Ch 1 - 3 Flashcards
Define– Intersectoral action for health
The promotion of health through the involvement of actors in other sectors, such as transport, housing, or education
Define – Libertarianism
Philosophical approach that favours individualism, with a free- market economic policy and non-intervention by government
Define– Public health
The science and art of promoting health and preventing disease through the organized efforts of society.
What was the “sanitary movement”?
- 18th century
- idea of contagion
- unsanitary conditions in newly industrialized cities
What was “preventative medicine”?
- 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
What was the “health field concept”? And it was a transition from what to what?
Transition from “preventative medicine” to “healthy public policy”.
- moving away from medicalization of public health
What was the HFA?
What did it inspire and branch off into?
“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
What are some ethical issues related to PH implementation?
- 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.)
In “Beaglehoe & Bonita paper 1998”, what should the role of the epidemiologist be and where should PH be going?
- 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
In “Rotham paper 1998”, what should the role of the epidemiologist be and where should PH be going?
- 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
Define– Age-standardization
A way of controlling for age so that we can compare rates of deaths or disease in populations with different age structure
Define– Life expectancy
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.
Define– Survival rate
The proportion of population who survives a disease for a specified period of time (typically 5 years).
What 3 data do you need to know to understand is happening to a population over time?
Birth
Death
Migration
Mortality data is used for what?
- Monitor progression/ decline of chronic disease
- Emergence of recent threats
- Evaluation of PH interventions
What components of mortality data are important?
How many
From what
Among whom
The composition of that population
What is the most common method of knowing how many people?
What are some obstacles with this method?
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
What is the most common method of knowing how many people?
What are some obstacles with this method?
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
How is cause of death classified?
ICD (International Classification of Diseases) developed by WHO
What are some of the challenges of classifying death?
- 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
What are some strategies around the challenges of a death registry?
- 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
How to calculate a death rate in a population?
(# 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.
How to calculate– crude death rate
see blue notebook for formula
How to calculate– cause specific mortality rate
see blue notebook for formula
