Lecture 2 - Concepts in Public Health Flashcards
What is public health practice?
Public health practice is an approach to maintaining and improving the health of populations that is based on the principles of social justice, attention to human rights and equity, and addressing the underlying determinants of health
Health is a ________________. Explain concept
Human right!
- The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic, or social condition
- Governments have a responsibility for the health of its citizens which can be fulfilled only by the provision of adequate health and social measures (e.g. income, access)
What is social justice and what does it do?
- Justice is the concept of fairness. Social justice is fairness as it manifests in society
- Social justice ensures that the population as a whole has equitable access to all public health initiatives implemented to minimize preventable death and disability
- By working to achieve social justice through the removal of structural barriers in society, we can reduce health inequities and ensure that everyone lives with dignity. (SDoH and structure should not be barriers to health)
What is shame and dignity? How can SDoH contribute to this?
- Shame is humiliation/embarassment
- Dignity is self-respect, a sense of self worth, having a sense of pride
- Those with lower economic status may feel shame when doing things like shopping at a thrift store or with a foodbank where they have to prove they need that food.
- Social justice intends to help preserve human dignity as it is an important part of human health (e.g. food school meal programs)
What is health equity and what is required to achieve it?
- Health equity is the absence of avoidable or remediable differences in health among groups of people
- Achieving health equity requires creating fair opportunities for health. It involves giving people who have experienced social or economic disadvantage what they need to enjoy full, healthy lives
Explain the difference between health equality versus health equity. Give examples
- Equality is giving everyone the same pair of shoes. Equity is giving everyone a pair of shoes that fits
- Equity is about giving people what they need to be the same where as equality is giving people the same things regardless of situation
- Equality = A community meeting about a local environmental health concern is held in English though English is not the primary language for 25% of the residents. Equity = The community leaders hire translators to attend the meeting or offer an additional meeting held in another language
- Equality = All public schools in a community have computer labs with the same number of computers and hours of operation during school hours. Equity = Computer labs in lower income neighborhoods have more computers and printers, as well as longer hours of operation, as some students don’t have access to computers or internet at home
What is the solution to creating a healthy environment?
Removing structural barriers to health
What are the central tenets of public health practice?
Public health practice places health promotion, health protection, population health surveillance, and the prevention of death, disease, injury and disability as the central tenets of all related initiatives
What is the aim of public health practice?
It aims to prevent disease by reducing risk factors that are related to disease and altering unhealthy behaviors that can lead to disease
What is health promotion?
- Health promotion is the process of enabling people to increase control over, and to improve, their health
- Health promotion is the process of empowering people to increase control over their health and its determinants
What is the main framework for health promotion in Canada?
Ottawa charter for health promotion
What are public health nutrition interventions and what should they do?
- A public nutrition health intervention is a program, service, strategy to policy that promotes behaviors that can improve nutrition at a population or community level (whereas clinical just focuses on individual)
- Interventions that use an upstream approach are endorsed by the world’s leading health agencies
- Interventions should be evidence-based
What are the aims of primary prevention, secondary prevention and tertiary prevention?
1) Primary prevention - aimed at preventing disease by reducing risk factors that are related to disease and altering unhealthy behaviors that can lead to disease. E.g. reducing sodium in food supply, tobacco cessation
2) Secondary prevention - aims to reduce the impact of disease by detecting and treating it as soon as possible to halt or slow its progress, and encouraging personal strategies to prevent recurrence. E.g. screening program at a fair for high bp or cholesterol
3) Tertiary prevention - helps people manage long-term, often-complex health problems (e.g. chronic diseases) in order to improve as much as possible their ability to function, their quality of life and their life expectancy. Not interested in this with public health
Give examples of programs to prevent heart disease by primary, secondary, and tertiary prevention
- Primary = A preschool program that promotes fruit and vegetable consumption among toddlers aims to help develop heart healthy eating habits early in life
- Secondary = A workplace-based wellness initiative that provides free cholesterol screening
- Tertiary = A clinic-based nutrition education program to patients with CVD aims to reduce the risk of cardiac events
Give examples of primary prevention strategies to prevent heart disease
- increase food literacy through nutrition education and nutrition skills
- Ban industrially produced trans fats in food
- Ensure access to healthy food in low-income neighborhoods (E.g. subsidize perishable foods in Northern Canada)
- Policies that address the distribution of the SDoH in the population that act as barriers to health e.g. ensure everyone has a ‘living wage’
What are universal nutrition interventions?
- Universal interventions are designed to apply to an entire population
- Are based on the belief that each member of society should have equal access to nutrition interventions. E.g. banning trans fats
What can happen when universal interventions are implemented?
- They can increase health inequities
- Universal programs may advantage people who are already in favourable positions or fail to proportionately improve the outcomes of those in less favourable circumstances, thereby widening the health gap
What is the purpose of front-of-package labelling and what could it actually do?
- Meant to reduce risk of nutrition-related chronic disease
- Could increase health inequities in the Canadian population because high income households can buy what ever they want. People who are in lower-income have to buy them regardless of the labelling
- Manufacturers may reformulate foods though so the warning label does not appear
What are targeted nutrition interventions?
- Interventions are intended to apply only to a subgroup of the population
- Eligibility is determined by criteria such as income, health status, employment status, age, gender, neighborhood, etc. which are barriers to equitable access to the determinants of health
- Food subsidies for healthy perishable food in low-income regions (e.g. Northern Canada)
Define policy
Policy is a consensus on the ideas that form the basis of action and hence underline decision-making
What is public health policy and what does it focus on?
- Public health policy is an intervention
- Public health policy is the laws, rules, regulations, actions, and decisions implemented within society in order to promote wellness and ensure that specific health goals are met
- Public health policy focuses on the broader structural and social determinants of health
What is NOURISHING framework of World Cancer Research Fund International (WCRFI)
- The NOURISHING framework is a comprehensive package of policies to promote healthier eating and prevent obesity and noncommunicable diseases (NCDs) including chronic diseases associated with diet such as heart disease, stroke, cancer, and diabetes
- 3 domains: food environment, food system, and behavior-change communication
- Each letter is a different policy area
- Best impact when everything works together
What is evidence-based practice? What are the types?
- Public health practice means basing interventions on evidence of what works or shows promise of working
- A best practice is an intervention, that has shown evidence of effectiveness in a particular setting and is likely to be replicable to other situations
- A promising practice is an intervention, program, service, or strategy that shows potential (or “promise”) for developing into a best practice
What is public health surveillance?
The ongoing, systematic collection, analysis and interpretation of health-related data essential to planning, implementation and evaluation of public health practice
