Concept Of Health And Disease Flashcards
1)Define health
2) Spectrum of health
1)A state of complete physical , mental , social well-being and not merely an absence of disease or infirmity .
2) positive health ( highest point )
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Better health
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Freedom from sickness
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Unrecognised sickness
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Mild sickness
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Severe sickness
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Death ( lowest point )
Changing concept in health
1) BIOMEDICAL CONCEPT - germ theory of disease
2) ECOLOGICAL CONCEPT - effect of environment on health
3) PSYCHOSOCIAL - effect of social , psychological , cultural , economic , political factors on health
4) HOLISTIC APPROACH
Indirect way of measuring health
1) PQLI
2) HUMAN DEVELOPMENT INDEX
PQLI ( Physical quality of life index)
1) does not consider INCOME
2) PARAMETERS
✓infant mortality rate
✓ literacy rate
✓ life expectancy at 1 year
3) scale 0 ( best) - 100 ( worst)
HDI ( HUMAN DEVELOPMENT INDEX)
1) PARAMETERS
✓ life expectancy at birth ( Highest in Japan )
✓ per capita income ( highest in qator )
✓ knowledge
* Mean year of schooling - Czech republic
* Expected year of schooling
2) scale 0 - 1
3) < 0.55 - LOW HDI countries
0.56 - 0.69 - MEDIUM HDI
0.70 - 0.79 - HIGH HDI
>_0.8 - VERY LOW HDI
Indicator of health
✓ ideal indicator - valid , reliable, sensitive, specific, feasible, relavant
1) MORTALITY INDICATORS
✓ crude death rate
✓ case fatality rate
✓ expectation of life
✓ infant mortality rate
✓ child mortality rate
✓ under 5 mortality rate
✓ adult mortality rate
✓ maternal mortality rate
✓ disease specific mortality rate
✓ proportional mortality rate
✓years of potential life lost
2) MORBIDITY INDICATOR
✓ incidence
✓ prevalence
✓ notification rate
✓ attendance rate in OPD
✓ admission, readmission, discharge rate
✓ duration of stay in hospital
✓ frequency of sickness or absence from work or school
Disability indicators
1) DALY( disability adjusted life year )
2) SULLIVANS INDEX ( life expectancy free of disability)
3) HALE ( health adjusted life expectancy)
✓ life expectancy at birth including time spent on poor health
4) QALY ( quality adjusted life year )
✓ no of yrs of life added by intervention
DALY ( Disability adjusted life year )
1) indicates DISEASE BURDEN
2) 1 DALY = 1 YR OF HEALTHY LIFE LOST
3) DALY = yrs of life lost ( premature death) + yrs of life with disability
Disease burden indicators
1) DALY
2) PROPORTIONAL MORTALITY RATE
Health care delivery indicators
1) doctor population ratio ( 1: 1000)
2) population ASHA ratio (1:1000)
3) population bed ratio
4) population subcenter ratio ( 1:5000)
Health services utilisation rate
1) % of children fully vaccinated
2) % of ANC MOTHER with minimum 4 checkup
3) bed occupancy rate
4) bed turnover ratio
5) average length of stay
6) % of population using family planning methods
1) Epidemiological triad
2) Epidemiological triangle
3) advanced triangle of epidemiology
1) agent , host , environment
2) agent , host , environment, time
3) causative factor , groups or population characteristics, environment social cultural factors
Multifactorial causation given by
Pentenkoffer
Web of causation given by
Mac mohan & pugh
Identify vulnerable area for prevention of disease
Natural history of disease
1) period of pre pathogenesis
✓ primordial prevention - prevention prior to onset of risk factor
✓ primary prevention -
Prevention prior to onset of disease
2) period of pathogenesis
✓ disease onest —> early complications —–> late complications —-> outcome
✓ include secondary and tertiary prevention
