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POPLHLTH 111 > Midterm exam > Flashcards

Midterm exam Flashcards

1
Q

RAMBOMAN

A

Recruitment
Allocation
Maintenance
Blind
Objective
Measurement
Analysis + adjustment

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2
Q

Five A’s access to care:

A

Affordability
Availability
Accessibility
Accommodation
Acceptability

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3
Q

NZDep (2025)

A

Communication
Income
Income
Employment
Qualifications
Owned home
Support
Living space
Living conditions

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4
Q

Sufficient Cause

A

A complete causal pathway leading to a disease
The complete pie

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5
Q

Component cause

A

Individual factor contributing to a sufficient cause.
A slice.

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6
Q

Necessary cause

A

Component cause present in every sufficient cause for a given disease.
Slice that is always needed

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7
Q

Causality

A

Relationship between a enxposure and an outcome where the cause increases the probability of an effect occurring

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8
Q

Correlation

A

A statistical correlation between two or more variables, indicating that they tend to vary together.
They show that the variables are related BUT does not prove that one causes the other

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9
Q

Poplhlth determinants
Level one

A

The individuals
Age, gender, constitutional factors, individual and lifestyle factors
Non-modifiable determinants

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10
Q

Poplhlth determinants
Level two

A

The community
Family, friends, attitudes and behaviors, social capita

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11
Q

Poplhlth determinants
Level three

A

The environment
Physical, built, cultural, biological, political

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12
Q

Upstream interventions

A

Macro/distal level
Government policies

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13
Q

Downstream interventions

A

Micro/proximal level
Treatment systems and disease management
Easier to modify compared to upstream

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14
Q

Distal determinants

A

Determinant of health that is DISTANT in time or place from change in health status

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15
Q

Proximal determinants

A

Determinant of health that is NEAR to the change in health status

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16
Q

Systematic reviews + meta analysis steps

A

Step one: review
Step two: assess
Step three: combine

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17
Q

Meta analysis

A

Mathematically combines all the GOOD studies if they are similar enough
Next best thing to do after a large study
Reduces random error

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18
Q

PROGRESS

A

Place of residence
Race/culture/ethnicity
Occupation
Gender
Religion
Education
Socioeconomic status
Social capital
+ disability

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19
Q

Inequity

A

Differences in distribution of resources/services across populations which do not reflect health needs

Inequities in health outcomes result from inequities in opportunities

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20
Q

Inequality

A

Measurable differences in health

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21
Q

Why reduce inequities?

A
  1. They are avoidable
  2. They are unfair
  3. They affect everybody
  4. Can be cost effective
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22
Q

Titanic: Two major processes undermining inequities

A
  1. Structural barriers
  2. Societal barriers/norms
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23
Q

Disparities =

A

Differences

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24
Q

Inequality =

A

unequal

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25
Inequity =
unjust situation --> lack of justice
26
Bradford Hill
1. Temporality 2. Strength of association 3. Reversibility 4. Biological gradient (dose response) 5. Biological plausibility of association 6. Consistency of association 7. Specificity of association
27
Cross-sectional
No follow up Prevalence Allocated by measurement ← or → Snapshot --> measures exposure and outcome at the same point in time Usually involves questionnaire or health surveys
28
CS - advantages
Not expensive Good at assessing health needs of a population Provides info on multiple exposures and outcomes
29
CS - disadvantages
Cannot determine whether a particular exposure caused the disease or not --> Causality❌
30
RCTs
Follow up ⬇ Random allocation Incidence and prevalence ⬇ ← Double blinding = no influence on study Used for investigating risk factors for disease (James Lind)
31
RCT - advantages
Good evidence of causality Reduces confounding --> ensure reliable and valid results Randomization = equal chance of receiving intervention and similar characteristics The effect of intervention can be determined without other factors influencing the outcome
32
RCT - disadvantages
Expensive --> usually small, requires meta analysis Not always possible due to ethical and practical reasons
33
Cohort
Prevalence and incidence Follow up --> longitudinal Allocated by measurement ⬇ ← Compares the occurrence of an outcome in those exposed to a risk factor to those not exposed Ethical --> observational study rather than experimenting (British doctors study)
34
Cohort - advantages
Time sequence can be determined --> causality measures exposure and outcome at the same time
35
Cohort - disadvantages
Expensive Not suitable for rare diseases Maintenance error
36
Incidence
⬇ EGO = (a/EG)/T CGO = (b/CG)/T Incidence rain drops N = number of raindrops falling OVER A PERIOD OF TIME Depends on the number of events (raindrops) that fall from the population cloud during a specific time period Used when the disease outcome is a common event that can be observed
37
Incidence - strengths
Measures new cases useful for studying causation Indicates risk of developing disease
38
Incidence - weaknesses
Requires follow up --> expensive Not useful for diseases with long duration
39
Prevalence
↖ EGO = (a/EG)/1 CGO = (b/CG)/1 Incidence drizzle + pool + leak + cloud Only measures N = amount of water in the pool AT ONE POINT IN TIME Determined by incidence, death and cure rate Snapshot
40
Prevalence - strengths
Measures existing cases --> useful for resource allocation Easier to obtain --> no follow up Easy to measure --> snapshot
41
Prevalence - weaknesses
Doesn't distinguish between new VS existing cases Can be influenced by disease duration Only measures N
42
RD - Risk Difference
RD = EGO - CGO Units = more information, more useful You can calculate RD if you know the RR and CGO
43
RR - Relative Risk
RR = EGO/CGO No units = less information Strength of association can be explored by calculating RR
44
Random error
Errors caused by chance
45
Non-random error (bias)
Errors caused by poor study design, processes or measurement
46
Confounding
****When the exposure is mixed with another factor that is also associated with the outcome study has a bias called "confounding" Confounding occurs if the exposure and comparison groups differ in other ways — not just the study 'exposure' — and if these other differences also have an effect on the study outcome. Then it is not possible to know whether the study exposure or the other factors caused EGO and CGO to differ.
47
Advantage of age-standardization
The effect of differences in the age structure of the two populations is reduced
48
95% Confidence Interval
95% chance that the true value in population lies between the 95% CI
49
Ecological studies
Can be experimental or non-experimental Can be CS or RCT Useful for comparing the health of populations in different places or times Involves group measurements not identifying individuals
50
Longitudinal studies
Only RCT or cohort
51
Regression to the mean
refers to the statistical phenomenon where an extreme measurement that is initially far from the average value, tends to become closer to the average value when measured again
52
RD overlaps 0 (no effect line)
There is probably NO statistically significant difference between EGO and CGO
53
RD does not overlap 0 (no effect line) OR no overlap between CGO and EGO
There is a statistically significant difference between EGO and CGO
54
How can you deal with confounding?
By dividing (stratify) the study into sub-studies (strata) so participants with the confounder are all in one study
55
Why is it impossible to measure the exact "truth"?
1. The study participants are moving targets 2. We can never study everybody
56
If EGO=CGO what does RR equal?
1
57
What does RR>1 mean?
Increased risk
58
What does RR = 1 mean?
Risk is the same
59
What does RR<1 mean?
Lower risk
60
Problems with age-specific death rates
1. gives us a lot of death rates (different age groups) 2. doesn't give a summary measure for the whole population
61
Age-standardized death rate =
∑expected deaths / standard population
62
Inequalities vs inequities
Not all inequalities are inequities but all inequities are inequalities
63
Structure
Environmental characteristics that influences health outcomes
64
Agency
The capacity of an individual to act independently

POPLHLTH 111 (3 decks)

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