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CSA > health and disease in the population e lecture > Flashcards

health and disease in the population e lecture Flashcards

1
Q

what does epidemiology mean

A

studies upon people

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2
Q

how do we find out about oral health and disease in the population

A

used to investigate outbreaks of infectious diseases

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3
Q

what does WHO define epidemiology as

A

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’

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4
Q

why are inspections of people undertaken

A

in order to record the pattern of oral health and disease for geographical areas or groups of people

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5
Q

what is epidemiology

A

the study of patterns of oral health and diseases in a population

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6
Q

what are the different types of epidemiology

A

surveillance and descriptive studies
analytical studies
experimental epidemiology

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7
Q

what are surveillance and descriptive studies

A

can be used to study the distribution of disease

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8
Q

what were analytical studies used for

A

determinants of disease

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9
Q

what is experimental epidemiology

A

assesses the effects of treatments preventive measures and intervention programmes

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10
Q

which regular surveys occur in the UK about childrens dentition

A

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

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11
Q

what is proportionate universalism

A

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

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12
Q

where do more people have caries

A

in more deprived areas

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13
Q

what is descriptive epidemiology

A

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)

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14
Q

give an example of descriptive epidemiology surveys

A

British Association for the Study of Community Dentistry (BASCD)

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15
Q

why are descriptive epidemiology surveys important

A

pivotal to demonstrate the oral health improvement when fluoride became much more widely used

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16
Q

when was fluoride toothpaste usage become more common

A

1980s

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17
Q

who is john snow

A

the first person to conduct epidemiology

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18
Q

which study did john snow carry out

A

outbreak of cholera in london

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19
Q

how many people died of cholera in 10 days

A

500 people

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20
Q

where was the central water source in london

A

water pump on broad street

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21
Q

describe analytical epidemiology

A

exploring the causes or determinants
hypothesis testing
case control and cohort studies

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22
Q

what is the purpose of a case control study

A

to establish association between exposure to risk factors and disease

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23
Q

who can be selected as cases

A

Members of the population with disease are selected as cases and risk factor information considered retrospectively

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24
Q

why is a second group also used in case control studies

A

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

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25
Q

what are the disadvantages of case control study

A

can be prone to bias and confounding

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26
Q

what is the definition of prevalence

A

the proportion of a population that are cases at a specific point in time

27
Q

what is point prevalence

A

single examination at one point in time

28
Q

what is period prevalence

A

proportion of the population that are cases at any time within a stated period

29
Q

what is the incidence

A

rate at which new cases occur in a population during a specified time period

30
Q

what was the incidence of thyrotoxicosis in 1982 in Furness

A

10 per 100000 in

31
Q

what was the incidence of thyrotoxicosis in 1982 in chester

A

49 per 100000

32
Q

what is cohort study

A

another type of analytical epidemiology

33
Q

what does cohort study involve

A

follow a group of people in the population to see what happens to them overtime

34
Q

what is prospective cohort studies

A

can be tailored to collect specific info into the future

35
Q

what is the disadvantage of prospective cohort studies

A

might be a long wait till you can examine the effect of the exposure and there might be a high number of dropouts

36
Q

what is retrospective

A

historical information look at events of the past info immediately available

37
Q

what is the disadvantage of retrospective

A

may not be complete or reliable and you may also be relying in peoples memory or far events

38
Q

what is attributable risk

A

a statistic to help describe just how much of an influence something is on disease status.

39
Q

what things are included in a cohort study 8 things

A 
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
40
Q

benefits of case control

A

More suitable for rare diseases
Examine one effect but several exposures
Cheap and quick to conduct

41
Q

disadvantages of case control

A

Prone to bias in measuring exposure

May be difficult to elucidate cause and effect

42
Q

benefits of cohort

A

Suitable for rare exposures
Examine multiple effects of single exposure
Can minimise bias in measuring exposure
Better at elucidating cause and effect

43
Q

disadvantages of cohort

A

Expensive and slow to conduct

Prone to drop out

44
Q

what do we need to do before epidemiology studies

A

test hypotheses about possible human causes and determinants of disease

45
Q

what is the gold standard of research

A

randomised control trial

46
Q

how is epidemiology used

A

planning of services as part of oral health needs assessment

47
Q

why health inequalities occur

A

due to differences in health experiences and health outcomes between population groups.

48
Q

why do health inequalities happen

A

socio-economic status, geographical area, age, disability, gender or ethnic group.

49
Q

what is health inequities

A

to differences in life chances or opportunities that are avoidable and due to the social and economic landscape.

50
Q

what are the key messages from marmots review

A

There is a social gradient in health

Health inequalities result from social inequalities

51
Q

which six policy objective will health inequalities require action on

A

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.

52
Q

what are general and oral health influenced by

A

form lifestyle choices to national policy

53
Q

how dow e get a successful public health approach

A

need to identify the wider determinants on health and adopt a partnership

54
Q

what is the social ecological theory

A

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

55
Q

how do we address health inequalities

A

Reduce exposure to risk
Address underlying causes of ill health
Social, economic, environmental factors
Individuals, families

56
Q

what is the inverse care law

A

who need healthcare but do not ask for it and those who do not need care but present at healthcare services

57
Q

what strategy came into play in 2005

A

choosing better oral health- more preventative treatment

58
Q

what stratergy came into play in 2006

A

NHS dental contract

59
Q

what stratergy came into play in 2009

A

delivering better oral health PCTs take over the statutory duty to monitor the oral health of their local populations

60
Q

what stratergy came into play in 2013

A

PCTs and SHAs are disbanded and a new organisation for healthcare is initiated

61
Q

who is primary care provided by

A

general dental practice

62
Q

who is secondary care provided by

A 
in hospital trusts, 
restorative 
orthodontics
oral surgery 
max fax
63
Q

who commissions dental services

A

NHS ENGLAND

64
Q

when was dental services commissioned by NHS england

A

april 2-013

CSA (51 decks)

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