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Population Health 102 > Lecture 3 and 4 > Flashcards

Lecture 3 and 4 Flashcards

1
Q

What are the common causes of health problems?

A

biological/genetic causes
behavioural causes
psychological causes
social causes

Transition :Transition from communicable –> non-communicable diseases

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2
Q

What are Proximal causes of health problems?

A

Downstream causes
Physiological factors/Biological and genetic Factors

Diet
Activity level and exercise
Alcohol consumption
Self-identity

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3
Q

What are common causes of mortality in NZ?

A 
Cancer
Heart/CVD
Respiratory
Diabetes (also a proportion of CVD mortality)
Transport Accident
Intentional Self-Harm
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4
Q

What are Distal causes of health problems?

A 
Middle stream:Behavioural , Psychological Factors Diet, Physical activity, 
Upstream: Social causes:
Cultural context
Political context
Education
Poverty
Social connections
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5
Q

What are the Models of Health and Illness?

A

Medical Model: focuses on biological factors, and proximal causes
Social Model: includes Biological AND psychosocial factors. Focuses on proximal AND distal causes

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6
Q

What is the Medical model of health?

A

Also known as the Biomedical Model
Assumes that:
Illness is caused by bacteria, a faulty gene, a virus, or an accident
Illness can be identified and classified
Illness is identified by medical professionals
Diagnosis of symptoms is relatively objective
Illnesses can be treated
Focuses on the Proximal causes
Was the dominant view until the late 20th Century
Was helpful when the main cause of mortality was communicable diseases

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7
Q

What is the Social Models of Health?

A

Multiple models
Clarify the broader determinants of health, including:
Biological/genetic
Behavioural (sometimes)
Psychological (sometimes)
Social
Both proximal and distal
Health status is the result of these determinants, individually as well as through complex interactions
e.g. Biopsychosocial Model, Dahlgren and Whitehead Social Model, WHO social determinants model etc

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8
Q

What are the three main sections of the Biopsychosocial model?

A

Biological –>
Psychological –>
Social –>

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9
Q

What are the layers of the Dahlgren and Whitehead Social Model of Health?

A
  1. general socioeconomic, cultural and environmental conditions
  2. living and working conditions
  3. social and community networks
  4. individual lifestyle factors
  5. Age, Sex, and constitutional factors
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10
Q

Which Model is more helpful with dealing with the causes of mortality in the present day.

A

Social Models

Different models are more effective for different causes

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11
Q

What is the overall conclusion for Health Models?

A

Contemporary health issues are better understood within a social model framework
The “social” component is often large when we try to understand the causes of common contemporary health issues
Many of the models are fairly vague about what is included in the ‘social’ component

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12
Q

What are inequalities?

A

Disparities: Being unequal
Usually a quantitative judgement
Health inequality = differences in health between groups

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13
Q

What are Inequities?

A

Injustice or unfairness
More difficult judgment to make
An ethical judgement
Health inequity= differences in health between groups that are unfair or unjust

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14
Q

What is the relationship between Inequalities and Inequities?

A

All inequities are inequalities, but not all inequalities are inequities

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15
Q

How do you use Contemporary Principles of Health Ethics to Judge Inequities?

A

Often tend to focus on the Principle of justice

But it may also relate to other principles

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16
Q

What are the four contemporary Principles of Health Ethics?

A 
Beneficence
Non-Maleficence
Respect for Autonomy
Justice
-These principles are all related with one another, they are not independent principles
17
Q

What does the contemporary principle of Justice involve?

A

Is the inequality as a result of the unfair distribution of resources? , respecting some groups’ rights more than others? , or applying laws that protect some groups more than others?
Does society systematically disadvantage certain groups?

18
Q

What does the contemporary principles of Beneficence and Non-Maleficence involve?

A

Is the inequality the results of some groups getting more health benefits from something? or groups having unfair exposure that will harm their health?

19
Q

What does the contemporary principles of Respect for Autonomy involve?

A

Is the inequality the result of some groups having an unfair inability to make informed decisions?

20
Q

What is the Marmot approach?

A

Inequalities that are preventable by reasonable means are unfair. Putting them right is a matter of social justice
- a good first stopping point

21
Q

What is the downfall of the Marmot approach?

A

What about the inequalities that are unjust but would require a much larger societal change or input of resources to reduce?
- excludes inequities due to this “unreasonableness” of health inequalities

22
Q

What can we do the improve health inequalities?

A

We could ensure that every person in society has an equal opportunity to have equality in health
i.e. equal: access to health care, access to healthy environments, access to understandable information to make informed choices, protection of rights, protection under the law, fair distributions of all resources

23
Q

What would ensuring every person in society has an equality in health require?

A

A society that values equity, fairness and justice for all
Resources: - More”health” resources to reduce inequities, AND/OR a more fair, and probably unequal, distribution of “health” resources to reduce inequities
BUT resources are scarce

24
Q

When does Rationing Exist?

A

Rationing occurs when there is scarcity

25
Q

When does Scarcity Exist?

A

Scarcity exists in health for two reasons:

  1. unavoidable scarcity - the resource itself finite and not able to be relocated from other resources
  2. Economic scarcity - the size of the resource is determined by its priority
26
Q

What are examples of Unavoidable Scarcity?

A

Organ donors, Land available for health facilities

27
Q

What are examples of Economic Scarcity?

A

Health budget vs spending on other areas (health,education etc) personal/household budgets

28
Q

What does rationing in health mean?

A

some people will not get health resources who would benefit fro it
Others will have to wait for resources, during which time they might be suffering or even die

29
Q

What are rationing options?

A
  1. Unavoidable scarcity:
    a. capacity to benefit
    b. Equal chances
  2. Economic scarcity
    a. market solution
    b. equal distribution
    c. equitable distribution
30
Q

What does the rationing option of Unavoidable scarcity consist of?

A

a. capacity to benefit: those who would benefit most from that health resource, have priority (organ transplants). involves “value” judgements
b. Equal chances: everyone has an equal chance of accessing the health resource

31
Q

What does the rationing option of Economic Scarcity consist of?

A

a. Market solution: give all the resources to the people, and let them spend as much as they want on health (will increase inequalities and unlikes to reduce)
b. Equal distribution: give everyone the same amount of the health resource
c. Equitable Distribution: distribute the health resources in a way that reduces inequities

32
Q

What are problems with rationing options?

A
  1. Capacity to benefit: very difficult to judge
  2. Equal chances: will often waste resources
  3. Market solution: will increase inequalities and will often waste resources
  4. Equal distribution: will not reduce inequalities and may increase them, due to not being purposeful when allocating resources and instead wasting them
  5. Equitable distribution: will not be seen as “fair” by those with less need
33
Q

What should we do about health problems?

A

Moral imperative?
Not always realistic when you are dealing with scarce resources
Having possible solutions doesn’t necessarily mean we can or should solve the problem
Whatever choice we make will involve a trade off

Population Health 102 (14 decks)

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