Block 4 Pop Health Flashcards
What is the Burden of Digestive Disease?
Global - Accounts for 16% of non-neonatal deaths under 5, and currently 4th leading cause of death. Also number 2 in causes of DALY’s at 4.8%.
Australia - 17.2 Million episodes per year (1 per person), and around 10-15% of all GP presentations.
Hospital Admissions - 45,000 admissions for gastro/year. Spend an equivalent amount of money as on cancer.
Resources - most common hospital separation after haemodialysis.
What is health promotion?
Process of enabling people to increase control over, and improve, their health. Goes beyond the health sector, looking at multifactorial well-being.
What are the principles of health promotion?
Involves population as a whole, rather than focusing on people at risk.
Directed towards action on determinants or causes of health/ill health.
Combines diverse but complementary methods or approaches
Aims to achieve effective and concrete public participation
Health professionals have special contributions in education and advocacy.
What are the five stages of change in health promotion?
Precontemplation - no intention of taking action in next 6 months.
Contemplation - Intends to take action in next 6 months
Preparation - Intends to take action within next 30 days, and has started taking behavioural steps.
Action - has changed behaviour for less than 6 months
Maintenance - has changed behaviour for more than 6 months.
What are the behavioural risk factors in general practice?
Smoking Nutrition Alcohol (and other drugs) Physical Activity SNAP
What are the 5 A’s of change?
Ask - ID patients with Risk Factors
Assess - Level of risk factor, relevance to individual, and readiness to change
Advise - Provide written information, lifestyle prescription, advice and motivation
Assist - Pharmacotherapies, support for self-monitoring
Arrange - Referral to special services/support/counselling. Follow up with GP.
Tobacco control strategies
What proportion of Australians >15 smoke every day?
16% and falling.
Smoking rate inversely proportional to income.
What are the 9 priority areas of the national tobacco strategy?
- Protect public health policy from tobacco industry interference
- Strengthen media campaigns to motivate quitting, discourage uptake, and reshape social norms.
- Continue to reduce affordability of tobacco.
- Reduce ATSI smoking
- Reduce smoking among high-prevalence populations
- Eliminate remaining advertising/promotion/sponsorship
- Further regulate contents, product disclosure of tobacco and alternative nicotine
- Reduce exceptions to smoke free environments
- Provide greater access to quitting support services.
What are the approaches to dependence?
Absolutist vs harm minimisation.
What are the two problems with health worker attitudes relating to dependence?
Failure to engage - moralising or not wanting to cure one dependency by creating another
Engaging but making it worse - rescuing someone who doesn’t want to be rescued, or overidentifying with the situation.
What are the NHMRC guidelines on alcohol use?
- For healthy men and women, drinking no more than two standard drinks on any day reduces the lifetime risk of harm from alcohol-related disease or injury
- For healthy men and women, drinking no more than four standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion
3a. Parents and carers should be advised that children under 15 years of age are at the greatest risk of harm from drinking and that for this age group, not drinking alcohol is especially important.
3b. For young people aged 15−17 years, the safest option is to delay the initiation of drinking for as long as possible.
4a. For women who are pregnant or planning a pregnancy, not drinking is the safest option.
4b. For women who are breastfeeding, not drinking is the safest option.
What health promotion initiatives in Australia aim to decrease overweight and obesity?
Healthy Active is overarching program, with several coming underneath, including ACT “Towards Zero Growth”.
What are the prevalence, causes and consequences of obesity?
60% overweight, >25% of whom are obese. 25% kids overweight, 6% obese. Indigenous 1.2 times more likely.
Causes - obesogenic environment - food, transport, urban planning, media, and organisation of work and leisure. “A normal response to an abnormal environment”.
What is the role of the doctor in body weight regulation?
Focus on 5 A’s. Ask, Assess, Advise, Assist, Arrange
Public advocacy - research, public policy, school interventions.
Focus on individual - are we doing this well as a practice.
Screen when Pts present for other issues.
