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Poplhlth 111 > Module 3 > Flashcards

Module 3 Flashcards

1
Q

What is the Public Health Model?

A

Define the problem

Identify risk and protective factors

Test and develop intervention strategies

Ensure widespread adoption

Monitor mediate and evaluate

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2
Q

What are the Bradford Hill criteria?

A
  1. Temporality
  2. Strength of Association
  3. Consistency of Association
  4. Biological gradient (dose-response)
  5. Biological plausibility of the association
  6. Specificity of association
  7. Reversibility
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3
Q

What is temporality?

A

Determine causal relationship, TIMELINE

Cause/exposure factor –> disease after exposure

Smoking leads to lung cancer to deaths

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4
Q

The strength of association?

A

Stronger association, more likely its causal in absence of known biases like confounding, selection.

British Doctors study : RR>10

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5
Q

Consistency of association?

A

Replication of the findings by different
investigators, at different times, in
different places, with different methods

Are you getting consistent results?

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6
Q

Bio gradeint?

A

Incremental change in disease rates in conjunction with corresponding changes in exposure

Chemicals in tobacco that are know to promote cancers. Increasing smoking per day has more deaths

Dose response

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7
Q

Bio plausibility of association?

A

Biological speaking, does it make sense? Person can have cancer if he smoked due to the chemicals in the cig?

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8
Q

Specificity?

A

A cause leads to a single effect
However, a single cause often leads
to multiple effect

Smoking leads to –> MULTIPLE OUTCOMES

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9
Q

Reversibility?

A

The demonstration that under
controlled conditions changing the
exposure causes a change in the
outcome

Smoke a lot higher chances but if I stopped smoking, change exposure, change outcome

British Drs study:
Reduced risk
after quitting

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10
Q

What are the 3 different types of causes?

A

Sufficient
Component
Necessary

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11
Q

Sufficient cause?

A

A Sufficient cause is a factor/s that will inevitably

produce the specific dis-ease

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12
Q

Necessary cause?

A

A Necessary cause is a factor (or component
cause) that must be present if a specific dis-ease is
to occur

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13
Q

Component cause?

A

Component cause is a factor that contributes
towards dis-ease causation, but is not sufficient to
cause dis-ease on it’s own

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14
Q

Example of different causes if the event is car crash?

A

Necessary cause: Car on car impact.

Sufficient cause: Faulty brakes (if you don’t stop, you will eventually hit)

Component: Sleepy driver, dim lights (by itself will not cause the crash)

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15
Q

Can you only have sufficient cause to cause an event?

A

yea

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16
Q

Can a necessary cause be in the sufficient cause?

A

yes

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17
Q

What is like the Ottawa charter but in Maori version?

A

Te Pae Mahutonga - 4 key tasks

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18
Q

What are the 4 key tasks of the Te Pae Mahutonga?

A

Mauriora
Waiora
Toiora
Te Oranga

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19
Q

Mauriora?

A

Access to Te Ao Maori

To the Maori world, cultural identity language and cultural spaces

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20
Q

Waiora

A

Environmental protections

How we modify/improve physical environment to improve health

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21
Q

Toiora

A

Healthy lifestyle

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22
Q

Te Oranga

A

Participation in society

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23
Q

WHat are the 2 prerequisites of Te Pae Mahutonga?

A

Nga Manukura (leadership - health pro and community leadership)

Te Mana Whakahaere (autonomy - capacity for self governance, community control and enabling political environment)

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24
Q

What is the objective of screening>

A

to improve health outcome, morbidity, mortality, disability

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25
Q

What class can screening be out under?

A

All it can be primary, secondary, and tertiary

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26
Q

Which target intervention does screening normally apply to?

A

High risk individuals

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27
Q

What is it called if the screening is applied to everyone?

A

Population based

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28
Q

What is an example of primary screening?

A

Screening for risk factor

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29
Q

Eg 2 screening?

A

Breast cancer, they already have the biological onset, they need diagnosis by detecting early stages of the disease

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30
Q

Eg 3 screening?

