Improving The Health Of The Nation

Question 1

What are the 3 domains of public health?

Answer 1

Health protection
Health improvement
Healthcare public health

Question 2

What is covered under health improvement?

Answer 2

Inequalities
Education
Housing
Employment
Family
Community
Lifestyles
Surveillance and monitoring of specific diseases and risk factors

Question 3

What is the virtuous cycle of public health?

Answer 3

A cycle that shows how health improvement can lead to saving money. The 5 steps are as follows:

1. Health improvement and early intervention public health
2. Improves health and health equality
3. Greater personal and population wellbeing
4. Reduced pressure on health and social care by more competent public
5. Money saved to invest in prevention and health improvement

Question 4

When approaching population health improvements, what are the 2 main approaches?

Answer 4

Population approach - encourage everyone to change, shifting the entire distribution
Risk reduction approach - move high risk individuals into normal range

Question 5

What are the 5 categories in determining health?

Answer 5

1. Age, sex and constitutional factors
2. Individual lifestyle factors
3. Social and community networks
4. Living and working conditions
5. General socio-economic, cultural and environmental conditions

Question 6

What are the 5 areas of health promotion?

Answer 6

Personal skills e.g stop smoking interventions
Community actions e.g media campaigns on tobacco-related harm
Supportive environment e.g no smoking policies on public transport
Healthy public policy e.g high tax on tobacco products
Reorient health services e.g preventative and intensive support services.

Question 7

What is a health needs assessment?

Answer 7

Assessing the:
Existing services
Incidence and prevalence
Effectiveness of interventions and cost-effectiveness

Question 8

What are the 5 stages of a logic model?

Answer 8

Resource/input -> activities -> outputs -> outcomes -> impact

Question 9

What are the 6 stages of the prochaska & diclemente stages of change model?

Answer 9

Precontemplation
Contemplation
Preparation
Action
Maintenance 
Relapse

Question 10

What is a diffusion of innovation graph?

Answer 10

A graph showing time on the x axis and percentage of adopters on the y axis

Question 11

What are the 4 types of prevention?

Answer 11

Primordial
Primary
Secondary
Tertiary

Question 12

What is primordial prevention?

Answer 12

Targets the general population to try and eliminate risk factors. Uses strategies such as health promotion and immunisation

Question 13

What is primary prevention?

Answer 13

Targets a susceptible population to try and reduce the risk of developing the disease. Strategies used are screening, immunisation, more health promotion

Question 14

What is secondary prevention?

Answer 14

Targets a asymptomatic population that already have the disease to try and slow down the progression. Strategies used are screening and starting treatments

Question 15

What is tertiary prevention?

Answer 15

Targeting the symptomatic population to try and minimise the consequences of the disease and treat the patient. Strategies are treatment

Question 16

What is the herd immunity threshold?

Answer 16

Proportion of the population needed to be immune in order to confer protection on the remaining susceptible individuals based on an infection that is transmitted solely from person to person

Question 17

What are the different screening programmes in the UK?

Answer 17

Screening in pregnancy
Newborn screening
Diabetic eye screening 
Cervical screening
Breast screening 
Bowel cancer screening 
Huntington’s disease screening
Abdominal aortic aneurysm screening

Question 18

What are the 2 screening biases?

Answer 18

Lead time bias
Length time bias
Volunteer bias

Question 19

What is lead time bias?

Answer 19

The time by which diagnosis is advanced because of screening which leads to an apparent increase in survival e.g. longer survival from diagnosis as occurred sooner.

Question 20

What is length time bias?

Answer 20

Diseases with a long latent phase are more likely to be picked up on screening than those with a short latent phase. Dont pick up rapidly progressing diseases that are more likely to do harm

Question 21

What is volunteer bias?

Answer 21

People that accept an invitation for screening tend to be at a lower risk of the disease and generally healthier.