Measuring Health and Disease Flashcards
Why do we need to measure health and disease?
Understand factors that influence disease distribution (causes and risks)
Prevent or control spread of diseases
Asses the service need of a population
Evaluate effectiveness of treatment and services
research
How can we meaure population and demographics? And what things in a population can we measure?
census and population profiles
Can measure: Death Disease QOL Risk Factors
How can we measure death?
Mortality rates
How can we measure disease?
morbidity rates
How can we measure QOL?
impact of diseases
How can we measure risk factors?
lifestyle
diet
exercise
What is epidemiology?
Study of distribution and determinants of health related states and events in specified populations and the applications of this study to control health problems
How can epidemioligy be used?
to look at Frequency Distribution Causation Natrual History Needs Assesment Prevention Evaluation
Give an example where epidemiology has been used?
in the study of the effect of fluorides, mottling and caries
Observation: Mottling and caries Distribition: colarado springs Causation: water suplies prevetion programme Grand rapids Evaluations done ? UK US, Holland
What are the limitations of clinical experience?
Patients may get better anyway placebo effect no controls follow up is hap hazard as those that dont get better wont return small numbers of patients
Describe the clinical iceberg phenomena
known to healthservices
symptoms but not sort advice
diseased nut not yet aware as no symptoms
where can data be sourced routinely?
census
cancer regisry
hospital episode stats
death certificates
Where can date be sourced other than routinely?
can be collected specifcally for the purpose ie research
what are the four types of population pyrmaids?
stage 1: expanding: pre industrial where birth and death rates are in balance
stage 2: expanding: developing countries where death rates are declining
stage 3: stationary where population growth levels off
stage 4: contracting populations where population is declining
What is the shape of Bristols population pyramid?
it is at stage 4: declining
What is the purpose of a population pyramid
it can be used to observe population changes over time and can be useful when planning health care services
What is the index of multiple deprivation (IMD) based upon?
based on the idea that there are distinct dimension of deprivation which can be recognised and measured spearatly
What does the index of multiple deprivation measure?
measures areas not individual level of deprovation
which 7 domains comprise the index of multiple deprivation?
income emplyment health and disability education skills and training barriers to housing and other services living environment crime
How is a IMD score created?
the values for each of the domain are combined to give an overall value
What is the rate?
number of events, cases, or deaths in a time period divided by the population in te same time period
what is the incidence rate?
frequency of NEW cases of an event in a population in a time period
what is the prevelance rate?
the number of existing vases of a disease divided by the population at a point in time
What three things causes the prevelance of a disease to decrease?
emigration
death
recovery
What one thing causes prevelance to increase?
incidence
How are mortality rates calculated?
from death certificates these have birth and death date on and also cause of wreath primary and secondary
What statstical calculation is always applied to create mortality rates?
they are always age standardised
What is the problem with obtaining mortality rates from death certificates?
the evidence is only as good as the person filling out the certificate
Only 47% had predicted cause of death
Discrepancy between death certificates and necropsy findings
What is a means of guaging the burden of disease?
QALY
quality adjusted Life years
Why is morbidity harder to measure than mortality?
due to the clinical iceberg effect
What oral disease can we give as a case study for measuring health and disease?
Oral cancer
What percentage of cancers does oral cancer comprise in UK?
4% in UK
What is the age standard incidence rate for oral cancer?
8/100000/yr
What is the prevalence rate for oral cancer in England and Wales?
3000/yr
What is the death rate for oral cancer in England and Wales?
1600/yr
Oral cancer is more common in which gender?
Male
1.6:1
In which group is oral cancer more commonly seen amongst?
90% occur in aged 40 +
What is the regional variation in oral cancer?
More common in N than S
More common in wales than England
What factors are related to oral cancer?
SES Smoking Tobacol Alcohol HPV Vitamin Def
How has the incidence rate for oral cancer amongst men aged 40-50. changed since 1975/6 and 2002/3?
It has increSsed with the biggest increase seen in those aged 45-49. The rates have more than doubled
How has the incidence rate for oral cancer amongst Men aged 80+ men changed since 1975/6 and 2002/3?
It has decreased, incidence has almost halved
What are the causes for the increase in oral cancer in young men?
HPV
diet
Alcohol
What three scales exist to measure social class?
Registrars generals social classes 1913 Social class by occupation National statistics socio economic classification 2001
What is the problem with using the national statistics socio economic classification?
Too technical it has 8 main categories (analytical scale )and 17 minor (operational scale )
What are the groups in the social class by occupation?
1: professional 2 : managerial 3n : skilled non manual 3m: skilled manual 4: partly skilled 5: unskilled
How much of the global population smokes?
1/3
Kills 1/10
Smoking ban in the UK introduced when?
2007
But not in bus shelters,nursing homes, prisons and psychiatric homes
