Lecture 14 epidemiology Flashcards
what does Epidemiology mean?
study of the occurrence and distribution of health-related
events, states or processes in specified populations…
What is population health? (definition)
health outcomes of a group of individuals including
the distribution of such outcomes within the group
What is population health
Groups of people in a particular geographic area
Group of people with something in common
Eg students at otago uni
How outcomes / health are distributed between groups within a population
what are the Differences between maori and pakeha in life expectancy?
All groups have increased over time
Maori males and females have a lower life expectancy than Pakeha males and females
Around 7 years in both males and females
Average at population level
what are the Differences between maori and pakeha in rheumatic heart disease?
Maori have higher rate of rheumatic heart disease compared to non maori
Maori 39 per 100000
Non maori 8 per 100000
what are the Differences between maori and pakeha in chronic pulmonary disease?
Maori have higher rate of chronic pulmonary disease
Shows pattern of health distribution by ethnicity
what is Socioeconomic status?
Social economic position in society
Considers poverty
Serious skin infections and socioeconomic status people Hospitalisations in NZ up to 24 year olds. 2010-2014.
what would it show?
Rate of hospitalization for serious skin infections increases as deprivation increases
Along the x axis are increases in deprivation
Type 2 diabetes for females over 25 years by socioeconomic status. 2014/15
what would it show?
X axis deprivation
As deprivation increases the percentage with type 2 diabetes also increases
Shows pattern of distribution by socioeconomic status
what are the Two important patterns of health distribution in New Zealand?
- Ethnicity
* Socioeconomic status
Distribution of neighbourhood deprivation for maori and non maori
X axis deprivation
Y axis percentage of population
Non maori are higher in the least deprived
Maori are smaller in the least deprived and higher in the most deprived scores
Shows in 2013 just over 23% (¼) of maori lived in areas with most deprived scores (decile 10) compared to 7% of non maori
Unequal distribution of socioeconomic status by ethnicity
Life expectancy of maori and non maori by income
Highest line on graph non maori high income
How do you measure Socioeconomic status (SES) in epidemiology?
Occupation
Income
Education (qualifications)
Assessing socioeconomic status relating to Occupation
Non workers
Classes of jobs
People changing jobs
Assessing socioeconomic status relating to income
Gross or net income
Personal income or household level (how many people relying on that income)
Assessing socioeconomic status relating to education
Highest qualification
Easy to remember (accurate)
Stable measure
Assessing socioeconomic status using living standard measures
Economic living standard index (ELSI)
Survey, Personal and household consumption spending, Income adequate to meet basic needs, Social participation
Assessing socioeconomic status by using deprivation measures
NZiDep (individual)
NZDep (area based)
Main measure of socioeconomic status in NZ
NZDep
NZ deprivation index
what is Area based NZ deprivation index (NZDep)?
Decile 1 - Least deprived score
Decile 10 - Most deprived score
Small areas of about 100 people
Applies to everyone
Variables included in NZDep2013
internet income employment education home (owned or living in) support transport
NZ deprivation index (NZDep) strengths
Considers a range of aspects of deprivation
Used for everyone
Determined from address
Absolute poverty
Extreme poverty
Inability to access basic minimum amount of societys resources
Relative poverty
Considering poverty in relation to others rather than to set standard
New Zealand deprivation index (NZDep)
- Neighbourhood measure (not individual)
- Range of aspects (not everything)
- Measures relative deprivation
- Not a label
- Complex behind the measure
Internationally Social gradient
People with greater level of deprivation have poorer health
Not a set point where pattern stops
How might socioeconomic status impact on health?
- Low SES have poor quality housing (cold, mould, overcrowd)
- lead to health conditions; Respiratory, Rheumatic heart disease
What determines our health
Bacteria, viruses, genetics
Smoke, drink, exercise (behaviour)
Social determinants
Social determinants of health
Conditions in which people are born, grow, live, work and age
Model that shows layers of factors that influence health
- Centre is Individual factors (age, sex, hereditary)
- Individual lifestyle (smoke, alcohol, diet, exercise)
- Social and community influences (what do others in community do?, social networks)
- Living and working conditions (Housing, employed, type of work)
- General socioeconomic, cultural and environmental conditions (Air quality, socio economic factors at a national level, housing)
Unmet need for primary health care in past 12 months 2014/15
Percentage of people with unmet needs for primary care increase with deprivation score
Unmet need
Unable to access GP, cost and transport
Health is not distributed equally in NZ disparities by
socioeconomic status and ethnicity
