Spectrum of health

Department of Community Medicine, BMC, SAGAR

1. SPECTRUM OF HEALTH AND TYPES OF EPIDEMIC By- dr.shefali jain ( p.g . FIRST YEAR)

2. SPECTRUM OF HEALTH

3. What is health? According to WHO- “health is a state of complete physical, mental and social well-being and not merely an absence of disease and infirmity.” In recent years it also include ability to lead a “socially and economically productive life”

4. Positive health The state of positive health - "perfect functioning" of the body and mind. It conceptualizes health -biologically, as a state in which every cell and every organ is functioning at optimum capacity and in perfect harmony with the rest of the body; -psychologically, as a state in which the individual feels a sense of perfect well-being and of mastery over this environment, and -socially, as a state in which the individual's capacities for participation in the social system are optimal.

5. The lowest point on health disease spectrum is death and the highest point corresponding to the WHO of positive health. The spectrum concept of heath emphasizes that the health of an individuals is not static: is a dynamic phenomenon and a process of continuous change, subjects to frequent subtle variations.

6. Health fluctuates within a range of optimal well being to various levels of dysfunction, including the state of total dysfunction, namely death. The transition from optimum health to ill health of often gradual and where one state ends other state begins.

7. It implies that health is a state not to be attained once and for all, but ever to be renewed. There are degrees or “levels of health” as there are severity of illness.

8. Determinants of health

9. Determinants Biological Behavioural Environmental Socio-economic Health system Sociocultural Ageing of the population Science and technology Information and Communication Gender Equality and social justice Human rights

10. Social factors influencing the health of people

11. TYPES OF EPIDEMIC

12. What is Epidemic? An epidemic is defined “as unusual increase in number of cases of illness or other health related events in a defined geographical areas and defined time periods.”

13. Common source epidemic Single exposure or “point source” epidemics. Continuous or multiple exposure epidemics.

14. Propagated Epidemics Person to person Arthropod vector Animal reservoir Slow ‘modern’ Epidemic: NC “ non-communicable diseases” Mixed Epidemics

15. I-Common Source Epidemic Single-exposure “point’ epidemics Exposure is brief and simultaneous (immediate or concurrent) exposure. All cases develop within one incubation period (food poisoning epidemics).

16. Features of epidemic curve: 1.Rises and falls rapidly, no secondary waves. 2. Tends to be explosives, with clustering of cases within narrow interval of time. 3. All cases develop within one incubation period .

17. Epidemic curve showing median incubation period during common source, single exposure epidemics

18. (B) Common source, continuous exposure The exposure from the same source may be prolonged- continuous, repeated or intermittent No explosive rise in number of cases Cases occur over more than one incubation period

19. (B) Continuous or repeated exposure Frequently not always due to exposure to an infectious agent They can result from contamination of the environment (air, water, food, soil) by industrial pollutants Minamata disease in Japan from consumption of fish containing concentration of methyl mercury

20. Epidemic curve showing single incubation period during common source,continous exposure

21. Outbreak of respiratory illness, the legionnaire disease in 1976 in USA was a common source, continuous or repeated exposure, no evidence of secondary cases.

22. Epidemic curve showing irregular peaks of single incubation period during common source,interrupted exposure

23. Propagated Epidemics Epidemics may start from a common source and then continue as a propagated epidemics Water borne epidemic as example the epidemic reaches a sharp peak, tails (end) off gradually over longer time of period.

24. Of infectious origin, with person to person transmission (hepatitis A,E and polio epidemics). Gradual rise and tails off over longer period of time. Transmission continues till depletion of susceptible or susceptible individuals are no longer exposed to source of infection. Communicability (speed of spread) depends on herd immunity among exposed and opportunities for contact with infective dose and secondary attack rate

25. Epidemic curve showing propogated epidemics

26. Mixed epidemic The curves shows feature of both common source and propagated epidemics. For instance, a common source outbreak followed by secondary person-to-person spread. Example-Epidemic caused by enteropathogens .

27. References K. Park , Park’s Textbook Of Preventive And Social Medicine, M/S Banarsidas Bhanot Publishers, 25 th Edition,2019 AM Kadri , IAPSM’s Textbook Of Community Medicine, Jaypee Brothers Medical Publishers, 1 st Edition. 2019 Roger Detels Et Al, Oxford Textbook Of Global Public Health, Oxford, 6 th Edition

28. Thank you