Environment and Socio economic status on Health and

Views:
 
Category: Education
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

Environment and Socio Economic Status on Health and Disease:

Environment and Socio Economic Status on Health and Disease Dr. N. Bayapa Reddy MD Asst. Professor Dept. of Community Medicine Chennai Medical College Hospital & Research Centre Trichy , Tamilnadu 9/20/2011 Dr N B R CMCH & RC

Objectives of family advisory programme :

Objectives of family advisory programme To study the family composition To study and observe environmental factors personal hygiene of the family members To study and observe social and economic factors. To observe the growth and development of the individuals and immunization status of children. To study health status, morbidity and mortality of the family members. To study the fertility, family welfare utilization Health care seeking behavior of the family 9/20/2011 Dr N B R CMCH & RC

Guidelines for approaching to a family:

Guidelines for approaching to a family Approaching and building rapport with local health personal Approaching community elders along with the local health workers and your supervisors and explaining to them the purpose of your interaction. Discussing local health problems with the community health workers and village elders 9/20/2011 Dr N B R CMCH & RC

After approaching a family consider the following:

After approaching a family consider the following Take proper permission Introduce your self to the family Build rapport with HOF Observe the environment outside the house keenly Enter the house respectfully Sit at a clean area and well light space along with members of the family Try to elicit information from any member of the family. 9/20/2011 Dr N B R CMCH & RC

ENVIRONMENT:

ENVIRONMENT Definition: The term environment implies all the external factors-living, non living-material and non-material-which are presenting surrounding the man. Environment- Components 1. Physical : non living components water, air, soil, housing, wastes, radiation.... 2. Biological : plant and animal life including bacteria, viruses , insects, rodents and animals. 3. Psychosocial: customs, culture values, habits, beliefs, attitudes, income, occupation, religion etc 9/20/2011 Dr N B R CMCH & RC

Slide 6:

9/20/2011 Dr N B R CMCH & RC

Types of houses:

1. Pucca- house made of brick, cement and iron... 2. Semi Pucca - A house that has fixed walls made up of pucca material but roof is made of Asbestos and red tiles 3. Kachcha- house made of mud, bamboo, leaves by the villagers in villages. Types of houses 9/20/2011 Dr N B R CMCH & RC

Pucca house:

Pucca house 9/20/2011 Dr N B R CMCH & RC

Semi-Pucca House:

Semi-Pucca House 9/20/2011 Dr N B R CMCH & RC

Semi pucca house:

Semi pucca house 9/20/2011 Dr N B R CMCH & RC

Katcha house:

Katcha house 9/20/2011 Dr N B R CMCH & RC

Over crowding :

The number of person sleeping in a room estimates overcrowding. Standards of overcrowding Adult man/woman above 10 years of age for the purpose of overcrowding is counted as one unit, and a child of one year but less than 1o years as half unit and child less than 1 year is not taken into account. Floor area of the room is taken into account. The following floor area and number of units are within permissible limits and the accommodation shall not be considered overcrowded: Over crowding 9/20/2011 Dr N B R CMCH & RC

Contd..... :

110 sq feet/more 2 units 90 sq feet/more but less than 110 sq feet 1.5 units. 70 sq feet/more but less than 90 sq feet 1 unit 50 sq feet/more but less than 70 sq feet 0.5 units Under 50 sq feet nil Number of rooms and number of sleeping persons in each room has been advised as follows: Contd..... 9/20/2011 Dr N B R CMCH & RC

Cont.....:

a. 1 room-2 units b. 2 room-3 units c. 3 room-5 units d. 4 room-7 units e. 5 room/more-10 Cont..... 9/20/2011 Dr N B R CMCH & RC

Slide 15:

Overcrowding in houses 9/20/2011 Dr N B R CMCH & RC

Slide 16:

9/20/2011 Dr N B R CMCH & RC

Slide 17:

9/20/2011 Dr N B R CMCH & RC

Source of drinking water :

Source of drinking water 9/20/2011 Dr N B R CMCH & RC

PUBLIC TAP:

PUBLIC TAP 9/20/2011 Dr N B R CMCH & RC

Public tap:

Public tap 9/20/2011 Dr N B R CMCH & RC

PUBLIC BOREWELL:

PUBLIC BOREWELL 9/20/2011 Dr N B R CMCH & RC

Boiling-:

Boiling- 9/20/2011 Dr N B R CMCH & RC

METHODS OF PURIFICATION OF WATER:

Filtration METHODS OF PURIFICATION OF WATER 9/20/2011 Dr N B R CMCH & RC

Liquid waste disposal:

Liquid waste disposal Open and running drainage 9/20/2011 Dr N B R CMCH & RC

Open and stagnant drainage :

Open and stagnant drainage 9/20/2011 Dr N B R CMCH & RC

Open and stagnant drainage:

Open and stagnant drainage 9/20/2011 Dr N B R CMCH & RC

Poverty:

Poverty 9/20/2011 Dr N B R CMCH & RC

Poverty :

Poverty Definition:- Inability to gratify the physiological needs, that is, need for survival, safety, and security. The minimum requirements for fulfilling the physiological needs are food and nutrition , shelter , and preventive and protective health care 9/20/2011 Dr N B R CMCH & RC

Socio economic status in Health and Disease:

Socio economic status in Health and Disease SES One of the important concern to provide health care services. To minimize the morbidity and mortality To better utilise the limited resources to improve the health of the needy people T he frequency of the diseases in different socio economic groups are different Ex: Chronic bronchitis, TB, Diarrhoea is more common in Lower class group. Diabetes, Hypertension, Obesity, CVD etc… in Upper class group 9/20/2011 Dr N B R CMCH & RC

Social class and Health:

Social class and Health Social class is positively correlated with health status of the family. People of Upper classes have a longer life expectancy, less mortality and better health and nutritional status. Mortality rates like IMR, MMR, general MR are all high in Lower class Family size, early marriages of women and bearing more children common in lower class 9/20/2011 Dr N B R CMCH & RC

Poverty line:

Poverty line In Indian, the poverty line is drawn on the basis of a per capita (adult) intake of 2,400 calories for the rural and 2,100 calories for the urban areas. The World Bank uses reference lines set as $1 and $2 per day in 1993. In1998 , 1.2 billion people worldwide had consumption levels below $1 a day (24 percent of the population of the developing world) and 2.8 billion lived on less than $ 2 a day ‘Poor’ can be classified into four sub-groups; Destitute, Extremely poor, Very poor, and the poor 9/20/2011 Dr N B R CMCH & RC

causes of poverty:

causes of poverty Individual : lazy, dull, inefficient or who lacks imitative would become poor. Culture or subculture of Poverty : The ‘culture blocks all attempts of the society to change the values, norms, beliefs and lifestyle of the poor. Economic Causes : Inflationary pressures have also increased poverty because the index of wholesale prices has been increasing. Poor investment in health Lack of capital too prevents industrial growth . Human capital deficiencies or lack of skills High rate of unemployment in the country too leads to the drop in the demand for labour. Demographic cause: Population explosion and growth. Social causes : These are discrimination; prejudices, casteism, communalism and Illiteracy affect employment opportunities and mal-distribution of resources. The wars and threats of war also force the state to spend huge amounts of money. 9/20/2011 Dr N B R CMCH & RC

Effects of poverty:

Effects of poverty 9/20/2011 Dr N B R CMCH & RC

Factors involved in social class differences in health and diseases:

Factors involved in social class differences in health and diseases Physical environment : housing, safe water, access to clean air, etc Difference in services provided : there are difference in the availability of services for different social groups. In some areas there is no doctor Material resources : income, wealth and possession of tools which can promote or help to achieve better health. 9/20/2011 Dr N B R CMCH & RC

Slide 35:

Genetic endowment : people in one social class tend to marry in the same social class Educational status : the illiterates are ignorant to pursuing measures which may conduce to good health Attitude to diseases : there are people who regard that illness is a punishment and others who regard that illness is due natural causes. 9/20/2011 Dr N B R CMCH & RC

Measures to reduce poverty:

Measures to reduce poverty Lifting import restrictions and boosting up exports; Controlling the borrowings; Selling units in public sector which are constantly undergoing losses; Collecting more taxes from people who can pay; Improving cost effectiveness by monitoring welfare expenditure; Making additional funds for development of small scale industries. Loans to the weaker sections of society may be provided at preferred rates while the extent of subsidy may be kept within reasonable limits; Lowering customs tariffs to make the Indian economy internationally competitive. Removing constraints on capita-intensive infrastructure industries, such as power, irrigation and telecommunication. Labor legislation for health and safety of workers; Growth in agricultural economy . 9/20/2011 Dr N B R CMCH & RC

