Module 3+ Flashcards
for a country entering the obesity epidemic - who gets fatter first?
high income, urban, middle-aged women
diets result from:
individual factors being affected by food environment (which is affected by food industry, governmount and society)
hallmark of environment effects of obesity
all age groups increasing simultaneously and equivalently, therefore must be environmental driver
food environments: [4]
- physical
- economic
- policy
- socio-cultural
drivers of obesity
neoliberal political economics, technologies for data mining/targeted marketing, national wealth
mediators of obesity
food availability, food prices, food composition, e-bikes/scooters, food and PA behaviours
moderators of obesity
culture, built environment, food culture/cuisine, local climate, religion
control (pandemic response)
reduce to an acceptable endemic level using feasible means
mitigation (pandemic response)
reduce to avoid overwhelming the health system
suppression (pandemic response)
reduce to minimise negative health impacts
elimination (pandemic response)
reduce to zero in a country or region for prolonged periods
eradication (pandemic response)
reduce to zero at a global level permanently
objectives of NZ’s initial covid response: [4]
- preventing illness and deaths especially in most vulnerable populations (equity)
- protecting the health care system and health care workers
- protecting the economy
- protecting pacific countries
roles of surveillance: [3]
- serves as an early warning system for impending outbreaks
- enables monitoring and evaluation of the impact of an intervention
- monitors and clarifies the epidemiology of health problems, guiding priority-setting and planning and evaluation of public health policy and strategies
R[eff]
the mean number of additional infections caused by an initial infection at a specific point in time
channels
relevant, accessible, trustworthy
message
appropriate, co-designed, tested
messenger
trusted, credible
opportunities in climate change
- mostly we know what we need to do
- the main barriers are political, not technical
- many of the solutions will have additional population health benefits
climate change - inequality vicious cycle
- multidimensional inequality
- greater exposure and vulnerability of disadvantaged groups to climate hazards
- disproportionate loss of assets and income suffered by disadvantaged groups
(made worse by climate hazards)
‘risk multipliers’ in unequal impacts of climate change
- heat extremes
- access to food, water, shelter
nz emissions
- 1/2 agriculture
- transport 18%
- not reducing
important direct effects of transport systems on health: [3]
- physical activity
- air pollution
- vechile crashes
inverse care law
the availability of good medical [or social] care tends to vary inversely with the need for it in the population served
personally-mediated racism
defined as prejudice and discrimination based on race/ethnicity
‘snowflake’ hypothesis
early development:
increased parental monitoring, parental stress/financial, geopolitical polarisation
over protection and low resilience
‘igen’ hypothesis
current aspects:
social media, internet access
increasing perfectionism, emphasis on exceptionalism, individual achievement, experience of racism and discrimination
‘doomer’ hypothesis
aspects affecting the future:
impact of job insecurities, housing affordability, climate crisis, political polarisation, disinformation and misinformation
service and policy changes for youth health
government increased spending in mental health services (services in schools, promotion efforts, addiction services) but young people now wait longer for specialist mental health services
Change in DALYs causes over time
CD is decreasing
NCD is increasing
“epidemiological transition”
Epidemiological Transition
shift in the common causes of death and disability from infectious diseases to chronic diseases
PAR
the amount of extra disease burden attributable to a particular risk factor in the population
a+b/p - b/cg
Risk Transition
changes in risk factor profile as countries shift from low to higher income where risk for CD is replaced with NCD
Double burden of disease
MIC have both NCD and Cd affecting them - challenges for health policy
Busted Myths of NCD
- 80% NCD in LMIC
- conc in poor
- not just old people
- can be prevented
Smoking trend NZ
over time smoking prevalence is decreasing
inequities persist in populations
Commercial sector impact on NCD
creates uneven distribution of risk
- changes social norms
- targetted ads
- conc of outlets
- influence on policy
- emphasis on education rather than upstream
Policy inertia
gov not willing to implement health policy
- lack of public demand
- conflicts of interest
- lobbying
Stratagies used by commercial sector
- partnership
- lobbying
- oppostion to policy
-employing narratives - self regulatory codes
industrial epidemic
Diseases arising from overconsumption of unhealthy commercial products
Who is the most at risk of AIDS
- women
- subsaharan Africa
- gay men
- injecting drug users
- mother to child
- LIC
Why is the death rate and new infections rate of HIV decreasing but number of people with HIV increasing
Prevention and treatment option have stopped people dying so they live longer with the disease
Feminisation of HIV
increasing proportions of new infections are among women, mostly due to heterosexual transmission of the infection
Social determinants of HIV
- gender violence
- negotiating condom use
- stigmatisation of testing and partner notification
- financial dependance
- lower access to health services
- early school drop out
How to improve HIV social determinants
- education
- financial freedom
- improve access to health services
HIV mother to child
Many children whose mothers are HIV-positive will be infected
can be prevented by testing
antiviral drugs prevent progression in mothers (secondary) and onset to children (primary)
HIV prevention
- condom usage
- education
- needle exchange
- prevent needle stick injuries
- screen blood
- testing and counselling
- antivirals for positive mothers
Māori Health is exemplified by systematic disparities
- in health outcomes
- health system responsiveness
- health system representation
- exposure to determinants of health
What has lead to worse Maori health
- poverty due to land stolen
- maori overrepresented in higher deprivation
The Right to Health
system of laws which endorses the right to health for all
right to health does not mean the right to be healthy
R2H RPF
Respect - no discrimination
Protect - no 3rd party interference
Fulfil - adopt measures to achieve equity
R2H in NZ
- Pae Ora
- NZ public health and disability act
- TOW
- UN declaration on rights of indigenous peoples
- Code of patient rights
