Block 1 Flashcards
What is statistical normality?
Based on the normal distribution that 95% of the population should be within ± 2.5 standard deviations of the mean
What is social normality?
What society finds acceptable or desirable. Changes within a given society, culture, and time.
What is optimal normality?
‘Normal’ value is determined by what is required for optimal health, not the mean/median of a population.
2 models of health?
Medical model and Social model
Define illness
Subjective experience, varying between people. One can be ill in the absence of disease.
Define sickness
A social role given to or taken on by a person perceived to be ill.
Define disease
Objective diagnosis using specific signs and symptoms. Deviation from the biological norm. Changes with medical advances.
Outline medical model
Health stems from biology and is the absence of disease. Medical model therefore shows that it is the health profession’s job to cure or treat to lessen symptoms.
Disadvantages of medical model of health
Power is in the hands of the medical profession.
- doesn’t include chronic disease.
- doesn’t consider the social influences on health.
Outline social model of health
Health is a social construction and is determined by a range of external factors. It is determined by the social and cultural, socioeconomic influences.
WHO definition of health
WHO: A state of complete social, physical and mental wellbeing and not merely the absence of disease or infirmity.
Health as absence from disease.
Health as functionality (ADLs.)
Health as freedom.
Health as an equilibrium.
What can influence people views on their health?
Age, gender, ethnicity and socioeconomic status
Define demography
The study of size, structure, dispersement and development of human populations.
What is the UN definition of a census?
The simultaneous recording of demographic data by the government at a particular time, pertaining to all the persons living in a particular territory.
What is CART(A)?
Assesses quality of health information. Completeness, Accuracy, Representativeness/Relevance, Timeliness, Accessibility
Low enumeration groups for UK Census
Travellers, migrants, undocumented, homeless, some students
Crude birth rate equations
Crude birth rate = Live births/1000 people in population.
General fertility rate equation
Live births/1000 women in pop. Of childbearing age. (Aged 15-44.)
Total fertility rate equation
The number of live babies that would be born is every woman lived to menopause and gave birth in accordance with the current, age-specific fertility rate.
2 types of death certificate?
Medical certificate of Cause of Death (Doctor) and Coroner’s certificate
Population estimate equation
Pop estimate = Census baseline + births – deaths ± migration.
Population projection in the UK
Longer lives, more elderly = more elderly care services, more chronic condition management, increased mental health issues e.g. dementia
4 sources for morbidity data.
Cancer registration system, hospital episode statistics, quality and outcomes framework (QoF) and Notifications of Infectious Diseases
2 Data coding systems
ICD-10 - conditions treated and investigated
OPCS-4 - operation details
Define prevalence
A measure of how common a disease is, as a proportion. (% or number in 1000/10000 etc.) - burden of disease
3 types of prevalence
- Point prev. = proportion of individuals with the condition at a specific point in time.
- Period prev. = proportion of individuals with a condition at any time during a specified time interval.
- Lifetime prev. = the proportion of individuals with the condition at any point during their lives.
Prevalence equation
P= (no. people with disease/total number of people) x 100 (for a %) or x 1000/10000 etc.
Define incidence
The rate at which new events occur in a population, over a defined period of time. Either expressed as per n people of n years, or as n-person years (essentially the same thing!)
Person years equation
person-years = no. of people x no. of years
Incidence equation
(number of new cases)/(no. people observed x years observed) x units (eg, 1000 for per 1000 people etc)
Factors affecting prevalence (4)
Incidence, recovery rate, death rate, transfer/migration rate
Define point estimate
Our best guess based on sample data.
Define sampling error
Difference between sample point estimate and the truth
Define standard error (SE)
Numerical value to represent sampling error.
Confidence interval equation (95%)
CIs= p ± (1.96*SE.)
How do you know if it is plausible that there is a difference between 2 populations?
Confidence intervals do not overlap.
What is infant mortality a good indicator of?
Health of a population. Correlates well with other proxy measures. Highly sensitive to social determinants and epidemics
Define epidemiological transition
Often indicates the socio-economic climate of a country, as once a country develops from pre-industrial to industrial economies, see a change in demography.
Less acute deaths, less communicable disease, less deficiency disease, and longer life expectancy. But chronic disease and non-communicable disease rates become higher.
Main causes of death in the UK
Men: Dementia, Cancer (lung, prostate, bowel,) circulatory system, resp system.
Women: Dementia, Cancer (lung, breast, bowel,) circ system, resp system.
Define health inequality
Systematic differences in health and illness between different social groups. Variations are not random, and some groups live longer than others. Gender, age, ethnic group and geography
What is social gradient?
Clear, stepwise gradient in health. With each step down the social ladder, health becomes poorer. Not just between the most privileged and most deprived groups, but evident across the whole spectrum. (infant mortality / male life expectancy etc.).
What are the social gradient exceptions?
Prostate, breast and skin cancer
Types of inequalities?
Geographical, socioeconomic, gender, ethnicity
How is socioeconomic status measured?
A number of ways: occupation, income, education, access to or ownership of assets (housing, car), index of multiple deprivation.
BUT The Registrar General’s socio-economic classification is based on occupation, which is proxy for status, income, education etc.
Why is there cultural/behavioural inequalities?
Variation in health behaviours and lifestyle. Increased cognitive load due to social circs - worry about future health.
Why is there material/nanomaterial inequalities?
Access to resources, income, housing, food, fuel for heating, transport, healthy meals, social activities, exercise facilities. Health = direct effect of poverty and deprivation. Shaped by broader factors, such as place in society, policies
Why are there psychosocial inequalities?
how their environment makes them feel. Direct = “allostatic load” physical disease and the link to the neuroendocrine pathway. Indirect = adoption of unhealthy behaviours such as smoking. Stresses of everyday living on low income and poorer material environments explain poorer health.
