Health and diseases

Name: Toni Thomas

Introduction
Health can be defined as a person's physical, mental and social condition. Physical health refers to the proper
functioning of the body systems. Mental health refers to a state of emotional and psychological well-being in which
an individual is able to use his or her cognitive and emotional capabilities, function in society and meet the ordinary
demands of everyday life. Social health involves the ability of an individual to form fulfilling interpersonal
relationships with others. It also involves the ability of the individual to adjust easily to various social situations and
act appropriately in a range of settings.
Disease is a disorder or malfunction of the mind or body, which damages good health. There are nine main
categories of disease but some diseases are more difficult to classify and fit into more than one of them.
1. Physical disease

These diseases involve temporary or permanent damage to the body and include all the other categories except
mental disease where there is no sign of physical damage to the brain. An example of a physical disease is multiple
sclerosis.
2. Mental diseases
These diseases affect a person's mentality, but may be accompanied by physical symptoms. Emotions, thoughts,
memories and personal and social behaviour can be affected. Some mental diseases are caused by degeneration of
brain tissue. An example would be Alzheimer's, a progressive deterioration in memory which is followed by a
general decline in all mental faculties (dementia). Other mental diseases appear to be accompanied by changes in the
blood flow to the brain, for example, Schizophrenia.
3. Social diseases
This is a very wide category that can include almost all infectious diseases and multifactorial diseases, which are
influenced by people's living conditions and their personal behaviour. For example, deficiency diseases may be the
result of lack of choice of food, due to shortage of money.
4. Infectious disease
Infectious diseases are caused by pathogens such as viruses, bacteria, fungi, protoctists, worms and insects, which
can be transmitted from person to person. This may be through normal social contact, for example, chicken pox, or
through food and water, sexual contact or an animal bite. Carriers are people who can transmit the pathogen but do
not have the disease symptoms.

5. Non-infectious diseases
These are all diseases which are not caused by pathogens and cannot be passed on by physical contact. An example
is sickle cell anaemia.
6. Degenerative diseases
These diseases are characterised by a gradual loss of function in one or more organs or tissues. In old age, this is
often the result of the failure of the bodies repair mechanisms, for example, loss of mobility due to worn joints.
Degenerative diseases, however, can occur in youth or middle age. They may be the result of poor nutrition in
childhood or due to the immune system attacking the bodys own cells. There are three main categories:

Diseases of skeletal, muscular and nervous tissues, for example, osteoarthritis.

Cardiovascular diseases of the circulatory system, for example, coronary heart disease.

Cancers.
7. Inherited diseases
These diseases are caused by genes and can therefore be passed from parent to child. They are also sometimes
called genetic diseases or disorders. An inherited disease is cystic fibrosis, which is characterised by a build-up of
sticky mucus. This makes breathing difficult and can act as a breeding ground for bacteria, therefore physiotherapy is
needed daily to remove the mucus.

8. Self-inflicted diseases
These diseases are caused by damage to a person's health by their own decisions and behaviour. The choice
to smoke or misusing drugs, sunbathing or eating a high fat diet would be included in this category.
9. Deficiency diseases
These are nutritional diseases caused by an inadequate or unbalanced diet. That is, one or more essential nutrient is
missing or in short supply, for example, a shortage of Vitamin C causes scurvy.

Morbidity and Mortality, Prevalence and Incidence

Morbidity refers to the unhealthy state of an individual whereas mortality refers to the state of being mortal. Both
terms can be applied at the individual level or across a population. For instance, morbidity rate deals with the
incidence of a disease across a population and/or geographic location during a single year, for example, the incidence
of seasonal flu. Details on morbidity are given from doctors records and hospital records.
This data can be expressed as:

Incidence the number of new cases diagnosed and reported over a particular period of time, usually a week,
a month or a year. For example the incidence of dengue fever from January 2009 to December 2010 in
Jamaica. Incidence rates can be further categorised according to various subsets of the population such as by
gender, by racial origin, by age group or by diagnostic category.
Prevalence the number of persons with a disease at a particular time or within a certain time period for
example a year. An example would be a change in prevalence of HIV/AIDS in the Caribbean from 1980 to
2000.

Mortality rate on the other hand is the rate of death in a population. Morbidity and mortality rates are often used to
calculate the prevalence of a disease for example measles, and how likely the disease is to be deadly, particularly for
certain demographics.

