Factors Influencing Health: Reducing Risk and Promoting Health
Dimensions of Health
"Health is a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity" (World Health Organization). Based on this broad definition of health, total health involves not only physical health, but also mental and emotional health, social health, intellectual health and spiritual health. These areas of health are interdependent. Genetic and biological factors, acute and chronic physical illnesses, and environmental conditions and stressors affect total health status.
Ways to Reduce Risk and Promote Health
Primary prevention involves actions to keep disease from occurring (such as immunizations). These actions include:
Secondary prevention involves actions to detect the presence of disease in its early stages when it is easier to treat (such as mammography). These actions include:
Tertiary prevention involves actions to reduce the severity of a disease that has already occurred, to minimize its complications, or to promote recovery (such as managing diabetes, cardiac rehabilitation, or alcohol and other drug rehabilitation). These actions include:
Principles for Reducing Risk and Promoting Health
Practical Steps for Reducing Risk and Promoting Health
Motivating or Predisposing Factors
What does a person need to know and value to want to engage in the new healthy behavior? Discover these by considering:
Enabling Factors
What information and skills does a person need to be able to participate in the new healthy behavior? Enhance enabling factors by:
Reinforcing Factors
What kinds of reinforcement or rewards would help a person continue with the new healthy behavior?
Source
Wooley, Susan, Behavior Mapping: A Tool for Identifying Priorities for Health Education Curricula and Instruction, Journal of Health Education-July/August, 1995, Volume 26, No. 4
Causes of Illness
A variety of hereditary, environmental and behavioral factors affect health and the risk of illness. The availability of health care (access to health care) also affects health risks; this factor is usually not within the health consumer's control. However, there are proven, effective ways to reduce the risks from other factors, including:
Practicing healthful living: Be proactive in developing a healthy lifestyle-eat a healthy diet, stay physically active.
Taking action to avoid or reduce known risks: Avoid the use of tobacco and activities such as riding without a safety belt or riding with an intoxicated driver. The use of alcohol and other drugs and/or participation in unprotected sexual activity also present known risks that can be avoided or prevented.
Obtaining regular checkups and recommended services to prevent disease: Get needed medical services, including immunizations and dental care, in order to keep disease from occurring or to catch disease in an early stage when it is more easily treated. Of course, health care must be available (and affordable) if health consumers are to access these needed services.
A Primer on Infectious Disease
Micro-organisms, also known as "germs," are living things so small that a microscope is required to see them. Microorganisms are responsible for infectious diseases. They. Micro-organisms, which have only a few hours to a few days to complete their full life-cycle, grow by simply dividing-they narrow in the middle until they split apart. Some organisms can reach maturity and divide in just ten to thirty minutes. This capacity for rapid growth underscores the importance of effective prevention and treatment measures.
Types of Germs
Bacteria, viruses and parasites are three types of micro-organisms, or germs, that live in the environment and inside the human body. Germs that live inside the body do not cause illness if the body can keep them in balance by limiting their growth and if they remain in the part of the body that has developed the ability to manage them. They can even be beneficial. For example, bacteria metabolism in the intestine is necessary for producing B-complex vitamins and vitamin K (which helps the blood to clot).
Germs that live inside the body and normally do not cause sickness may cause illness if they get into a part of the body that is not accustomed to dealing with them. For example, e.coli bacteria normally inhabit the colon. However, if these bacteria get into the blood, they may cause serious illness and even death. The blood, the spinal fluid and the lymph nodes are sterile and do not have germs. If germs get into these areas, disease and death can occur, often rapidly.
Healthful Balance
Overgrowth of germs that normally live in the body destroys the healthful balance and allows infection or disease to develop from the overgrowing organisms. Overgrowth of germs can occur due to frequent or over-use of antibiotics or steroids, malnutrition, immunosuppressive drugs or heavy irradiation (as in cancer treatment), or with chronic diseases such as diabetes and cancer.
Overuse or unnecessary use of antibiotics is not wise. Bacteria can become resistant to antibiotics as mutation occurs in the bacteria. The bacteria change in ways that cause the antibiotics to no longer be effective. These resistant bacteria can emerge resistant to one antibiotic or to closely related groups of antibiotics.
Balance is also destroyed by germs from a source outside the body that invade the body. The germs that may be normal to one person may not be normal to another person's body and may cause sickness when introduced into another person. This forms the basis for routine hygiene measures such as hand-washing following urination or defecation. The germs in the body of one person may be non-pathogenic (non- disease causing), but these same germs can create serious illness in another person.
Where Germs Come From
Places Where Germs Can Enter The Body
Germs can enter the body through the following areas or conditions.
How Germs Do Their Dirty Work
Germs invade the body and destroy normal cells.
How the Body Fights Germs
Unbroken skin is the body's first line of defense. Healthy skin actually secretes substances that kill bacteria. Most organisms cannot pass through unbroken skin.
Even a small injury to the skin, however, can allow germs that are on the surface of the skin to enter the body and cause infection. Proper hygiene (hand-washing, bathing, shampooing, wearing clean clothing) can reduce this risk of infection. Proper wound care for even small scratches is important in preventing infection.
The eye itself is not covered with skin; it is protected by the motion of the eyelids and the constant washing of the tears. The eyelids are lined by a thin, transparent membrane called the conjunctiva, which help to protect the eye.
