Lecture 3 - Patterns of disease globally and overtime

Question 1

1. Historically, disease patterns were dominated by what kind of diseases?
2. Our burden of disease is dominated by what?
3. NZ is a high income country and Sierra Leone is a low income country - what are top cases of death in each?

Answer 1

1. Communicable
2. Non-comunicable diseases
3. NZ had only one communicable disease and Sierra was dominated by non-communicable diseases

Question 2

1. What measure do you use to quantify the burden of disease for mortality + morbidity?
   (also, what is disease burden and morbidity?)
2. What does it measure?

Answer 2

1. Use DALYs - tries to capture the consequences of living with health conditions as well as mortality.

DALY = Years of life lost due to premature mortality (YLL) + Years lost due to disability (YLD) [includes lifetime you lose due to disease and time you lived with disability of disease]

Morbidity: Any departure from physiological or psychological wellbeing (so illness and the consequences of it…..quality of life/how much damage a disease does to you)

Disease burden: Impact of health problem as measured by financial cost, mortality, morbidity or other indicators

2. Measures the gap between a population’s current health status and the ideal health status, “Ideal health status” = entire populations living to an advanced age free of disease and disability

Question 3

1. Demographic transition explains what

2. Epidemiological transition explains what

Answer 3

1. Demographic = changes in population and birth rates over time. Growth and change in populations of time.
   - The demographic transition explains the changes in populations over time from having high birth and death rates and low total population numbers, to having low birth and death rates and increasing total population numbers. This helps to explain why there are increasingly larger proportions of the population in the older age groups.
2. Epidemiological = changes in population and disease patterns over time (e.g. now communicable diseases are more dominant)

Question 4

Briefly explain the four stages of demographic transition

Answer 4

Stage 1 (Preindustrial): High birth + high death rate and population numbers are low.

• Have lots of infectious diseases (tend to kill young kids so high death rate of kids)
• Don’t have resources to help that e.g. not 3 meals a day etc

Stage 2: Death rates start to drop but birth rates still high so population beings to grow i.e. people starting to live longer

Stage 3: Birth rate begins to fall. Could be due to e.g. availability of contraception, women gaining more rights or focussing on e.g. careers. Child is now more likely to source so don’t needa produce many

• You’ve dealt with lack of food, sanitation etc
• Moving from infectious to non-communicable diseases
• More in the developing countries (in the transition)

Stage 4: Population stable at high levels and birth death rates stable at low levels
-There is resistance to antibiotics etc now etc and evolving health systems (they all set up to deal with diseases that have got resistance now) so they aint ready

Question 5

4. Briefly explain the epidemiological transition

Answer 5

The epidemiological transition explains the change in disease burden over time. Historically communicable disease dominated the disease burden in populations but over time there has been a decreasing burden of communicable disease and an increasing burden of non-communicable disease. Non-communicable disease levels have now increased to a point where they are the dominant disease burden in most populations.

Question 6

Double burden of disease

1. It’s not a point in time but a…..
2. So what is it?
3. More noticeable when?

Answer 6

1. Period of time (not a point in)
2. Both communicable and non-communicable disease are important and occurring in a defined population over the same period of time.
3. More noticeable when a country or defined population is transitioning through the demographic and epidemiological transitions over a short time period.

Question 7

Healthy ageing populations

1. People in our pops are now…..
2. What’s expected to increase?
3. Dropping what played a huge role?

Answer 7

1. Living longer
2. Longevity
3. Dropping death rates

Question 8

Compression of morbidity (morbidity = consequences of chronic disease)

1. Morbidity occurs….
2. Slow progression from what to what?
3. Will create an increase in what a decrease in what?
4. Maintain what and improve what?

Basically, what is it trying to do?

Answer 8

1. Later in life
2. Slow the progression from chronic disease to disability
3. Will create an increase in milder chronic disease but a decrease in the period of time a person experiences severe disability
4. Maintain function and improve wellbeing

“Healthy older persons are a resource for their families, communities and the economy.”

Trynna make it so that the consequences of chronic disease/severing disability effects occur later in life i.e. compress the sever disability caused by chronic diseases into a shorter period at the end of a person’s life

Question 9

Summary - read over it plz

Answer 9

Disease patterns have changed over time from a dominance of communicable disease to a dominance of non-communicable disease – epidemiological transition
• Populations have grown and changed over time, life expectancy is increasing – demographic transition
• Can you explain what a DALY measures?
• Can you describe a double burden?
• Why is the concept of healthy ageing populations important?