Lecture 2 - Determinants of health and role of health policy

Question 1

What are the 3 arguments for how income and health are interrelated?

Answer 1

Income is a major factor: If you raise average income of poor countries good health will follow

Income is one of a number of factors: but is not necessarily the more important. You can have good health at a low cost

Reverse direction of causation: it is not income that leads to good health, but good health that leads to income

Question 2

What is a Preston curve?

Answer 2

The Preston curve depicts the relationship between life expectancy at birth and real per capita income across different countries.

The curve is generally convex, meaning it starts to flatten out at higher income levels.

At lower income levels, there’s a strong positive correlation between income and life expectancy.

At higher income levels, the curve starts to flatten, suggesting a diminishing effect of income on life expectancy.

Question 3

What are Beveridge’s 5 giants?

Answer 3

1) Idleness (unemployment)
2) Ignorance (education)
3) Squalor (poverty)
4) Disease
5) Want

Question 4

What are primary, secondary and tertiary prevention?

Answer 4

Primary prevention: action taken prior to onset of disease

Secondary prevention: action that halts the progress of a disease

Tertiary prevention: measures to reduce disability, minimise suffering

Question 5

What are the 3 possible intervention approaches?

Answer 5

1. Population at risk: Prevent disease in individuals with higher risk (Rawlsian)
2. Population approach: Increase overall population health (Utilitarian)
3. Vulnerable populations: Decrease health inequalities between socially defined groups (Egalitarian)

Question 6

What is the problem with the population-at-risk approach to interventions?

Answer 6

Blames the victim; does not prevent other individuals from being at risk

Question 7

What is the problem with the population approach to interventions?

Answer 7

May increase health inequalities since intervention is generalised

Question 8

What is the problem with the vulnerable population approach to interventions?

Answer 8

May lead to positive discrimination (a form of discrimination that favours someone by treating them differently in a positive way); may lead to stigmatisation; may be less efficient in terms of population health

Question 9

What is the demographic transition? What are the 3 stages?

Answer 9

The demographic transition is a well-established theory in demography that describes the historical shift in a population’s birth and death rates as a country develops economically and socially.

1. Pre-transition: In this stage, both birth and death rates are high, resulting in slow population growth.
2. Transition: In this stage, death rates start to decline while birth rates remain high, leading to rapid population growth.
3. Post-transition: In this stage, both birth and death rates have reached low levels, resulting in slow or even negative population growth.

Question 10

What is the epidemiologic transition?

Answer 10

The epidemiologic transition, also sometimes called the disease transition, is a theory that describes the shift in the patterns of disease that a population experiences as it undergoes economic and social development. It focuses on the changing causes of death and illness across different stages of development.