Block 2: Week 4- Promoting health + preventing illness COPY Flashcards

1
Q

LO: Understand the difference between health promotion and disease prevention

Define prevention

A

Actions aimed at eradicating, eliminating or minimising the impact of disease/disability.

If none of these are feasible, preventing the progress of disease + disability

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2
Q

LO: Understand the difference between health promotion and disease prevention

Define health promotion

A

Enabling people to increase control over their health and its determinants + therby improve their health

Offers positive + inclusive concept of health as a determinant of the quality of life, encompassing mental + spiritual wellbeing

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3
Q

LO: Distinguish between the concepts of primary, secondary and tertiary prevention

What is primary prevention: state of diease, aims, examples + services?

A

State of disease:

Pre-disease

Aim:

Prevent disease actually occuring

Examples:

  • Immunisation
  • Health Education in schools

Services

  • Public Health/ GP
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4
Q

LO: Distinguish between the concepts of primary, secondary and tertiary prevention

What is secondary prevention: aims, examples + services

A

State of disease:

Latent/ Early Stages of Disease

Aim:

  • Early detection of disease
  • Early treatment- stop/halt progress

Examples:

  • Screening/ case detection
  • Brief interventions
  • Adequate treatment

Services

  • GP
  • Hospitals
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5
Q

LO: Distinguish between the concepts of primary, secondary and tertiary prevention

What is tertiary prevention: aims, examples + services?

A

Disease stage:

  • Symptomatic (irreversible/ diasbility)

Aim

  • Limit damage to:
    • Reduce severtity
    • Max. QoL

Examples:

  • Rehab
  • Palliative
  • Hospitals
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6
Q

LO: Distinguish between the concepts of primary, secondary and tertiary prevention

Who is the target of primary/ secondary prevention?

A

Individuals @ high risk

OR

Whole popluation

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7
Q

LO: Distinguish between the concepts of primary, secondary and tertiary prevention

What is the Individuals at high risk stratergy

A

Bring preventive care to individuals @ high risk

Needs detection if those @ risk

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8
Q

LO: Distinguish between the concepts of primary, secondary and tertiary prevention

What is the Population stratergy

A

Directed @ whole population irrespective of individual risk level

  • Directed towards SE, behavioural + lifestyle changes
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9
Q

LO: Distinguish between the concepts of primary, secondary and tertiary prevention

Compare and contrast the individual high risk + population approaches

A

Individuals @ high risk

Strengths:

  • Extension of clinical approach: dr + pt highly motivated

Weaknesses:

  • Identification resouce intensive
  • Medicalises prevention
  • Stigmatises individuals
  • Not a lasting change @ population level

Population:

Strengths:

  • Benefits whole population
  • Attempts control root cause/ determinants
  • Shifts cultural norms
  • Works passively
  • More permanent

Weaknesses:

  • Small individual benefit
  • Low subject motivation
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10
Q

LO: Distinguish between the concepts of primary, secondary and tertiary prevention

What is the Rose Prevention Paradox?

A

Preventive measures that brings large benefits to community offers little to each participant

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11
Q

LO: Describe the range of activities that encompass health promotion

Where is this derived form?

What are the main action areas?

A

Ottawa Charter for health promotion (WHO, 1986)

Action areas:

  1. Build healthy public policy
  2. Supportive environemnts
  3. Reinforce community actions
  4. Develop personal skills
  5. Reorientation of health services tx towards prevention
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12
Q

LO: Describe the range of activities that encompass health promotion

What are the two models of entity of health promotion?

What do they help determine?

A
  • Ewles + Simnett: 5 approaches
  • Beattie: 4 quadrants
  1. Maps field of health promotion: range of methods
  2. Makes aim + choice of strategies explicit
  3. Helps select most effective/ acceptable stratergies
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13
Q

LO: Describe the range of activities that encompass health promotion

What is Ewles + Simnett’s 5 approaches in Health Promotion?

A

Describes 5 approaches in health promotion

  • Medical (eg: screening)
  • Behaviour change (eg: smoking cessation group)
  • Educational
  • Client centered (issue identified by client/ community)
  • Societal change (policy, legislation)
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14
Q

LO: Describe the range of activities that encompass health promotion

What is Beattie’s Model of Health Promotion?

