chapter 4

Diseases can be communicable or non-communicable as well as chronic or acute. Non-communicable diseases are amongst the leading causes of death in the U.S. but they are not contagious and may be caused by things such as genetics, environmental factors or lifestyle choices rather than pathogens. Communicable diseases are caused by pathogens and can be spread from person to person through either direct or indirect transmission. An epidemiologist's goal of disease prevention and control exists on three levels. During the primary stage, the focus is on immunization, health education, and promoting good health in general. This stage can be considered the pre-disease stage. In the secondary stage, a disease has been identified and the focus has shifted from prevention to controlling the spread of that disease. Preventative measures at the secondary level may not only include public health education, but may also involve things such as isolation and quarantine. By the time the disease reaches the tertiary level of prevention, the focus has become applying both the primary and secondary measures as well as preventing a relapse of the disease. This could in a sense be the recovery phase of the disease because people are recovering and life is returning to normal.When studying the health of a population, an epidemiologist would be concerned with the various rates of natality, morbidity and mortality. While many of those rates have a margin of error, an epidemiologist can use them to follow the course of a disease through a population or to determine the impact of certain lifestyle choices such as smoking or tanning beds on the health of a population. The results of those studies can be used to make recommendations about the prevention and control of diseases, but people are still choosing to engage in behaviors that put themselves at risk.

invisible

Racism and cultural genocide have had a huge impact on the Native American culture for generations. These issues date back to 1492 when Christopher Columbus first denied the humanity of the native people as justification for the actions of the white men and continued in 1755 when Spencer Phipps delared war against all Native Americans and placed a bounty on their heads. The cultural genocide continued with the forced assimilation of Native Americans into white culture and the removal of Native American children from their parents. These children were sent to schools hundreds of miles from their families and were abused and taught the English language. Racism toward Native Americans continues today though in ways that are much more subtle. The Native American population is excluded from politics because they are considered a separate entity and therefore have no vote in the legislature even though many of the issues may have a direct impact on them. DHHS still tends to react differently to concerns in Native American families and is much more likely to terminate the rights of the parents. We now have several programs geared toward improving the quality of life for Native Americans, but they rely on a few token individuals to obtain funding and actually impact the lives of very few.

invisible

Video Reflection

After watching the movie I felt that racism is around us way more than sometimes we realize. A prime example of everyday racism can be demonstrated with major league baseball teams which have mascots such as the Cleveland Indians. Or even within our youth, they associate Indians living in wigwams on watersides due to how they are portrayed on television. Especially because when most people think of racism they think of African Americans almost automatically just because of the well known speeches (like ones by Martin Luther King Jr. is known for "I have a dream...") and struggles that they have dealt with. However there are other races and cultures around us that are also struggling with inequality such as the Indians or French. The video specialized on the Indians and their constant battle with keeping their faith and culture. Most people with Indian heritage don't like to admit their heritage and sometimes do not inform their children of their ancestry. I know personally my friend who attends UMF didn't find out she had Indian blood until her sophomore year and ended up getting a full scholarship for her remainder on campus. As wonderful as that is for my friend, it is sad that a group of people do not know their heritages due to discrimination. People took Indian's children away and sent them to reform schools in order to de-Indianize them. These children were on constant watch and was expected to be seen but not heard in many different ways and if they were to dare speak their own language they would be beaten. Which seems horrible because our country is all about freedom of speech and individuality. This was due to the fact that people believed if you took away a speech (which they did through reform schools) or group unit (by separating the families) then you took away their culture. Because Indians were lower in the economic strata these relationships meant the world to them. Discrimination towards Indians is not thought about usually when hearing the word, however this may be due to the fact that growing up we believed that the pilgrims were friendly towards the Indians when in reality they hated each other and had rewards for someone who captured an Indian. The pilgrims also tried to kill off the Indians by making trades and giving them infected blankets full of smallpox while they got vegetables or other useful materials. A stereotype for Indians has been that they are lazy, dirty, and drunks. This perception of a person could be for any individual person or race. These qualities are personal and not adequate for categorizing for a group of people.

