concepts in epidemiology

Question 1

public health definition

Answer 1

the health outcomes of a group of individuals including the distribution of such outcomes within the group

Question 2

two axes of health in NZ

Answer 2

1. socioeconomic status
   people of lower SES have poorer health
2. ethnicity
   Māori and pacific have poorer health

Question 3

how is socioeconomic status measured

Answer 3

occupation, income, education, living standard measures, deprivation (NZi Dep)

Question 4

NZDep

Answer 4

area based measure of deprivation looking at factors like access to internet, qualifications, employment, income, access to a car etc

Question 5

two types of poverty

Answer 5

absolute poverty
relative poverty

Question 6

absolute poverty def

Answer 6

income level below which a min nutritionally adequate diet plus essential non food requirements is not affordable. the amount of income a person, family or group needs to purchase an absolute amount of the basic necessities of life

Question 7

relative poverty def

Answer 7

the amount of income a person, family, or group needs to purchase relative amount of basic necessities of life: these basic necessities are identified relative to each society and economy

Question 8

burden of disease

Answer 8

impact of a health problem as measured by financial cost, mortality, morbidity or other indicators

Question 9

how does burden of disease differ between countries

Answer 9

• low income countries have higher levels of communicable disease
• high income countries have higher levels of non communicable diseases

Question 10

two types of diseases contributed to this burden

Answer 10

1. communicable disease: infectious diseases that can spread from person to person (HIV, influenza, the plague)
2. Non communicable disease: internal diseases suffered by an individual, they cannot be transmitted from person to person (cancer and heart disease)

Question 11

DALYS

Answer 11

• disability adjusted life year
  a way to measure the burden of disease
• the sum of DALY’s across the population can be though of as a measurement of the gap between current health status and an ideal health situation (where the entire population lives to an advanced age free of disease and disability)

Question 12

DALY equation

Answer 12

DALY= YLL + YLD
YLL= yrs of life lost due to premature mortality
YLD= yrs of life lost due to premature disability/ health conditions

Question 13

Transition theories

Answer 13

1. demographic transition
   showing changes in birth and death rates and total population overtime
2. epidemiological transition
   showing changes in disease patterns over time
   - these transitions occur together as a population is developing

Question 14

demographic transition

Answer 14

• initially there is high birth and death rates, and a low total population
• death rate decreases, followed by birth rate
• total population increases and both death and birth rates stabilise
• this happens as a country is developing

Question 15

epidemiological transition

Answer 15

• in the least developed countries there is high lvls of communicable disease
• in developing countries we see a double burden of both communicable & non communicable disease
• in the developed countries there are high levels of non communicable disease

Question 16

transition overall pattern

Answer 16

as a country becomes more developed there is a decrease in communicable diseases and a corresponding increase in non communicable diseases

Question 17

ageing population

Answer 17

• as a country becomes more developed, people generally live longer
• we can see this in the changing shape of the graph
• it also links in with both transitions, in a more developed country people have longer life expectancy but also lower fertility and older people also contribute more to non communicable diseases (epidemiological transition)

Question 18

compression of morbidity

Answer 18

• aims to slow the progression from chronic disease to morbidity
• creates an increase in milder chronic disease but a decrease in the period of time a person experiences severe disability
• prolonging life to elderly ages by suppressing communicable diseases has its disadvantages, unpleasant non communicable diseases eg: diabetes
  eg: diabetes can eventually turn from a chronic disease into a severe disability, we want to minimise the time people have the ‘ morbid’ disabled condition for
• this means that people can have a good quality of life and contribute to society for longer

Question 19

epidemiology definition

Answer 19

the study of the distribution and occurrence of health related events, states or processes in specified populations

Question 20

how many people does NZDEP apply to per area

Answer 20

~ 100-200

Question 21

social determinants of health

Answer 21

• age, sex & hereditary factors
• individual lifestyle factors
• social and community influences
• living and working conditions
• general socioeconomic, cultural and environmental conditions

Question 22

why measure disease occurrence in populations?

Answer 22

provides us with information on where health resources need to be directed

Question 23

comparing populations

Answer 23

• do the age structures differ?
• does the disease risk vary by age?