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HMS119 Population Health & Culture > Lecture 2 (13/07/21) > Flashcards

Lecture 2 (13/07/21) Flashcards

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1
Q

Define Epidemiology?

A

study of DISTRIBUTION of; and DETERMINANTS of HEALTH-RELATED EVENTS (HRE) in specified POPULATIONS

and

the APPLICATION of this study to the CONTROL of those HRE

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2
Q

Define Distribution?

A

frequency and pattern of disease

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3
Q

Define Determinants?

A

factors that improve health or cause disease

e.g. smoking, exercise, etc.

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4
Q

What 3 Greek words is the word ‘Epidemiology’ derived from?

A

Epi: population
Demos: upon
Logos: Knowledge

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5
Q

Epidemiology is a method of causal reasoning. What does this mean?

A

Causal reasoning: process of identifying the causality (relationship between a cause and its effect)

  • looking at relationship between exposures and health outcomes
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6
Q

While the clinician usually focuses on treating and caring for the individual, what does the epidemiologist focus on?

A

Looking at the frequency and pattern of events (distribution)

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7
Q

While the clinician usually focuses on treating and caring for the individual, the epidemiologist focuses on looking at the frequency & pattern of events.

What does this include?

Hint: I am an epidemiologist who watches ESPN

A

I: INTERVENTION to prevent additional cases / recurrences

E / S: identifying the EXPOSURE / SOURCE that caused the illness

P: whether there is POTENTIAL for further spread in the community

N: NUMBER of people who have been exposed

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8
Q

What are the 3 Stages of Disease (natural progression)?

A

1) Pre-disease stage: Primary Intervention
2) Latent disease: Secondary Intervention
3) Symptomatic: Tertiary Intervention

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9
Q

What are the 4 factors that cause disease when interacting?

Hint: now i HAVE a disease

A

H: Host- vulnerabilities, resistance

A: Agent- biological, chemical, physical, social, psychological

V: Vector- mosquito, human, water, food, fomites, etc.

E: Environment- physical, social, political, economic

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10
Q

What is the BEINGS model?

A
  • concept that suggests that when these 9 factors interplay, it causes human disease and consequences
  • therefore, these 9 factors are known as preventable causes (can be used to aid in prevention in human disease and its consequences)
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11
Q

What are the 9 factors in the BEINGS model?

A

B: Biologic & Behavioural factors

E: Environmental factors

I: Immunologic factors

N: Nutritional factors

G: Genetic factors

S: Services, Social, Spiritual factors

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12
Q

What are Determinants of Health?

A
  • factors that determine the health of individuals/populations
  • these factors can be positive or negative
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13
Q

What are the types of determinants?

A
  • genetic determinants
  • social determinants
  • physical & environmental determinants
  • behavioural determinants
  • health care determinants
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14
Q

What are Genetic Determinants?

A
  • age
  • biological sex
  • inherited health conditions
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15
Q

What are Social Determinants?

A
  • conditions in which people are born, grow, live, work and age
  • shaped by the distribution of money, power and resources at local, national and global levels
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16
Q

What are Physical & Environmental determinants?

A
  • natural environment (i.e. green spaces)

- built environments (i.e. housing quality, conditions and exposures)

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17
Q

What are Behavioural Determinants of health?

A
  • behaviours of an individual / population that risks contracting/preventing the disease
    i. e. smoking, exercise, nutrition, etc.
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18
Q

What are Health Care Determinants?

A
  • availability of quality health care, access and health insurance
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19
Q

What is Health Equity?

A

Each individual has the potential to reach his/her full health potential

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20
Q

What is Health Inequity?

A

differences in health outcomes between groups of people that are considered preventable or unfair

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21
Q

What are some Health Factors?

A
  • health behaviours
  • clinical care
  • social and economic factors
  • physical environment
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22
Q

Examples of health behaviours

A
  • tobacco use
  • diet & exercise
  • alcohol use
  • unsafe sex
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23
Q

Examples of clinical care

A
  • access to care (i.e. location, time, cost, types of services)
  • quality of care (i.e. specialists, diagnostics, treatment options, etc.)
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24
Q

Examples of social and economic factors

A
  • education
  • employment
  • income
  • family & social support
  • community safety
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25
Q

Examples of physical environment

A
  • environmental quality

- built environment

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26
Q

What Interventions targeting Determinants can work to improve people’s health?

A
  • education
  • connection to family, community, culture and country
  • employment and income
  • housing
  • interaction with government systems
  • health behaviours
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27
Q

What are some leading causes of morbidity in Samoa?

A
  • pneumonia
  • other complications of pregnancy and delivery
  • injuries, wounds, poisoning and certain other consequences of external causes
  • infections of the skin and subcutaneous tissue
  • diabetes mellitus
  • acute bronchitis and bronchiolitis
  • hypertension
  • diarrhoea and gastroenteritis
  • other maternal care related to foetus and amniotic cavity and possible delivery
  • typhoid fever
28
Q

What are some leading causes of mortality in Samoa?

A
  • diabetes mellitus
  • cancers (all sites)
  • cerebrovascular diseases
  • other heart diseases
  • hypertensive disease
  • pneumonia
  • injuries, wounds, poisoning and certain other consequences of external causes
  • chronic lower respiratory diseases
  • ischaemic heart disease
  • certain conditions originating in the perinatal period
  • septicaemia
  • liver diseases
29
Q

Define Disease Burden

A

the impact of a health problem as measured by financial cost, mortality, morbidity and other indicators

30
Q

How is Disease Burden often quantified?

