health and disease in the population e lecture Flashcards
what does epidemiology mean
studies upon people
how do we find out about oral health and disease in the population
used to investigate outbreaks of infectious diseases
what does WHO define epidemiology as
the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems’
why are inspections of people undertaken
in order to record the pattern of oral health and disease for geographical areas or groups of people
what is epidemiology
the study of patterns of oral health and diseases in a population
what are the different types of epidemiology
surveillance and descriptive studies
analytical studies
experimental epidemiology
what are surveillance and descriptive studies
can be used to study the distribution of disease
what were analytical studies used for
determinants of disease
what is experimental epidemiology
assesses the effects of treatments preventive measures and intervention programmes
which regular surveys occur in the UK about childrens dentition
conducted to examine how healthy the dentition of our children is
examining different age groups and they study the pattern of caries year after year to see if oral health is improving or worsening. These surveys also help to determine which geographical areas of the UK have worst dental health
what is proportionate universalism
are reading anything to do with addressing inequity in population health. The term proportionate universalism means that you would give healthcare or preventive efforts which are proportional to needs
where do more people have caries
in more deprived areas
what is descriptive epidemiology
distribution of disease, risk factors and determinants of health in a population or sub-group
Usually describes disease in relation to characteristics of the population e.g. time, place, personal characteristics (age, sex, ethnicity)
give an example of descriptive epidemiology surveys
British Association for the Study of Community Dentistry (BASCD)
why are descriptive epidemiology surveys important
pivotal to demonstrate the oral health improvement when fluoride became much more widely used
when was fluoride toothpaste usage become more common
1980s
who is john snow
the first person to conduct epidemiology
which study did john snow carry out
outbreak of cholera in london
how many people died of cholera in 10 days
500 people
where was the central water source in london
water pump on broad street
describe analytical epidemiology
exploring the causes or determinants
hypothesis testing
case control and cohort studies
what is the purpose of a case control study
to establish association between exposure to risk factors and disease
who can be selected as cases
Members of the population with disease are selected as cases and risk factor information considered retrospectively
why is a second group also used in case control studies
who do not have the disease are also included often used for rare diseases or one where little is known re the association between risk factor and disease of interest
what are the disadvantages of case control study
can be prone to bias and confounding
what is the definition of prevalence
the proportion of a population that are cases at a specific point in time
what is point prevalence
single examination at one point in time
what is period prevalence
proportion of the population that are cases at any time within a stated period
what is the incidence
rate at which new cases occur in a population during a specified time period
what was the incidence of thyrotoxicosis in 1982 in Furness
10 per 100000 in
what was the incidence of thyrotoxicosis in 1982 in chester
49 per 100000
what is cohort study
another type of analytical epidemiology
what does cohort study involve
follow a group of people in the population to see what happens to them overtime
what is prospective cohort studies
can be tailored to collect specific info into the future
what is the disadvantage of prospective cohort studies
might be a long wait till you can examine the effect of the exposure and there might be a high number of dropouts
what is retrospective
historical information look at events of the past info immediately available
what is the disadvantage of retrospective
may not be complete or reliable and you may also be relying in peoples memory or far events
what is attributable risk
a statistic to help describe just how much of an influence something is on disease status.
what things are included in a cohort study 8 things
Longitudinal study Fixed or dynamic Subjects are categorised on the basis of being exposed to the cause (or protective factor) or not Retrospective or prospective Data analysis Crude rates of outcome Standardised rates or ratios of outcome Attributable risk
benefits of case control
More suitable for rare diseases
Examine one effect but several exposures
Cheap and quick to conduct
disadvantages of case control
Prone to bias in measuring exposure
May be difficult to elucidate cause and effect
benefits of cohort
Suitable for rare exposures
Examine multiple effects of single exposure
Can minimise bias in measuring exposure
Better at elucidating cause and effect
disadvantages of cohort
Expensive and slow to conduct
Prone to drop out
what do we need to do before epidemiology studies
test hypotheses about possible human causes and determinants of disease
what is the gold standard of research
randomised control trial
how is epidemiology used
planning of services as part of oral health needs assessment
why health inequalities occur
due to differences in health experiences and health outcomes between population groups.
why do health inequalities happen
socio-economic status, geographical area, age, disability, gender or ethnic group.
what is health inequities
to differences in life chances or opportunities that are avoidable and due to the social and economic landscape.
what are the key messages from marmots review
There is a social gradient in health
Health inequalities result from social inequalities
which six policy objective will health inequalities require action on
Give every child the best start in life
Enable all children young people and adults to maximise their capabilities and have control over their lives
Create fair employment and good work for all
Ensure healthy standard of living for all
Create and develop healthy and sustainable places and communities
Strengthen the role and impact of ill health prevention.
what are general and oral health influenced by
form lifestyle choices to national policy
how dow e get a successful public health approach
need to identify the wider determinants on health and adopt a partnership
what is the social ecological theory
whereby the relationships between the individual, their environment and disease are brought together. The diagram show individuals are at the centre with a set of fixed genes
how do we address health inequalities
Reduce exposure to risk
Address underlying causes of ill health
Social, economic, environmental factors
Individuals, families
what is the inverse care law
who need healthcare but do not ask for it and those who do not need care but present at healthcare services
what strategy came into play in 2005
choosing better oral health- more preventative treatment
what stratergy came into play in 2006
NHS dental contract
what stratergy came into play in 2009
delivering better oral health PCTs take over the statutory duty to monitor the oral health of their local populations
what stratergy came into play in 2013
PCTs and SHAs are disbanded and a new organisation for healthcare is initiated
who is primary care provided by
general dental practice
who is secondary care provided by
in hospital trusts, restorative orthodontics oral surgery max fax
who commissions dental services
NHS ENGLAND
when was dental services commissioned by NHS england
april 2-013