Poverty alleviation programs in India:

Poverty alleviation programs in India Government is running many schemes and programs such as Integrated Rural Development Program (IRDP), Training Rural Youth for Self-Employment (TRYSEM), Food for Work Program (FWP) which later became the National Rural Employment Program (NREP), Rural Landless Employment Guarantee Program (RLEGP), which later on merged on Jawahar Rozgar Yojna Program, and Antoyodaya Program. 9/20/2011 Dr N B R CMCH & RC

Social Health Insurance:

Social Health Insurance Social Insurance is the payment of health care service made through a health fund. Contributors usually come from the pay roll , social insurance for government employees in India. Private insurance refers to the insurance contributions or premiums, which based on risk. Usually the premiums are based on the actuarial risks, i.e. the expected average cost of providing care for them. It means that people who are in high-risk groups pay more. In employer-based insurance the employers (usually of large corporations) or private bodies serve as the third party payer or collection agent, e.g., Employees State Insurance(ESI) in India 9/20/2011 Dr N B R CMCH & RC

Financial Situation:

Financial Situation What is the source and amount of his income? Does it seem sufficient for general needs? Is it adequate to meet his cost of medical care in addition? Does the family lose total or a part of income due to illness of the patient? Can they compensate this from other sources yes/no If yes specify 9/20/2011 Dr N B R CMCH & RC

Slide 40:

9/20/2011 Dr N B R CMCH & RC RELAX !!!

Slide 41:

9/20/2011 Dr N B R CMCH & RC Environment

Slide 42:

House Drinking water Sanitary latrine Type Ownership Own/rented No of available Rooms (Exclude the Kitchen and waranda ) No of persons per room Source Distance Availability Utilisation 9/20/2011 Dr N B R CMCH & RC If Not Utilizing the Sanitary latrine reason: problem in water supply / foul smell and dirty/ other specify Separate bath room available Yes/No Separate kitchen is available yes/no Waste disposal: Dust bins/ Heaps/ throwing surrounding area Drainage facility: Pit/ open drain/ open stagnant/ no drainage system Mosquito breeding present / absent Overcrowding present / absent Note: Type of house P- Pucca SP- Semi Pucca K – Katcha Source of Drinking water tap with in the house/ public tap / bore well/ well/lake/canal/river

Slide 43:

9/20/2011 Dr N B R CMCH & RC Socio Economic Status

Slide 44:

Urban area Kuppuswamy’s scale : education, occupation, income Verma scale : family composition, education of members, income, social position, and socio cultural practice Hollingshead scale: residence, occupation, and education Rural area Udai pareek and G Trivedi scale Freeman scale For both; BG Prasad scale 9/20/2011 Dr N B R CMCH & RC Socio Economic Status scales

Slide 45:

Education Score Occupation Score Per capita Income Score Education Score Occupation Score Per capita Income Score Honour (or) PhD. 7 Professional 10 >19575 12 Graduate (or) PG 6 Semi Professional 6 9788-19574 10 Higher Secondary(11-12) & ITI 5 Clerical, Shop-owner form 5 7323-9787 6 High School Level (9-10) 4 Skilled 4 4894-7322 4 Middle (6-8) 3 Semi Skilled 3 2936-4893 3 Primary (1-5) 2 Unskilled 2 980-2935 2 Illiterate 1 Un employed 1 <979 1 Total Score 9/20/2011 Dr N B R CMCH & RC GRAND TOTAL SCORE = Note: For education and occupation include only head of the family Score S.E. Class 26-29 Upper (1) 16-25 Upper Middle (ii) 11-15 Lower Middle (iii) 5-10 Upper Lower (iv) <5 Lower (v) Material possession Tractor / Bullock cart: Yes/No Cycle/ Scooter: yes/no Radio/ TV yes/no Farm Land in acres and animals: Social participation: public leader/panchayat member/ any organization House , family and caste Kuppuswamy’s scale Udai pareek’s scale

Slide 46:

9/20/2011 Dr N B R CMCH & RC Thank u….

authorStream Live Help