Introduction to public health

Question 1

3 aims of public health

Answer 1

focus on population (vs individual)
improve population health
reduce health inequities within the population

Question 2

Does it focus on upstream and downstream factors?

Answer 2

yes

Question 3

two key tools used?

Answer 3

biostatistics and epidemiology

Question 4

who was the founder of public health

Answer 4

John Snow

Question 5

describe John Snow’s work

Answer 5

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

Question 6

define: risk factor

Answer 6

doesn’t CAUSE a disease, but is strongly associated with it

Question 7

what are the 4 risk factors

Answer 7

predisposing
enabling/disabiling
precipitating
reinforcing

Question 8

predisposing?

Answer 8

age, sex

Question 9

enabling/disabling?

Answer 9

low income, poor nutrition

Question 10

precipitation?

Answer 10

exposure to disease agent

Question 11

reinforcing?

Answer 11

repeat exposure to a risk factor

Question 12

what is a sufficient cause

Answer 12

risk factor that can, on its own, lead to a disease occuring

Question 13

what is a necessary cause

Answer 13

without this risk factor, the disease can’t occur.

• prerequisite
• but if not sufficient, won’t cause disease

Question 14

example of sufficient and necessary causes and diseases?

Answer 14

ebola: exposure to ebola virus will lead to ebola
huntingtons: exposure to gene mutation will lead to huntingtons disease

Question 15

example of neither sufficient nor necessary cause?

Answer 15

cigarette smoking

• not necessary as lung cancer can happen without smoking
• not sufficient as smoking won’t always cause lung cancer

Question 16

example of necessary but not sufficient cause?

Answer 16

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

Question 17

purpose of bradford hill criteria

Answer 17

helps establish whether causation has occurred

Question 18

temporality

Answer 18

when cause proceeds effect

Question 19

reversibility

Answer 19

when you remove the cause, then the disease goes away/is diminished

Question 20

plausibility

Answer 20

whether the cause–> effect relationship is legit based on current knowledge

Question 21

consistency

Answer 21

whether the cause–>effect relationship matches current research

Question 22

strength

Answer 22

when there’s a strong cause–>effect relationship (ie. high odds ratio)

Question 23

dose response

Answer 23

when you change intensity of cause, you change intensity of effect.

Question 24

there’s only one of the bradford hill criteria which is essential to establish causation, what is it?

Answer 24

temporality