Health, Health Risks, and Mapping Public Health

Abstract

The innovation of the Lalonde Report= (1975) looked at health, and did not take disease as the starting point of the model. The Lalonde Report, the conceptual model of public health and the VTV model, look at health at a group level.

The core is formed of health determinants: the endogenous determinants (internal environment or human biology); the health determinants lifestyle and behavior; the exogenous determinants (physical environment, social environment), and the health determinant with preventive medical care (health care organization). The innovation was above all: the health determinants lifestyle and behavior, and more attention being paid to the environmental determinants physical and social environment. Concerning health problems, there is often a combination of endogenous health factors, lifestyle and environmental factors, and socio-environmental factors (Sect. 2.1).

The endogenous determinant concerns physiological and psychological factors that affect health or health problems: (1) genetic, hereditary factors and (2) acquired properties. Hereditary factors include: abnormalities in the genes, abnormalities in chromosomes, multifactorial health problems, and predisposition to a disease. Acquired properties include: immune system abnormalities, high blood pressure, high cholesterol, differing glucose levels, overweight and obesity, aging, and mental ill health (Sect. 2.2).

The health determinants lifestyle and behavior involve all kinds of behaviors that have a positive or negative impact on the health and/or on a health problem: feeding behavior, alcohol and drug use, smoking behavior, movement behavior, sexual behavior, and health skills (for self-management). Health behaviors, and especially changes, are an important way for nursing professionals to improve the health of patients, mostly by promoting self-management (Sect. 2.3).

The physical environment (external environment) is classified into chemical, physical and biotic factors. Health effects are determined by the extent of exposure. Important recording routes are inhaled air, food, skin, and eyes. Behavior determines the extent of exposure (Sect. 2.4).

The social, exogenous health determinant concerns the influence of work and school, socio-economic status and social environment (social relations). In particular, when unfavorable factors are combined, they lead to health differences (Sect. 2.5).

Positive effects of medical care on the health determinant and prevention are: decreased mortality, greater quality of life, early care, and treatment. Adverse effects are (iatrogenic): antibiotic resistance, hospital-acquired infections, and drug side effects (Sect. 2.6).