Epidemiology of CHD Flashcards
Define public health.
The science and art of preventing disease, prolonging life, and promoting health through the organised efforts of society
What elements are included in individual determinants?
Gender Beliefs Motivation Age Skills
What elements are included in social environment?
Social cohesion Culture Income Equity Social support
What elements are included in built environment?
Urban design
Green space
Transport
Land-use patterns
What elements are included in natural environment?
Air
Water
Weather
Topography
What is at the centre of the roots of CHD?
Physical activity and active living
What type of study describes the health status of a population?
Descriptive study (time, place and person)
What type of study understands the natural history of a condition?
Longitudinal study
What type of study identifies the causes of medical problems?
Observational study
How can evaluation and action on medical and health promoting interventions be undertaken?
Monitoring through routine data and observational studies
Intervention through experimental studies
What are the 3 steps to ‘achieving the correct diagnosis’?
Define numerator (clinical condition) and denominator (who makes up at risk population) Dig out good sources of information Describe what the data shows and interpret
What are some examples of good and reliable sources of data?
scotpho. org
isdscotland. org
bhf. org
What are the 6 stages of a disease, starting with onset and ending in outcome?
Onset Symptoms Seek care Diagnosis Treatment Outcome ---> cure ---> control ---> disability
The Framingham Study definition of ‘risk factor’ can be split up into 4 aspects and based on 2 pieces of evidence. Define it.
Aspect of ... • personal behaviour • lifestyle • environmental exposure • genetic trait, Which on the basis of epidemiological evidence... • is associated with a health-related condition • considered important to prevention
What does ‘pathogenic’ mean?
Linked to disease state
What does salutogenic mean?
Linked to health
What does ‘interactive’ mean?
Two factors that together increase risk
What are the 3 different types of risk factor?
Marker of risk (associates, not causal)
Causal risk factor (associated and causal)
Modifiable risk factor (causal but can be modified by intervention)
What was the objective of the Framingham Heart Cohort Study?
To identify the common factors or characteristics that contribute to CVD by following its development over a long period of time in a large group of participants who had not yet developed overt symptoms of CVD or suffered a heart attack or stroke
What were the key risk factors for CHD as shown by Framingham study?
High systolic BP
High total to high density cholesterol ratio
How can performance monitoring be carried out?
Quality Outcomes Framework data
Data from smoking cessation services
Lifestyle surveys
Data about the outcomes for individual clinicians
What should performance monitoring target?
Prevention
Treatment
Rehabilitation
Structure
Process
Outcome
“….. potentially modifiable risk factors account for ……% of acute MI”
9
90
What are these 9 potentially modifiable risk factors?
Smoking Hypertension Lipids Abdominal obesity Diabetes Fruit & Veg intake Alcohol Exercise Psychosocial
What are the 4 approaches to CVD epidemiology?
Describe
Understand
Identify causes
Evaluate medical and health promoting interventions
