Foundational Concepts

Question 1

What is population health?

Answer 1

An approach to health that aims to improve the health of the entire population and to reduce health inequities among population groups

Question 2

What is health?

Answer 2

o Health is multidimensional and not merely the presence or absence of disease
o It also has social, psychological, and cultural determinants and consequences

Question 3

What is a disease?

Answer 3

o Abnormal, medically defined changes in the structure or functioning of the human body

Question 4

What is illness?

Answer 4

o Also called sickness
o Individual’s experience or subjective perception of lack of physical or mental well-being and consequent inability to function normally in social roles

Question 5

What is disability?

Answer 5

Results from an interaction between people with a certain health condition, personal factors, and environmental factors which result in
 Impairment
 Activity limitation
 Participation restrictions

If we reduce barriers and stigma and increase accessibility, we reduce the amount of disability experienced

Question 6

How can we reduce the amount of disability someone experiences?

Answer 6

Reduce barriers and stigma

Increase accessibility

Question 7

What 3 views of health did we examine?

Answer 7

Biomedical - biological causes and treatment of illness

Behavioural - behaviours cause disease

Socioenvironmental - heath is a product of your environment (political, economic, psychosocial)

Question 8

Describe the biomedical view of health

Answer 8

o Focuses on the causes and treatments of ill health and disease in terms of biological cause and effect
o Ignores psychological factors but we know behaviours play a role in health
o Many communicable diseases declined before treatments were developed due to improvements in sanitation, nutrition, etc.

Question 9

Describe the behavioural view of health

Answer 9

o Also called lifestyle
o Posits that people’s behaviours are primarily what causes disease
o Does not consider larger factors that influence their behaviors

Question 10

Describe the socioenvironmental view of health

Answer 10

Views health more holistically as the product of ones environment:
 Political
 Economic
 Psychosocial

Encompasses the SDoH

Question 11

Which view of health is aimed at identifying the infectious cause of a disease and developing an effective treatment?

Answer 11

Biomedical

Question 12

Before we developed antibiotics, what were ways that many communicable disease rates were decreased through population health initiatives?

Answer 12

This is part of the biomedical view of health

Sanitation, nutrition, etc. decreased rates of disease prior to definitive treatments

Question 13

What view of health has the fundamental belief that disease is primarily caused by an individuals choices and behaviour?

Answer 13

Behavioural

Question 14

What view of health encompasses the social determinants of health?

Answer 14

Socioenvironmental

Question 15

What are the 3 parts of the epidemiological triangle?

Answer 15

Host
Agent
Environmental

Question 16

What agents may be involved in the epidemiological triangle?

Answer 16

chemical (e.g., lead)
biological (e.g., bacteria)
physical (e.g., violence)

Question 17

What host factors may be involved in the epidemiological triangle?

Answer 17

o May be genetic or acquired
o Influence susceptibility to disease

Question 18

What environmental factors may be involved in the epidemiological triangle?

Answer 18

o Biological, social, or physical
o May affect exposure and susceptibility

Question 19

What health model did we review that shows us that all diseases are multifactorial and may be preventable by changing factors specific to the host, the environment, or the agent?

Answer 19

Epidemiological triangle

Question 20

Based on the epidemiological triangle, what does successful control of the disease require?

Answer 20

Action at multiple points of the triangle (host, agent, environment)

Question 21

How do social determinants of health relate to the epidemiological triangle?

Answer 21

SDoH change our susceptibility to an infectious agent:

Host - our biology

Environment - affects both the physical environment such as waste disposal, water/air/soil quality, food quality etc. and the psychosocial environment

Question 22

What are the 5 principles of primary health care?

Answer 22

MEMORY TIP: Primary healthcare PATCH up our health

P - public participation
A - accessibility
T - technology that is appropriate
C - collaboration between sectors
H - health promotion

Question 22

What is the underpinning concept of SHOH?

How do we achieve health for all?

