Lecture 14 epidemiology

Question 1

what does Epidemiology mean?

Answer 1

study of the occurrence and distribution of health-related

events, states or processes in specified populations…

Question 2

What is population health? (definition)

Answer 2

health outcomes of a group of individuals including

the distribution of such outcomes within the group

Question 3

What is population health

Answer 3

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

Question 4

what are the Differences between maori and pakeha in life expectancy?

Answer 4

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

Question 5

what are the Differences between maori and pakeha in rheumatic heart disease?

Answer 5

Maori have higher rate of rheumatic heart disease compared to non maori

Maori 39 per 100000

Non maori 8 per 100000

Question 6

what are the Differences between maori and pakeha in chronic pulmonary disease?

Answer 6

Maori have higher rate of chronic pulmonary disease

Shows pattern of health distribution by ethnicity

Question 7

what is Socioeconomic status?

Answer 7

Social economic position in society

Considers poverty

Question 8

Serious skin infections and socioeconomic status people Hospitalisations in NZ up to 24 year olds. 2010-2014.
what would it show?

Answer 8

Rate of hospitalization for serious skin infections increases as deprivation increases

Along the x axis are increases in deprivation

Question 9

Type 2 diabetes for females over 25 years by socioeconomic status. 2014/15
what would it show?

Answer 9

X axis deprivation

As deprivation increases the percentage with type 2 diabetes also increases

Shows pattern of distribution by socioeconomic status

Question 10

what are the Two important patterns of health distribution in New Zealand?

Answer 10

• Ethnicity

* Socioeconomic status

Question 11

Distribution of neighbourhood deprivation for maori and non maori

Answer 11

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

Question 12

Life expectancy of maori and non maori by income

Answer 12

Highest line on graph non maori high income

Question 13

How do you measure Socioeconomic status (SES) in epidemiology?

Answer 13

Occupation
Income
Education (qualifications)

Question 14

Assessing socioeconomic status relating to Occupation

Answer 14

Non workers
Classes of jobs
People changing jobs

Question 15

Assessing socioeconomic status relating to income

Answer 15

Gross or net income

Personal income or household level (how many people relying on that income)

Question 16

Assessing socioeconomic status relating to education

Answer 16

Highest qualification
Easy to remember (accurate)
Stable measure

Question 17

Assessing socioeconomic status using living standard measures

Answer 17

Economic living standard index (ELSI)

Survey, Personal and household consumption spending, Income adequate to meet basic needs, Social participation

Question 18

Assessing socioeconomic status by using deprivation measures

Answer 18

NZiDep (individual)

NZDep (area based)

Question 19

Main measure of socioeconomic status in NZ

Answer 19

NZDep

NZ deprivation index

Question 20

what is Area based NZ deprivation index (NZDep)?

Answer 20

Decile 1 - Least deprived score
Decile 10 - Most deprived score

Small areas of about 100 people

Applies to everyone

Question 21

Variables included in NZDep2013

Answer 21

internet
income
employment
education
home (owned or living in)
support
transport

Question 22

NZ deprivation index (NZDep) strengths

Answer 22

Considers a range of aspects of deprivation
Used for everyone
Determined from address

Question 23

Absolute poverty

Answer 23

Extreme poverty

Inability to access basic minimum amount of societys resources

Question 24

Relative poverty

Answer 24

Considering poverty in relation to others rather than to set standard

Question 25

New Zealand deprivation index (NZDep)

Answer 25

• Neighbourhood measure (not individual)
• Range of aspects (not everything)
• Measures relative deprivation
• Not a label
• Complex behind the measure

Question 26

Internationally Social gradient

Answer 26

People with greater level of deprivation have poorer health

Not a set point where pattern stops

Question 27

How might socioeconomic status impact on health?

Answer 27

• Low SES have poor quality housing (cold, mould, overcrowd)
• lead to health conditions; Respiratory, Rheumatic heart disease

Question 28

What determines our health

Answer 28

Bacteria, viruses, genetics
Smoke, drink, exercise (behaviour)
Social determinants

Question 29

Social determinants of health

Answer 29

Conditions in which people are born, grow, live, work and age

Question 30

Model that shows layers of factors that influence health

Answer 30

• 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)

Question 31

Unmet need for primary health care in past 12 months 2014/15

Answer 31

Percentage of people with unmet needs for primary care increase with deprivation score

Question 32

Unmet need

Answer 32

Unable to access GP, cost and transport

Question 33

Health is not distributed equally in NZ disparities by

Answer 33

socioeconomic status and ethnicity