Block 5 Pop Health

Question 1

What was the burden of disease for Cancers, Infectious Diseases, and Blood Disorders in 2010?

Answer 1

Cancers - 820,000 DALY’s, 16.5% BoD
ID - 100,000 DALYs, 2.1% BoD
Blood disorders - 60,000 DALYs, 1.1% BoD.

Question 2

What is the overall incidence of cancer in Australia?

Answer 2

540,000 pa, of which 430,000 are NMSC, so only 110,000 notifiable.

Question 3

What are the five largest risk factors for burden of disease in Australia?

Answer 3

Dietary risks
High BMI
Smoking
Hypertension
Physical inactivity
(Radiation also important).

Question 4

What is life course epidemiology?

Answer 4

The study of the long-term effects on later health or disease risk of physical or social exposures throughout the lifespan from gestation onwards.

Question 5

What is life course perspective?

Answer 5

Means that the health status at any given age, for a given birth cohort, reflects both contemporary conditions and prior living circumstances.

Question 6

What are the four levels of prevention?

Answer 6

Primordial - Avoid emergence/establishment of social, economic and cultural patterns of living that contribute to an elevated risk of disease.

Primary - Limit the incidence of disease by controlling causes and risk factors

Secondary - cure patients and reduce consequences through early diagnosis and treatment.

Tertiary - Reduce progress or complications of established disease - therapeutic and rehab medicine.

Question 7

How do patterns of childhood illness and injury in different countries influence health priorities?

Answer 7

Developing countries - focus on infectious disease and malnutrition (e.g. malaria nets and effective treatment)
Developed countries - focus on physical activity, nutrition, obesity, and immunisation/screening.

Question 8

What is a DALY?

Answer 8

–“The Disability Adjusted Life Year or DALY is a health gap measure that extends the concept of potential years of life lost due to premature death (PYLL) to include equivalent years of ‘healthy’ life lost by virtue of being in states of poor health or disability.”

Question 9

What measures does a DALY combine?

Answer 9

–“DALYs for a disease are the sum of the years of life lost due to premature mortality (YLL) in the population and the years lost due to disability (YLD) for incident cases of the health condition.”

Question 10

What are the most important major preventers of infectious disease?

Answer 10

Vaccination, together with food, clean water, and sanitation.

Question 11

What vaccine-preventable diseases are still prevalent in Australia?

Answer 11

Hepatitis B
Influenza
Meningococcal infection

Question 12

What are the ideal characteristics of a vaccine?

Answer 12

Safe
Protective
Give sustained protection
Induces appropriate immune response for given infection - (neutralising antibody vs cell-mediated)
Practical considerations (cost, stability, administration, side effects)

Question 13

What special groups may require vaccination and why?

Answer 13

O/S travellers - No immunity to new disease, risky behaviour
Splenectomy patients - High risk from encapsulated organisms
Immunosuppressed patients - Concern about live-attenuated viruses
Health care providers - Front-line workers, needle-stick
Abattoir workers - Exposure to Q fever
Horse trainers - Exposure to Hendra virus

Question 14

What is the hygiene hypothesis?

Answer 14

Changes in lifestyle, diet, and sanitation in industrialised countries, has led to a decrease in infectious exposures to the developing immune system, that is associated with a rise in allergic diseases.
Less infectious diseases has increased the immune systems’ affinity for auto-antigens.