Answer 22

Underpinned by social justice and equity in health, with a focus on the population, community, and individuals

Achieving health for all requires the participation of multiple sectors of society, not only health care, as well as the participation and involvement of community members

Question 23

How does the physical environment (both indoors and outdoors) affect human health?

Answer 23

Part of the epidemiological triangle

o Directly – exposure to potentially hazardous agents such as chemicals or radiation
o Indirectly – global warming diminishing food production

Question 24

Describe the built environment and how it can affect human health

Answer 24

Part of the environment on the epidemiological triangle

o Manmade physical surroundings like parks, buildings, infrastructure etc.
o Can influence rates of physical activity, healthy eating, and injuries
o Design is critical to issues of obesity, and equity

Question 25

What is included in the psychosocial environment?

What are mediating factors that can improve the psychosocial environment?

Answer 25

Part of the environment on the epidemiological triangle

Includes
o Relationships
o How we deal with stressors
o Social support
o Social networks

Mediating factors
o Personality characteristics
o Coping styles
o Presence of social support

Question 26

How does spirituality, an aspect of the psychosocial environment affect health?

Answer 26

Part of the environment on the epidemiological triangle

o Helps promote good coping skills and emotional connectedness
o Psychological/social dimensions affected by effects of an illness must be considered to achieve healing, which is a more holistic term than treating

Question 27

How can the built environment affect our psychosocial health?

Answer 27

Part of the environment on the epidemiological triangle

o Manmade physical surroundings like parks, buildings, infrastructure etc.
o Can influence socialization and mental health

Question 28

What is lifestyle and how does it relate to the epidemiological triangle?

Answer 28

Lifestyle involves the aspects of people’s behaviour and surroundings that they control

While the individual does have some control over these, we understand that they are shaped by the social and economic environmental conditions that they live in

Question 28

How are behavioural and modifiable risk factors related to the epidemiological triangle and greater social determinants of health?

Answer 28

• Behaviour is influenced by the social, physical, and economic environment in which people live and work
• Healthy living involves “making positive choices that enhance your personal physical, mental, and spiritual health”
• Individuals are more empowered to make positive choices when they have an adequate income, employment, education, and social support, for example

Question 29

What is improving access to health service mean?

What are some ways to accomplish this?

Answer 29

Improving access to health services means reducing barriers to accessing care for underserved groups

MEMORY TIP: PLEAS for access

P - provide bus and childcare services
L - language services
E - extended clinic hours
A - accessible clinic locations
S - safe and welcoming practical environments

Question 30

Describe health inequality how does this differ from health inequity?

Answer 30

Health inequality
o Higher incidence of disease in a particular group compared with other groups of population
o An absence of health inequality in a population would present as a disease that is randomly or equally distributed among all groups of population

Health inequity
o Inequities in health that are deemed to be unfair or unjust (social, racial, class, etc.)

Question 31

What are differences in health deemed to be unfair or unjust due to social, racial, class, etc.?

Answer 31

Health inequities

Question 32

What is the higher incidence of disease in a particular group compared with other groups of the population called?

Answer 32

Health inequality

Question 33

What are the key action areas for health promotion?

Answer 33

MEMORY: need to REHAB health promotion

R - reorienting health services to health promotion (away from biomedical)

E - environments that are supportive are created

H - Health literacy skills increased

A - Action of the community strengthened

B - building healthy public policy

Question 33

Why do health inequities exist?

Answer 33

the production and distribution of wealth and power

Question 34

What are the 7 domains that the 36 core competencies are divided into by the Public Health Agency of Canada?

Answer 34

o Public health sciences (5 competencies)
o Assessment and analysis (6 competencies)
o Police and program planning, implementation, and evaluation (8 competencies)
o Partnerships, collaboration, and advocacy (4 competencies)
o Diversity and inclusiveness (2 competencies)
o Communication (4 competencies)
o Leadership (6 competencies)

Question 35

What does Ross Upshur’s framework for analyzing the ethical implications of a public health intervention include?

Answer 35

Harm
Least restrictive means
Reciprocity
Transparency