A

Screening for bone density following chemo for breast cancer, they have undergone treatment and already diagnosed, emergence of a complication is what is screened we want to treat and reduce complication of the disease already diagnosed

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31
Q

What question is with screening?

A

Do we spend our money on screening or not?

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32
Q

WHat is the criteria for screening?

A 
Suitable: 
disease
test 
screening programme 
treatment
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33
Q

Suitable disease?

A

a. An important public health problem
i. Relatively common
ii. Relatively uncommon
1) Early detection and intervention - better outcome
b. Knowledge of them natural history of the disease )or relationship of risk factors to the condition)
i. Detectable early (detectable risk factor/disease marker)
ii. Increase duration of pre-clinical phase

34
Q

Suitable test?

A 
Reliable consistent results
safe
simple
affordable
acceptable
accurate
35
Q

Suitable screening programme?

A

If lose an arm benefits do not outweigh the harm.

Decrease mortality increase survival time thru early detection, diagnosis treatment

36
Q

Suitable treatment?

A

Terminal illness “you have disease.. but we have no treatment..”

Should get early treatment early detection

effective, accessible, acceptable

37
Q

How does screening work?

A

Less expensive than diagnostic test, identify the groups that are test +ve and -ve so cheap for all population .

The +ve people move to diagnostic test.

38
Q

What is diagnostic test?

A

Invasive more specific and best test for the persons to determine if they have disease. Expensive so that is why not WHOLE POP

39
Q

Do the flowchart of screening of disease

A

ok

40
Q

When talking about accuracy under the suitable test what is involved?

A

Sensitivity and Specificity

41
Q

Sensitivity?

A

Ability of the test to identify correctly those who HAVE the disease from all individuals with the disease

TRUE POSITIVE= a/a+c

42
Q

Specificity

A

Ability of the test to identify those who DO NOT have the disease from all the individuals free from the disease.

TRUE NEGATIVES = d/d+b

43
Q

What does it mean when the sensitivity of screening test is high?

A

The proportion of true positives is high

44
Q

What does it mean when screening specificity is high?

A

The proportion of true negatives is high

45
Q

Leading time bias vs length time bias

A

RECHECK LEC

46
Q

Social model of disability?

A

Disability is seen as a social issue caused by policies, practices, attitudes and or environment NOT individual issue

Ridding society of barriers rather than relying on curing people who have impairments

47
Q

Medical model of disability

A

Disabled people are labeled by their illness of issue
Disability is an individual problem
Promotes the view that disabled people as dependent and needing to be cured or cared for (justifying the way in which disabled people have been systematically excluded from society)
Disabled people are the problem, not the society
Control resides with professionals
Choices for the individual are limited to the options provided and approved by the helping expert

48
Q

What does the GDB look at disability/ what view?

A

Medical model of Disability

49
Q

What is the difference between NZDep and IMD?

A

NZDep gets their info from the Census which is a once every 5 years getting info about NZ and its structural (age-sex) population, GOLD STANDARD, but this is prevalence, a SNAPSHOT

IMD get information from IDI, a longitudinal study where data is collected from public gov organisations. This, however can over and under rep certain populations as only people who have been to hospital for example is included which means we are excluding all the healthy people. This is however, longitudinal so it keeps being updated.

50
Q

What is the aim of GDB project?

A

Systematic approach to summarises the burden of disease and injury at population level based on epidemiological principles and evidence

Take account deaths and disability when estimating burden of disease

51
Q

WHat is DALY

A

SUmmary measure of pop health with premature death and disability rep the health of the population as a single number

52
Q

What is the DALY equation?

A

YLD + YLL

53
Q

YLL?

A

Years life lost

  1. Number of deaths from the disease in a year
  2. Years of life lost relative to ideal age
54
Q

YLD?

