A.7 Epidemiology concepts Flashcards
Summarise basic concepts of public health, health promotion, and epidemiology.
What is public health according to the World Health Organization?
The art and science of preventing disease, prolonging life and promoting health through the organised efforts of society
WHO, n.d-2
How does the Public Health Association of Australia define public health?
An interdisciplinary approach to health which focuses on population-wide programs to prevent rather than cure disease and illness
PHAA, n.d.
What is health promotion?
The process of enabling people to increase control over the determinants of health and thereby improve their health
WHO, as cited by the Australian Health Promotion Association, n.d.
Define epidemiology.
The study of determinants of disease across populations, and of ways to reduce the impact of these diseases on the health of the community
Doherty Institute, n.d.
What role does the Australian Government play in public health funding?
The Australian Government provides most public health funding
AIHW, 2018
What percentage of an individual’s length and quality of life is accounted for by healthy behaviours, social and economic support, and the physical environment?
80%
CSIRO Futures, 2018
List the six broad strategies that represent the fundamentals of public health according to Duckett & Wilcox.
- Creating safer environments
- Reducing risks of transmission
- Identifying disease early
- Encouraging healthy behaviours
- Building healthier communities
- Enabling function (infrastructure)
What are examples of creating safer environments in public health?
- Air and water quality
- Occupational health and safety
- Food handling and manufacture
- Road safety
- Vector eradication
What are key examples of reducing risks of transmission?
- Immunisation
- Quarantine
- School exclusion
- Contact tracing
- Reducing risky behaviours
- Outbreak investigations
What is the aim of identifying disease early?
To reduce the incidence of a condition and to identify people with an early stage of the disease
This includes primary and secondary prevention.
What is an example of a health promotion activity?
Advertising regulation and prohibition
This can include campaigns around smoking, alcohol, and exercise.
What is the purpose of community development in public health?
To work with communities to improve their health outcomes and quality of life
This approach involves listening to community needs.
What is the role of the Australian Health Protection Principal Committee?
It is the key decision-making committee for health emergencies, developing national health protection policies
It comprises all state and territory Chief Health Officers.
Define the population at risk in epidemiology.
The number of potentially susceptible people to the conditions or events under consideration
This includes those who share a characteristic that makes them vulnerable.
What does incidence measure in epidemiology?
The rate of occurrence of new cases arising in a given period in a specified population at risk
It provides a measure of the risk of the condition.
Fill in the blank: The _______ of a condition is the rate of occurrence of new cases arising in a given period.
incidence
True or False: The incidence must always include a unit of time.
True
What is the aim of the National Cervical Screening Program?
To target women aged 25–74 for a 5-yearly test that looks for human papillomavirus (HPV) evidence
What was the participation rate in the National Bowel Cancer Screening Program in 2018-19?
43.5% of invitees participated
What are the five strategic areas of the healthy communities approach?
- Community involvement
- Political commitment
- Healthy public policy
- Multi-sectoral collaboration
- Asset-based community development
What is the incidence of a condition?
The rate of occurrence of new cases arising in a given period in a specified population at risk.
What does the numerator represent in calculating incidence?
The number of new events in a specified period.
What is cumulative incidence?
The number of new cases arising in the study period divided by the population at risk at the beginning of the period.
How is cumulative incidence often presented?
As cases per 1,000 population.
What is prevalence?
The frequency of existing cases in a specified population at risk at a given point in time.
What does high prevalence indicate?
High incidence and/or prolonged survival without a cure.
What is period prevalence rate?
The total number of cases at any time during a specified period, divided by the population at risk midway through the period.
What is lifetime prevalence?
The total number of persons known to have had the condition for at least some part of their lives.
What is case fatality?
The proportion of cases with the specified condition who die within a specified time.
What is the crude mortality rate?
The number of deaths during a specified period divided by the number of persons at risk of dying during the same period.
What is the infant mortality rate (IMR)?
The number of deaths per year of children less than one year of age divided by the number of live births in the same year.
What does the child mortality rate describe?
The probability of a child dying before reaching five years of age, based on deaths of children aged 1–4 years.
What is life expectancy?
The average number of years an individual of a given age is expected to live if current mortality rates continue.
What are disability-adjusted life years (DALYs)?
Composite measures used to assess and compare the fatal and non-fatal effects of different diseases and injuries on population groups.
What is risk difference?
