18 Public Health Policy

Question 1

Primary prevention

Answer 1

Reduce incidence
Stop the emergence of new cases of events
Ex: vaccination

Question 2

Secondary prevention

Answer 2

Reduce prevalence
Early disease detection
Ex: screening

Question 3

Tertiary prevention

Answer 3

Reduce the number/impact of complications

Ex: slowing the progression of MS, stroke rehabilitation

Question 4

2 benefits of an expanded risk factor model

Answer 4

1. Risk factors are unequally distributed, so this allows us to understand and locate the factors that may explain the unequal distribution
2. Provides us with multiple key points where we can intervene to reduce the incidence of disease

Question 5

Macroenvironmental exposures

Answer 5

Broad risk factors that affect the entire population

Ex: air pollution, water quality

Question 6

Microenvironmental exposures

Answer 6

Things that affect the individual

Ex: diet, exercise, if you wear a seatbelt while driving

Question 7

Policy action of health issues must consider which 4 things

Answer 7

Political considerations (political will)
Economic factors
Social values
Good evidence

Question 8

Population approach

Answer 8

Lower the mean level of risk factor within the population to shift the whole distribution
Encourage everyone to change, shifting the entire distribution

Question 9

High-Risk approach

Answer 9

Narrow group of people are targeted to change a very specific risk
Move high risk individuals into normal range

Question 10

What are 5 factors that limit the benefits of the high risk approach?

Answer 10

Time
Money
Personal motivation
Supportive family
environment
Supportive social environment

Question 11

Advantages to the high risk approach

Answer 11

Provider and patient motivation
Therapies/approaches tailored to individual patients may be more effective and safe
Avoids those who are not at risk
Benefit-risk ratio favorable

Question 12

Disadvantages to the high risk approach

Answer 12

Limited effectiveness
High cost
Change rests on individual
Effects are often temporary (deal with condition not root causes)
Only directed at high risk individuals, not moderate risk

Question 13

Advantages to population approach

Answer 13

Broad impact on many people (high avoidable burden)
Cost effective
Collective rather than individual efforts
Easier to implement

Question 14

Disadvantages to population approach

Answer 14

Low patient/physician motivation
May not be publicly acceptable
May not respect autonomy
Cannot be tailored to individual needs
May benefit some groups more than others