L15 - public health and promotion Flashcards
What are the 3 domains of public health?
Health promotion/improvement, health protection, health services and care
What are quality of life indices?
Life expectancy at birth
What are causes behind risk factors?
Socio-economic status, gender, age, employment, education, deprivation, income, geography (north/south divide), sexual behaviour, politics, wars, movements, drugs
Define health promotion
The process of enabling people to increase control over and improve their health (Ottawa charter 1986)
What does health promotion involve?
knowledge transfer - campaigns; clinical interventions - screening/immunisation; health public policy - legal, fiscal and societal measures, infrastructure, politics; community development - groups set their own agenda and liase with organisations to create sustainable action
Describe difference in gender gonorrhoea diagnoses in England and wales
Double the number of diagnoses in males than females from 1925-2010
What are the upstream and downstream determinants for health?
upstream: life conditions
downstream: risk factors
What is the Tannahill model?
Health promotion model. Venn diagram showing overlap between prevention (medical intervention to reduce risk), protection (legislative, fiscal and social) and education (influencing knowledge and attitudes).
What are the levels of prevention set by WHO?
Primordial, primary, secondary, tertiary
Define primordial prevention
prevention of unhealthy lifestyle behaviours from birth
Define primary prevention
health promotion, specific protection, screening, immunisation, vitamins
Define secondary prevention
clinical diagnoses and treatment
Define tertiary prevention
disability rehab, intensive care
What are the approaches to disease prevention?
High risk and Population
What are the strengths of a high risk approach?
Efficient, effective, appropriate, easy to evaluate, high patient and clinician motivation
What are the strengths of a population approach?
equitable, radical, large potential, behaviourally appropriate
What are the weaknesses of a high risk approach?
May be palliative and temporary, risk prediction may not be accurate, may be limited, high cost of screening, difficult ot identify screening borderlines, hard to change individual behaviours
What are the weaknesses of a population approach?
small advantage to individual, poor motivation of patient and clinician, low benefit/risk ratio
Order the interventions from high to low cost and individual effort
Counselling and education, clinical intervention, protective intervention, changing individual mindset, socioeconomic factors
What did the Wanless 1,2,3 report identify?
Health priorities: smoking, alcohol, obesity, sexual health, teenage pregnancy, mental health
What did the Marmot review set out?
6 key policy objectives addressing the determinants of health in response to the WHO publication in 2008 ‘closing the gap of the generation’
Related to life-course
What does the PHOF do?
sets out a vision for public health outcomes and indicators that will help to understand how public health is improving and being protected
How many admissions are caused by smoking?
Males: 6%
Females: 3%
What were the subjects addressed to promote smoking cessation in the UK?
Policy, legislation, taxation, media, school, workplace, support 1-2-1, smoking cessation clinics, group sessions
How does CQUIN work?
Incentivises hospitals to make some intervention to reduce alcohol and smoking by offering cash reward
How does NAS work?
Ends cheap alcohol sales and restricts marketing
What are the key public health programmes
Smoking cessation, alcohol harm reduction, sexual health chlamydia, teenage pregnancy, obesity, immunisation