The difference in occurrence rates between exposed and unexposed groups in the population.
What is relative risk?
The ratio of the risk of occurrence of a condition among exposed people to that among the unexposed.
What are predisposing factors in disease causation?
Factors such as age or specific genetic traits that may increase the likelihood of disease.
What are enabling factors in disease causation?
Factors such as low socio-economic status or limited access to medical care that may favor disease development.
What are precipitating factors?
Factors such as exposure to a specific disease agent that are associated with the onset of a disease.
What are reinforcing factors?
Factors such as repeated exposure or environmental conditions that may aggravate an established condition.
What is temporal relationship in establishing causation?
Determining if the cause precedes the effect.
What is primary prevention?
Limiting disease incidence by controlling specific causes and risk factors.
What is secondary prevention?
Aiming to reduce the more severe consequences of disease through early diagnosis and treatment.
What is tertiary prevention?
Aiming to reduce the progress of complications/impairments from established disease.
What does sensitivity measure in a screening test?
The proportion of people in the screened population identified as having the disease.
What does specificity measure in a screening test?
The proportion of people identified as disease-free by the screening test.
What is health surveillance?
The systematic collection, analysis and interpretation of health data essential for planning, implementing, and evaluating public health activities.
What is the purpose of positive predictive value?
The probability of the person having the disease when the test is positive.
What is the average duration in relation to a condition?
The total number of years of the condition divided by the number of cases.
What is the role of epidemiological studies?
To measure the relative contribution of each factor to disease occurrence.
What does the term ‘interaction’ refer to in epidemiology?
The effect where two or more causes acting together have a greater impact than would be expected by summing the individual effects.
What is the significance of the dose-response relationship?
Determining if increased exposure to the possible cause is associated with increased effect.
What are positive and negative predictive values used for?
To assess the merits of diagnostic tests
Predictive value depends on sensitivity, specificity, and disease prevalence.
What does efficacy mean in medicine?
The extent to which there is a beneficial therapeutic effect from a given intervention.
What is compliance in the context of treatment?
The extent to which patients follow medical advice.
What is practical effectiveness assessed through?
Studying a group of people more representative of the real world.
What is the best method for measuring efficacy and effectiveness?
Randomised controlled trials.
What is a cancer cluster?
A greater-than-expected number of cancer cases within a group in a geographic area over a period.
What is the primary purpose of conducting an epidemiological investigation of a suspected cancer cluster?
To determine whether exposure to a specific risk factor or environmental contaminant might be implicated.
True or False: Demonstrating a statistically significant association proves causation.
False.
What are the two dimensions of exposure in environmental epidemiology?
Level and duration.
What significant issue related to climate change was noted by the Climate Commission in 2011?
Rising temperatures could trigger an extra 205,000 cases of gastroenteritis per year.
What does dose-effect refer to?
The relationship between dose and severity of effect in an individual.
What does dose-response describe?
How the likelihood and severity of adverse health effects are related to the amount and condition of exposure.
What is the burden of disease?
A measure used to assess and compare the relative impact of different diseases and injuries on populations.
What percentage of the burden of disease in Australia is contributed by chronic diseases and injuries?
Most of the burden.
Fill in the blank: Burden of disease quantifies the health loss due to disease and injury that remains after _______.
[treatment, rehabilitation, or prevention efforts].
What is data linkage?
A process that can generate more complete pictures of the health of communities.
What are the two forms of study widely used in epidemiology?
Experimental and observational studies.
What type of study follows a group over a period to compare the rates of condition development?
Cohort studies.
In case-control studies, participants are selected based on what criteria?
Whether they have or do not have the condition of interest.
What do randomised controlled trials aim to provide evidence of?
Cause and effect.
What do systematic reviews involve?
Extensive literature searches to identify valid studies and summarise results.
What is the significance of qualitative research in health studies?
It describes, explores, and explains health-related phenomena.
What percentage of the total burden of disease in Australia was due to tobacco use in 2015?
9.3%.
What is one major issue associated with data linkage?
Ensuring that data matching is accurate.
What is the potential impact of the National Bowel Cancer Screening Program as demonstrated by data linkage?
It has positively impacted Australia’s bowel cancer morbidity and mortality.
What is the relationship between socioeconomic status and the burden of disease?
The burden for the lowest socioeconomic group is 1.5 times that of the highest.
