WITH CORRECT ANSWERS
\.1. What does it mean to take an upstream approach to health care? What are
some examples of upstream, midstream, and downstream risk factors for disease?
What are some examples of upstream, midstream, and downstream policies to
promote health?
- ANSWERS -Address distal causes of healthcare, that put you at risk for
proximate causes of disease. Look at unemployment, living in a food desert,
condition of the atmosphere.
Downstream - ER, trauma nurse (CDC response to an outbreak, chronic disease
operations)
Disease and injury
Mortality
Midstream - PCP (transportation from residence to a hospital/parks)
Neighnorhood Conditions
Risk Behaviors (smoking, drinking, violence)
Upstream - healthcare people that focus on transportation/housing and settings
(government agencies, schools and corporations)
,Social inequality (race, gender)
INstitutional power (gov., busiiness, school)
\.According to Link & Phelan, what does it mean to contextualize risk factors? -
ANSWERS -1) understand why people come to be exposed to risk factors or
protective factors, and
2) determine the social conditions under which those risk factors are related to
disease
Example: Understanding patterns of heart disease•We know that smoking is a risk
factor for heart disease:
It is not enough to identify individual behavior as a risk factor
We need to know WHY people are engaging in the behavior
How are social conditions causing/contributing to the behavior?
We cannot change individual behavior without understanding how exposure to
risk occurs
\.What is a Blue Zone? What habits do Blue Zone inhabitants tend to share? -
ANSWERS -Pockets where people live longer than anywhere else in the world.
The world's highest percentages of centenarians.
Habits Shared:
, -Cherish Family
-Social Engagement
-Less Smoking
-Semi-vegetarianism (plant based diet)
-Legumes
-Constant Moderate Physical Activity
\.Explain what is meant by a fundamental causes approach to understanding
health and illness? - ANSWERS -Focuses on the "root cause," rather than
intervening mechanisms. Includes an emphasis on access to resources that help
individuals avoid disease.
"The essential feature of fundamental social causes is that they involve access to
resources that can be used to avoid risks or to minimize the consequences of
disease once it occurs."
\.Explain the difference between proximate and distal causes of disease. -
ANSWERS -Proximate - Downstream behavioral or biological risk factors
E.g., high blood pressure, poor diet, smoking, UV rays
Distal - Upstream factors that put you at risk for the proximate causes
E.g., unemployment, living in a "food desert," condition of the atmosphere
\.researchers believed that once factors linking socioeconomic status (SES) to
health were identified, the link between SES and disease would disappear. Why