHY the physical health differences?

• Genetics? (but everyone shares 95)
• Biological redundancy (sex explanation)
• Hormone protection/risk (sex explanation)
• Economic barriers
• Cultural barriers (stereotypes)
• stereotypes concerning minorities might still be
  impacting mental health Drs treatment and
  behavior...

15
WHY the physical health differences?

• Scientific research and understanding
• Access to Medical Procedures
• Responses to stress
• Social Support (direct and/or buffering effect)
• Perceived vs Actual Supports
• Quantity vs quality
• Types of support
• Race and Sex differences?

16
Doctor-Patient Care

• Female doctors spend more time (on average) with
  patients than male doctors
• especially when taking patents history
• Male doctors deliver authoritarian instructions
  Female doctors deliver proposals

17
Psychological Health

• What is normal?
• Independence, autonomy goal setting are
  epitome of good mental health
• females diagnosed more often with depression and
  borderline personality disorder
• males diagnosed more often with anti-social
  disorder and narcissism
• this is a matter of degree NOT absolute

18
DSM as the diagnostic tool

• Positivist Model vs Social/historical Model
• Role of gender roles
• Removed from the DSM hysteria, homosexuality,
  self-defeating personality disorder

19
Depression

• The most consistent sex difference in mental
  health
• Reasons for depression?
• Reporting Bias?
• Expression differences?
• Rumination vs distraction

20
Possible reasons for Misdiagnosis

• Cultural expression of symptomatology
• Unreliable research instruments
• Clinician bias
• Western bias