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HSPH/Cancer > HSPH Revision Guide > Flashcards

HSPH Revision Guide Flashcards

1
Q

What is health?

A

State of complete physical, mental and social well being, and not merely the absence of disease or infirmity

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2
Q

How do we measure health?

A 
Health status
Person's body structure or function
Person's symptoms and what they can or can't do
extent 
Extent to which condition affects person's normal life
research
Health outcomes
Physiological indicators
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3
Q

What contributes to increased health costs

A

Population growth (0.8%)
Ageing populations
Medical Technology
Increase prevalence of chronic conditions
Staffing costs
Failure of productivity in NHS to match other sectors

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4
Q

NHS Long Term Plan 2019

A

Making sure everyone gets best start
Delivering world-class care for major health problems
Supporting people to age well

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5
Q

Health meaning

A

Dynamic condition resulting from a body’s constant adjustment and adaptation in response to stress, and changes in the environment for maintaining an inner equilibrium called homeostasis

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6
Q

Interplay between individual and environment

A

Epigenetics
Study of changes in organisms caused by modification of gene expression rather than alteration of the genetic code itself
Human Genome Project

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7
Q

Eudaimonic

A

Highest human good and realisation of one’s potential

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8
Q

Social determinants of health

A

Any social factor that can potentially impact on health and wellbeing
e.g. poverty, education, employment
Any cultural influences
Poverty distress

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9
Q

Dahlgren + Whitehead 1991

A

Layers of influence on health

Map of the relationship between the individual, their environment and the disease

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10
Q

Health Inequalities

A

Unjust and avoidable differences in people’s health (outcomes) across the population and between specific population groups
Go against principles of social justice because they are avoidable
Don’t occur randomly or by chance
Limit chance to live longer, healthier lives

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11
Q

Causes of health inequalities

A

Politics, poverty, physical, economics, social, cultural

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12
Q

Public health surveillance

A

Continuous, systematic collection, analysis and interpretation of health-related data needed for the planning, implementation, and evaluation of public health practice

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13
Q

Public health surveillance impact

A

Serve as early warning system for impending public health emergencies
Document impact of an intervention
Monitor and clarify epidemiology of health problems

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14
Q

Evidence Based medicine

A

Integration of best research evidence with clinical expertise and patient values

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15
Q

Social Determinants of health

A

Conditions in which people are born, grow, live, work and age
Shaped by distribution of money, power + resources at global, national and local levels
Responsible for health inequalities

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16
Q

Health inequality

A

Differences in the health outcomes of individuals or groups

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17
Q

Equality Act 2010 Protected characteristics

A

Age, gender, disability, gender reassignment, pregnancy, maternity, race, religion or belief, sex and sexual orientation

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18
Q

Social Class

A

Segments of population sharing broadly similar types and level of resources, with broadly similar style of living + some shared perception of their collective condition

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19
Q

Social Class levels

A

I. Professional (doctor, accountant, lawyer)
II. Intermediate (manager, schoolteacher)
IIIn. Skilled non-manual (secretary, shop assistant)
IIIm. Skilled manual (bus driver, butcher)
IT. Partly skilled (postman, bus conductor)
V. Unskilled (cleaner, dock worker)

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20
Q

Social class and health Whitehall I + II

A 
Inverse gradient of CVD risk with social class
Women had greater angina + morbidity than men
Obesity, shorter height + family history of HD were found to be more prevalent in lower level job ppl
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21
Q

Shit Life Syndrome

A

Poor working aged people locked in cycle of poverty and neglect

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22
Q

Poverty

A

Weakens social structure
Decreases access to care
Increase pressure on NHS

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23
Q

Absolute poverty

A

A set standard- the same in all countries and does not change over time

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24
Q

Extreme Poverty

A

Living on less than 1.25 dollars per day

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25
Q

Relative poverty

A

A standard defined in terms of the society in which an individual lives, differs between countries and over time

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26
Q

Poverty Across London

A

London has higher than 21% England poverty rate average
High poverty West London
Tower Hamlets, Hackney + Newham have poverty above 45%

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27
Q

Social exclusion

A

alienation or disenfranchisement of certain people within society

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28
Q

Social gradient in health

A

Inverse relationship between grade of employment + risk of death
Lower the grade of employment, the higher the risk of death

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29
Q

Brunner + Marmot 1999

A

Stress as a mediator

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30
Q

GCPH 2016

A

Deaths of despair in middle aged white ment- de-industrialisation, de-stabilisation, poverty, deprivation

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31
Q

Warraich 2017

A

Medical success- better at treating conditions + prolonging life so now more people are living with chronic conditions

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32
Q

White, Adams and Heywood 2019

A

Health Inequality Loop

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33
Q

Chronic Illness

A

Long term condition where there is no cure, and which are managed with drugs and other treatment

