Introduction to public health Flashcards
3 aims of public health
focus on population (vs individual)
improve population health
reduce health inequities within the population
Does it focus on upstream and downstream factors?
yes
two key tools used?
biostatistics and epidemiology
who was the founder of public health
John Snow
describe John Snow’s work
cholera outbreak
was thought that it was caused by bad air (miasma theory)
John Snow refuted it and found it was due to dirty water
define: risk factor
doesn’t CAUSE a disease, but is strongly associated with it
what are the 4 risk factors
predisposing
enabling/disabiling
precipitating
reinforcing
predisposing?
age, sex
enabling/disabling?
low income, poor nutrition
precipitation?
exposure to disease agent
reinforcing?
repeat exposure to a risk factor
what is a sufficient cause
risk factor that can, on its own, lead to a disease occuring
what is a necessary cause
without this risk factor, the disease can’t occur.
- prerequisite
- but if not sufficient, won’t cause disease
example of sufficient and necessary causes and diseases?
ebola: exposure to ebola virus will lead to ebola
huntingtons: exposure to gene mutation will lead to huntingtons disease
example of neither sufficient nor necessary cause?
cigarette smoking
- not necessary as lung cancer can happen without smoking
- not sufficient as smoking won’t always cause lung cancer
example of necessary but not sufficient cause?
tuberculosis
- necessary: exposure to mycobacterium tuberculosis is required for TB to happen
- not sufficient: requires other risk factors - weakened immune system, genetics, malnutrititon, poverty, crowded housing - to cause it
purpose of bradford hill criteria
helps establish whether causation has occurred
temporality
when cause proceeds effect
reversibility
when you remove the cause, then the disease goes away/is diminished
plausibility
whether the cause–> effect relationship is legit based on current knowledge
consistency
whether the cause–>effect relationship matches current research
strength
when there’s a strong cause–>effect relationship (ie. high odds ratio)
dose response
when you change intensity of cause, you change intensity of effect.
there’s only one of the bradford hill criteria which is essential to establish causation, what is it?
temporality