Chapter 1 cardiovascular Diseases

Cardiovascular disease is a disease of the heart and blood vessels. These diseases are multifactorial as they are
influenced by many factors and there is no one underlying cause. Cardiovascular diseases include stroke,
hypertension, atherosclerosis and coronary heart disease.
Stroke a stroke occurs when an artery or arteries in the brain are blocked, or burst with leakage into brain tissue.
The brain tissue is starved of oxygen and nutrients and this may lead to death of the tissue. A survivor of strokes will
notice that their brain compensates for the functions that they have lost.
Hypertension this is a condition where an individual has a blood pressure higher than the normal. There may be no
symptoms initially, but there is an increased risk of damage occurring to the artery walls. This stimulates the
development of atheroma and increases the chances of developing angina or suffering a stroke or heart attack. High
blood pressure is more likely to occur in persons who smoke, are overweight, drink excessive alcohol, physically
inactive, or eat a diet rich I fat or salt. As such hypertension is considered a lifestyle disease due to these practices.
The normal blood pressure for a young adult is approximately 16.0 kPa systolic and 10.7 kPa diastolic. A diastolic
pressure above 13.3 kPa increases the risk of cardiovascular problems and a diastolic pressure above 17.3 kPa is
considered very serious as this may lead to death.
Atherosclerosis this is the development of plaque in the arteries. The process leading to atherosclerosis initiates
with the deposition of yellow fatty streaks containing a high amount of cholesterol in the inner coat of the arteries.
The deposits form beneath the inner lining known as the endothelium. Fibres are later deposited in the cholesterol
and they start to calcify and become hard in a process called arteriosclerosis. The deposits are referred to
atheromatous plaques. As a plaque size increases, it projects into the lumen of the artery and begins to block it. This
usually occurs in the aorta and coronary arteries which supply the muscle of the heart. If the plaque breaks through
the smooth endothelium, its rough surface usually causes a blood clot to develop. This is known as thrombus which
may build up until it is large enough to block the artery. If this clot breaks away, it may block another artery. This
process is called embolus. The artery wall becomes weaker with plaques and may stretch as a result. Once an artery
is blocked, the tissue it supplies will suffer oxygen starvation and will be severely damaged or die. If thrombosis
occurs in a coronary artery (coronary thrombosis), the heart is damaged and a heart attack is likely to occur. If
thrombosis occur in the brain (cerebral thrombosis) a stroke may occur.
Coronary Heart Disease the two coronary arteries branch from the base of the aorta, just above the aortic valve.
Disease of these arteries supplying the cardiac muscle is coronary heart disease. If one of these artery is blocked,
then there is a reduction in the supply of oxygen and nutrients to some of the heart tissue, which may lead to the
death if the tissue. The heart in turn has to work harder to force blood through the coronary arteries and so blood
pressure increases. Additionally, the cardiac output does not increase sufficiently during times of high demand such
as during exercise.
Chapter 2 - Dengue fever

Dengue fever is an infectious disease that is common in the Caribbean and in other parts of the world. It is
considered an emerging disease as it is on the increase, both in terms of the number of cares and its geographical
spread.
The causative agents of dengue fever are a group of related viruses, the dengue fever viruses known as DENV. Each
virus consists of genetic material in the form of RNA and three structural proteins capsid proteins form the core of
the virus as they surround the RNA. The other two proteins form a smooth surface that completely surrounds the
lipid bilayer developed from host cells.
The dengue virus is transmitted from infected to uninfected persons by Aedes aegypti female mosquitoes, the vector.
Female mosquitoes feed on blood to gain protein for their eggs. They inject an anticoagulant in their saliva to prevent
blood clotting while they remove blood. While they feed on an infected person, the viruses are transferred within the
blood. The viruses enter the cells of the gut of the mosquito, replicate and after 8 10 days are transferred to the
salivary gland of the mosquito. The virus remains in the female mosquito to be transmitted to an uninfected person
when the mosquito wants to feed on blood.
After a short incubation period, which is usually 4 7 days, an infected person starts developing symptoms:

Pain in muscles and joints

Painful flu-like symptoms such as high fever
Rash, nausea, severe headache, vomiting and swollen lymph glands

Prevention and Control

Prevention is seen as the best means of control for the dengue virus. There are specific measures that can be
undertaken to prevent dengue fever such as fumigation, draining bodies of stagnant water and placing predators of
mosquito larvae into water courses such as irrigation ditches. People should avoid being bitten by mosquitoes by:

Wearing long clothing to avoid exposure of skin during the day when mosquitoes tend to bite
Putting up screens on windows and doors to prevent the entry of mosquitoes
Keeping areas around houses clean and free of possible breeding sites
Using mosquito coils and repellents. Repellents with DEET as the active ingredient is considered the most
effective.

