August 17, 2015

Determinants of health and Health Equilibrium Host factors

What causes DISEASE?

Genetic predisposition
Lifestyle
Immunity
Virulence
Climate change
Environmental Pollutants
Stress
Personality
Race
Sanitation
Occupation
Gender
Age

Disease causation
A. Old concepts
1. The world of demons-primitive supernatural is expressed by sorceries,
incantation, magic presentations, totems and taboos.
2. The wrath of god- disease as a punishment of sin
3. Metaphysical medicine- fortune telling, astrology and occult
4. The concept of natural causation- greek idea of 4 elements: Fire-yellow bileliver dse, Earth-black bile, Water-phlegm, Air-blood
5. The concept of contagium animatum- germ was started by Fracastorius in
the 15th century that was strengthened by early observations of physicians on
the plague, smallpox, syphilis and measles.
6. The great sanitary awakening- the filth theory of disease gave better result
in the practical control of epidemic diseases.
7. The beginning of the modern era-the beginning of the 16 th century, the
existence of bacteria was widely accepted.
B. Modern concepts of disease causation
-States that disease is a result of multi-factorial causation than just by one
cause
FACTORS: Host, Agent, Environment
**Determinance- what determines disease
C. 4 Ecologic models for disease causation
1. The Lever or the balance
2. The Triangle
3. The Wheel
4. The Web of causation

1. The Lever or the balance

-At both ends of the lever are the host and agent factors. The environment
acts as a fulcrum.
2. Triangle
-Consist of host agent and environment
3. Wheel
-Depict man-environment relation. At the center of the wheel is the
genetic component of the individual. Surrounding man is his environment
that is divided into biological, social and physical.
4. Web of Causation
-the effect is not dependent on an isolated cause but is a result of chains
of causation in which each link itself is a result of a complex genealogy of
antecedents.
A. THE HOST
Is an individual exposed to the agent
Vertebrate or invertebrate species capable of being infected or
affected by an agent
Is susceptible to the agent and in the presence of favorable
environment, he affords subsistence or lodgment of the agentdisease occurs
Host= Patient
Susceptible-more likely, prone to
For epidemiologic purposes host may be a case, a carrier or a
contact
In Parasitology- he may be classified as definitive or intermediate.
HOST FACTORS
1. Inherent characteristics
-attributes of the host which are easily documented, and are
therefore important and reliable in the analysis of disease
causation.
-age, sex and race
a. Age single most important single factor related to disease
occurrence
Childhood infections- comprised of diseases that may
give rise to lasting or solid community
Aging process- wear and tear of body- degenerative
diseases
Example: Mongolism is more common among the elderly
mothers
b. Sex some diseases may be more common in one sex than
the other due to different patterns of behavior or activitiesrecreation, travels, occupation- differing opportunity for
exposure to the source
Anatomic differences- diseases of reproductive system

 Females- thyroid disesase, gallbladder disesase, obesity,

psychoneurosis
Males- peptic ulcer, inguinal hernia, accidents,
arteriosclerotic heart disease
c. Ethnic or race- certain races appear to be more susceptible
to some diseases
Black- Sickle cell anemia, tuberculosis, rickets
Japanese- gastric cancer
Experience with the disease and environmental factors
may be responsible for some of the above.
2. Host defense- these are specific defenses that every human
being has by virtues of his anatomic and physiologic make-up
Examples: the design of the human skeleton itself, the intact
skin and its accessory structures, the reflexes and the
immunologic response of man.
3. General health status- these are factors related to the health
status that influence the reaction of the host to the disease
Examples:
Physiologic state- sleep disorders
Nutritional- malnourished children are more prone to
infectious disease
Inter-current and pre-existing disease
(comorbidity- presence of two or more disease
conditions) - diabetes mellitus and heart disease.
4. Aspects of human behavior- these factors govern the degree
of exposure that the individual has to the disease agent. These
include behavior acquired through customs, habits, culture that
are closely related to health and disease.
Example:
Diet and food handling practices
Human excreta disposal
Personal hygiene
Recreational habits
Religion
Occupation
1. Miners-pneumoconiosis
2. Farmers-schistosomiasis, pesticide poisoning
3. Radiologist-radiation
4. Automobile factory worker- lung cancer