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POPLHLTH 111 > Module 3 > Flashcards

Module 3 Flashcards

1
Q

social gradient

A

phenomenon whereby low socioeconomic groups have worse health outcomes (+ shorter lives) than those more advantaged in terms of SEP
- most key social determinants follow gradient

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2
Q

socio-economic position

A

Social (people, place, ethnicity) and economic factors that influence what positions individuals or groups hold within the structure of a society
- ranking structure

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3
Q

determinants must be

A
  • objective
  • measurable
  • meaningful
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4
Q

SEP aka

A

Socioeconomic status, social class (UK), social stratification (US)

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5
Q

why measure SEP

A
  • Quantify level of inequality within or between societies
  • Highlight changes (stratification/differences between/within groups) to population structure over time, between Census periods, between generations
  • Understand relationship between health and other social variables (age, sex, ethnicity)
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6
Q

SEP history

A

Have been associated with health and life chances for as long as social groups have existed

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7
Q

individual lifestyle factor indicators

A
  • education
  • occupation
  • income
  • housing
  • assets/wealth
  • use of services
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8
Q

social and community influences

A

PARENT’s indicators (some evidence for association between parent-child)
- commonly used to measure SEP in studies of children/adolescents

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9
Q

living and working conditions

A

area-based measures

  • deprivation (NZ index of deprivation - NZDep, Index of Multiple Deprivation - IMD)
  • access to resources/services (accessibility indices)
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10
Q

deprivation

A

State of observable and demonstrable disadvantage relative to the local community or wider society or nation to which an individual, family or group belongs
- 1 is best => 5 is worst

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11
Q

deprivation features

A
  • another way of measuring people’s relative position in society but reports based on where they live, not who they are
    • respondents more willing to respond and easier to ask as surveyor
  • focus on material deprivation
    • easier to measure “don’t have”s than “have”s
  • should be applied to conditions and quality of life that are of lower standard than is ordinary in a particular society
    • what is defined as ordinary is predominantly Eurocentric
    • don’t factor in intragenerational accommodation => focus on majority
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12
Q

poverty

A

lack of income/resources to obtain normative standard of living

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13
Q

potential access

A

service available

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14
Q

realised access

A

service actually utilised

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15
Q

general socioeconomic, cultural and environmental conditions

A

group populations with similar SEP levels together

- cross-sectional or longitudinal analyses

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16
Q

areas where policy environ. shapes actions on social determinants of health

A
  • child poverty
  • education
  • employment and working conditions
  • minimum income for healthy living
  • healthy communities to live and work in
  • social determinants and prevention (causes of causes)
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17
Q

global determinants

A
  • Income inequality
  • National income
    • Gross Domestic Product (GDP) per capita
      (used by economists)
  • Literacy rates
  • Free trade agreements
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18
Q

understanding causes of causes

A

work backwords, asking why?
- access to health care -> income -> employment status -> educational attainment -> access to education -> discrimination -> belonging to a marginalised group

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19
Q

unwelcome types of growth

A
  • jobless growth
  • ruthless growth
  • voiceless growth
  • rootless growth
  • futureless growth
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20
Q

access

A

relates consumers’ ability or willingness to enter into the healthcare system

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21
Q

reasons for seeking health service - patient side

A
  • predisposing factors
  • enabling factor
  • need
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22
Q

health service - hospital side

A

enough resources?

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23
Q

when patient side and hospital side meet

A

most likely to utilise/access health services

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24
Q

dimensions of access

A
  • Viewed as a set of more specific areas (dimensions) representing degree of fit between the patient and healthcare system
  • Generally independent of one another but not standalone and can be linked
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25
Q

influences of access

A
  • patient satisfaction
  • service utilisation
  • provider practice patterns
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26
Q

availability

A

relationship of volume (quantity) and type of existing services (and resources) to the clients’ volume and type of needs

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27
Q

availability examples

A
  • supply of providers (physicians, dentists etc.)
  • facilities (clinics, hospitals etc.)
  • specialised programs/services (mental health, emergency care etc.)
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28
Q

accommodation

A

relationship between manner in which supply resources are organised to accept clients and the clients’ ability to accommodate these factors/their expectations

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29
Q

accommodation examples

A
  • appointment system
  • hours of operation
  • walk-in facilities
  • telephone services
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30
Q

acceptability

A

relationship between clients’ and providers’ attitudes to what constitutes appropriate care

