Module 3 Lecture 22 Flashcards
Epidemiology can play a central role in preventing disease injury by:
- unravelling the causal pathway
- directing preventive action
- evaluation of effectiveness
Why is the need for prevention growing
the limitations in curing disease are becoming apparent and cost of medical care is escalating which leads to more discrepancies between social groups
Population based (mass) strategy
- Focuses on whole population
- Aims to reduce the health risks/improve the outcome of all individuals in the population
- Useful for a common disease or widespread cause
- Shifts population in a favourable direction
- Examples include immunisation and water fluoridation
High risk strategy
- Focuses on individuals perceived to be a higher risk
- Intervention is well matched to individuals and their concerns
- Shift the high risk group close to the normal population
e. g. intervention targeting obese adults, intravenous drug users
Advantages of population strategy
- Radical- addresses underlying cause
- large population benefit for whole population
- Behaviourally appropriate - trying to shift societal norms
Disadvantages of population strategy
- Small benefit to individuals
- Poor motivation of individuals
- Whole population is exposed to downside of strategy (less favourable benefit-to-risk ratio)
Advantages of high risk individual strategy
- Appropriate to individuals
- Individual motivation
- Cot effective use of resources
- Favourable benefit-to-risk ratio
Disadvantages of high risk individual strategy
- Cost of screening
- Temporary effect
- Limited potential
- Behaviourally inappropriate (e.g. moving outside of cultural norms)
Effects of health promotion
- Acts on determinants of wellbeing
- Health/wellbeing focus
- Enables/empowers people to increase control over and improve their health
- involves whole population in every day context
Primary Care
Patients regular source of healthcare e.g. GP, Pharmacist, Physiotherapist
Secondary Care
Specialist care e.g. Neuroligists, dermatologists
Tertiary Care
Hospital based care, Rehabilitation, Institutionalised Services
Alma Ata 1978: Declaration of healthcare
- Protect and promote healthcare
- Advocated a health promotion approach to primary care
Alma Ata Prerequisites for health
Peace and safety from violence, shelter, education, food, income and economic support, stable ecosystem and sustainable resources and social justice
The Ottawa Charter for health promotion
Mobilise action for community development
The Charter acknowledges that health is:
- a fundamental right for everybody
- That it requires both individual and collective responsible
- The opportunity to have good health should be equally available
- And that good health is an essential element of social and economic development - elements of equity and equality were brought in
The 3 basic strategies of the Ottawa Charter
1) Enable: to provide opportunities for all individuals to make healthy choices through access to information, life skills and supportive environment
2) Advocate: to create favourable political, economic, social, cultural and physical environments by promoting/advocating for health
3) Mediate: to facilitate/bring together individuals, groups and parties with opposing interests to work together/come to a compromise for the promotion of health
5 Priority Action areas
- Develop personal skills e.g. life skills education in schools and awareness campaigns
- Strengthen community action e.g. self help groups and community organised services, communitiy initiatives etc.
- Create supportive environments e.g. implementing air control measures, water and sanitation progtammes, workplace safety measures etc.
- Reorient health services towards public healthcare e.g. Care process responsive to needs of patient and families , health and education services etc.
- Build healthy public policy e.g. taxation on alcohol and cigarettes, mandatory seat belt use, banning smoking in public places etc.
Disease prevention
- Disease focus
- Looks at particular diseases and ways of preventing it
Natural history of disease and prevention strategies
Primary: Limit the incidence of disease by controlling specific causes and risk factors e.g. immunisation, seat belt regulations
Secondary: reduces the more serious consequences of disease e.g. screening people 65+ from risk fractures
Tertiary: Reduce the progress of complications of established disease e.g. counselling disease for PTSD, rehab for stroke patients
Health Protection
- Predominantly environmental hazard focused
- Risk/Hazard assessment
- Monitoring
- Risk communication
- Occupational health
