10. Population Health Flashcards
Discuss the concept of health and Public health
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
Organised response by society to protect and promote health, and to prevent illness, injury and disability
- Describe the three key areas of Public Health
1) Disease prevention - action to reduce the onset, causes, complications or recurrence of disease 2) Health promotion - process of enabling people to increase control over and improve their health 3) Health protection - create and maintain environments that promote health, protect people from exposure to hazards in the environment
- Discuss the importance of each task of Epidemiology for Public health
Risk factor - predictive epidemiology, predicts groups to target
Health state - descriptive epidemiology, the effect of the risk factor - distribution and proportion
Investigate causes - casual epidemiology, determine if there is correlation or if due to confounding factors
- Describe the differences between the individual and the public health approach to establish determinants of health and disease ?
Public health
Unit the population
Intervenes on upstream risk factors
Multidisciplinary approach
Backed by scientific evidence
Funded by govts, non-profits, charities
Results in prevention
Reduction in disease exposure, incidence, mortality
Individual
Unit is the individual or series of pts
Intervenes on established or incipient disease
Interprofessional approach
Funded by govts, insurance, out-of-pocket
Results in disease prevention or mgmt
- Discuss the importance of Public Health in improving general and oral health states in populations
Public health problems are widespread and serious conditions that affect a significant proportion of the population with severe consequences, and comes at a high cost to society in terms of healthcare, loss of productivity etc… important to address at a societal level
- Describe the high-risk and the population level approaches for prevention
High-risk:
Approach that concentrates its efforts on individuals with risk factor above a given threshold => Great benefit to the individual, impt in addressing inequalities, but does not consider the exposure/frequency of disease in the population, does not identify who is more at risk or drivers of the disease in the population
Population level:
Approach that seeks to shift entire distribution curve of risk to a lower level
tries to remove common cause of problem, almost everyone benefits. but may not address health inequalities and does not have as large benefit to any given individual
- Describe the levels of prevention and give examples in general and oral health for all levels
Primary - intervening before health problems occur
Water fluoridation, fluoridated toothpaste, fluoride varnish, fissure sealants, sugar taxation, dental education, social determinants of health
Secondary - screening to identify health problem at early stages, aim to stop or reverse
Fluoride on incipient lesions, mouthguards, Small restorations
Tertiary - management of established health problem to slow or stop progression
Implants, prosthodontic rehabilitation, periodontal surgery
- Explain the relevance of surveillance systems for Public Health
Ongoing systematic collection, analysis and interpretation of outcome-specific data → helps to identify common causes and risk factors for disease, and address these risks in order to decrease incidence of disease in population → impt in planning and implementation and evaluation of public health strategies
- Describe the main epidemiological case definitions of a) dental caries, b) periodontal diseases and c) tooth loss
Dental caries - local pathological process of the extrasomatic background, leading to enamel decalcification, decomposition of dental hard tissue, and in consequence to formation of a dental cavity
Periodontal disease- when examining six sites of tooth, at least 2 teeth with more than 6mm CAL and 1 tooth with 5mm deep pocket in interproximal sites
Tooth loss - Functional dentition >21 teeth, severe tooth loss <10 left
- Reflect on the different dimensions measured by the DMF/dmf index.
Decayed - untreated dental caries, Missing - Filled - access to/dental services received
Measure of caries experience - DMF can only increase and not decrease
- Discuss the global patterns of the most prevalent oral conditions, including the distribution of these conditions by socioeconomic factors.
Untreated dental caries is the single most common condition globally, affecting an estimated 2.5 billion people. Severe gum disease – a major cause of total tooth loss – is estimated to affect 1 billion people worldwide.
The report underscores the glaring inequalities in access to oral health services, with a huge burden of oral diseases and conditions affecting the most vulnerable and disadvantaged populations. People on low incomes, people living with disabilities, older people living alone or in care homes, those living in remote and rural communities and people from minority groups carry a higher burden of oral diseases.
This pattern of inequalities is similar to other noncommunicable diseases such as cancers, cardiovascular diseases, diabetes, and mental disorders. Risk factors common to noncommunicable diseases such as high sugar intake, all forms of tobacco use, and harmful use of alcohol all contribute to the global oral health crisis
- Describe patterns of the distribution of the most common diseases in the Australian population
1 in 5 Australians reported toothache in previous 12 months
1 in 4 Australians avoided food due to dental problems
Socioeconomic gradients in oral health impacts - indigenous lack of access to healthcare
- Discuss the patterns of preventive dental care in Australia
- Discuss the drivers for patterns of care in Australia
Barriers:
Perceived need
Financial factors
Organisational availability