A

Authoraitative –> Negotiated

Individual –> Community

  • Health persuasion (Mass media, education)
  • Legislative action
  • Personal counselling
  • Community development (community led action)
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15
Q

LO: Describe the range of activities that encompass health promotion

What do you need to consider with interventions?

(NOT IN REVISION GUIDE)

A
  • Methods
  • Who to target
    • Individuals
    • Populations
  • Research evidence
    • Effectiveness
    • Cost-effectiveness
  • Impact on health inequalities
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16
Q

LO: Summarise the best-evidence for how health inequalities can be tackled

Why are Drs interested in health inequalities?

A
  • Reduced costs of disease
  • Reduced premature deaths
  • Good medical practice can make difference
  • Key theme in government health policy
17
Q

LO: Summarise the best-evidence for how health inequalities can be tackled

What is the aim of tackling health inequalities?

A

Yield more equal distribution of health across population groups

18
Q

LO: Summarise the best-evidence for how health inequalities can be tackled

What are the main determinants of health inequalities?

Which repors states this?

A

Determinants of social inequality, determined by social +economic status

Can affect health directly + indirectly

2) Commission on Social Determinants of Health (2008)

19
Q

LO: Summarise the best-evidence for how health inequalities can be tackled

What review states ‘what will reduce health inequalities’ and what are the recommendations to do this?

A

Marmot Review

What will reduce health inequalities?

  • Reduced social gradient –> progressive universalism
  • Action across all social determinants
  • Action from all sectors
  • Participatory decision making @ local level
20
Q

LO: Summarise the best-evidence for how health inequalities can be tackled

What are the 2 methods for tackling/ reducing the social gradient in health?

A

1) Levelling up- progressive/ proportionate univeralism -> refers to resourcing and delivering of services at a scale and intensity proportionate to the level of need.
2) Tackling social disadvantage [Not recommended]

21
Q

LO: Summarise the best-evidence for how health inequalities can be tackled

What does tackling the gradient: levelling up approaches consist of?

What are the strengths + weaknesses?

A
  • Population wide approach
  • More equal distribution of health chances across SE groups
  • Health Improvement for ALL groups but increases down SE ladder
  • Provide resources/services at a progressively greater level as need increases

PROGRESSIVE/ PROPORTIONATE UNIVERSALISM

22
Q

LO: Summarise the best-evidence for how health inequalities can be tackled

What does tackling social disadvantage approache consist of?

What are the strengths + weaknesses?

A
  • Aims to improve health of worst off ONLY
  • BUT not population wide stratergy therefore won’t tackle social gradient in health
23
Q

LO: Summarise the best-evidence for how health inequalities can be tackled

What is meant by upstream and downstream approaches to tackling health inequalities, and examples of each?

A

Action across all determinants, all sectors + all levels

Upstream factors: Wider health influences- public policy approaches

Downstream factors: Health behaviours/ lifestyle- smoking, diet, access to care

Upstream generally more useful as we need to address root cause. Downstream won’t reduce ‘number people falling in river’

24
Q

LO: Summarise the best-evidence for how health inequalities can be tackled

Some examples of interventions that have been shown to reduce health inequalities and to increase inequalities

A

These are upstream interventions

  • Water fluoridation (Riley 1999)
  • Tobacco price increase
  • Improving education level for children/ young people
  • Folic acid supplements (Lorenc, 2013)
25
Q

LO: Explain the role that doctors and health care professionals can play in combating health inequality

A
  • Working for health equity: the role of healthcare professionals
    • Knowledge + skills –> social detminants, social Hx, non-medical services referal
    • Working with individuals + communities
    • Tackling health inequalities among NHS staff
    • Work in partnership with other agencies
    • Working as advocates for individuals, communities + general population
  • Clinicians –> Quality health care, support services referal, aware of/ address inequality attributable admissions
  • Avodcates –> Services/ programmes for better health outcomes
  • Managers/ Clinical leads –> Model employer
  • Educatiors –> Provide placements in disadvanted areas, investiagate social determinants + local projects