Glands along the eyelid secrete an oily substance that helps keep the tears from evaporating too quickly and keep the eye moist. Tears are continually produced by the lacrimal gland (located above the eye) and wash across the eyes (aided by blinking of the eyelids) to help keep the surface of the eye moist and germ free. The tears contain antibodies and lysosome, which can kill certain bacteria. As tears wash across the eyes, organisms on the eye are carried into the nose and excreted. Eyelashes and eyebrows also help protect the eye from sweat and dust and other foreign particles.
Although the eye is not totally defenseless, it is highly vulnerable to injury and infection. Care must be taken to avoid injury-using special precautions during sports and play-and to avoid infection that results from rubbing the eyes with hands that have been contaminated with germs from other parts of the body or from contact with other infected people or contaminated objects.
The nasal passages are protected by the lining of mucous and cilia. Dust, bacteria and other particles adhere to the mucous and are swept outward by the motion of the cilia or are expelled by a cough or a sneeze. Coughing and sneezing are bodily responses to foreign matter (including germs) in the nasal passages and lungs. Coughing and sneezing are major ways of transmitting germs from one person to another.
The gastrointestinal tract is protected to some extent by the acidic nature of the gastric juices and by the bile secreted from the gall bladder into the upper small intestine. Germs that get by the defenses of the stomach may succumb to bile.
Phagocytes are cells that digest and hence remove bacterial cells or dead tissue from the blood or body tissues.
The genitourinary system is protected to some extent by the acidic and mucous environment of its thickly layered cells.
The body also provides its own chemical protection through substances that secrete a protein called interferon that kills viruses.
Inflammation-A Defensive Response
Inflammation is a defensive response to an irritant or injury. There are four signs of inflammation: redness, swelling, heat and pain. Inflammation promotes healing by:
Immunity
Immunity is the ability of the body to resist infection. It can be achieved passively, such as the immunity that infants possess against certain diseases at birth. It can be achieved actively-by recovery from diseases such as measles, where the body has naturally developed a defense against future invasion. Active immunity can also be achieved by immunization, in which a protein substance is deliberately introduced into the body so the body will react to produce antibodies to defend against future such invasions of the same substance. Immunization may have to be repeated at intervals to assure adequate protection.
Protecting the Body from Infectious Disease
There are three important behaviors that help protect the body from infectious disease.
Infection Control
Understanding where germs come from and how germs enter and exit the body and are spread to others provides valuable information in reducing their spread and minimizing the risk for illness. Concrete examples of common childhood contagious diseases can illustrate how germs are spread and can help remind children of the importance of hand-washing and other measures of proper hygiene.
Some human germs are spread by social contact such as holding hands, kissing, coughing, sneezing, preparing food with unwashed hands. Infections such as colds and flu can be spread by sneezing and coughing into hands, not washing those hands and then touching other people or other objects. Hand should be washed frequently when you or someone around you has a colds. Tissues and handkerchiefs and other measures used to control the spread of infection can actually spread the infection unless properly disposed of or laundered.
Infections such as scabies can spread by close personal contact and shared linen or clothing. Lice can spread to others who share infected combs, brushes, and linen. Impetigo can spread to playmates who touch infected areas on an infected child.
Germs may be spread by direct contact with infected animals. Hands should be washed after playing with animals.
Germs are also transmitted through soil, air, food, water, milk and feces. For example: Tetanus and gas gangrene can be deposited in the soil from human and animal feces and survive for long periods of time. If someone steps on a rusty nail that has been contaminated with these tetanus spores and the nail punctures the skin, the tetanus organism is introduced into the person. (The route of entry is broken skin.) If the person is not properly immunized against tetanus, the result can be fatal.
Germs also come from objects that have been contaminated by an infected person. For example: Infection with pinworms results from eating the microscopic eggs that are left by infected people on many kinds of surfaces, including bed linens, clothing, food, drinking glasses, eating utensils, toilet seats, bathroom fixtures, toys, sand in sandboxes. The pinworms leave infected people through the rectum (intestinal tract); if those infected do not properly wash their hands, they can transfer the eggs to other objects or other people or back into their own bodies again. People who then touch the contaminated hands or towels or other items can then become infected (route of entry is through the mouth) if they eat without washing their own hands, drink from an infected persons glass or ignore basic rules for good hygiene.
Germs can be transferred by vectors, in which case the organism adheres to an insect's body. For example: A fly lands on infected feces, then lands on food eaten by human who becomes infected with typhoid, or a tick bites an infected host, ingests the organism and then bites someone and transfers the organism, such as Rocky Mountain Spotted Fever.
Guideline: if it's wet and comes from someone else's body, it can be infectious.
Immunizations
The purpose of immunization is to protect people from organisms that can cause serious disease. Immunizations accomplish this purpose using a variety of agents:
Because the viruses and bacteria that cause disease still exist, vaccinations, which have been developed for them, are still necessary. Without these vaccinations, diseases such as polio, measles, rubella and pertussis could return and lives would be disabled or unnecessarily lost.
One of the diseases that can be prevented by immunization is measles. Measles may sound so familiar that we forget how deadly it can be. As recently as 1995, more than a million deaths worldwide were caused by measles. If vaccinations for measles were ended, there could be as many as 2.7 million deaths.
Reference: Dubay, E. C., and Grubb, R. D., Infection Prevention and Control 2nd Edition, C.V. Mosby Co., St. Louis, 1978.
