Life Course Perspective on Public Health Flashcards
What is the major body that releases news in relation to medical news
Public health England
what underpins public health England’s strategic plan
- reducing the inequalities in all that they do
what are health inequalities
Health inequalities are the unjust and avoidable differences in people’s health
WHO = Health inequalities can be defined as differences in health status or in the distribution of health determinants between different population groups.
What are health inequities
Health inequities are avoidable inequalities in health between groups of people within countries and between countries. These inequities arise from inequalities within and between societies.
What do health inequities arise form
Health inequities arise from health inequalities
What are the world health organisation priorities
- Health for all
- Health emergencies
- Women, children, adolescents
- The health impacts of climate and environmental change
- A transformed WHO
What are the open working group sustainable development goals
Achieve universal health coverage
Maternal deaths: Target MMR of 50/100,000 live births
Access to family planning
Child/Infant mortality: below 20/1,000 IMR all countries
End epidemics: HIV/AIDS, TB, malaria, neglected tropical diseases
Noncommunicable diseases mortality: 30% reduction
Include mental health
Why are there open working group sustainable development goals chosen
- They are chosen because they are specific indicators of the health of the soceity
What are the economic benefits of investing in health
- investment in economic prosperity
- healthier, educated population boosts economic productivity of individuals and economic group
how much does the UK spend per person on healthcare
In 2017 the UK spent £2,989 per person on healthcare,
What is the median for members of the organisation for economic co=operation and development for health care per person
Median for members of the Organisation for Economic Co-operation and Development: OECD (£2,913 per person).
Why is the US spend so much on health care per person
- this is because they are privatized, lots of money goes to the administrations
what is the GDP that the uK spends on healthcare
As a percentage of GDP, UK healthcare spending fell from 9.8% in 2013 to 9.6% in 2017, while healthcare spending as a percentage of GDP rose for four of the remaining six G7 countries.
the more that you spend on healthcare…
the better the healthcare becomes as a nation - except the US
what 4 things account for the largest expenditure in the world
- cigarettes - 50 billion
- alcohol - 105 billion
- narcotics drugs - 400 billion
- Military spending - 780 billion
how much is spent globally in dollars on
- basic education
- water and sanitation
- reproductive health for all women
- basic health and nutrition
- basic education = 6 billion
- water and sanitation - 9 billion
- reproductive health for all women = 12 billion
- basic health and nutrition = 13 billion
How much tax revenue does tobacco bring in in tax revenue versus how much it costs the NHS
tax revenue = 12 billion
costs the nHS between 3 billion and 6 billion pounds for the NHS
How much is the tax on cigarettes and what types of tax is applied to cigarettes
Pre tax - £1.24
tobacco duties - £4.70
VAT - £1.19
Define the cause of disease
The CAUSE OF DISEASE is a factor that is associated with the incidence of the disease so that if the intensity or prevalence of the factor in a population changes, the incidence of the disease changes in ways that cannot be explained by changes in other factors
Define prevalence
– the proportion of a population who has the condition at any one time
Define incidence
– the number of new cases or the probability of occurrence of a given medical condition in a population within a specified period of time
define risk factors
Risk factors are variables associated or correlated with an increased incidence of disease or infection
Association and correlation do not necessarily mean causation
Both the probability of an factor occurring and the severity of impact (not everyone is affected in the same way)
Give some examples of risk factors
- Nutritional = e.g. managing diabetes
- socioeconomic status - lower socioeconomic areas have a lack of nutrition so you either have food desert or food insecurity.
- Environmental
- Epigenetic
- Road Traffic Accidents
- Social isolation
- Overexposure to the sun
What is the main approach to prevention of disease
- in terms of reducing peoples susceptibility to chronic illness you tend to look at risk factors and try to reduce the risk factors
What is a food desert
this is a lack of nutritional food in the area
What is food insecurity
Food insecurity - this is when you cannot afford the food therefore you go without food or buy cheap food such as fast food
What factors influence health status and determine health differentials or health inequalities
Natural, biological factors, such as age, gender and ethnicity;
Behaviour and lifestyles, such as smoking, alcohol consumption, diet and physical exercise;
Physical and social environment, including housing quality, the workplace and the wider urban and rural environment;
access to healthcare
What are determinants of health
Often used as a synonym for risk specifically in community health policy
What are the 4 key steps of risk assessment
- Hazard identification
- dose response assessment
- exposure assessment
- risk characterization
describe the model at looking about epigenetic changes
- Have environmental exposures across life stages
- molecular sensors - epigenetic changes and genetic changes
- observable phenotypes and biomarkers that can be targeted
- disease prevention
What are the major challenges for health services
- Chronic disease
- Long term conditions
- multimorbidty
- Increasing gap between those with the worst health and those with the best health
What is the definition of a long term chronic illness
Long-term conditions or chronic diseases are conditions for which there is currently no cure, and which are managed with drugs and other treatment, for example: diabetes, chronic obstructive pulmonary disease, arthritis and hypertension.