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31
Q

acceptability examples

A
  • consumer reaction to provider attributes

- providers’ attitudes about preferred patient attributes/financing mechanism

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32
Q

accessibility

A

relationship between location of supply and clients, taking into account client transportation resources and travel time, distance and cost

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33
Q

affordability

A

cost of provider services in relation to clients’ ability and willingness to pay for these services

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34
Q

affordability examples

A
  • providers’ insurance and deposit requirements
  • clients’ income, ability to pay, existing health insurance
  • clients’ knowledge of prices, total cost, GP surcharge, possible credit arrangements
  • client perception of worth relative to total cost (value of cost)
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35
Q

direct cost

A

paid to provider

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36
Q

indirect cost

A

time off work, fuel, car etc.

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37
Q

patient satisfaction

A
  • art of care
  • technical quality of care
  • accessibility/convenience (accessibility and accommodation)
  • finances (affordability)
  • physical environment (acceptability)
  • availability
  • continuity
  • efficacy/outcomes
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38
Q

population structure

A
  • age

- sex

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39
Q

population composition

A

other attributes

  • ethnicity
  • education
  • religion
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40
Q

population (pyramids) are

A

a window into the past and future

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41
Q

demographic transition

A

global shift from high to low birth/death rates and the one-off spurt in population growth that accompanies the trend
- began in 1700s

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42
Q

population data sources for epidemiology

A
  • census
  • integrated data infrastructure (IDI)
  • estimated resident populations (ERP)
  • vital events
  • health service utilisation and outcomes (HSU)
  • nationally representative surveys
  • ad hoc surveys
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43
Q

data considerations

A
  • ethics, data privacy/confidentiality
  • purpose of data collection vs use in analysis
  • population vs population SAMPLES
  • participants representative of NZ pop.?
  • objective vs subjective measures of health
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44
Q

events determining population structure

A
  • age-sex structure is a function of previous patterns/trends in fertility, migration and mortality events
  • vital events affect structure in different ways/extents (fertility/infant mortality: dramatic but time lag, adult mortality: less dramatic/variable, migration: dramatic)
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45
Q

population structure determining events

A
  • fertility, mortality, migration not evenly distributed across population by age and sex
  • age-sex structure has crucial influence on rates at which events occur in population
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46
Q

dependency ratios

A

pop. defined by law as dependent pop./working age x 100

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47
Q

dependent pop. and working age

A 
dependent pop:
- children: 0-14
- eldery: ≥65
working age:
- 15-64
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48
Q

types of ageing

A
  • numerical ageing

- structural ageing

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49
Q

numerical ageing

A

absolute increase in pop. that is elderly

  • due to improvements in life expectancy
  • reflects previous demographic patterns (reduction in infant/child mortality + increased probability of survival at old age)
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50
Q

structural ageing

A

increase in proportion of pop. that is elderly

  • driven by decline in fertility/birth rates
  • began occurring in 1800s
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51
Q

relationship between numerical and structural ageing

A

occur independently of each other with different causes and different implications

  • high death rates => pop won’t age numerically
  • high birth rates => pop won’t age structurally
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52
Q

population impacts of ageing

A
  • natural decline of pop.

- absolute decline of pop.

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53
Q

natural decline

A

occurs when deaths > births in a pop.

  • combo of absolute and structural ageing
  • more elderly (than children) = more deaths (than births) eventually, despite increasing life expectancy
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54
Q

absolute decline

A

occurs when there is insufficient migration to replace lost births and increased deaths

  • competition for migration
  • not expected to happen in NZ for 70+ years but happening in some european/asian countries
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55
Q

transitional growth

A

compounding of pop. growth driven NOT by rising birth rates but declining infant/child mortality rates

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56
Q

premature ageing

A
  • low fertility
  • increased life expectancy
  • migration driven gains at older age (accelerated structural ageing)
  • migration driven losses at younger age
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57
Q

inequities and politics

A

pophlth is laden with politics => addressing inequities is political
- all govt want to improve health/wellbeing of society but HOW improvements are approached differs widely

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58
Q

inequalities

A
  • measurable differences/variations in health (EGO, CGO, prevalence, incidence)
  • social gradient
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59
Q

health inequalities

A

differences in HEALTH experience/outcomes between different population groups
- according to SEP, area, age, disability, gender, ethnic group

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60
Q

inequities

A
  • inequalities that are deemed to be unfair/stemming from some form of injustice
  • relations of equal and unequal power (who has power to make changes, political/social/economic power, justice/injustice)
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61
Q

health inequities

A

differences in distribution of resources/services across population which do not reflect health needs

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62
Q

equity

A
  • response to need => cater/tailor intervention

- for whom? NZ? all of NZ? Te Tiriti O Waitangi?

