01-DETERMINAN PROMKES

8/13/2019 01-DETERMINAN PROMKES

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DETERMINAN

PROMKESMUH. SYAFAR


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THE MEANING OF HEALTH

Health is state of complete physical, mental,and social well-being and not merely the

absence at disease or infirmity (WHO, 1947)

Health is the condition of organism whichmeasures the degree to which its aggregate

powers are able to function (Obertenffer, 1960)

Health can be regarded as an expression of

fines to the environment, as a state at

adaptation (Dubos, 1965)


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Healt is a state at well-being sufficient to

parform at adequate level of physical,

mental, and social activity taking age into

account (Lalonde, 1974)

Health the quality at life involving

dynamic interaction and interdependence

among the individuals main train a

continuum at balance and purposeful

direction with environment where be is

functioning (Dunn, 1967)


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Health is the capacity to cope with on

adapt to discruptions among the organic,

social, and personal components atindividuals health system (Bates and

Winders, 1984)

Health can be defined as the quality of

peoples physical, psychological, and

sociological functioning that enables the

to deal adequately with the self and

others in a variety of personal and social

situations (Redwonth, 1992)


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Health as quality of life, involving social,

mental and biological fitness on the partof the individual, which result from

adaption to the environmen (Shirreffs,

1982)

Component of health but also includes

skill development values awareness,positive self-concept, cognition, other

variables (Horowitz, 1985)


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Multidimensional and includes

vocational health as well as the moretraditional health components (Eberst,

1985)

Social health, mental health, emotional

health, spiritual health and physical

health, (Dintiman and Greenberg, 1992),(Linda Ewels,2000)


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SOCIAL DETERMINANTS OF

HEALTH


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Determinants of health

Proximal determinants of health

Distal determinants of health

Disability adjusted life years (DALYs)

Ecological fallacy

Social capital


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Determinats of health :

1. Proximal determinants or downstream factors

2. Distal determinants or upstream factors

The entanglement of the social determinants of health

Gender Ethnicity

Wealth Education


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Disability-Adjusted Life Year

(DALY)

Daly adalah ukuran beban penyakit secarakeseluruhan, yang dinyatakan sebagai

jumlah tahun yang hilang akibat sakit, cacat

atau kematian dini.


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Kerugian Ekonomi penderita HIV dan

AIDS di Indonesia Tahun 2010

Jumlah Penderita tahun 2010 =

21.770 orang

Hasil perhitungan

Biaya Perawatan per hari Rp. 1.000.000Biaya perawatan per orang

dalam 1 tahun 12 X Rp.

30.000.000,-

Rp.30.000.000,-

Total biaya perawatanpenderita di Indonesia dalam

setahun = 21.770 x Rp.

360.000.000,-

Rp. 7.837.200.000.000,-


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Pengeluaran Biaya Merokok Penduduk di

Indonesia Tahun 2007

Jumlah Penduduk :225.000.000 penduduk Hasil Perhitungan

Jumlah Perokok : 28 x 225.000.000 = 65.000.000

Harga rokok per batang rerata diisap 10

batang/hari

Total konsumsi perhari : 65.000.000 x 10

btg

650.000.000 batang

Total Harga : 650.000.000 x Rp.1.000,- Rp.650.000.000 batang

Dalam 1 bulan 30 X 650 milyar Rp.19,5 Trilyun/bulan

Dalam setahun 19,5 Trilyun x 12 bulan Rp. 234 Trilyun/tahun

Cukai rokok (April 2010) Rp. 28,3 Trilyun


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Pengeluaran Biaya Merokok

Penduduk di Makassar

Jumlah Penduduk : 1.300.000

penduduk

Hasil Hitungan

Jumlah Perokok : 22,1 % x

1.300.000 =

287.300 Orang

Harga rokok perbatang Rp.1.000,-

/batang rerata diisap 10-12

batang/hari

Total harga 287.300 x Rp. 1.000,- Rp. 3 milyar/hari

Dalam 1 bulan 30 hari x Rp. 3

milyar

Rp. 90 milyar/bulan

Dalam setahun Rp.90 milyar x 12

bulan

Rp. 1,08 Trilyun


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Ecological Fallacy

About the relationship

between individual wealth

and individual health.


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Social Capital

Social Capital is a term that became of interest

to many health researchers looking at socialdeterminants of health

Trust and Reciprocity


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ENVIRONMENTAL

DETERMINANTS OF HEALTH


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Environmental health

Ecologically sustainable development

Equaity and environmental healthjustice

Physical settings

Life support systems


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Mandala of health: a model of the human

ecosystem

Spirit

Body Mind

Family Psycho-

economic

environment

Personal

behaviour

Physicalenvironment

Humanbiology

Work

Sick-

care

system

Human-care environment

Community

Lifestyle

Cultur

Biosphere


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Local effects of loss of global sustainability

GLOBAL CHANGE AUSTRALIAN LOCAL EFFECTS

Air

OzoneGlobal warming

Melanomas (worlds highestlevel,) TasmaniaFloods, droughts, changed pollination patterns

Water

Imigration

Forest clearances

Salting, acidification of soils

Increased erotion, drop in rainfall

LandProductive land Reduced by 10 per cent every year,

60 per cent degraded

Life

Biodiversity More mammals extinct than any other continent

PeoplePopulation Waste production per head second in Organization for

Economic Cooperation and Development

Energy

Energy Life Geenhouse gases increasing by 16 per cent

(8 per cent allowed by 2008 in the Kyoto Agreement


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Physical Settings

Urban Environments

Rural and Remote Environments


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Life Support Systems

Air Pollution

Water Pollution

Contaminated Food


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BIOLOGICAL DETERMINANTS

OF HEALTH


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Biological determinants of health and

disease

Models of disease causality

The role of genes

Race and ethnicity as determinants ofhealth and disease

Morbidity and mortality in relation to age

Gender differences in health and diseaseUnderstanding biological markers of risk


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Disease refer to a wide range of

heterogeneous, intra-individual factors that

drive, mediate, or moderate the pathways

towards health or disease

Interactions between genes, behaviours and

environments

Biological determinants of

health and disease


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Gene-environment interation

pattents an example of :

1. Single gene disease-sickle cell

anaemia

2. Multi-gene diseases


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Gender Differences in risk Factors and protective facvtors for

cardiovascular diseases (prevalence rates except for saturated fats)

DETERMINANTS MALES (%) FEMALES (%)

Risk factors

Smoking (current smokers)

High blood pressure (>140/90)

High LDL (bad) cholesterol (>3.5 mmol/I)

Overweight + obesity (body mass index >25 kg/m2)High abdominal girth (m>102cm, f>88cm)

Diabetes

Saturated fat intake (% of energy)

18

31

50

6727

8

13

13

27

42

5234

7

13

Protective factors

Psysically active (>150 minutes/week)

Alcohol intake (low risk pattern in 60+ age group)

Vegetable and fruit consumption (>five serves/day)

Adequate HDL (good) cholesterol (>1.0 mmol/I)

56

67

39

81

44

62

47

95


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Case study

Ama, a small, tree-year-old child, was playing with hersiblings outside her home in a smal, semi-urban, slum

area. While chasing her older brothers she trod on a

nail. Her mother washed the wound and bandaged it.

The wound remained red and angry. Over a week the

wound did not heal, the area remained red and angry,

with flaring up the leg. Ama began to complain that she

had pain in her groin, she became weak and febrile.Ama was taken to hospital when her mother could not

control her fever and she died within a few days of a

few days of admission.

Documents

01-DETERMINAN PROMKES