2. Introduction to public health Flashcards
what things do you think of when you hear public health?
- screening programs
- vaccinations
- public information and awareness campaigns
- sanitation
- hygiene information
define public health
the science and the art of preventing disease, prolonging life and promoting health through organised efforts of society.
- a collective endeavour
how is public health different from clinical medicine?
- public health tends to focus on entire populations not single patients
- public health includes facilitation and promotion of healthy behaviours and environments
- unlike medical care that we receive through when we need it, public health is required all of the time
what is part of the clinical health ice berg?
- known to medical sciences
- aware of illness but not sought advice
- diseased but not yet aware of illness
- well
what are the 3 domains of public health?
- health protection
- health improvement
- population health care
what comes under health protection?
infectious diseases
environmental hazards
Emergency response
what comes under health improvement?
health inequalities
wider determinants of health
behaviour changes
what comes under population health care?
healthcare quality
health policy
commissioning and priority setting
NHS
what is health intelligence epidemiology?
the collection of data that informs the practice and application of the 3 domains of public health
Example: health protection and climate change
emergency response to extreme weather
outbreak control
infectious disease surveillance
Example: health improvement and climate change
behaviour changes like diet and travel
urban design
active travel
Example: population healthcare and climate change
routine data
health in all policies initiative
sustainable healthcare
what are determinants of health?
factors that influence health
upstream determinants refer to factors that influence health before the disease process begins.
what impact do wider determinants of health have?
they often have greater influence on health than access to of use of health care services
what are some determinants of health?
- mental health
- diet
- genetics
- education
- family dynamics
- commercial companies
- sleep
- housing
- Social wellbeing
- age
- access to healthcare
- Pollution
what are some biomedical targets for public health?
- CVD
- cancer
- HIV
- diabetes
- obesity
what are some behavioural targets for public health?
- smoking
- diet and nutrition
- physical activity
- substance abuse
- stress
- sexual behaviours
- hand hygiene
what are some socio-environmental targets for public health?
- Poverty
- unemployment
- housing
- social isolation
- air pollution
- commercial influences
- hazardous living and working conditions
what is the Nuffield ladder of interventions?
- Eliminate choice
- Restrict choice
- guide choice through disincentives
- guide choice through incentives
- guide choices through changing default policy
- enable choice
- provide information
- do nothing
Nuffield ladder of interventions: eliminate choice
seat beats
Nuffield ladder of interventions: restrict choice
banning smoking in public places
Nuffield ladder of interventions: guide choice through disincentives
sugar tax
Nuffield ladder of interventions: guide choice through incentives
no road tax on EV
Nuffield ladder of interventions: guide choice through changing default policy
serving salad with burgers
Nuffield ladder of interventions: enable choice
changing beer glass shape
Nuffield ladder of interventions: provide information
calorie information on menus
Nuffield ladder of interventions: do nothing
bike helmets
who does public health in England?
- Local public health teams run by local government
- national public health bodies
- Epidemiologists and public health academics
- professionals and policy makers in other sectors
what does the kind of data used in public health depend on?
the area being examined
the amount of resources available
what evidence is used to make public health decisions?
- morbidity and mortality statistics
- census data
- health care data like hospital admissions
- fingertips, WHO and ONS data
also specific surveys, audits and other data
what does public health evidence help us to do?
- see where policy or interventions or events have had an impact on health
- identify needs: where or with whom we need to intervene
- understand what is acceptable or feasible
- decide what policies and practices are justifiable - avoid nanny state
what are the levels of disease prevention?
Primary
Secondary
Tertiary
what is primary disease prevention?
prevention of disease in health populations like immunisations
what is tertiary disease prevention?
reducing the long term impact (mortality or morbidity) once the disease is established
what are health inequalities?
variation in health between population groups resulting from a variety of social and economic processes that are unequally distributed within or between populations
what kind of things cause health inequality?
economic status
race
gender
poverty
government/politics
what is health inequality?
a choice and created by Society and not disease
what did Michael Marmot say?
the unnecessary disease and suffering of disadvantaged people is a result of the way we organise our affairs