give examples of chronic illnesses
Long term condition
Chronic illness
Chronic condition
Chronic diseases
Noncommunicable diseases (NCDs)
How many deaths are non communicable diseases responsible for
Noncommunicable diseases (NCDs), including heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for almost 70% of all deaths worldwide.
Give examples of non communicable diseases
including heart disease, stroke, cancer, diabetes and chronic lung disease
Who are long term conditions more prevalent in
- Long-term conditions are more prevalent in older people (58 per cent of people over 60 compared to 14 per cent under 40)
- more deprived groups (people in the poorest social class have a 60 per cent higher prevalence than those in the richest social class and 30 per cent more severity of disease).
How much do long term conditions cost
Treatment and care for people with long-term conditions is estimated to take up around £7 in every £10 of total health and social care expenditure
How many GP appointments, outpatient appointments and inpatient bed days do long term conditions cause
- about 50 per cent of all GP appointments
- 64 per cent of all outpatient appointments
- over 70 per cent of all inpatient bed days.
when do people who live in deprived area experience multiple health problems
Some people living in a deprived area will have multiple health problems 10 – 15 years earlier than people in affluent areas.
- the most deprived have a high prevalence of long term health conditions than the affluent people
describe the number the long term health conditions that unskilled workers have in comparison to professional groups
Unskilled labourers suffer from LTC’s more than those from professional groups (52% vs 33%)
what is the biggest cluster of long term health conditions
- pain
- diabetes
- COPD
Most prominent co-morbidities in people from both backgrounds…..
Most prominent co-morbidities in people from both backgrounds but higher prevalence in those from deprived areas
how much has cardiovascular deaths decreased by
For males, the death rates from heart disease (ischaemic heart disease) and stroke (cerebrovascular disease) have reduced by about 50% since 2001
what has there been a increase in the death rate
- increase in the death rate from dementia and Alzheimer’s of more than 60%
- deaths from liver disease have increased by 12%
How much as lung cancer deaths fallen by
- lung cancer deaths have reduced by almost 1/3
define healthy life expectancy
the number of years lived in self-assessed good health)
What is the biopsychosocial model of the disease
includes:
- Biology - age, sex, disease state
- Psychology - attitudes/beliefs, mood states
- Social - work, family, peers, relationship, socioeconomic status
- Environment - school, work place, social norms
What is the idea of the biopsychosocial model of disease
Behaviours, thoughts and feelings may influence a physical state.
Disputed idea that only the biological factors of health and disease are worthy of study and practice.
Argued that psychological, social & environmental factors influence biological functioning and play a role in health and illness also.
What do you have to think about when living with a chronic illness
How do people respond to diagnosis?
How does it affect someone’s identity?
How do people manage their condition?
What resources help them to cope?
what does a serious chronic illness lead to
Loss of self
- restricted lives
- social isolation
- being discredited
- feeling of burdening others
What are the implications for doctor-patient relationship for the doctor and patient
doctor – interested in explaining the aetiology of the disease
patient – trying to make sense of the disruption caused by the disease
What are the challenges for doctors
Management
- non adherence
- lifestyle change
- burden of treatment for patient
- communicating with patient
- co-mordbities
- co-ordiantion of health care
Prevention
- lifestyle change
- exercise, diet, smoking
- communication
- self management
What are the policy for individual health and lifestyle choice
Mismatch between health professional training and patient experience
Tension between government policy and reality of peoples’ lives e.g.poverty
Different models in use depending on perspective – global, national, clinical, individual
Acknowledging we do not know the whole story of health and illness at macro level
Describe does the adverse childhood experiences (ACEs)
- adverse child experiences
- disrupted neurodevelopment
- social, emotional and cognitive impairment
- adoption of health-risk behaviours
- disease, disability and social problems
- early death
