Block 2: Week 4- Promoting health + preventing illness COPY Flashcards
LO: Understand the difference between health promotion and disease prevention
Define prevention
Actions aimed at eradicating, eliminating or minimising the impact of disease/disability.
If none of these are feasible, preventing the progress of disease + disability
LO: Understand the difference between health promotion and disease prevention
Define health promotion
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
LO: Distinguish between the concepts of primary, secondary and tertiary prevention
What is primary prevention: state of diease, aims, examples + services?
State of disease:
Pre-disease
Aim:
Prevent disease actually occuring
Examples:
- Immunisation
- Health Education in schools
Services
- Public Health/ GP
LO: Distinguish between the concepts of primary, secondary and tertiary prevention
What is secondary prevention: aims, examples + services
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
LO: Distinguish between the concepts of primary, secondary and tertiary prevention
What is tertiary prevention: aims, examples + services?
Disease stage:
- Symptomatic (irreversible/ diasbility)
Aim
- Limit damage to:
- Reduce severtity
- Max. QoL
Examples:
- Rehab
- Palliative
- Hospitals
LO: Distinguish between the concepts of primary, secondary and tertiary prevention
Who is the target of primary/ secondary prevention?
Individuals @ high risk
OR
Whole popluation
LO: Distinguish between the concepts of primary, secondary and tertiary prevention
What is the Individuals at high risk stratergy
Bring preventive care to individuals @ high risk
Needs detection if those @ risk
LO: Distinguish between the concepts of primary, secondary and tertiary prevention
What is the Population stratergy
Directed @ whole population irrespective of individual risk level
- Directed towards SE, behavioural + lifestyle changes
LO: Distinguish between the concepts of primary, secondary and tertiary prevention
Compare and contrast the individual high risk + population approaches
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
LO: Distinguish between the concepts of primary, secondary and tertiary prevention
What is the Rose Prevention Paradox?
Preventive measures that brings large benefits to community offers little to each participant
LO: Describe the range of activities that encompass health promotion
Where is this derived form?
What are the main action areas?
Ottawa Charter for health promotion (WHO, 1986)
Action areas:
- Build healthy public policy
- Supportive environemnts
- Reinforce community actions
- Develop personal skills
- Reorientation of health services tx towards prevention
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?
- Ewles + Simnett: 5 approaches
- Beattie: 4 quadrants
- Maps field of health promotion: range of methods
- Makes aim + choice of strategies explicit
- Helps select most effective/ acceptable stratergies
LO: Describe the range of activities that encompass health promotion
What is Ewles + Simnett’s 5 approaches in Health Promotion?
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)
LO: Describe the range of activities that encompass health promotion
What is Beattie’s Model of Health Promotion?
Authoraitative –> Negotiated
Individual –> Community
- Health persuasion (Mass media, education)
- Legislative action
- Personal counselling
- Community development (community led action)
LO: Describe the range of activities that encompass health promotion
What do you need to consider with interventions?
(NOT IN REVISION GUIDE)
- Methods
- Who to target
- Individuals
- Populations
- Research evidence
- Effectiveness
- Cost-effectiveness
- Impact on health inequalities
LO: Summarise the best-evidence for how health inequalities can be tackled
Why are Drs interested in health inequalities?
- Reduced costs of disease
- Reduced premature deaths
- Good medical practice can make difference
- Key theme in government health policy
LO: Summarise the best-evidence for how health inequalities can be tackled
What is the aim of tackling health inequalities?
Yield more equal distribution of health across population groups
LO: Summarise the best-evidence for how health inequalities can be tackled
What are the main determinants of health inequalities?
Which repors states this?
Determinants of social inequality, determined by social +economic status
Can affect health directly + indirectly
2) Commission on Social Determinants of Health (2008)
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?
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
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?
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]
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?
- 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
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?
- Aims to improve health of worst off ONLY
- BUT not population wide stratergy therefore won’t tackle social gradient in health
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?
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’
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
These are upstream interventions
- Water fluoridation (Riley 1999)
- Tobacco price increase
- Improving education level for children/ young people
- Folic acid supplements (Lorenc, 2013)
LO: Explain the role that doctors and health care professionals can play in combating health inequality
- 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