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63
Q

equity - ministry of health definition

A
  • In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust
  • Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes
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64
Q

manawhenua

A

right of Maori tribe to manage particular area of land

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65
Q

mataawaka

A

Maori living in Auckland

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66
Q

PROGRESS stands for

A
  • Place of residence
  • Race/ethnicity/culture/language
  • Occupation
  • Gender/sex
  • Religion
  • Education
  • Socioeconomic status
  • Social capital
    + Disability
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67
Q

PROGRESS is…

A
  • socially stratifying factors that drive variations in health outcomes
  • helps use spectrum of social stratifiers as opposed to just one
  • helps avoid unintended intervention effects that may increase the gap between the most and least disadvantaged
  • advantage/disadvantage? why?
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68
Q

PROGRESS-Plus includes

A
  • personal characteristics that attract discrimination (e.g age, disability)
  • features of relationships (e.g smoking parents, excluded from school)
  • time-dependent relationships (e.g leaving hospital, respite care, temporarily at disadvantage)
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69
Q

PROGRESS-Plus considers…

A

additional context-specific factors

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70
Q

Reasons for reducing inequities

A

1) UNFAIR (societal value)
- poor health is the consequence of an unjust distribution of underlying social determinants of health
2) AVOIDABLE
3) affect EVERYBODY
- everyone may be affected by the conditions of the weakest/most vulnerable members of their community
4) reducing them can be COST-EFFECTIVE (more instrumental consideration)

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71
Q

inequities in health outcomes result from

A

inequities in opportunities

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72
Q

Drawing a Lorenz curve

A

1) order the population from lowest to highest and ask
- what % of wealth is owned by the poorest 10% pop?
- what % of wealth is owned by the poorest 20% pop? etc.
2) draw a line of absolute equality (45º)
3) draw line based on available data (concave)
4) the more concave, the greater the income inequality in a pop.

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73
Q

gini-coefficient

A

ratio of area between the line of perfect equality and the observed Lorenz curve to the area between the line of perfect equality and the line of perfect inequality

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74
Q

interpreting the gini-coefficient

A

0: very equal society
1: very unequal society

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75
Q

improvements in average health status and narrowing differentials by socioeconomic status

A

are not always correlated
- e.g policies aiming to narrow the gap may conflict with interventions that would achieve the greatest health gain for the pop. overall

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76
Q

exclusion is:

A

(other than moral considerations)

  • costly
  • inefficient (represents loss of potential resources)
  • unsafe
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77
Q

implications of (income) inequities

A
  • unequal society
  • less social cohesion
    • notion of support: support system? Who do you contact?
  • less trust between groups
    • neighbourhood? Relationship with neighbours?
  • increased stress
  • reduced economic productivity
  • poorer health outcomes
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78
Q

reducing inequities can be achieved through…

A

the redistribution of resources according to need
- extent of redistribution is a matter of social preference
Using examples of best practice it is possible to improve performance of others, and therefore reduce inequities
- everybody else is brought up

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79
Q

inequity myths busted

A

1) widening inequalities: NOT a necessary outcome of “high waged, highly educated, economically expanding society” (wealthier society)
2) everybody is NOT better off in a society that is “economically expanding and predominantly middle class [and increasingly unequal]”
3) NOT inevitable that public health interventions result in widening of health inequalities (while SOME may)

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80
Q

A society that tolerates a steep socioeconomic gradient in health outcomes

A

will experience a drag on improvements in life expectancy, and pay the cost via excess health care utilisation

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81
Q

systematic disparities

A

exemplify maori health and is highly visible in:

  • health outcomes
  • exposure to determinants of health
  • health system responsiveness
  • representation in health workforce
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82
Q

systematic disparities are the result of

A

underperformance of the govt., society and systems

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83
Q

disparities

A

differences

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84
Q

inequalities simplified

A

unequal but no judgement

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85
Q

inequities simplified

A

brings in factor of social justice/fairness

- does everyone have equal chances?

