Global Health- Non-infectious diseases (CVD) Flashcards
What is the difference between clinical practice and epidemiology
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
Describe Epidemiologic transition and the Global Burden of Disease
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
How have CVD death rates changed from the 1950s-2000s
They have decreased
Which sex is more likely to die from CVD
Males
When did smoking and diet start to worsen
In the early 1990s.
Why do we need to standardise for age
If we didn’t taker age out- more older people- hence we would see an increase- need to eliminate this confounding factor.
What is strange with the situation in Eastern Europe
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,
What is the link between menopause and deaths from CVD
Menopause appears to increase the number of deaths from CVD.
Which European countries have a low rate of CVD mortality
Western European countries in Mediterranean area, impact of the Mediterranean diet.
Describe the changes in age-standardised death rates due to CVD
USA- decreasing
EU- decreasing
Japan and Eastern countries- increasing
In which regions do the majority of deaths before 70 occur
Developing regions
What measure do we use in epidemiological studies
Rate
Where do the majority of deaths from cardiovascular diseases occur
Developing countries
List the biggest modifiable risk factors for CVD
High Blood Pressure
Smoking and second hand smoke
Diet low in fruits
High BMI
How does BP change with age
It increases
Describe the proximal and distal risk factors for CVD
Proximal- BP, Cholesterol
Distal- Socioeconomic status, education, inequality, climate change, pollution
Results in epidemiological strategies.
How is smoking prevalence changing in england
it is decreasing
Describe the regional trends in worldwide BMI
BMI in women is increasing in most areas- obesity is increasing
Describe the regional trends in worldwide diabetes
Prevalence of diabetes is increasing
How long does an excessive risk factor usually remain for
10 years
Describe some of the treatments for CVD
AMI treatments, Secondary Prevention, Angina drugs, BP treatment (statin therapy reduces cholesterol).
Where is most of the burden for disease
In the developed world
Why will there be a bigger burden of CVD in the future
BP rises with age, elderly population is increasing, hence there will be more people at risk at suffering from CVD.
How do we test for genetic effects within the population
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
What is omics
Link between proximal and distal susceptibility to disease
Describe the global burden of non-communicable disease
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.
Describe the inequalities in non-communicable diseases
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.
Describe the demands on healthcare caused by non-communicable diseases in the UK
- 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
Describe the healthcare costs associated with non-communicable diseases in the UK
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
Describe the inequalities associated with non-communicable diseases in the UK
- 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%