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34
Q

Noncommunicable Diseases

A

Including HD, stroke, cancer, diabetes and chronic lung disease
Collectively responsible for almost 70% of deaths worldwide

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35
Q

Prevalence of Long Term Conditions

A 
Older people (58% of people over 60 compared to 14% under 40)
More deprived groups (people in poorest social class have 60% more prevalence than those in richest social class, and 30% more severity of disease)
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36
Q

Long term conditions impact

A

50% all GP apps
64% all outpatient apps
Over 70% of all inpatient bed days

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37
Q

Men death rates from conditions

A

HD and stroke reduced by 50%
Lung cancer reduced 1/3rd
Dementia + alzheimers increase 60%
Liver disease increase 12%

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38
Q

Female death rates

A

HD and stroke halves

Alzheimer + dementia doubled

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39
Q

Female vs Male life expectancy 2016

A

3.6 years greater for F

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40
Q

Impairment

A

An injury, illness or congenital condition that causes or is likely to cause a loss or difference of physiological or psychological function

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41
Q

Disability

A

Restriction of ability caused by the condition

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42
Q

Handicap

A

Disadvantage that results when a disability or impairment limits or prevents the fulfilment of a role

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43
Q

International classification of Functioning, Disability and Health (WHO 2001)

A

Integrates medical and social models
Recognises the significance of environment
Focus on components of health

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44
Q

International classification of Functioning, Disability and Health (WHO 2001)
KEY COMPONENTS

A

Body structures and functions
Activities
Participation

45
Q

Stigma

A

A mark of shame, disgrace or disapproval that results in an individual being rejected, discriminated against and excluded from participating in a number of different areas of society

46
Q

Bury

A

Biographical distribution

47
Q

Charmaz

A

Loss of self

Serious chronic illness may lead to restricted lives, social isolation, being discredited, burdening others

48
Q

NHS Ten Year Plan

A

New service model, more NHS action on precent + health inequalities, progress of care quality + outcomes, better care for major health conditions, support NHS staff

49
Q

Tower Hamlets Wellbeing strategy 2012

A 
Stop increase in obesity and overweight children
Reduce tobacco prevalence
Higher physical activity
Reduce STIs
Reduce drinking + drugs
50
Q

Trauma informed public health approaches for adults & children

A

Prevent (toxic stress)
Protect
Prepare
Promote

51
Q

Gender identity

A

Refers to a person’s innate felt sense of being male or female

52
Q

Gender variance/gender non-conformity

A

Behaviours and interests that fit outside what is considered ‘normal’ for a child or adult’s assigned biological sex e.g. tom boy

53
Q

Gender dysphoria

A

A condition where a person experiences discomfort or distress because there’s a mismatch between their biological sex and gender identity.

54
Q

Gender fluidity

A

Wider, more flexible range of gender expressions, with interests and behaviours that may even change from day to day

55
Q

Genderqueer- nonbinary

A

Fluidity of gender expression that is not limiting

May not identify as male or female, but as both/neither/blend

56
Q

Health expectancy

A

A measure of morbidity (used to describe how often a disease occurs in a specific area or a term used to describe a focus on death)

57
Q

Women vs men mortality + morbidity

A

Women have lower mortality but higher morbidity

Women can expect to live longer in poor health than men- 10.7years

58
Q

Whitehall II

A

Mortality lower in women

59
Q

Queer theory

A

All sexualities are pluralistic, fragmented and frequently constructed

60
Q

Biographical time

A

The processes, experiences and events that occur during an individual persons lifetime

61
Q

Historical time

A

The impact of cohort effects upon the individual experience of ageing

62
Q

Erikson’s Stages of Development

A

Stage 7= 40-65, generativity vs. stagnation

Stage 8= 65+, late adulthood

63
Q

Ageism

A

Discrimination or unfair treatment based on a person’s age

64
Q

Equality Act 2010

A

prevent discrimination

65
Q

Ethnicity

A

A group of individuals who identify themselves or are identified by others as belonging to a social grouping which is distinct (in language, lifestyle, religion etc.)

