Global Health- Non-infectious diseases (CVD)

Question 1

What is the difference between clinical practice and epidemiology

Answer 1

Clinical medicine is concerned with cases of disease and the disease burden for the individual patient [Num
Epidemiology/Public Health is concerned with disease rates and the burden of disease in populations

Question 2

Describe Epidemiologic transition and the Global Burden of Disease

Answer 2

During the epidemiologic transition, a long-term shift occurs in mortality and disease patterns whereby pandemics of infection are replaced by degenerative and man-made diseases

Question 3

How have CVD death rates changed from the 1950s-2000s

Answer 3

They have decreased

Question 4

Which sex is more likely to die from CVD

Answer 4

Males

Question 5

When did smoking and diet start to worsen

Answer 5

In the early 1990s.

Question 6

Why do we need to standardise for age

Answer 6

If we didn’t taker age out- more older people- hence we would see an increase- need to eliminate this confounding factor.

Question 7

What is strange with the situation in Eastern Europe

Answer 7

High age-standardised mortality from CVD; dissolution of USSR, more freedom, increased use of alcohol and drugs, incorporation of western diet, increased age-standardised mortality,

Question 8

What is the link between menopause and deaths from CVD

Answer 8

Menopause appears to increase the number of deaths from CVD.

Question 9

Which European countries have a low rate of CVD mortality

Answer 9

Western European countries in Mediterranean area, impact of the Mediterranean diet.

Question 10

Describe the changes in age-standardised death rates due to CVD

Answer 10

USA- decreasing
EU- decreasing
Japan and Eastern countries- increasing

Question 11

In which regions do the majority of deaths before 70 occur

Answer 11

Developing regions

Question 12

What measure do we use in epidemiological studies

Answer 12

Rate

Question 13

Where do the majority of deaths from cardiovascular diseases occur

Answer 13

Developing countries

Question 14

List the biggest modifiable risk factors for CVD

Answer 14

High Blood Pressure
Smoking and second hand smoke
Diet low in fruits
High BMI

Question 15

How does BP change with age

Answer 15

It increases

Question 16

Describe the proximal and distal risk factors for CVD

Answer 16

Proximal- BP, Cholesterol
Distal- Socioeconomic status, education, inequality, climate change, pollution
Results in epidemiological strategies.

Question 17

How is smoking prevalence changing in england

Answer 17

it is decreasing

Question 18

Describe the regional trends in worldwide BMI

Answer 18

BMI in women is increasing in most areas- obesity is increasing

Question 19

Describe the regional trends in worldwide diabetes

Answer 19

Prevalence of diabetes is increasing

Question 20

How long does an excessive risk factor usually remain for

Answer 20

10 years

Question 21

Describe some of the treatments for CVD

Answer 21

AMI treatments, Secondary Prevention, Angina drugs, BP treatment (statin therapy reduces cholesterol).

Question 22

Where is most of the burden for disease

Answer 22

In the developed world

Question 23

Why will there be a bigger burden of CVD in the future

Answer 23

BP rises with age, elderly population is increasing, hence there will be more people at risk at suffering from CVD.

Question 24

How do we test for genetic effects within the population

Answer 24

When people migrate, they tend to take their disease rates with them. Migrant study- see what happens to migrants when they move to other countries. If there are changes, genetics is not a factor. Lee-Hon-San study is an example

Question 25

What is omics

Answer 25

Link between proximal and distal susceptibility to disease

Question 26

Describe the global burden of non-communicable disease

Answer 26

Non-communicable disease is the major cause of mortality in high-income countries, and its importance is growing in middle- and low-income countries as the control and treatment of infectious disease improves.

Question 27

Describe the inequalities in non-communicable diseases

Answer 27

The risk of developing a non-communicable condition often increases with age. Therefore the prevalence of these conditions tends to be higher in the high-income countries due to their older population.
Morbidity and mortality can often be improved with healthcare. Therefore the burden of disease can disproportionately affect lower-income countries where resource scarcity can limit healthcare provision, and they suffer under the dual burden of communicable and non-communicable disease.
As knowledge about the causes of non-communicable conditions continues to grow, richer countries are often able to take action to protect their population. For example, they may introduce stricter controls over occupational chemical exposure, tobacco control interventions, and healthy eating initiatives.

Question 28

Describe the demands on healthcare caused by non-communicable diseases in the UK

Answer 28

• Chronic diseases are a major burden on the UK NHS.
• This burden will only increase as the population ages.
• Modifiable factors increase the risk of common chronic conditions and the need for healthcare, including obesity, high BP, smoking, and physical inactivity.
• Obesity is common. In England >60% of the adult population and 30% of children are overweight or obese.2
• 30% of adults in England have high BP and almost half of these are not being treated for it.2
• 22% of adults in England are current cigarette smokers

Question 29

Describe the healthcare costs associated with non-communicable diseases in the UK

Answer 29

Healthcare costs for chronic conditions increase as technologies advance.
• In 2008/09 the UK NHS had a budget of >£100 billion which equates to approximately £1980 per person.3
• Over 800 million prescriptions were dispensed in the community by the NHS in 2009, costing >£8.5 billion.4
• 18 of the 20 most commonly prescribed drugs treat non-communicable diseases and 4 of the top 5 of these drugs were for cardiovascular disease

Question 30

Describe the inequalities associated with non-communicable diseases in the UK

Answer 30

• The prevalence of non-communicable conditions increases with age.
• Men are more likely to be a current cigarette smoker than women (24% v 20%).2
• Obesity is more common in populations living in the most deprived areas compared to the most affluent areas (27% v 24%).5
• Smoking is much more common in the most deprived communities (34%) than the most affluent (14%