Health 1 & 2 Flashcards
What is meant by health ?
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
M. Huber 2011
‘the ability to adapt and self-manage in the face of social, physical and emotional challenges’
Julian Tudor Hart 1971
Inverse Care Law
Inverse Care Law
The relationship between the need for health care and its actual utilisation.
In other words, those who most need medical care are least likely to receive it.
Conversely, those with least need of health care tend to use health services more (and more effectively).
Disproportionate Care Law
A disproportionate care law which persists in high-income countries, whereby socially disadvantaged people receive more health care, but of worse quality and insufficient quantity to meet their additional needs.
What are the determinants of health ?
The determinants of health include:
the social and economic environment
the physical environment
the person’s individual characteristics and behaviours
Income and social status
A higher income and social status are linked to better health.
The greater the gap between the richest and poorest people, the greater the differences in health.
Education
Low education levels are linked with poor health, more stress and lower self-confidence.
Physical Environment
Safe water and clean air, healthy workplaces, safe houses, communities and roads all contribute to good health.
Employment and working conditions
People in employment are healthier, particularly those who have more control over their working conditions
Social Support Networks
A greater support from families, friends and communities is linked to better health.
Culture
Customs and traditions, and the beliefs of the family and community all affect health.
Genetics
Inheritance plays a part in determining lifespan, healthiness and the likelihood of developing certain illnesses.
Personal behaviour and coping skills
Balanced eating, keeping active, smoking, drinking, and how we deal with life’s stresses and challenges all affect health.
Health Services
Access and use of services that prevent and treat disease influences health
What is meant by the social determinants of health ?
The conditions in which we are born, we grow & age, and which we live and work.
WHO
World Health Organisation
What has significant influence on our social, cultural and physical environments ?
Business
Name some commercial determinants of health
Business
Food/obesity
Tobacco
Vaping
Alcohol
Gambling
Cars
Household goods
Gadgets
Beauty/Toiletries/ Clothes
Unhealthy commodities
Young people are particularly at risk.
Disproportionate effect on most vulnerable communities and populations so widening inequalities.
Health inequalities by WHO
Differences in health status
Differences in distribution of health determinants
Health inequalities by Public Health Scotland
Unfair differences in health within the population across social classes and between different population groups.
Not random, largely socially determined and not inevitable.
Review of Health inequalities
Sir Michael Marmot 2010
‘Serious health inequalities do not arise by chance, and they cannot be attributed simply to genetic make-up, bad, unhealthy behaviour or difficulties in access to medical care…. Social and economic differences in health status reflect and are caused by, social and economic inequalities in society.
Health inequalities that are preventable by reasonable means are unfair. Putting them right is a matter of social justice.’
Public Health development
4 Broad waves of public health change
(with a fifth wave)
5 waves of public health development
Structural - clean water, sewers, drainage
Biomedical - antibiotics, early vaccines
Clinical - lifestyle-related diseases
Social - social determinants of health
Cultural - a culture for health
What is public health ?
Public health is the science and art of preventing disease, promoting health and well-being and prolonging life through the organised efforts of society.
3 Domains underpinned by health intelligence
Health :
Protection - immunisation and screening
Improvement
Quality
Ten core activities of public health practice
Preventing epidemics
Protecting the environment, workplaces, water and food
Promoting healthy behaviour
Monitoring the health status of the population
Mobilising community action
Responding to disasters
Assuring the quality, accessibility and accountability of medical and social care
Reaching out to link high risk and disengaged people to needed services
Researching to develop new insights and innovative solutions
Leading the development of sound health and care policy and planning
Public health approach
problem —–> response
Describe a public health approach
Surveillance
Risk factor identification
Intervention and evaluation
Implementation
Set of activities in health protection
Ensure the safety and quality of food, water, air and the general environment.
Prevent the transmission of communicable diseases.
Manage outbreaks and other incidents which threaten the public’s health.
How does health protection, protect health ?
Risk assessment
Risk management
Risk communication
Planning and prevention
Describe the epidemiological triad
Host
Agent
Environment
(all causes of disease)
Factors affecting the risk of disease
Age
Pre-existing conditions
Immune status
Sanitation
Overcrowding
Virulence
Drug resistance
Describe the chain of infection
Infectious agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Strategies to control spread at the infectious agent stage
Diagnosis
Study
Prevention of antibiotic resistance
Strategies to control spread at the reservoir stage
Treatment
Exclusion
Vector control
Water treatment
Cleaning regimes
Strategies to control spread at the portal of exit stage
Condoms
Wound care
Tissues
Closure of food premises
Face masks
Recall of products
Disposal of clinical waste
Strategies to control spread at the mode of transmission stage
Hand washing
Food safety
PPE
Cleaning regimes
Isolation
Strategies to control spread at the portal of entry stage
PPE
Condoms
Wound care
Hand washing
Strategies to control spread at the susceptible host stage
Immunisation
Prophylaxis
Exclude causes/contacts
What is prophylaxis ?
Treatment given or action taken to prevent disease
How do infectious diseases present to Public Health ?
Notified as a result of :
- Clinical identification of a notifiable disease
- Laboratory identification of a notable organism
- Clinical identification of a ‘Health Risk State’
How are notifiable diseases reported ?
To be notified by REGISTERED medical practitioners
Based on reasonable clinical suspicion
DO NOT AWAIT LABORATORY CONFORMATION
Name 5 notifiable diseases
Cholera
Diptheria
Measles
Meningococcal disease
Rabies
How are notifiable organisms reported ?
To be notified to Public Health by diagnostic laboratories
Electronic notification is acceptable for non-urgent organisms. e.g. via ECOSS system
Where notifications are sent to a regional/national diagnostic laboratory (e.g. ecoli) notification is the DUTY of the originating laboratory.
PH
Public Health
Name 4 notifiable organisms
Bacillus
Clostridium
Hepatitis
Measles
What is a health risk state ?
A highly pathogenic organism
OR
Any contamination/poison/other hazard which is a significant risk to public health.
What do public health teams do with a notification ?
Public Health response is triggered to :
- identify the source
- prevent continued exposure
- prevent onward spread
What happens with the data recorded for local and national surveillance ?
Indicators of possible outbreaks/epidemics.
Mapping disease trends over time.
Sporadic
Occasional cases occurring irregularly
Endemic
Persistent background level of occurrence (low to moderate levels)
Epidemic
Occurrence in excess of the expected level during a given time or period
Pandemic
Epidemic occurring in or spreading over more than one region of the world
Outbreak
2 or more people who experience a similar illness or confirmed infection and are linked by a common factor.
OR
When the observed number of cases unaccountably exceeds the expected number for a given time and place.
Definition of a public health incident
Single case of a serious illness with major public health implications (e.g. Ebola)
Two or more linked cases (outbreak)
Higher than expected number of cases (outbreak)
High likelihood of a population being exposed to a hazard
IMT
Incident Management Team
What is an IMT ?
Multi-agency group convened to investigate and manage a public health incident.
Level of response / members of the IMT will vary depending on scale of incident.
Members of IMT
HPT
Clinical staff
Primary care
Laboratory staff
PHS
Local authority staff (e.g. EHO, education)
Communications team
Environmental agencies (e.g. SEPA, Scottish Water)
Food Standards Scotland
Third sector organisations
