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Road Trip: The Common Cold

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by

Samantha Fernandes

on 13 February 2014

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Transcript of Road Trip: The Common Cold

Discover

Tours

Microsocial
Workplace Policies
Macrosocial
Community
Cell
Society
Community
Inappropriate use of health services
Macrosocial
Individual
Individual
Sickness Presenteeism

Health

Microsocial
What is it?
A viral infectious disease that infects the upper respiratory system
Who will be the focus?
Nasal stuffiness, sore throat, sneezing, cough, watery eyes, fatigue...
Genetics
Personality
Education
Lifestyle
Job
Sleep
Stress
Limited access to...
Grocery stores
Positive spaces
Places to exercise
A group of people living in the same place or having a particular characteristic in common
Community Disadvantage
Characterized by...
High rates of poverty
Low rates of education
Low rates of home ownership
Built environment
Safety
Walkability
Pollution
Crowding
A group of people who share a defined territory or culture
Workplace relationships
Martial and family relationships
Social capital
Colleagues, supervisors
Spouse, children
Role in community groups, circle of friends, social diversity

Roles
Provide a meaningful purpose to life
Support psychological health and well-being
People involved in community, work, and family decision-making processes benefit from positive affective state
Workers in subordinate jobs often have little involvement in decision-making
Negative attitudes
Increase in relationship conflicts
Negativity can run through workplaces when the economy is in recession
Increasing likelihood of conflict
Those experiencing conflicts at home or work have an increased susceptibility to infectious disease
In fact, conflicts between coworkers, worries of underemployment or unemployment can increase risk of a cold by 220%!
So, what does all of this mean?
Stress
What happens?

Now, What If...

Stress and the immune system are linked by NE and cortisol and regulation of the inflammatory response


Lets Tie it all Together

How Is It Regulated?

Causes symptoms of a cold

Glucocorticoid Receptor Sensitivity

Inflammation

The Immune System
Non-specific Immunity
Specific Immunity


How do we Defend Ourselves?

A cold is an infection of the mucus membranes of the respiratory tract, most commonly by a rhinovirus

The Common Cold

HPA Axis

CRH
ACTH
NE
Cortisol

The Stress Response

The Home Invasion Analogy

Over 100 rhinoviruses have been identified
One reason we don’t become immune to the cold
Cortisol
can only end inflammation if the cells are responsive to cortisol
Long term chronic stress can cause a loss of sensitivity to cortisol
Loss of sensitivity = loss of regulation and control of inflammatory response
Employment Standards: Sick Days
10 days personal emergency leave per year for companies >50 employees
No regulations for companies <50 employees

Employment Standards: Minimum Wage
Minimum wage for adults $10.25
Full-time worker would make ~$18,000/yr
Low-income cut off is $21, 359 (after tax)
Market Basket Measure ~$17,400

High vs Low SES Patterns
80% of those with high-income jobs have access to paid sick days but only 36% of those in low-income jobs do

The working class in North America
Why is it a critical health issue?
Economic Consequences
1.5 million workdays lost each year
Equivalent to $1B in productivity
83% of workers go to work despite having symptoms


Low job satisfaction
Legislation that prohibits sick people from coming to work needs to offer compensation
Only half of full-time workers in the US receive paid sick days

Many employers opt to not have strict policies
Believe it is costly to pay an employee who is not at work
Presenteeism becomes an issue when sick employees perform below par
Women
People with children
People who work in education, care and welfare
Low monthly income
Experience of symptoms
Assessment of own health status
Health-related concerns and behaviours

= Burden to the system
Transmission
Workers who go to work sick also risk transmission of illness to others
Even worse health outcomes
Increased cost
Loss of productivity
Social Support
Family members can take over some responsibilities while recovering

Bacteria
Virus
Changes in the weather
Going outside without a coat
Wet hair in cold weather
Walking bare feet
29% of families reported ED use
60% of families reported visiting their doctor's office

Low-income household
Very young children
High folk belief score
Belief that antibiotics are required

Kissing a sick person
Interventions
Current Focus Hand-Washing
Health in All Policies
Macrosocial
Raising minimum wage
Paid sick leave
Community
Public awareness and educational campaigns
Microsocial
Wellness programs in the workplace
Transmission also becomes a public health problem when workers use public transit, or come into contact with people in other sectors
Do people have a moral obligation to stay home when they are sick although they may face a financial loss?
Social support and relationships are important factors to recovering from the cold
A social network may be a source of health information
Coworkers and employers may be more understanding of circumstances if there is a positive attitude in the workplace
The inflammatory response is what makes us feel sick
Usually not a problem, but decreased cortisol sensitivity prevents termination of inflammation
Over exaggerated inflammation makes us feel sick and gives us our symptoms of catching a cold
What if Sgt. Cortisol is always around yelling at people and telling them what to do?
They might stop responding or lose some of their sensitivity to his orders
Exaggerated inflammatory response
Economic Consequences
Societal Consequences
$25 billion to the US for lost productivity
Additional $40 billion on medical costs
Antibiotic resistance
Individuals seeking treatment for common cold are prescribed antibiotics
Cost of prescribing antibiotics for the common cold annually is $37.5 million
Overuse and misuse of antibiotics
Case Study: Connecticut
First state to mandate paid sick leave
1.5 years later...
Only 10% of employers had cost increases over 3%
Decreased spread of illness and increased morale
80% of employers are supportive of the law
Children of low-income families also stand to benefit
The causes of the causes
The Common Cold
Antibiotics
SES
Highly impacted by knowledge, attitudes, and beliefs about colds
Full transcript