Lecture 3 (Sept 17) Flashcards

1
Q

Public Health

A
  • No common definition
  • Health of populations
  • Prevention & promotion
  • Not addressed by Canada Health Act
    Like a where’s Waldo picture book
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2
Q

Population health PHAC 2012:

A

An approach to health that aims to improve the health of the entire population and to reduce health inequities among population groups

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3
Q

10 Essential Public Health Services ( don’t need to memorize) Just know a few :)

A
  1. Assess and monitor population health
  2. Investigate, diagnose and address health hazard and not root causes
  3. communicate effectively to inform and educate
  4. Strengthen, support and mobilize communities
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4
Q

What happened in Toronto Spring 1999?

A

200 Tibetan refugees crossed from buffalo
* Sent to shelter in Toronto awaiting processing
5 were found to have active, contagious MDR TB strain
* Media hyped up the story to emphasize public health risk to Canadians; worked up previous anxieties related to Kosovar and Chinese refugees

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5
Q

Important Disease and surveillance concepts

A

Ideally always evidence based

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6
Q

Communicable disease transmission 4 of them

A

Direct (person to person)
Indirect (Through a vehicle like water or food)
Indirect (vector) bridging such as zoonotic infections (malaria, Lyme disease)
Airborne

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7
Q

TB is spread through:

A

The air in tiny droplets
that live in the air for several hours

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8
Q

Pulmonary or Active TB

A

when TB bacteria escapes the granuloma
Infectious, deadly if not treated
Adherence is important; prompt treatment is necessary

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9
Q

13 million people in the states have

A

TB

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10
Q

Latent TB

A

Tb is trapped in the granuloma
Not infectious
Prophylaxis for at risk people (e.g. HIV, dialysis, incarcerated, homeless, First Nations, Transplant)

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11
Q

MDR-TB

A

Multi drug resistant TB (expensive, public health threat)
~$250,000 anual to treat

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12
Q

Framing

A
  • Mental structures that people use to provide categories and a structure to their thoughts
  • How potential hazard is processed? How policy is perceived? How policy is evaluated?
  • Demonstrated how the same set of facts can be used to present different messages
  • How to best influence an outcome
  • Helps determine what stakeholder can participate
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13
Q

What are different ways we could frame what happened in Toronto Spring 1999?

A

-Illegal immigration
-Infectious Disease transmission and natural progression of disease
Public Health & Risk to public
-Cost, cost benefit, opportunity costs
-“Old disease”: many physicians have not been trained to recognize it or have little experience

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14
Q
A
  • decisions involve risk
  • not doing anything involves risk
  • Uncertainty
  • How well risk is understood
  • extent to which it evokes dread
  • How many people exposed
  • Less acceptable if classified as involuntary, dread, or catastrophic (vs. common)
  • Media attention alters perceived risk
  • Risks with identifiable victims are more severe than statistical
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15
Q

risk of getting TB in London Ontario is about the same as

A

getting hit by a car

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16
Q

Prevalence

A

Is an epidemiological measure of how often a disease or condition occurs in a population. It measures how much of a particular disease or condition exists in a population at a particular point in time.

17
Q

Incidence

A

measures the rate of occurrence of new cases of disease or condition. Incidence is a relative measure which considers the number of new cases in a specific time period (e.g. annually) in relationship to the population which is initially disease free.

18
Q

Tuberculosis in Canada 2017

A
  • 2.6% increase from 2016-2017
  • Increase from 4.8-4.9 per 100 000 people
  • Foreign born individual continue to make the majority of cases (71.8%)
  • Canadian born indigenous people (21.5 per 100 000 population)
  • higher among males
  • 45.6% were between 15 and 44 years
  • The incidence rat was highest among adults over 75
  • 80.4 % were treated successfully in 2016
19
Q

Screening 6 (these could be broken into smaller cards if you have time :) )

A
  • Mass screening (screen everybody)
  • Selective screening (only screening populations at risk)
  • Multiphase screening ( do it now, do it 2 months from now)
  • Surveillance (looking for data which suggests the virus is active in our environment) ex. testing ticks mosquitos etc.
  • Case finding ( Go looking in a specific area ex. food poisoning, or in a specific factory)
  • Population surveys a research method that involves collecting data from a specific group of individuals to measure attitudes, behaviors, or characteristics of a larger population.
20
Q

Institutional Arrangements

A

“Institutional arrangements are the policies, systems, and processes that organizations use to legislate, plan and manage their activities efficiently and to effectively coordinate with others in order to fulfill their mandate.“ (UNDP 2016)

21
Q

Jurisdictional Issues

A

Sorry You’re gonna have to go back and make this one

22
Q

Constitution Act 1982

A

Charter of rights and freedoms
Repatriation of the constitution
has 7 parts

23
Q

Canada Health Act, 1984

A

Legislation:
- publicly funded health insurance

24
Q

Role of the Federal Government in 1982

A

The Supreme Court of Canada stated
The federal government pays the provinces back for the immigrant health costs
Duty to First Nations and Inuit, Veterans and active military, prisoners in federal penitentiaries

25
Role of the provincial government
- Public hospitals and clinics - Drug benefit plans ( and deciding what is in/out) - Training and regulation of physicians and the health professionals - Long term care
26
Role of municipality (Public Health
The health Protection and promotion Act (HPPA) 1983 1998 - amalgamation of metropolitan Toronto into one administrative unit, reducing number of PHUs from 5 to 1 (Toronto Public Health) Typical responsibilities included vaccinations, communicable disease tracking/tracing/treatment, vector borne disease surveillance, sexual health, etc.
27
Additional Stakeholder in the Toronto Immigrant TB case
TB specialists The media
28
What are the factors which make TB specialists stakeholders
Drug resistance symptoms vs. screening Medical school curriculum Quality of care: uneven and potentially dangerous Social, psychological and pharmacological
29
What are the factors which make Media stakeholders
Timing relevance fame Human interest
30
Effects Framework
effectiveness unintended effects equity
31
Implementation framework
Cost Acceptability Feasibility
32
Canada Health Transfer
The full cash contributions from government to provincial and territorial health insurance plans
33
The federal government is most involved in health in ways directly related from 3 constitutional powers
- The spending power - The power to pass laws for peace, order - Good government and criminal law power
34
IFHP
Interim Federal Health Program provides limited, temporary coverage of health-care benefits to people in the following groups who aren’t eligible for provincial or territorial health insurance resettled refugees refugee claimants certain other groups When Stephen Harper was in power he took this away for 4 years
35
HPPA
The health Protection and promotion Act
36