How can we measure the health of the population? Flashcards
Why do you need to measure the health of the population? (5)
- Find out how common a disease is (prevalence) & how many new cases occur (incidence)
- identify longitudinal trends
- service planning : do we have the right services in the right place
- identify patterns and differences between different population groups
- are interventions having an ill-effect
Give examples of major causes of death in the past 150 years.
- Infectious diseases big killer eg TB in 1800
- Now leading causes are heart disease, cancer, strokes
- Other countries esp poor countries, infectious diseases still main cause e.g.
- Zambia
- 1-5: congenital abdnormalities
- 5-34: suicide
- 35-64: CHD and breast cancer
- 64+: CHD
7 sources of information on the health of the population
- census
- death certification
- health survey for england
- general lifestyle survey
- GP research database
- hospital episode statistics
- National/regional/local audits or surveys
What is the health survey for England?
- Annual population survey
- contains questionnaire answers( demographic information, smoking status, self reported information on health, illness, treatment, health service usage), blood and saliva smaple analysis, height/weight
- additional information on key theme each year
- freely availible online
What is the General Lifestyle Survey?
- Sample from whole of Great Britain
- Formerly called General Household Survey
- Demographic info about households, families & people
- Housing tenure and household accommodation
- Access to vehicles
- Employment
- Education
- Health and use of health services
- Smoking and drinking
- Family information, marriage. Cohabitation & fertility.
What is Hospital Episode Statistics?
- Details of all admissions to NHS hospitals in England and all outpatient appointments.
- Started 1989
- Secure details on:
- Diagnoses and operations
- Age, gender, ethnicity
- Time waited and date of admission
- Geographical information on where treated
What is Clinical Practice Research Datalink?
- Anonymised longitudinal data from 625 general practices serving approx 5 million patients. (Previously known as general practice research database).
- Used for:
- Clinical research planning
- Drug utilisation
- Studies of treatment patterns
- Clinical epidemiology
- Drug safety
- Health outcomes
- Health service planning
What are the key methods of measuring health and disease (4)
- Birth and fertility rates
- Incidence
- Prevalence
- Mortality rate
Define Birth rate?
number og live births per 1000 population
Define fertility rate
number of live births per 1000 women aged 15-44
Define total fertility rate
the average number of children that a woman would bear if they experienced the age-specific fertility rates at that point in time
Define prevalence
- the proportion of people in a population of known size who have a particular disease at one point in time
- All cases/population at risk
- useful for planning services
- Prevalence= x% or x/100,000 population
Define incidence
- the number of new cases over a period of time in a population of known size
- Number of new cases/ population at risk
- Incidence= x/100,000 population per year
Define infant mortality rate
the number of deaths in children under 1 out of all live births
- highly coorelated with expectation of life, and with overall economic status
- hughly infant mortality rates are amenable to change through public health measures- e.g. care of pregnant women, infant immunisation & nutrition programmes)
What is crude mortality rate?
Define Diesase Specific Death Rate.
What are the advantages and disadvantages of usig mortality data as a measure of population health?
What is direct standardisation?
Age specific death rates from a study population are applied to a standard population structure
what would be the death rate in the standard population if it had the age and sex-specific death rates experienced by the population I am looking at?
What are the advantages and disadvantages of direct standardisation?
What is indirect standardisation?
Age-specific rates from a standard population are applied to a study population structure (standardised mortality ratio)
- Calculate age-specific death rates for the UK
- Multiply these rates by the number of people in each age-band in Anytown to give the expected number of cases if Anytown had the same rates as the UK
- Sum the expected number of cases in Anytown (all age bands)
What are the advantages and disadvantages of indirect standardisation?
