Lesson 4 Flashcards
What are some interchangeable terms for S.E.P?
Social class, social stratification, socio-economic background, socio-economic status (SES)
What is S.E.P?
Social and economic factors which affect the position where groups or individuals stand, within the societal structure.
The determinants must be objective, measurable and meaningful
What are some of the determinants regarding S.E.P?
Income, Education, Occupation, NEET (NOT in education employment, or training)
Why measure S.E.P?
SEP is used to quantify the level of inequality within or between societies
May highlight changes to population structures over time, between census periods or even between generations.
How is S.E.P measured for individuals? (E.I.O.H.A)
Education (more likely to take on board health issues and messages)
Income- more material goods
Occupation- status and power
Housing
-Assets and Wealth
How is S.E.P measured for populations?
Area measures
i.e deprivation and access
Who has the best access why and how?
Population Measures
income inequality
Literacy Rates
GDP ( gross domestic product per capita
Advantages and disadvantages of each individual determinant of S.E.P?
Income = sensitive topic
Education = Usually easier to obtain (less sensitive)
Different standard in different countries or population
Occupation =Hard to determine which occupation should be measured (e.g. should past occupation be taken into account?)
Can see social mobility
Which measure of S.E.P is the best/gold-standard?
There is no gold standard!
Income is the best option
What does screening in health involve?
Screening involves identifying risk factors for disease or unrecognised disease by applying tests on a large scale to a population
What is the screening criteria?
Suitable test, suitable treatment, suitable screening programme
Why do we need the screening criteria?
Not enough money in the health care system to fund every single health problem, so the screening helps us to decide what does get screened and how
How is a suitable disease determined?
- Relatively common or uncommon (early detection leads to better outcome)
- Knowledge of the natural history of disease.
Is screening women for alcohol intake to prevent breast cancer primary, secondary or tertiary?
Primary
Dealing with a risk factor- screening for alcohol intake to prevent breast cancer.
Is screening for bone density following chemotherapy for breast cancer primary, secondary or tertiary?
Tertiary
After clinical diagnosis- have had treatment. They are screening for bone density which is a complication of breast cancer.
Is breast cancer screening primary, secondary or tertiary?
Secondary
Is to prevent further complications.
What are the two measures of accuracy in a screening test?
Sensitivity and specificity
Define sensitivity:
The ability of the test to correctly identify those who have the disease (a), from all individuals with the disease (a+b)
Represents the likelihood of a + test in those who have the disease
How is sensitivity calculated?
a / a+b x 100%
(True positives / those with disease) x 100%
Define specificity?
The ability of the test to correctly identify those who do NOT have the disease (d), from the individuals free from the disease (b+d)
Represents the likelihood of a – test in those who do NOT have the disease
How is specificity calculated?
d / b+d x 100%
(True negatives / those without disease) x 100%
Are sensitivity and specificity fixed characteristics?
Yes!
Think of it as how good the test actually is, and the science behind it!
When is the sensitivity of a screening test high?
If the proportion of true positives (a) is high.
When is the specificity of a screening test high?
if the proportion of true negatives (d) is high.
What do the predictive values show?
Are a reflection of the proportion of disease in the population AND a reflection of the ability of the screening test to detect a +/- result