A

Years Lived w Disability

  1. No. cases with disability with disease
  2. Average duration of disability till death
  3. Weight of disability
55
Q

Gains of DALY

A

Attention to previously hidden burden of mental health issues and injures as major public health problems

Recognise non communicable diseases as a major and increasing problem in low and middle income countries (not just rich countries

56
Q

Challenges of DALY

A

Disability weights are considered the same as severity of impairment relating to a disease, DO NOT VARY W A PERSON’S SES

Criticised fro its potential to represent people with disabilities as burden

57
Q

What is the 2030 agenda?

A

Benefits for adolescents now
For their future adulthood
And their children

58
Q

What are the 3rd dimensions of Haddon Matrix

A
  1. Effectiveness
  2. Freedom
  3. Equity
  4. Feasibility
  5. Stigmatisation
  6. Unforeseen circumstances
  7. Preference/accessibility
59
Q

What are the 7 domains of IMD

A 
Crime 
Education 
Housing 
Access
Health
Employment 
Income
60
Q

Another comparison of NZDEP and IMD is… map wise…

A

In NZDEP we can see that the whole ‘neighborhood’ is deprived but IMD gives us the lens to see the underlying issues of why it is deprived. What are the factors? WHich that means allows us to specifically target what we can do to fix.

61
Q

What is your visualisation fo NZdep vs IMD

A

That NZDEP indicators are one sentence (not much) but IMD is extensive af

62
Q

What makes Big Data BIG

A

Velocity - speed at which data create and analysed

Variety - types of data available

Veracity - accuracy and credibility of data

Volume - computing capacity required to store and analyse data

Value - costs required to undertake big data should pay dividends to patent and organisation

Variability - internal consistency of your data

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

63
Q

What is the Right to Health?

A

The gov doing the bare minimum to provide the opportunity for the public to be healthy like Human Rights

64
Q

What is the Right to be Healthy?

A

More than doing the bare minimum like personal lifestyle policies, endorsing organisations which promote healthy wellbeing.

65
Q

Feminisation of HIV epidemic

A

Refers to the observation that increasing proportion of new infections are among women, primarily due to heterosexual transmission of the infection

66
Q

Tobacco control acronym

A

Monitor tobacco use and prevention policies
Protect people from tobacco use (upstream, law)
Offer help to quit (downstream)
Warn about the dangers
Enforce bans on tobacco adverts
Raise taxes on tobacco

67
Q

Epidemiological transition

A

characteristic shift in the
composition of causes of death and disability from
communicable to non-communicable diseases

68
Q

Demographic transition

A

decline in fertility and mortality rates observed in most developed and several developing countrie

69
Q

Risk transition

A

Changes in risk factor profiles as countries shift from low to higher income countries where common risks for prenatal and communicable disease (unhygienic water) are replaced by non communicable diseases like tobacco

70
Q

Double burden of disease

A

Many middle income countries previously common risks for prenatal and communicable disease co exist with increasing factor of non communicable diseases.

71
Q

Industrial epidemics

A

Disease arising from overconsumption of unhealthy commerical products

72
Q

Horizontal equity?

A

yreferstoaninterventionthattreatsallpeople

equallyorinauniversalway

73
Q

Vertical equity?

A

referstoastrategythat
resultsinunequaltreatmentofpeoplebasedontheirunequalriskof
injury

74
Q

Effectiveness

A

Is there goof evidence that the intervention would work?

75
Q

Cost

A

What are the costs of implementing and or enforcing the program of policy may be also relevant to consider who beas this cost as there may be inequity issues (low income fam may not be able to afford)

76
Q

Freedom

A

Extent to which the freedom of a particular group is compromised can result in resistance to the intervention

77
Q

Stigmatisation

A

Concept that intervention should NOT stigmatise people whenever possible (like low income fam to qualify for a product)

78
Q

Preferences/acceptability

A

Proposed strategy to the affected community or individuals - importance of perceptions and involved socioeconomic cultural context norms and values

79
Q

Feasibility

A

Is ti effective is it likely to be applicable in the setting

80
Q

Unforseen adverse consequences

A

Thisrelatestosituationslikefencingapropertyresultinginlimitedaccess
tohousefromroadandsecurityconcernsforvehicleorpersonalsafety.

Poplhlth 111 (4 decks)

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