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poplhlth 111 > Module 3 > Flashcards

Module 3 Flashcards

1
Q

Epidemiology definition

A

The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems.

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2
Q

Population based (mass) strategy

A

Attempts to move the whole distribution of disease exposure and outcomes in a more favourable direction

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3
Q

High risk (individual) strategy

A

Only affects individuals over a certain threshold of the distribution

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4
Q

Population-based strategy advantages

A
  • radical (addresses underlying causes)
  • large potential benefit for whole population
  • behaviourally appropriate
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5
Q

Population-based strategy disadvantages

A
  • small benefit to individuals
  • poor motivation of individuals
  • whole population is exposed to downside of strategy (less favourable benefit-to-risk ratio)
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6
Q

High-risk strategy advantages

A
  • appropriate to individuals
  • individual motivation
  • cost effective use of resources
  • favourable benefit-to-risk ratio
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7
Q

High-risk strategy disadvantages

A
  • cost of screening
  • temporary effect
  • limited potential
  • behaviourally inappropriate
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8
Q

Health promotion

A

acts on determinants of wellbeing of the whole population in everyday contexts

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9
Q

Ottawa charter

A

health promotion: ‘mobilise action for community development’

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10
Q

Ottawa charter acknowledges that health is: [4]

A
  • a fundamental right for everybody
  • that it requires both individual and collective responsibility
  • the opportunity to have good health should be equally available
  • good health is an essential element of social and economic development
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11
Q

Ottawa charter basic strategies: [3]

A
  1. Enable
  2. Advocate
  3. Mediate
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12
Q

Enable (OC)

A

To provide opportunities for all individuals to make healthy choices through access to information, life skills and supportive environments

  • An individual level strategy
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13
Q

Advocate (OC)

A

to create favourable political, economic, social, cultural and physical environments by promoting/advocating for health and focusing on achieving equity in health

  • A systems level strategy
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14
Q

Mediate (OC)

A

To facilitate/bring together individuals, groups and parties with opposing interests to work together/come to a compromise for the promotion of health

  • A strategy that joins up individuals, groups and systems
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15
Q

Ottawa charter priority action areas: [5]

A
  • develop personal skills
  • strengthen community action
  • create supportive environments
  • reorient health services towards primary health care
  • build healthy public policy
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15
Q

Primary prevention strategy

A
  • limit the occurrence of disease by controlling specific causes and risk factors
  • reduces disease incidence
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16
Q

Secondary prevention strategy

A
  • early detection to reduce the more serious consequences of disease
  • reduces prevalence
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17
Q

Tertiary prevention strategy

A
  • reduce the complications of established disease
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18
Q

Health protection

A
  • predominantly environmental hazard focused
  • risk/hazard assessment
  • occupational health & monitoring
  • risk communication
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19
Q

systematic inequities for Māori: [4]

A
  • in health outcomes
  • in exposure to the determinants of health
  • in health system responsiveness
  • in representation in the health workforce
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20
Q

Māori health promotion

A

the process of enabling Māori to increase control over the determinants of health and strengthen their identity, thus improving their health and position in society

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21
Q

cultural identity

A

Mauriora

22
Q

participation in society

A

Te Oranga

23
Q

healthy lifestyles

A

Toiora

24
Q

environmental protection

A

Waiora

25
Q

community leadership

A

Ngā Manukura

26
Q

autonomy

A

Te Mana Whakahaere

27
Q

estabilishing population health priorities: evidence based measures: [3]

A
  • descriptive
  • explanatory
  • evaluative
28
Q

descriptive evidence (prioritisation)

A

who is most least affected?
- historical trends
- future trends

29
Q

explanatory evidence (priorisation)

A

what are the determinants/risks? why are we getting worse/better? why are populations different (equity)?

30
Q

PAR

A

if the association is causal then this is the amount of disease (theoretically) we could prevent if we removed the risk factor from the particular population

31
Q

evaluative evidence (prioritisation)

A

what can improve health outcomes (and in whom)? is the intervention improving health outcomes? economic feasibility?

32
Q

Screening

A

This can apply to all levels of disease prevention.
Pop gets screened –> those who test pos go to gold standard test—> if pos then treatment. All neg will get rescreened at a time interval of choice

33
Q

Screening Criteria

A
  1. suitable disease
  2. suitable screening test
  3. suitable treatment
  4. suitable screening programme
34
Q

Suitable disease (screening)

A

needs to be an important health problem
can be common or uncommon
so detection leads to better health outcome

35
Q

Suitable test (screening)

A

reliable
safe
affordable
accurate
go against the gold standard

36
Q

Specificity

A

d/cg x 100
is high if the proportion of true negatives is high
fixed measure

37
Q

Sensitivty

A

a/eg x 100
high if proportion of true pos is high
fixed measure

38
Q

PPV

A

a/a+b
proportion who really have the disease of all who tested positive
changes with prevalence
if higher prev then a higher so higher PPV

39
Q

NPV

A

d/c+d x 100
probability of not having the disease if test is negative
not fixed

39
Q

Suitable treatment Screening

A

evidence of early treatment leading to better outcomes

40
Q

Suitable screening programme

A

benefits must outweigh harm
RCT evidence screening result is less deaths or increased survival time
reach all of community
cost effective

41
Q

Lead time Bias

A

survival time = time of death - time of diagnosis
if diagnosed earlier then appearance of more survival time even though disease progression is the same

42
Q

Length time bias

A

slower cases of disease progression more likley to be diagnosed than rapid cases

43
Q

Reasons for GBD Project

A

wanted info for policy on both death and disability
burden of disease
take account of fatal and non fatal outcomes

44
Q

DALY

A

Disability Adjusted Life Years
DALY = YLL + YLD
says burden of disability is the same in very country

45
Q

YLL

A

years of life lost
- number of deaths per year
- years lost per death relative to ideal age

46
Q

YLD

A

years lived with disability
- disability weight
- number of cases
- average duration until recovery or death

47
Q

Communicable Diseases

A

infectious diseases which can be transmitted e.g HIV

48
Q

Non Communicable Diseases

A

not able to spread
e.g CVD

49
Q

Low income country DALY

A

mostly CD
few NCD
lower age of death

50
Q

High Income country DALY

A

mostly NCD
few CD
higher age of death
Better healthcare

51
Q

Gains of the DALY approach

A
  1. drew attention to previously hidden burdens such as mental health
  2. NCD as an issue in both LIC and MIC and HIC
52
Q

Medical vs Social model of disability

A

Medical - thinks of those with a disability as a burden, individual problem, seen as dependent
Social - not the problem of the person but caused by social and environmental barriers

poplhlth 111 (5 decks)

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