Chapter 3 - Hiv/aids
Acquired Immunodeficiency Syndrome is caused by the Human Immunodeficiency Virus which weakens and
then destroys the bodys immune system. HIV is a retrovirus. Its RNA is used as a template to make DNA, which is
the reverse of what usually occurs in cells. The virus has surface proteins that interact with proteins on the surface of
T-lymphocytes. The virus fuses with the host cell and the RNA molecule enters the cell. The viral RNA is used as a
template by reverse transcriptase to assemble double-stranded DNA. This molecule enters the nucleus where it is
attached to the host DNA by the viral enzyme integrase. This incorporated viral DNA is now a provirus. It has the
tendency to remain inactive for several years. When the DNA is activated, it is used as a template for host RNA
polymerase to make complete RNA as the genetic material for new viruses and mRNA to make viral proteins.
Protease cuts the protein produced on ribosomes into short sections which are then assembled around RNA to make
new viruses. These travel to the cell surface membrane and leave surrounded by host cell membrane and HIV
glycoproteins are incorporated.

The infection remains symptomless for a long time until the appearance of various opportunistic diseases such as
tuberculosis and a rare form of pneumonia. These diseases develop as the number of T-lymphocytes has decreased
because they have been destroyed by the HIV infection.
HIV is not transmitted by a vector but by direct contact between the blood of an infected and the blood of an
uninfected person. Methods of transmission are:

Blood in a needle or syringe that is used on an infected person and then on an infected person. This can
happen when a needle or syringe is not sterilised after use or when a needle is shared between intravenous
drug users.
Vaginal or anal sex between a person who is infected and someone who is not
Across the placenta during pregnancy
At birth when blood of an infected mother and the blood of her baby mix.
Blood from an infected person is used in transfusion or as a contaminant

There is a short incubation period of several weeks after which there are mild flu-like symptoms that are often
misdiagnosed.
Treatment, Prevention and control
AIDS is caused by a virus and while bacteria can be controlled by antibiotics, these are not effective against viruses.
Most treatments are therefore limited to relieving symptoms. Present research on treatment and prevention is
concerned about three areas
1. Developing a vaccine for the disease
2. Restoring or improving the damaged immune system of infected persons
3. Developing drugs that will inhibit growth of the virus and also treat resulting infections and symptoms.
HIV/AIDS is difficult to control as it is transmitted primarily during sexual intercourse. Health authorities can
distributed information about transmission but they are unable to control peoples sexual behaviour. Methods that
have been employed include:

Providing information about the risks of HIV/AIDS, the precautions that should be taken to avoid infection
and infected persons should take to avoid infecting others.
Issuing of free condoms
Voluntary testing centres
Testing the HIV status of pregnant women and providing antiretroviral drugs to infected persons
Organisations that deal with the virus coordinate activities in prevention and control.

Chapter 4 - Diabetes Mellitus

Diabetes mellitus is a non infectious, degenerative disease where insulin is not secreted or its target cells do not
respond or respond poorly. There are two types:
1. Type 1 not enough insulin is secreted by pancreatic -cells. This type normally develops in the early stage
of life.
2. Type 2 begins with insulin resistance, a condition in which cells fail to properly respond to insulin. Type 2
diabetes is usually associated with a variety of risk factors such as diet and obesity. This type develops later
in life.
Type 2 diabetes is the more common form as is a serious health issue in the Caribbean. Symptoms of the disease
include:

Extreme fatigue; weight loss with loss of muscle tissue

Itches around genital areas
Feeling intense thirst and urinating a lot especially at nights
Blurred vision due to the drying of the lenses of the eyes
Recurring infections of candida causing the disease known as thrush whose growth is promoted by glucose in
the urine.

Risk factors that promotes Type 2 diabetes:

Genetics diabetes tends to run in the families, and persons who have family members with Type 2 diabetes
are at risk of developing it themselves.
High BMI high BMI is associated with obesity. Obesity increases the risk that target cells do not respond to
insulin. Fat tissue also interferes with the bodys ability to use insulin.
Age diabetes is more common in older persons. This is because the pancreas does not secrete insulin as
efficiently and target cells become less responsive to insulin.
Diet a diet high in fat, with insufficient fibres and much refined sugars increases the risks of diabetes

Prenatal malnutrition studies have found that persons whose mothers suffered famine have a higher
prevalence of diabetes than others. This may be as a result of the predisposition of prenatal malnutrition to
obesity.

The main aim of diabetes treatment is to control blood glucose levels and to prevent diabetes complications. These
three areas are the main focus:

Nutrition be aware of the foods eaten, when they are eaten and the quantity in which they are eaten.
Following a meal plan can also aid in weight loss and lower the risk of developing complications.
Physical Activity his is an important part of controlling diabetes and preventing complications such as heart
disease and high blood pressure.
Medication oral medication may be given by a doctor t help control blood glucose levels for example
insulin.

