2. Introduction to public health

Question 1

what things do you think of when you hear public health?

Answer 1

• screening programs
• vaccinations
• public information and awareness campaigns
• sanitation
• hygiene information

Question 2

define public health

Answer 2

the science and the art of preventing disease, prolonging life and promoting health through organised efforts of society.
- a collective endeavour

Question 3

how is public health different from clinical medicine?

Answer 3

1. public health tends to focus on entire populations not single patients
2. public health includes facilitation and promotion of healthy behaviours and environments
3. unlike medical care that we receive through when we need it, public health is required all of the time

Question 4

what is part of the clinical health ice berg?

Answer 4

1. known to medical sciences
2. aware of illness but not sought advice
3. diseased but not yet aware of illness
4. well

Question 5

what are the 3 domains of public health?

Answer 5

1. health protection
2. health improvement
3. population health care

Question 6

what comes under health protection?

Answer 6

infectious diseases
environmental hazards
Emergency response

Question 7

what comes under health improvement?

Answer 7

health inequalities
wider determinants of health
behaviour changes

Question 8

what comes under population health care?

Answer 8

healthcare quality
health policy
commissioning and priority setting
NHS

Question 9

what is health intelligence epidemiology?

Answer 9

the collection of data that informs the practice and application of the 3 domains of public health

Question 10

Example: health protection and climate change

Answer 10

emergency response to extreme weather
outbreak control
infectious disease surveillance

Question 11

Example: health improvement and climate change

Answer 11

behaviour changes like diet and travel
urban design
active travel

Question 12

Example: population healthcare and climate change

Answer 12

routine data
health in all policies initiative
sustainable healthcare

Question 13

what are determinants of health?

Answer 13

factors that influence health
upstream determinants refer to factors that influence health before the disease process begins.

Question 14

what impact do wider determinants of health have?

Answer 14

they often have greater influence on health than access to of use of health care services

Question 15

what are some determinants of health?

Answer 15

1. mental health
2. diet
3. genetics
4. education
5. family dynamics
6. commercial companies
7. sleep
8. housing
9. Social wellbeing
10. age
11. access to healthcare
12. Pollution

Question 16

what are some biomedical targets for public health?

Answer 16

1. CVD
2. cancer
3. HIV
4. diabetes
5. obesity

Question 17

what are some behavioural targets for public health?

Answer 17

1. smoking
2. diet and nutrition
3. physical activity
4. substance abuse
5. stress
6. sexual behaviours
7. hand hygiene

Question 18

what are some socio-environmental targets for public health?

Answer 18

1. Poverty
2. unemployment
3. housing
4. social isolation
5. air pollution
6. commercial influences
7. hazardous living and working conditions

Question 19

what is the Nuffield ladder of interventions?

Answer 19

1. Eliminate choice
2. Restrict choice
3. guide choice through disincentives
4. guide choice through incentives
5. guide choices through changing default policy
6. enable choice
7. provide information
8. do nothing

Question 20

Nuffield ladder of interventions: eliminate choice

Answer 20

seat beats

Question 21

Nuffield ladder of interventions: restrict choice

Answer 21

banning smoking in public places

Question 22

Nuffield ladder of interventions: guide choice through disincentives

Answer 22

sugar tax

Question 23

Nuffield ladder of interventions: guide choice through incentives

Answer 23

no road tax on EV

Question 24

Nuffield ladder of interventions: guide choice through changing default policy

Answer 24

serving salad with burgers

Question 25

Nuffield ladder of interventions: enable choice

Answer 25

changing beer glass shape

Question 26

Nuffield ladder of interventions: provide information

Answer 26

calorie information on menus

Question 27

Nuffield ladder of interventions: do nothing

Answer 27

bike helmets

Question 28

who does public health in England?

Answer 28

1. Local public health teams run by local government 2. national public health bodies 3. Epidemiologists and public health academics 4. professionals and policy makers in other sectors

Question 29

what does the kind of data used in public health depend on?

Answer 29

the area being examined the amount of resources available

Question 30

what evidence is used to make public health decisions?

Answer 30

1. morbidity and mortality statistics 2. census data 3. health care data like hospital admissions 4. fingertips, WHO and ONS data also specific surveys, audits and other data

Question 31

what does public health evidence help us to do?

Answer 31

1. see where policy or interventions or events have had an impact on health 2. identify needs: where or with whom we need to intervene 3. understand what is acceptable or feasible 4. decide what policies and practices are justifiable - avoid nanny state

Question 32

what are the levels of disease prevention?

Answer 32

Primary Secondary Tertiary

Question 33

what is primary disease prevention?

Answer 33

prevention of disease in health populations like immunisations

Question 35

what is tertiary disease prevention?

Answer 35

reducing the long term impact (mortality or morbidity) once the disease is established

Question 36

what are health inequalities?

Answer 36

variation in health between population groups resulting from a variety of social and economic processes that are unequally distributed within or between populations

Question 37

what kind of things cause health inequality?

Answer 37

economic status race gender poverty government/politics

Question 38

what is health inequality?

Answer 38

a choice and created by Society and not disease

Question 39

what did Michael Marmot say?

Answer 39

the unnecessary disease and suffering of disadvantaged people is a result of the way we organise our affairs