86
Q

structural issues

A
  • physical barriers?

- location advantage/disadvantage?

87
Q

social issues

A

influences of social values

88
Q

leveling or privileging

A

equitable distribution is not always equal distribution

- NZ particularly hung up on providing equal access

89
Q

types of interventions

A
  • structural interventions

- social interventions (rights based approach and commitment to review and level playing field)

90
Q

population-based approach

A
  • NOT aimed at individual behaviour
  • are people able to access services and know how to access them?
  • do not focus on the negative group (not what’s wrong with them) but the environ./system
91
Q

determinants of ethnic inequities in health

A

1) Differential access to health determinants or exposures leading to differences in disease influence
2) Differential access to health care
3) Differences in quality of care received

92
Q

Internationally, minorities report:

A
  • Less likely to feel they have been listened to
  • Less time spent with health care provider
  • Less likely to have received adequate explanations
  • More likely to have unanswered questions
  • More dissatisfaction with health service and system
93
Q

Maori history

A

1) early contact

2) official engagement

94
Q

early contact

A
  • initially flourished - economically, socially

- beginning of complex changes

95
Q

official engagement

A
  • colonisation
  • declaration of independence
  • treaty of waitangi
96
Q

colonisation

A

heralding an era of depopulation, disease and dispossession

  • not value-free
  • assumptions held by colonisers
  • notions of superior and inferior peoples,
  • notions of civilisation especially religious but also including economic and scientific knowledge e.g. land use, conservation
  • notions of deserving & undeserving
  • ? still obvious today - societal barriers
97
Q

treaty of waitangi implications

A
  • creation of govt
  • maori land
  • different or denied citizenship
98
Q

Creation of Government – Art I & II

A

– Art I - Construction of state sector – justice system, education, health, welfare etc - remnants of treaty (treaty-based)
– Constitution Act 1852 – created settler government
– Who got to vote - maori had to get individual title
– Laws and policies – Art II
(Disregard for Māori voice/authority despite Art II)

99
Q

govt - relation to health

A

policy alienation

100
Q

Māori land

A

= historical basis of settler wealth
– Pre-emption clause of ToW
– The Māori Land Court – 1860s • Individual title

101
Q

land - relation to health

A 
Land alienation
– social disruption of community
– breakdown of political power & alliances 
– economic resource depletion & poverty 
– resentment by indigenous peoples
102
Q

Different or denied citizenship – Art III

A

– Pensions – Old Age Pensions – 1898

– Social Security Act 1938

103
Q

Pensions – Old Age Pensions – 1898

A
  • Equal provisions for Māori and pākehā
  • [Asians particularly excluded]
  • Māori access difficult – thru Māori Land Court
  • Māori regularly removed from rolls
  • Reduced amount paid to Māori
104
Q

– Social Security Act 1938

A

• Underpayment continued until after WWII

105
Q

unequal citizenship - relation to health

A

– entrenchment of poverty & dependency
– increased barriers to development
– acceptance of inequity by non-indigenous groups
– resentment, frustration and anger
– social breakdown, crime, high risk behaviours

106
Q

powerful, historical predisposing factors lie outside of control

A

while resulting inequality in health status from action that one was responsible for could not be described as unfair, health is more than a matter of personal choice

107
Q

For Māori health development, we need to…

A

address the structural barriers to equitable access to the determinants of health and to address attitudes in society that stigmatises one group or assigns them differing value

108
Q

levels of racism

A
  • institutionalised racism
  • personally mediated racism
  • internalised racism
109
Q

institutionalised racism

A

differential access to goods, services, and opportunities of society by race

  • normative (societal norms)
  • sometimes legalised
  • inherited disadvantage (initial historical insult, biological determinism)
  • unearned privilege
  • inaction in face of need
  • structural barriers
110
Q

institutionalised racism examples

A
  • material conditions

- access to power

111
Q

material conditions

A

differential access to:

  • quality education
  • sound housing
  • gainful employment
  • appropriate medical facilities
  • clean environment
112
Q

access to power

A

differential access to:

  • information
    e. g one’s own history
  • resources
    e. g wealth and organisational infrastructure
  • voice
    e. g voting rights, representation in government, control of media
113
Q

personally mediated racism

A

prejudice and discrimination

  • could be intentional or unintentional
  • act of commission as well as omission
114
Q

prejudice

A

Differential assumptions about the abilities, motives, and intentions of others according go their race

115
Q

discrimination

A

Differential action toward others according to their race

116
Q

personally mediated racism examples

A
  • lack of respect
  • suspicion
  • devaluation
  • scapegoating
  • dehumanisation
117
Q

internalised racism

A

acceptance by members of the stigmatised races of negative messages about their own abilities and intrinsic worth

118
Q

levels of racism comparison

A

institutionalised racism is the most fundamental and once this is addressed, other levels of racism may cure themselves over time

119
Q

levels of racism - role of govt

A 
has the:
- power to decide
- power to act
- control of resources
dangerous when:
- allied with one group
- not concerned with equity
120
Q

racism against pacific people in 1970s

A
  • viewed as units of productivity (humanity not part of anyone’s vision)
  • got beaten up by police for nothing (injustice)
  • forced to cut hair (even though it had cultural significance)
121
Q

dawn raids

A

1974-1976

  • Kicking out people with expired visas
  • Didn’t feel like New Zealander
  • Revenge
122
Q

springbok tour

A
  • Non-violence didn’t cut it
123
Q

evidence for institutional racism against pasifika

A

statistics don’t change even though it looks like it on the surface

124
Q

Crucible years

125
Q

what the panthers did

A
  • legal aid
  • tenants aid brigade (TAB)
  • police investigation group (PIG patrol)
  • homework centres
  • paremoremo prison visits
  • community programmes
  • protests
126
Q

legal aid booklet and human rights

A
  • Educating teenagers, having the knowledge and understanding to protect themselves (being able to ask “am I under arrest”)
  • Didn’t know their human rights and more importantly their legal rights
127
Q

TAB

A 
rent strikes (now Tenants Tribunal)
- not paying rent until the house is brought up to liveable standards
128
Q

PIG patrol

A

Now Police Conduct authority

- accusing police of little things such as uniform codes so that they don’t get arrested for nothing

129
Q

Paremoremo prison visits

A

creating bus to visit their families (in prison due to their institutions)
- otherwise would not be able to see them due to being too far

130
Q

community programmes

A

Food co-ops, street/kids Xmas parties, Seniors’ concerts & outings, Westend News deliveries, lawn-mowing services for Seniors

131
Q

protests

A
  • Not accepting things like above

- Supporting by partaking in all these activities

132
Q

pacific panther collaborations

A
  • Black Panther Party USA
  • Mayor of Auckland City - Sir Dove-Meyer Robinson
  • Politicians: Minister of Justice
  • Nga Tamatoa
  • During school visits?
133
Q

3-point panther platform:

A

1) Peace resistance against racism
- What is racism?
- Institutional
- Personal
- Internalised
- Everyday
2) Celebrate mana Pacifica
- your own identity
3) Educate to liberate

134
Q

pacific panthers next steps

A
  • Becoming political - raising awareness of racism and doing something about it
  • Putting Pacific people in NZ and Ponsonby on the map - we are here to stay!
  • Changing attitudes towards Pacific Islanders
  • The first example of Pacific activism in NZ by a group of 18-19 year old first NZ-born
    Polynesian generation
135
Q

key principles for population health - COVID19

A

1) sizing up pandemics
2) choosing a response strategy
3) choosing interventions as part of elimination strategy
4) vaccinating against COVID-19
5) measuring impact of pandemic response and equity
6) reducing risk of cases and outbreaks
7) using testing to control COVID-19
8) using information and combating misinformation
9) planning for future scenarios
10) lessons for improving public health

136
Q

factors influencing response to pandemic

A
  • how transmissible
  • how severe and unequal
  • how controllable
  • how certain the info is and how stable the threat is
137
Q

how transmissible

A

reproduction number, RoReff

138
Q

how severe and unequal

A
  • case fatality risk (CFR) and infection fatality risk (IFR)

