MOD 2- Lect 13-15 Flashcards
what are Causes of Causes
Individuals - any events characteristics or other entities that bring about a change for better or worse
downstream meaning
interventions operate at the proximal level eg treatment systems and disease management- lifestyle nutrition and smoking
Upstream meaning
interventions at macro level, government policies and international trade agreement- this CAN not be changed overnight
Dahlgren and WHitehead model (DWM) components
General socioeconomic cultural and environment conditions- living and working conditions
society and community network
Individual lifestyle factors
Decribe Level 1 of DWM
the individual
life values
learned behavior
Describe level 2 of DWM
Community ‘who you know’
influence friends - family
What are structural determinants of healthcare
social and physical environment conditions/ patterns (social determinants) that influence choices and opportunities available
What are Agency within healthcare
capacity of an individual to act intently and make free choices
What is individual healthcare
Clinicians deal with individuals aim to treat disease= restored health
What is population heath
concerned with groups of individuals and context of their environment
What is Causes of the problem
establishing casual relationship to provide evidence based practice
Determines the relationship of association between given exposure and disease outcomes in population
Can preventative action be before the cause is identified
YES
WHat is epidemiologies association with causal effect
suffient amount of studies which are diverse- limiting confounding and random error- to find the relationship between exposure and outcome
Describe Bradford hills framework ‘aid to thought’
- temporality
- strength of association
- consistency of A
- Biological gradient (dose response)
- Biological plausibility of A
- Specific of A
- Reversibility
Describe temporality
1st cause then disease- essential to establish causal relation
eg. smoking and lung deaths
Strength of Association
stronger an association the more likely to be absence of bias
eg: RR greater than 10
Consistency of association
replication of finding in multiple studies
eg: multiple studies have shown similar results
Biological grandient
Incremental change in diesease rate in conjuction with changes in exposure
eg as Exposure goes up so does diesease
Specificity of Association
acknowledging
health issues have many causes and many outcomes share causes
reversibility
demonstration that’s under controlled conditions changing exposure causes change in outcome
what is a cause of a disease
Event condition characteristic which plays an essential role in producing the disease
Sufficient cause
whole pie
minimum set of conditions without any one disease would not occur
not a single factor often 7
Component Cause
a factor that contributes towards disease but is not sufficient to cause disease on its own
Necessary cause
factor that must be present if a specific disease is to occur
WHat is ROTHMANS casualty pie
given disease can be caused by more than 1 causal mechanism
every causal mechanism always has some environment component causes
Effects of changing causal pie
clocking/ removing component= prevention of disease no need to identify all causes to prevent
INTERVENTION possible at anytime
WHAT is Te PAE mahutonga 4 key tasks
- mauriora- access to te ao maori
- waiora- environmental protection
- toira- healthy lifestyle
- te oranga- participation in society
WHAT is Te PAE mahutonga 2 prerequisites
Nga Marukura-
Te Mana Whakahaere
Maori Health Benefits
Mainstream health have been less effective
Health population needs to determine determinants not just surface causes
One size does not fit all. as maori have different history/ social and cultural context
Describe the structure of the Dahlgren and Whitehead model
- age, sex and constitutional factors
- Individual lifestyle factors
- Social and community networks
- general socioeconomic, cultural and environmental conditions
N
N
What is the Public/Population health framework aim to do
Provide maximum benefit to the largest number of people at the same time reducing inequities in distribution and wellbeing
what is Nga Manukura
leadership, health professional and community leadership
what is Te mana whakahaere
capacity for self governance
community control and enabling political environment
What is the relationship between maori and mainstream health
Mainstream health is less effective for Maori
- does not take in Maori social, histiral, cultural contents
- MAori health may be applicable to whole population and have beneficial effects