A
  • QALYs (quality-adjusted life years)

- DALYs (disability-adjusted life years)

31
Q

Define Burden of Disease

A

measures the impact of living with illness and injury and dying prematurely

32
Q

What is used to estimate Burden of Disease?

A

HALYs (health-adjusted life years)
: calculate the combined effects of mortality and morbidity in populations, allowing for comparison across illnesses or interventions between populations

33
Q

How are HALYs measured?

A

DALYs and QALYs

34
Q

What do DALYs measure?

A

the difference between the current state of population health and an ideal situation where everyone reaches the age of standard life expectancy in perfect health

35
Q

Explain this: DALYs are based on an assumption that ‘time’ is the most appropriate gauge of burden of disease

A

the greater the time lived with a disability, or with the disabling results of an illness, OR
the more time lost due to premature death,
the greater the burden of disease is considered to be

36
Q

What do QALYs measure?

A
  • both the quantity and quality of life lived

- used to analyse the cost-effectiveness of clinical (or public health) interventions

37
Q

Researchers using a biomedical understanding of burden of disease are interested in the the following:

A
  • morbidity
  • mortality
  • trends
  • risk attributions
38
Q

Define Morbidity

A

number of people in a population living with a health problem, and the severity of that health problem

39
Q

Define Mortality

A

number of people in a population who die as a result of a health problem, and whether or not their deaths are considered premature (before the expected duration of life)

40
Q

Define Risk Attributions

A

links between illness, disability or death outcomes to recognised risk factors

41
Q

What does Economic Burden of Disease focus on?

A

financial costs of illness for individuals, households, healthcare systems, and societies

42
Q

How is economic burden of disease measured?

A
  • direct costs

- indirect costs

43
Q

Define Direct Costs as a measure of economic burden of disease

A

value of expenses on prevention, diagnosis, and treatment

i.e. immunization and screening programs, in-hospital and out-patient care, visits to physicians and medications

44
Q

Define Indirect Costs as a measure of economic burden of disease

A

value of labour and productivity losses

i.e. lost income and economic output due to illness-related absences from work, reduced productivity at work due to illness, or premature death

45
Q

7 Principles of Holistic Care

PIRITI L

A
  1. “Prevention is the best intervention” (Prevention & Treatment)
  2. “Integration of healing systems is effective” (Integration of Healing Systems)
  3. ” Holistic medicine is relationship-centered care” (Relationship-centred care)
  4. “Care should be individualized” (Individuality)
  5. “Teach by example”
  6. “Healing powers are innate” (Innate healing powers)
  7. “All experiences are learning opportunities” (Learning opportunities)
46
Q

Define Primary Health Care

A

Model of care that aims at ensuring health services are available, accessible, acceptable & affordable

47
Q

Key words to define Primary Health Care

A
  • essential
  • practical
  • scientifically sound
  • socially acceptable
  • universally accessible
  • full participation
  • affordable cost
  • sustainable
  • self-reliance
  • self-determination
48
Q

What is the goal of Universal Health Coverage (UHC)?

A
  • ensure that all people obtain the health services they need without suffering financial hardship
  • equity of access to health care (regardless of financial background or geographical location)
49
Q

What are the dimensions of universal health coverage?

A
  1. Who is covered
  2. Which services are covered
  3. What proportion of the cost is covered
50
Q

What objectives do WHO incorporate to define universal health care?

A
  1. equity of access to health services
  2. quality and effective health services
  3. financial-risk protection
51
Q

What are some strategies for universal health coverage?

A
  • reduced out-of-pocket spending
  • increased prepayment
  • risk pooling (fund pooling)
52
Q

What does out-of-pocket spending mean?

A

direct payments

53
Q

What does prepayment propose?

A

funds to pay for health care services are collected in advance of care being accessed

54
Q

What does risk pooling (fund pooling) refer to?

A
  • the management of financial resources in such a way that financial risk is shared amongst the population
  • requires a prepayment system and thus provides a service to all, free at the point of access
55
Q

What are 3 fundamental, interconnected problems impeding progress of health system financing?

A
  1. availability of resources
  2. over-reliance on direct payments
  3. inefficient and inequitable use of resources
56
Q

Define Biostatistics

A

refers to statistical methods used to analyse health data

57
Q

What are 3 classes of measures used in Epidemiology?

Hint: FAP

A

F: frequency
A: association
P: potential impact

58
Q

What are some measures of frequency of disease?

A
  • incidence
  • prevalence
  • morbidity
  • mortality
  • ratio
  • proportion
  • rate
59
Q

Define Incidence

A

occurrence of new cases of disease/injury in a population over a specified period of time

60
Q

Define Prevalence

A

number of cases of a disease that are present in a particular population at a given time

61
Q

Define Morbidity

A

state of being symptomatic or unhealthy for a disease of condition

62
Q

Define Mortality

A

occurrence of death

63
Q

Define Ratio

A
  • descriptive measure
  • relationship between two numbers

e.g. males : females

64
Q

Define Proportion

A
  • ratio where the numerator is included in the denominator
  • comparison of a part as a whole

e.g. males born / total number of babies born

65
Q

Define Rate

A
  • proportion with a specification of time
  • measure of the frequency with which an event occurs in a defined population over a specified period of time

e.g. (deaths in 1999 / population in 1999) x 1000

HMS119 Population Health & Culture (7 decks)

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