A story that stuck out to me in the movie would be the woman who lost her daughters over the fact that she was an Indian and got a ride with a person who was not seen as socially stable to be giving her and her child a ride in the case of the emergency.

Overall racism is still an issue within the United States and in Maine itself and we as people are the only cure for this by accepting everyone regardless of their racial background or beliefs.

Reflection for Video

As I was watching the video I felt angry at the fact that this still happens today, and that people are still not admitting to the fact that it is not happening. I guess I am just as bad because I turn away from any knowledge of this because I do not want to face the facts that sit right in front of me. My family lives in Old Town, just down the street from Indian Island, home of the Penobscot Tribe. I always used to ask questions about why it was its own island, and I never was told until I looked into it myself. I loved the movie and the truth that it sent out to everyone. There was so much history that I never knew and was glad that it was displayed in such a true way. The idea of the children being separated at the schools that Indian children were sent to growing up was awful. I could not believe the abuse that children were put through, physical, emotional and sexual abuse was shocking, I had no idea that that ever happened. I think that fact has been hidden, at least to me, throughout all our history books. I could not believe the physical labor that children in schools had to endure. The government tried to destroy the native language of the people, and take all the land from others, and just overall wanted to exterminate them. It was hard to hear the truth being said, and seeing the faces of those that it happened too, and the fact that it happened so close to home took a toll on my outlook, and gave me knowledge that I am glad I know.

First Reflection

The way we viewed an epidemiologist with illnesses within communities is very similar to how a doctor is with his patent's individual illnesses. Epidemiology is traced back to 300 BC to Hippocrates who created the correlation between diseases and the environment. A great example of what Hippocrates preached would be John Snow's discovery between the disease cholera and London's town water pump. Even though we fully agreed that the environment has a lot to do with illnesses and the spreading of them, we also believed that illness is also self caused in some cases with people's individual choices which is uncontrolled by epidemiologists. For example cigarette smoking. Epidemiologists can only take the procedures to try and limit the amount of people who smoke cigarettes but sometimes it has to be an individuals choice to quit versus someone trying to force them. Some lifestyles such as heavy partying and drug inducing can lead to other illnesses such as hepatitis or liver disease. This is important to epidemiologists because they are concerned with the rates within a population and all rates are based upon the population at risk. While most people at risk are the very young and the very old, this spectrum is now branching out to people in the "in between" category. This is due to lifestyle choices that we discussed before through diet, lack of exercise, genetics, or poor choices. It used to be that mortality was the number one source of viewing illness however, causes of death is sometimes not an accurate way to provide a clear picture of health for populations. It has to do with geographic regions and then can be segmented into smaller parts within a state. Obviously places like college campuses are going to have more rough housing and deaths by different causes than Florida which has an increasing elderly population. Take for example the girl that was found deceased at Orono a couple weeks ago. It is not as likely to find an elderly person in her same situation.

What makes epidemiologists so important is that they are responsible for diseases and notifying potential outbreaks that could happen in certain areas. They notify hospitals and generate reports which are posted such as the Morbidity and Mortality Weekly Report. A great example for our time era would be the outbreaks of H1N1 that we have had in the past year. This disease even though it was viewed as being acute but deadly was known about months before the possible H1N1 outbreaks. These reports are great for places like our college campus because people are living in such close quarters and being exposed to many different people and germs all the time. The only downside to the reports issued by the epidemiologists would be that they sometimes don't have the most accurate data and this is due to the doctors being so busy and trying to fit as many patients a day as they can that they sometimes don't find time to notify the epidemiologists about all the outbreaks or diseases that they dealt with in a day. Another downside to these reports is that even though epidemiologists calculate the number of years lost with deceased people but fail to recognise if they were battling another type of disease that is not viewed as chronic such as depression. People do not live enjoyable lives with depression and sometimes can lead to death itself if the disease is serious enough.

Either way epidemiologists are important to our health as a society by trying to provide accurate information to the public about how they can improve their health and prevent disease or to doctors who can provide care for the ill.

02/03/10

Testing for Intro to Community Health :)