- inequalities of pandemic and responses

139
Q

how controllable

A
  • available interventions and effectiveness
  • feasibility of response, sector capacity, public acceptability and adherence
  • economic assessment, cost of action and inaction, counterfactuals
140
Q

how certain the info is and how stable the threat is

A
  • availability and quality of info, experience, dogma
  • science capacity, ability to track threat and generate/test scenarios
  • stability of threat, evolution
141
Q

pandemic response choices

A
  • control

- elimination

142
Q

pandemic response choices - control

A

reduce to an acceptable endemic level using feasible means

  • mitigation
  • suppression
143
Q

pandemic response choices - control - mitigation

A

reduce to avoid overwhelming the healthcare system

144
Q

pandemic response choices - control - suppression

A

reduce to minimise negative health impacts

145
Q

pandemic response choices - elimination

A

reduce to zero in a country or region for prolonged periods

- eradication

146
Q

pandemic response choices - elimination - eradication

A

reduce to zero at a global level permanently

147
Q

reproduction number

A
  • basic reproduction number

- effective reproduction number

148
Q

basic reproduction number, Ro

A

mean number of infections directly generated by 1 case in a population where all individuals are susceptible to infection

149
Q

effective reproduction number, Reff or Rt

A

mean number of additional infections caused by an initial infection at a specific time
- Reff > 1 => exponential increase

150
Q

elimination interventions

A
  • exclusion of cases
  • case and outbreak management
  • preventing community transmission
  • social safety net
151
Q

vaccinations

A

as the basic reproduction number increases, the herd immunity threshold increases

152
Q

herd immunity threshold

A

proportion of pop. that needs to be vaccinated

= 1 - 1/Ro

153
Q

measures of vaccinations

A
  • herd immunity threshold
  • vaccine effectiveness
  • vaccine coverage = total pop.
  • population immunity = vaccine effectiveness x vaccine coverage
154
Q

measures of success of pandemic response

A
  • cases
  • deaths
  • life expectancy impact
  • economy using average GDP
  • freedoms using stringency index
  • equity in hospitalised cases, vaccinated proportion
155
Q

epidemiological triad

A

environment, organism, host

156
Q

strategies in order of effectiveness

A

1) elimination
2) engineering controls
3) administrative controls
4) PPE

157
Q

misinformation

A

false information that is spread, regardless of intent to mislead

158
Q

disinformation

A

deliberately misleading or biased information; manipulated narrative or facts; propaganda

159
Q

variables in NZDep2013

A
  • communication
  • income
  • employment
  • qualifications
  • owned home
  • support
  • living space
  • transport
160
Q

NZDep - communication

A

people aged <65 with no access to the Internet at home

161
Q

NZDep - income

A
  • people aged 18-64 receiving a means of tested benefit

- people living in equivalised households with income below an income threshold

162
Q

NZDep - employment

A

people aged 18-64 unemployed

163
Q

NZDep - qualifications

A

people aged 18-64 without any qualifications

164
Q

NZDep - owned home

A

people not living in own home

165
Q

NZDep - support

A

people aged <65 living in a single parent family

166
Q

NZDep - living space

A

people living in equivalised households below a bedroom occupancy threshold

167
Q

NZDep - transport

A

people with no access to a car

168
Q

NZDep appropriate uses

A
  • planning and resource allocation
    (Distribution uses areas NOT individuals so that individuals are not stigmatised - “People living in the most deprived neighbourhoods” NOT “the most deprived people”)
  • research
  • advocacy
169
Q

IMD vs NZDep13

A
  • IMD has more indicators, indicate relative importance and show causes
170
Q

ecological fallacy

A

error that arises when information about groups of people is used to make inferences about individuals

171
Q

Three Levels of Influence

A

1) The person
- Age, sex, biology, behaviour risk factors and lifestyle
- Attitudes to physical activity, health and well-being
2) The community
- Availability of parks and recreation opportunities
- Family, friends and neighbours’ habits in relation to healthy activities
3) The environment
- Physical, built, school, work, home

172
Q

healthy environments

A
  • The physical, social or political setting(s) that prevent disease while enhancing human
    health and well-being
  • Chronic diseases such as CVD and obesity are associated with environments that favour
    more sedentary lifestyles and/or poor nutrition
173
Q

elements of healthy environments

A
  • Clean air and water
  • Appropriate housing
  • Access to wholesome food
  • Safe community spaces
  • Access to transport
  • Opportunities to incorporate exercise as part of daily life
174
Q

ways of measuring built environments

A

often context-specific thus depends on research question on health outcome of interest

