Social Aspects of Diseases

Dr. Mostafa Arafa Associate Prof. of Family and Community medicine Faculty of medicine, medical sciences King Khaled University, S.A.

The prevention of disease is a major role of public health programs. In developing and implementing prevention programs the environmental & social factors are increasingly recognized as important components, depending on many reasons.

Another important concern of environmental factors also has been developed because of the difficulty in getting individuals to change their behavior.

A third reason for the increasing interest in environmental factors is the fact that distribution of many diseases remains relatively constant over time even though individuals come and go from the population.

The term environment is a general one describing many different conditions and influences under which any person or thing lives or develops. The environment is a result of a continuous interaction between natural and human made components, social process and the relationship between individuals and groups.

RATIONAL FOR ENVIRONMENTAL APPROACH FOR DISEAS PREVENTION Magnitude of disease problem For example ; CHD, cancers, mental illness, diabetes and stroke

Difficulties in changing behavior To prevent disease we increasingly ask people to begin do things that they have not done previously, to stop doing things that they have been doing for years and to do more of some things and less of others.

Pattern of disease rates Some groups often have a characteristic over time even though individuals come and go from these groups. If groups have different rates over time, there may be something promotes or discourages disease among individuals in those groups.

There are three important factors, through which the environment affects the incidence, severity, and persistence of non-infectious diseases : Socio-economic status, Marital status and Gender.

Socioeconomic status A consistent finding dated from the twelfth century, is that people in the lowest socioeconomic groups have the highest rates of morbidity and mortality, whether the socioeconomic status was studied in relation to education, income, or occupation: the lower the level the higher the death and morbidity rate.

Marital status It has been known for many years that people who are not married- whether single, separated, widowed or divorced- have higher mortality rates than married people.

Gender One of the most well-established facts among students of health and disease is that men have higher mortality rates than women. This excess of male deaths occurs at every age and for every major cause for which comparison is possible. foe any age.

Another social factors affecting disease incidence 1.Life events: life events can increase the rate of illness, especially minor diseases 2.Behavior pattern: “type A” behavior persons are more exposed to stressful life events. This behavior pattern is said to be exhibited by persons engaged in a relatively chronic and chronic struggle to obtain unlimited number of things in the environment in the shortest time.

TWO IMPORTANT EXAMPLES FOR BEHAVIORAL FACTORS AFFECTING HELATH; SMOKING & ALCOHOL

Health effects of smoking 1.Excess mortality 2.Economic cost 3.Cardiovascular diseases  Coronary heart disease  Peripheral arterial occlusion disease  Cerebrovascular disease

Health effect of smoking (cont.) 4. Cancer 5. Gastrointestinal diseases 6. Diseases of the mouth 7. Passive effect of smoking on children’s health, adults and lung cancers 8. In utero effect of maternal smoking

Smoking control measures Smoking cessation classes Clinical intervention Special community intervention programs

Smoking prevention : This can be accomplished by a number of mechanisms: changes in the public attitudes towards smoking acceptability, restriction that limit supply to youth, high price to reduce product affordability, and specific educational programs designed to reduce acquisition of the smoking habit..

Alcohol-related health problem The consumption of alcohol is important to public health because it contributes to the etiology, course, and outcome of numerous acute and chronic physical, psychological, and behavioral problems.

Alcohol – related physical, psychological and behavioral problems : 1- psychological- behavioral 2- acute alcohol withdrawal syndrome 3- GIT symptoms e.g. gastritis, cancers 4- respiratory symptoms e.g. T.B., pneumonia 5- neurological e.g. epilepsy, head injuries

Strategies for prevention Recognition of the relationship among per capita alcohol consumption, rates of heavy use, and the incidence of alcohol-related health problems has focused attention on primary prevention strategies aimed at the drinking population, generally with the principle objective of reducing per capita alcohol consumption.

Strategies for prevention (cont.) These strategies comprise two groups; first health protection measures and the second group is the health promotion measures. The two approaches are complementary and interactive, and it is unlikely that one would be effective without the other. A third group of measures include preventive health services.

Strategies for prevention (cont.) Health promotion measures include activities that individuals and communities can use to promote health life style. For example: public education programs, health warning labels, advertizing and marketing, and media portrayals.

Summary The importance of social factors in the etiology of diseases is becoming increasingly clear. The evidence of some factors is weak or still unclear. Nevertheless, we will need to use data emerging from researches because today most serious diseases are influenced by the social environment. Continuous research on social factors must come an important priority in both public health planning and program development.