Module 1 Flashcards
Determinants of Health
Range of factors that combine to affect the health of individuals/communities
Includes the: socioeconomic environment physical environment individual characteristics & behaviors - per BCIT Concept Definition
12 determinants of health overall
12 Determinants of Health
Erudite Ironman Hid Pizza Snacks Greedily Cause Puppies Sabotaged His Ear Bling
income/social status education/literacy social support networks employment/working conditions social enviroments physical environments personal health practices & coping skills healthy child development biology/genetics health services gender culture
Population health
Study: Health outcomes of a population measured by the related determinants of health & health-status indicators
Process: Aims to promote health of groups/populations and mitigate health inequities
Health analysis and intervention at the macro level
Health status indicators
Quantifiable data used to describe the health of a population. Typically these are epidemiological rates
ex: crude death rate life expectancy infant mortality rate maternal mortality rate proportional mortality rate
Levels of prevention
Primary
prepathogenesis –> health promotion
disease prevention
Secondary
early pathogenesis –> early diagnosis + interrupt disease progression
emphasis on screening
Tertiary
pathogenesis –> treatment and management of disease/chronic illness
Quaternary
Epidemiology
1) study of the distribution of disease in a population & the related determinants of health
2) application of this knowledge to address population health problems
(involves statistics, data analysis, causation )
Types of epidemiology
Descriptive
examines health outcomes in terms of person, place, time
–> identify actual/potential health problems in a population
Analytical
examines etiology of disease & the assoc DofH
–> identify risk factors for illness/disease
Etiology
cause (origin) of disease/illness
Epidemiology methodology
Quantitative
measures the strength of association b/w exposures & outcomes to determine causality
evaluate interventions & monitor changes in population health over time
explanatory power –> explains the etiology of a health event/outcome by collecting + analyzing medical + epidemiological data
Epidemiology Function
Improve health & survival of populations
study distribution/causation of disease –> measure the effectiveness of various health interventions –> improve health outcomes
Chronic Disease Management (CDM)
multidisciplinary approach with an emphasis on prevention, early detection, management of chronic conditions
goal: promote individual health maintenance & client independence as much as possible
collaborative. clients = partners in their own care
CDM Partners
individuals, families, groups, communities, populations
Disease
pathophysiology –> alteration in structure/function
observable/visible signs of disease
entails a diagnosis
objective
Illness
subjective perception of disease
not visible/observable
human experience of symptoms + suffering
how the disease is perceived, lived with, responded to by the client
Three levels of prevention
primary, secondary, tertiary
three epidemiological methods/approaches
Epidemiological triangle
Life course approach
Web of causality
Types of analytical epidemiology
observational
interventional
Epidemiological Triangle
Three factors that contribute to disease
Agent
Host
Environment
From a population health perspective, the epidemiological triangle focuses on the health of humans
Only suitable for simple cause/effect situations
Agent
The “WHAT” of the Epidemiological triangle
What is causing the disease? This could be the pathogen (microorganism causing disease/infection) or the organism that is infecting humans
Can be chemical, biologic, physical, nutritional
ex: Listeria bacteria or mosquitos infecting humans with Zika
Host
The “WHO”
The person who gets infected & their individual characteristics that contribute/defend against infection/disease
Environment
The “WHERE”
Anything internal/external to the host/agent that contributes to disease. Influences host/agent to increase/decrease likelihood of infection
Cause/allow disease transmission
Web of Causality
Concept map showing all the causes/determinants of health that contribute to disease/infection
Life Course Approach
Connecting early childhood development with adult health outcomes
Consists of three effects:
Latent (fetal/infancy stage)
Pathway (how early childhood leads us down certain pathways that determine adult health outcomes)
Cumulative (the cumulative effects of environmental risks throughout ones life on adult health)
Types of Transmission
Contact (Direct or Indirect)
Air-borne
Vector borne
Droplet
Chain of Infection
The cycle of infection –> chain of events leading to disease/infection
Interrupting the chain of infection = prevents disease/improves health outcomes
Infectious Agent Reservoir (where it grows) Point of Exit Mode of Transmission Point of Entry Susceptible Host
Virulence
How intense/contagious a disease is
the higher the virulence = the higher the likelihood of infection/intensity of the disease
Prevalence
How pervasive a disease is in the population. Constitutes all ACTIVE, existing cases
New cases + existing cases / total population x 100
Incidence
Occurrence of new cases
New cases / total population x 100
Types of agents
Physical
Biological
Chemical
Nutritional
“Pea Body Came Near”
Screening
Testing of an asymptomatic, at risk-population for a particular disease/condition
Is not diagnostic
Specificity
The ability of a screening test to rule out who DOESN’T have the disease
Sensitivity
The ability of a screening test to identify who DOES have the disease
Reliability
The ability of a test to consistently produce similar results across time/space
Reliability does not equal accuracy, but is an important trait for a test
Validity
The ability of a test to correctly measure what it set out to do
Positive Predictive Value
Measures a tests ability to positively identify cases out of the screened population
Out of the positively screened clients, how many of these actually have the disease
High PPV will mean more true positives and less false positives
Negative Predictive Value
Measures a tests ability to correctly identify false cases
Out of negatively screened clients, how many actually don’t have the disease
High PPV will mean more true negatives and less false negatives
4 Types of Epidemiological Studies
Donna Ate Every Eclaire + Icing
Descriptive –> identifies health issues, related determinants
Analytical –> identifies mechanism of disease (causation)
Ecological –> focuses on aggregate (group data)
no individual focus
attempts to make connections between variables and health outcomes
Experimental/Intervention –> clinical/community trials
Public Health Surveillance
ongoing collection + analysis of health data on populations used for the planning, implementation and evaluation of public health practice
2 Definitions of health
Negative = absence of disease. Runs on a spectrum from healthy –> not healthy
Positive = more holistic interpretation of health. One can be healthy but still have disease/condition
Health as a resource to live a meaningful life
Multidimensional aspects of health
Physical
Social
Mental
Spiritual
Stability
maintenance of health –> physiological, social and functional
ability to adapt to our environment (resiliency) and maintain homeostasis
Actualization
Ability to live up to our fulfill potential
Health is instrumental to our own personal goals.
Chronic Care Model Components (7)
Health System - Organization of Healthcare
Self-Management Support (patient autonomy/independence)
Decision Support (EBDM)
Delivery System Design
Clinical Information Systems (public access to info)
Community Resources & Policies
Epidemic
higher than expected prevalence of a disease than expected in a restricted geographical location
ex: SARs, Ebola
Endemic
disease that is native to that geographical area
ex: Malaria is only found in certain countries
Pandemic
high prevalence of a disease globally
ex: Covid, Influenza
Interrelated concepts of population health
capacity building determinants of health health promotion illness injury prevention epidemiology chronic disease management cultural safety collaboration global citizenship primary healthcare