  • Urban density: Population and/or employment density
  • Land-use mix: Residential, commercial, industrial, wasteland
  • Street connectivity: “Lollipop” neighbourhoods vs. well connected streets
  • Community resources: Access to recreational facilities or healthy foods
175
Q

community resource accessibility index

A

36 facilities representing 6 domains:

  • Recreational: Parks, beaches
  • Public Transport: Bus, ferry stops
  • Educational: Childcare, primary, intermediate
  • Shopping facilities: Dairy, supermarket, banks
  • Health: Plunket, GP, pharmacy, A&E
  • Social: Marae, Churches, community halls etc
176
Q

five key determinants of health

A

1) class and socio-economic gradient
2) early child development
3) poverty, deprivation and social exclusion
4) health literacy
5) gender

177
Q

characteristics of big data

A

1) volume
2) velocity
3) variety
4) veracity

178
Q

big data - volume

A

computing capacity required to store and analyse data

179
Q

big data - velocity

A

speed at which that data are created and analysed

180
Q

big data - variety

A

types of data sources available

- text, images, social media, administrative

181
Q

big data - veracity

A

accuracy and credibility of data (truth)

- how likely can it be replicated

182
Q

big data - addition Vs of relevance through development of data science and other related research

A

5) variability
6) value
7) visualisation

183
Q

big data - variability

A

internal consistency of your data

- e.g reproducible research

184
Q

big data - value

A

costs required to undertake big data analysis should pay dividends for your organisation and their patients

185
Q

big data - visualisation

A

use of novel techniques to communicate the patterns that would otherwise be lost in massive tables of data

186
Q

using privilege

A

with privilege comes responsibilities:

  • To advocate strongly for our members of society who do not have a voice
  • Challenge social norms and be the agents of change
187
Q

Challenges of big data

A

1) data governance
2) data generation
3) data output

188
Q

Data governance

A

Storage, transferring, sharing and privacy

189
Q

Data generation

A

Capturing, curating, updating and accuracy

190
Q

Data output

A

Analysis, querying large datasets and generating meaningful and reliable outputs

191
Q

Imd domains

A
  • employment
  • income
  • crime
  • housing
  • health
  • education
  • access
192
Q

IMD - employment

A

Measure the degree to which working age people are excluded from employment

193
Q

Income

A

Captures the extent of income deprivation in a data zone by measuring state-funded financial assistance to those with insufficient income

194
Q

Crime

A

Measures risk of personal and material victimisations (mostly theft, burglaries and assaults): damage to person or property

195
Q

Housing

A

Proportion of people living in overcrowded housing and the proportion living in rented accommodation

196
Q

Health

A

Identifies areas with high level of ill health (hospitalisations, cancer) or mortality

197
Q

Éducation

A

Captures youth disengagement and the proportion of the working age population without a formal qualification

198
Q

Access

A

Measures cost and inconvenience of travelling to access basic services (supermarkets, GPs, service stations, ECE, primary and intermediate schools)

199
Q

Urban design concepts

A
  • street connectivity
  • traffic calming and other street design features
  • mix of residential, commercial and business uses
  • public open spaces and physical activity spaces
200
Q

Street connectivity key features

A

Grid like pattern

201
Q

Street connectivity health related benefit

A

Reduces distance between destination, encouraging use of active transport

202
Q

Traffic calming key features

A

Street width, cycle lanes, traffic management, pedestrian crossings

203
Q

Traffic calming health related benefit

A

Facilities that encourage walking and cycling and discourage driving

204
Q

Land use mix key features

A

Different uses of land within given zone

205
Q

Land use mix health related benefit

A

Increases opportunities for active transport

206
Q

Public open Space key features

A

Open spaces in close proximity of residents: pools, parks, playgrounds

207
Q

Public open spaces health related benefit

A

Increase opportunities for physical activity

208
Q

Climate change direct effects

A

Floods, infection hurricanes drought heat fire

209
Q

Climate change indirect effects

A

Spread of disease vectors, agriculture and food supply, migration

210
Q

Actions against climate change

A
  • planetary diet
  • bikes for transport
  • better heating

POPLHLTH 111 (5 decks)

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