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Pop Health 111 > Module 3 > Flashcards

Module 3 Flashcards

(57 cards)

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1
Q

Temporality

Bradford Hill Criteria 1995

A
  • First the cause then the disease

- Establish a causal relationship

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2
Q

Strength of Association

Bradford Hill Criteria 1995

A
  • Statistically significant
  • Stronger the association, more likely to be causal in absence of known biases (selection, information, and confounding)
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3
Q

Consistency of Association

Bradford Hill Criteria 1995

A
  • Replication of findings by different investigations, at different places, at different times, with different methods
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4
Q

Biological Gradients

Bradford Hill Criteria 1995

A
  • Dose-response
  • Incremental change in disease rates in conjunction with corresponding changes in exposure
  • As exposure increases, death rates also increase
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5
Q

Biological Plausibility of Association

Bradford Hill Criteria 1995

A
  • Does the association make sense biologically?
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6
Q

Specificity of Association

Bradford Hill Criteria 1995

A
  • A cause leads to a single effect, however a single cause often leads to multiple effects
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7
Q

Reversibility

Bradford Hill Criteria 1995

A
  • Under controlled conditions changing the exposure causes a change in the outcome
  • Multiple causes for a disease outcome - 1:1 relationship between causes and outcomes
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8
Q

Sufficient cause

A

A factor that will inevitable produce the specific disease

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9
Q

Necessary cause

A

A factor that must be present if a specific disease is to occur

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10
Q

Component cause

A

A factor that contributes towards disease causation but is not sufficient to cause the disease on its own

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11
Q

Population based Health Action

A

Focuses on the whole population but reducing the health risk or improve the outcome of all individuals

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12
Q

Advantages of a Population bases Health Action

A
  • Addresses underlying causes - Radical
  • Large potential benefit of the whole population
  • Shifts social norms
  • Behaviourally appropriate
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13
Q

Disadvantages of a Population bases Health Action

A
  • Small benefit to individuals - Prevention Paradox
  • Poor motivation of individuals who’s population is exposed to the downside of the strategy (benefit to risk less favourable)
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14
Q

High Risk Health Action

A
  • Focuses on individuals perceived to be of high risk and has targeted interventions for them to move them to the norm of the population
  • a large number of people at a small risk may give rise to more cases of disease than the small number who are at a high risk
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15
Q

Advantages of a High Risk Health Action

A
  • Individual motivation
  • Cost effective use of resources
  • Favourable benefit to risk ratio
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16
Q

Disadvantages of a High Risk Health Action

A
  • Cost of screening
  • Need to identify at risk individuals
  • Temporary effect/ongoing process
  • Behaviourally inappropriate - not changing social norms
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17
Q

Prerequisites for health

A
  • Peace and safety from violence
  • Shelter
  • Education
  • Food
  • Income and economic support
  • Stable ecosystem and sustainable resources
  • Social justice
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18
Q

3 Basic Strategies

Ottawa Charter

A
  1. Enable
  2. Advocate
  3. Mediate
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19
Q

Enable

Ottawa Charter

A

Provide opportunities for all individuals to make healthy choices through access to information, life skills, and supportive environments
Individual level

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20
Q

Advocate

Ottawa Charter

A

Create favourable political, economic, social, cultural and physical environments buy promoting/advocating for health
Systems level

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21
Q

Mediate

Ottawa Charter

A

Facilitate/bring together individuals, groups, and parties with opposing interest to work together/come to a compromise for the promotion of health
Systems and individual levels

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22
Q

5 Priority Action Areas

Ottawa Charter

A
  1. Develop personal skills
  2. Strengthen community action
  3. Create supportive environments
  4. reorient health services toward primary health care
  5. Build healthy public policy
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23
Q

Primary Disease Prevention

Study These Flashcards
A

Limiting incidence of disease by controlling specific causes and risk factors
e.g. immunisation

