Module 2: Causality & Causes of Causes & SEP

Question 1

Causality in epidemiological studies

Answer 1

Identify associations between potential exposures with outcomes but not done via human experiments

Question 2

Lind’s experiment

Answer 2

Proved that cures can be found before finding causes e.g. Cholera and scurry

Question 3

Bradford Hill framework

Answer 3

Non strict criteria for causal relationship

Question 4

Temporality - BHF

Answer 4

Key to causality - First cause then disease

Question 5

Strength of association - BHF

Answer 5

Stronger association means causal association in absence of cofounding

Question 6

Reveribilty - BHF

Answer 6

If you can show removal of causes removes outcome

Question 7

Biological gradient - BHF

Answer 7

Change in disease rates has corresponding chnages in outcome

Question 8

Biological plausability of association - BHF

Answer 8

Does the cause make biological sense

Question 9

Consistency - BHF

Answer 9

Many similar repeated studies show similar results

Question 10

Specfitiy - BHF

Answer 10

Cause has a single effect

Question 11

Specficity - BHF

Answer 11

Cause has a single effect

Question 12

Rothmans causal pie model

Answer 12

Recognises multiple factors can contirbute to being a cause

Question 13

Rothmans pie model weakness

Answer 13

Assumes all causes are deterministic always

Question 14

Sufficient cause - RPM

Answer 14

All factors are the minimum requirement of disease “whole pie”

Question 15

Component cause - RPM

Answer 15

A factor contributing to a disease but isn’t sufficient to cause it alone “Slice of pie”

Question 16

Necessary cause - RPM

Answer 16

A factor necessary for cause

Question 17

Causation probability

Answer 17

A cause increases probabilty of outcome

Question 18

Probability of outcome rises to 1

Answer 18

Sufficient cause

Question 19

Probability of outcome rises from zero

Answer 19

Necessary cause

Question 20

Contributws to moving probability from zero to 1

Answer 20

Component cause

Question 21

Downstream determinants

Answer 21

Interventions at micro level - Easily changed in one day “Proximal causes”

Question 22

Upstream determinants

Answer 22

Interventions at macro distant level thus requires formal change e.g. government, political

Question 23

Dahlgren and whitehead model

Answer 23

Framwork identifying determinants of health and levels of intervention

Question 24

Level 1 intervention: Individual (D&WH)

Answer 24

Non modifiable factors - Genes, inherited biology, lifestyle habits

Question 25

Level 2 intervnetion: Community (D&WH)

Answer 25

Social and community influences, housing and work

Question 26

Level 3 intervnetion: Enviromental (D&WH)

Answer 26

Socioeconomic, culutral and enviroment conditions e.g. buildings, religion, climate, political, city design

Question 27

Four social capitals components

Answer 27

1. Natural eniroment to support life and human activity 2. Social norms and values in society 3. Human involves peoples skills, knowlegde, wellbeing 4. Financial/physical is countries financial and physical assets

Question 28

Structure in Pop hlth

Answer 28

Social determinants influencing choice and opportunity

Question 29

Agency in Pop hlth

Answer 29

Capactiy of individuals/community to make own choices

Question 30

Socio economic position

Answer 30

Status, class, stratification of people in society is measured to quantify level of inequity in relationship between health and social variables

Question 31

SEP for individuals

Answer 31

Education, income, occupation, housing, assets and wealth

Question 32

SEP for populations

Answer 32

Area based - deprivation and access Population based - Income inequality, literacy rates(life expectancy), Gross domestic product per capita (Health prioritisation)

Question 33

SEP on Dahlgren & whitehead model

Answer 33

Education is key determinant for opporutnitiess, income, assets and wealth but everything is integrated

Question 34

SEP - Social influence

Answer 34

Parents SEP influences childrens SEP

Question 35

SEP - Housing/work

Answer 35

Employment, housing and sanitation

Question 36

SEP - Intergenerated SEP

Answer 36

Generational influence of SEP from parent to grandchild

Question 37

SEP - General socioeconomic, cultural and environmental conditions

Answer 37

Population groups with similar SEP levels

Question 38

SEP - Global determinants

Answer 38

Income inequality, national income, literacy rates, free trade agreements

Question 39

Causes of causes/social gradient

Answer 39

Individuals with lowest income have poorest health care due to a causal linkage Education -> employment -> Income -> access Education -> access -> Discrimination -> Being in a minority group