66
Q

Race

A

Classification of physical characteristics such as skin colour + hair texture, which reflect ancestry and or geographical origins
Socially constructed category that changes over time and place

67
Q

Culture

A

Its own distinctive ways of classifying the world

Gives us means by which to make sense of the world and to construct meaning

68
Q

Institutionalised racism

A

The collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture, or ethnic origin. It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantage minority ethnic people

69
Q

Institutionalised racism 2

A

Patients from ethnic minorities who are identified as those falling outside of these constructed norms of patient behaviour

70
Q

Racism

A

A belief that some races are superior to others

Used to justify a position that racial inequalities are ‘natural’

71
Q

Prejudice

A

A positive or negative evaluation of another person based on their perceived group membership e.g. race, class or gender

72
Q

Discrimination

A

The prejudicial treatment of an individual based on his or her membership, or perceived membership, in a certain group or category

73
Q

Stereotype

A

A conventional, formulaic, and oversimplified conception, opinion, or image of a group of people or things

74
Q

Epidemiology

A

The study of patterns of disease and the factors that influence the emergence, propagation and frequency of a disease in a population
Employs the research strategy of measuring differential exposure variables of populations. The key assumption being that a change in exposure can alter disease incidence

75
Q

Ethnicity

A

One of several variables that are used to subdivide the population for purposes of health research and for planning service provision

76
Q

Social construction

A

The understanding that every day knowledge is creatively produced by individuals and is directed towards practical problems

77
Q

Ethnic group

A

Based on an individual conception of social group membership and personal identity

78
Q

Ethnic origin

A

An allocated definition based on common ancestry or place of origin

79
Q

CVD + Framingham Risk Score

A

Combined risk of CVD highest in south Asians, then white ppl, then people of African origin

80
Q

Intersectionality

A

The inseparable effect of holding multiple identifiers of disadvantage

81
Q

Diabetes in Tower Hamlets

A

43% children in yr 6 overweight/obese- in London average 39%
Lowest no. of adults eating fruit and veg
23% physically inactive

82
Q

Diversity

A

Any dimension or factor that is used to differentiate groups and people from one another

83
Q

Adherence

A

The extent to which a person’s behaviour – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider
40%

84
Q

Compliance

A

Assumes passive patient

85
Q

Concordance

A

Focuses on decision making process

hard to measure quantitively

86
Q

Measuring adherence

A

Clinical/direct observation, indirect observation, self report method

87
Q

Highest primary adherence by drug class

A

Antimicrobial

88
Q

Highest primary adherence by patient age

A

under 18

89
Q

Prescription non-adherence

A

28%

90
Q

Intentional vs. Non-intentional adherence

A

Intentional- socially condemned, complex to understand and change
Non-intentional- socially less blame, easier to understand and change

91
Q

Chronic medication adherence

A

50% not taken

92
Q

New medication adherence

A

30% don’t after 10 days

93
Q

Kidney transplant adherence

A

22% don’t adhere

94
Q

HIV antiretroviral adherence

A

37-83% adherence

95
Q

Necessity-Concerns Framework

A

Horne et Al

Whether someone adheres to treatment is guided by weighing up necessity beliefs against concerns

96
Q

Necessity Beliefs

A

Belief in treatment efficacy, belief that illness requires treatment

97
Q

Concern beliefs

A

Worries about side effects

Unsure of self-efficacy

98
Q

Health Literacy

A

The cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand and use information in ways that promote and maintain good health

99
Q

Doctor as a professional

A

ethical and legal guidelines • reflect, learn & teach others • multi-professional team • protect patients and improve care • deal effectively with uncertainty & change • methods of improvement • recognise own personal health needs

100
Q

Professionalism

A

Moral contract that exists between a professional and the public
attitudes, values and behaviours required of the modern doctor and how those can be taught, nurtured and learned. • role and evolution of professional regulation and standards • changing forces of society and their impact on professionalism • importance of professionalism and it’s practice within the context of modern medicine.

101
Q

GP Professionalism

A

How to address low patient engagement in healthcare and increase health literacy. 2. How to promote and maintain therapeutic optimism when working in areas of high deprivation. 3. How to effectively use evidence-based medicine (EBM) when working with patients with high levels of multi-morbidity and social complexity. 4. How to meet effectively the health needs of migrants including people seeking asylum and refugees.

102
Q

Biopsychosocial model

A

Behaviours, thoughts and feelings may influence a physical state. • Disputed the long-held assumption that only the biological factors of health and disease are worthy of study and practice. • Argued that psychological and social factors influence biological functioning and play a role in health and illness also. • More realistic model in light of the role lifestyles play in a society having entered the new millennium. • This new theoretical model therefore has been developed in an attempt to improve on the disease approach and narrow view with respect to health and illness held by the medical model so that psychological and social factors of the individual can also be considered

When given treatment, need to make sure works biologically but also improves way the person lives

103
Q

Obesity England ranking

A

40th in world

104
Q

Obesity in adults england

A

28.1%

105
Q

Men vs women obese

A

2/3 men

6/10 women

106
Q

Bullying

A

Offensive, malicious and insulting behaviour

107
Q

Harassment

A

Unwanted conduct affecting dignity

108
Q

Resilience

A

Ability to bounce back after adverse effects

HSPH/Cancer (8 decks)

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