24
Q

Secondary Disease Prevention

Study These Flashcards
A

Reduce the more serious consequences of the disease

e.g. screening for cancers

25
Tertiary Disease Prevention
Reduces the progress of complications of established diseases e.g. rehabilitation
26
Health Promotion
- Determinants of health - Empowers people to increase control over and improve their health - Involves whole populations in everyday contexts
27
Primary Care
Patients regular source of health care
28
Secondary Care
Specialist care
29
Tertiary Care
Hospital based, rehabilitation
30
Health Protection
- Monitoring - Risk communication - Occupational Health
31
Determinants of Inequities in Health
1. Differential access to heath determinants or exposures leading to differences in disease incidence 2. Differential access to healthcare 3. Differences in quality of care received
32
Te Pae Mahutonga
Bases o the southern cross and is a fundamental component of health promotion from a Maori point of view - Also applies to other New Zealanders
33
4 Key Tasks of Te Pae Mahutonga
1. Mauriora 2. Waiora 3. Toiora 4. Te Oranga
34
Cultural Identity | Key Task of Te Pae Mahutonga
Mauriora - Te Ao Maori - The Maori World - Make sure strategies align with Maori culture and values - Regain language and culture through health promotion - No need to fit to western standards
35
Environmental Protection | Key Task of Te Pae Mahutonga
Waiora | - healthy physical, social, cultural, political environment
36
Healthy Lifestyle | Key Task of Te Pae Mahutonga
Toiora | - Ensuring accessing a healthy lifestyle is possible
37
Participation in Society | Key Task of Te Pae Mahutonga
Te Oranga - Education, employment, income - Being an active member in society - Socioeconomic determinants of health
38
2 Prerequisites of Te Pae Mahutonga
1. Nga Manukura | 2. Te Mana Whakahaere
39
Leadership | Prerequisite of Te Pae Mahutonga
Nga Manukura - Health professional and community leadership - Respect that communities have their own solutions to health problems
40
Autonomy | Prerequisite of Te Pae Mahutonga
Te Mana Whakahaere - Capacity for self governance - Community control and enabling political environment
41
Screening in health
- Involves identifying risk factors for disease or unrecognised disease by applying test on a large scale to a population
42
Criteria for Screening
1. Suitable disease 2. Suitable test 3. Suitable treatment 4. Suitable screening programme 5. Improve health outcomes
43
Suitable disease
- Important health problem - Knowledge of relationship of risk factors to condition - Increased duration of pre clinical phase (b/w symptoms and diagnosis)
44
Suitable test
- Reliable - Safe, simple, cheap - Accurate (Sensitivity/Specificity)
45
Suitable treatment
- Evidence of early treatment leading to better outcomes - Effective, acceptable, accessable - Evidence based on who should be offered treatment
46
Suitable screening programme
- Benefits must outweigh the harm - RCT evidence that screening results in reduced mortality/increased survival time - Cost effective - Health system can support all elements - Reach groups most likely to be effected by disease
47
Sensitivity
The likelihood of a positive test in those with the disease = (TRUE POSITIVES/ALL WITH THE DISEASE) x 100 = a/(a+c) - The sensitivity of a screening test is high if the proportion of true positives is high - Fixed characteristic of the test
48
Specificity
The likelihood of a negative test in those without the disease (TRUE NEGATIVES/ALL WITHOUT THE DISEASE) x 100 = d/(b+d) - The specificity is high if the proportions of true negatives is high - Fixed characteristic of the test
49
Positive Predictive Value (PPV)
- The probability of having the disease if the test is positive = (TRUE POSITIVES/ALL WHO TEST POSITIVE) x 100 = a/(a+b)
50
Negative Predictive Value (NPV)
- The probability of not having the disease if the test in negative = (TRUE NEGATIVES/ALL WHO TEST NEGATIVE) x 100 = d/(c+d)
51
Lead Time Bias
Apparent increase in survival time when you measure survival after diagnosis compared to survival after screening
52
Length Time Bias
Calculating mean survival from screened patients can give wrong impression of longer than average survival time if there are different progressions of the disease (e.g. slow and fast)
53
TB Control
1. Anti TB educational campaigns 2. TB prevention coordinated with community partners 3. Improving living conditions 4. Creating an environment supporting TB testing 5. Pre-migration TB screening and notification of proven/suspected TB cases
54
Decision Criteria | Dimension 3 Haddon Matrix
1. Effectiveness 2. Cost 3. Freedom 4. Equity 5. Stigmatisation 6. Preferences 7. Feasibility
55
Factors | Dimension 1 Haddon Matrix
1. Host 2. Agent 3. Physical environment 4. Social environment
56
Population Attributable Risk (PAR)
Amount of extra disease attributable to a particular risk factor in a particular population = PGO-CGO (PGO = (a+b)/Population)
57
Attributable Risk (AR)
Risk Difference (RD) - Amount of extra disease attributable to a particular risk factor in the exposure group = EGO - CGO

Pop Health 111 (4 decks)

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