Chapter 5 - cancer
Cancer is a group of diseases that affect different parts of the body. Each one is as a result of a single cell growing
uncontrollably to form a tumour. Cancers are caused by mutations in genes that control cell growth and division. Not
all tumours are cancers; they are either malignant or benign. Cancers are malignant tumours as the cells may spread
from their source and invade adjacent tissues. They may travel through lymphatic vessels or the blood streams to
remote areas in the body. This spreading through the body is termed metastasis and the tumours formed I other areas
of the body are secondary cancers.
Carcinogens are environmental factors that cause damage to DNA. Further factors are needed to promote the
proliferation of these damaged cells by mitosis. Tobacco smoke contains both groups of substances and so is strong
cause of cancer.

Environmental Hazards ionising radiation, certain chemical such as dioxins, asbestos and benzpyrene,
ultraviolet light in sunlight, x-rays are carcinogenic.
Food Additives these are tested for safety by regulatory organisations to ensure that any potential
carcinogens no longer have approval for use in processed foods. Studies have shown that nitrosamines and
nitries in red and processed meats may be associated with gastric cancer. These are substances added as
preservatives to prevent formation of toxins.
Viruses infection with several viruses are linked to the development of cancer. Human papilloma viruses
(HPVs) are the main cause of cervical cancer. Infection with Epstein-Barr virus and T-cell leukaemia virus
increases the risk of blood cancers. HIV positive persons are at a greater risk of blood cancers.
Genetic factors certain types of cancer occur most often in families than in the rest of the population.
Mutations ain ether BRCA1 and BRCA 2 genes are linked to the minority of breast cancer cases. The mutant
alleles are inherited dominantly.

Awareness should be made of the symptoms of cancer as early diagnosis and treatment often means that tumours can
be removed before they spread and damage other vulnerable tissues. Symptoms of four of these cancers are:

Breast cancer: a painless lump in either of the breasts of both men and women.
Cervical cancer: abnormal vaginal bleeding for instance between normal periods, a vaginal discharge with
unpleasant smell, discomfort or pain during sexual intercourse.
Lung cancer: persistent cough, coughing up blood, chest and/or shoulder pains.
Testicular cancer: unusual painless lumps in the testes.

Screening programmes for persons at risk of cancers include:

Mammography involves taking x-rays of the breast and checking the images for signs of tumour.
Cervical Screening very effective at detecting early stages of cancer. Cervical smears are examined
microscopically for signs of cancerous cells. The cancer is destroyed by the laser treatment.

Chapter 6 - Social and economic implications of diseases

HIV/AIDS

Many people who live with AIDS or HIV also have to live with the stigma of how other people may treat them. This
may stem from certain individuals not being completely educated on the basics of the disease or the virus. Many people
avoid people known to be infected with the illness out of fear that they may contact the disease. HIV and AIDS cannot
be transmitted through casual contact.
Some people who disclose to their future or present employer that they are HIV positive or carry the AIDS virus may
be discriminated against. They may be told they will not be hired or they will be let go for a reason that can not be
supported or backed up.
One important social effect of HIV and AIDS is relationships. When someone is carrying the disease it can be difficult
for them to start new relationships and, in some cases, maintain existing ones. Having the disease means they cannot
have intercourse with anyone else unless they wear protection---but even then it is a grave risk of possibly passing the
virus to someone else. Many people also may sever their ties with someone who is sick because of the emotional strain
it causes on the relationship.
HIV and AIDS affects economic growth by reducing the availability of human capital. Without proper prevention,
nutrition, health care and medicine that is available in developing countries, large numbers of people are falling victim
to AIDS.

People living with HIV/AIDS will not only be unable to work, but will also require significant medical care. The
forecast is that this will probably cause a collapse of economies and societies in countries with a significant AIDS
population.

The HIV/AIDS pandemic has an impact on labour supply, through increased mortality and morbidity. This is
compounded by loss of skills in key sectors of the labour market.
The long period of illness associated with AIDS reduces labour productivity.

Cancer

Cancer and its treatment result in the loss of economic resources and opportunities for patients, families, employers,
and society overall. These losses include financial loss, morbidity, reduced quality of life, and premature death.

Diabetes

Diabetes management requires strict adherence to a self-care regimen, including blood glucose testing, medication, diet
and exercise. This often challenges people with diabetes and those who care for them, potentially affecting
interpersonal relationships and indirectly affecting glucose control.