Ch 1 - 3 Flashcards

1
Q

Define– Intersectoral action for health

A

The promotion of health through the involvement of actors in other sectors, such as transport, housing, or education

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2
Q

Define – Libertarianism

A

Philosophical approach that favours individualism, with a free- market economic policy and non-intervention by government

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3
Q

Define– Public health

A

The science and art of promoting health and preventing disease through the organized efforts of society.

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4
Q

What was the “sanitary movement”?

A
  • 18th century
  • idea of contagion
  • unsanitary conditions in newly industrialized cities
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5
Q

What was “preventative medicine”?

A
  • emerged in developed countries in the mid 20th century
  • focus on the concept of hygiene
  • health professionals assumed they knew best and played a key role
  • education thought to be sufficient to change behaviors
  • screening interventions became popular
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6
Q

What was the “health field concept”? And it was a transition from what to what?

A

Transition from “preventative medicine” to “healthy public policy”.
- moving away from medicalization of public health

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7
Q

What was the HFA?

What did it inspire and branch off into?

A

“Health for All by 2000” initiative by WHO.

  • emphasized intersectoral action
  • 38 targets
  • some were vague. some already achieved, and some countries would never be able to achieve it.
  • branched off into “Healthy cities” by local administrations
  • concern for global environment grew out of this
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8
Q

What are some ethical issues related to PH implementation?

A
  • collective good vs. individual freedoms
  • methods in which PH efforts are carried out
  • how certain topics like addiction and mental health are addressed reflect biases (incarceration vs treatment)
  • who is making the decisions and what agendas do they have (like tobacco companies lobbying, etc.)
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9
Q

In “Beaglehoe & Bonita paper 1998”, what should the role of the epidemiologist be and where should PH be going?

A
  • should take a multidisciplinary approach
  • focus more on the political process to improve PH
  • should take a global perspective that looks at societal, cultural and environmental causes of disease
  • public health should take a larger responsibility for pop health and not medical care
  • decrease focus on risk factors for disease on an individual level
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10
Q

In “Rotham paper 1998”, what should the role of the epidemiologist be and where should PH be going?

A
  • studying social causes of diseases and eliminating social inequities is important, but epidemiology is about studying specific causes of diseases
  • they have the right to specialize, and thru their research have made advances that save lives like Vitamin A supplementation and folic acid
  • public health advances are won slowly via social change, but epidemiology can help fill in the gaps with their efforts
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11
Q

Define– Age-standardization

A

A way of controlling for age so that we can compare rates of deaths or disease in populations with different age structure

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12
Q

Define– Life expectancy

A

The average number of years a person can expect to live in a given population. It can be expressed as life expectancy at birth or at a particular age. It is based on current patterns of mortality so, technically, it is not a measure of how long a child born today can expect to live as we cannot yet know the death rates that will apply at different ages in the future. It is, however, the most widely used summary measure of mortality in a population.

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13
Q

Define– Survival rate

A

The proportion of population who survives a disease for a specified period of time (typically 5 years).

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14
Q

What 3 data do you need to know to understand is happening to a population over time?

A

Birth
Death
Migration

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15
Q

Mortality data is used for what?

A
  • Monitor progression/ decline of chronic disease
  • Emergence of recent threats
  • Evaluation of PH interventions
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16
Q

What components of mortality data are important?

A

How many
From what
Among whom
The composition of that population

17
Q

What is the most common method of knowing how many people?

What are some obstacles with this method?

A

Census

  • Big undertaking, requiring a lot of resources.
  • Political (area with a lot of ethnic groups)
  • Difficult to reach segments of population
  • What questions and the # of
18
Q

What is the most common method of knowing how many people?

What are some obstacles with this method?

A

Census

  • Big undertaking, requiring a lot of resources.
  • Political (area with a lot of ethnic groups)
  • Difficult to reach segments of population
  • Type and number of questions
  • Misreporting– heaping, where people who don’t know their age then to round up to nearest 5
19
Q

How is cause of death classified?

A

ICD (International Classification of Diseases) developed by WHO

20
Q

What are some of the challenges of classifying death?

A
  • Investigation into the death may be limited for various reasons.
  • pt’s social class, etc, may influence how it’s classified
  • country may be using a different version of ICD
21
Q

What are some strategies around the challenges of a death registry?

A
  • surveys using the sisterhood method, where women are asked about the health outcomes of their siblings
  • verbal autopsy, asking close contacts what the symptoms were leading up to the death
22
Q

How to calculate a death rate in a population?

A

(# of events)/ (the population at risk). Careful that a person counted in the numerator, would also be counted in the denominator. For example, if people from surrounding areas come to a central area with a hospital to die, it makes that area look like the death rate is higher.

23
Q

How to calculate– crude death rate

A

see blue notebook for formula

24
Q

How to calculate– cause specific mortality rate

A

see blue notebook for formula

25
Q

How to calculate– age specific mortality rate

A

see blue notebook for formula

26
Q

How to calculate– infant mortality rate

  • neonatal mortality
  • post neonatal mortality
A

see blue notebook for formula

27
Q

How to calculate– perinatal mortality rate

A

see blue notebook for formula

28
Q

What is the function of age-standardization?

A

Takes into account the underlying age structural differences in a population. Sometimes a lower number of deaths can be just because there’s less people at that age to begin with. Or a higher number of deaths can reflect that there’s more people in that age group.

29
Q

What is “direct age standardization”?

What 2 things do u need?

A

A way to compare 2 sets of data that may have different age structures in the population. Need 2 things:

  1. age-specific mortality rates from the population you are interested in
  2. a defined standard population with a known age structure (number of persons in each age category).
30
Q

What are the 3 “standard pop” usually used for standardization?

A

Segi standard– for countries with more young people
European standard- Scandinavian pop with more elders
WHO pop–2000-2025 modeling

31
Q

What is the SMR (standardized mortality ratio)?

When is it used?

A

Used for indirect age-standardization. The ratio (×100) of observed to expected deaths in a study population. Used for looking at district data or smaller pop. With smaller groups/ numbers of deaths, the data is subject to variations due to chance.

32
Q

What is used to calculate “life expectancy”?

A

Life tables– made up of age-specific mortality rates.

33
Q

What is “survival” analysing?

What application is this commonly seen in?

A

Time between an event (disease onset, diagnosis) and an endpoint (death, readmission).
Cancer survival rates is often used to compare quality of care between countries.