Module 3 Lecture 22

Question 1

Epidemiology can play a central role in preventing disease injury by:

Answer 1

• unravelling the causal pathway
• directing preventive action
• evaluation of effectiveness

Question 2

Why is the need for prevention growing

Answer 2

the limitations in curing disease are becoming apparent and cost of medical care is escalating which leads to more discrepancies between social groups

Question 3

Population based (mass) strategy

Answer 3

• 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

Question 4

High risk strategy

Answer 4

• 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

Question 5

Advantages of population strategy

Answer 5

• Radical- addresses underlying cause
• large population benefit for whole population
• Behaviourally appropriate - trying to shift societal norms

Question 6

Disadvantages of population strategy

Answer 6

• Small benefit to individuals
• Poor motivation of individuals
• Whole population is exposed to downside of strategy (less favourable benefit-to-risk ratio)

Question 7

Advantages of high risk individual strategy

Answer 7

• Appropriate to individuals
• Individual motivation
• Cot effective use of resources
• Favourable benefit-to-risk ratio

Question 8

Disadvantages of high risk individual strategy

Answer 8

• Cost of screening
• Temporary effect
• Limited potential
• Behaviourally inappropriate (e.g. moving outside of cultural norms)

Question 9

Effects of health promotion

Answer 9

• 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

Question 10

Primary Care

Answer 10

Patients regular source of healthcare e.g. GP, Pharmacist, Physiotherapist

Question 11

Secondary Care

Answer 11

Specialist care e.g. Neuroligists, dermatologists

Question 12

Tertiary Care

Answer 12

Hospital based care, Rehabilitation, Institutionalised Services

Question 13

Alma Ata 1978: Declaration of healthcare

Answer 13

• Protect and promote healthcare

- Advocated a health promotion approach to primary care

Question 14

Alma Ata Prerequisites for health

Answer 14

Peace and safety from violence, shelter, education, food, income and economic support, stable ecosystem and sustainable resources and social justice

Question 15

The Ottawa Charter for health promotion

Answer 15

Mobilise action for community development

Question 16

The Charter acknowledges that health is:

Answer 16

• 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

Question 17

The 3 basic strategies of the Ottawa Charter

Answer 17

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

Question 18

5 Priority Action areas

Answer 18

• 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.

Question 19

Disease prevention

Answer 19

• Disease focus

- Looks at particular diseases and ways of preventing it

Question 20

Natural history of disease and prevention strategies

Answer 20

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

Question 21

Health Protection

Answer 21

• Predominantly environmental hazard focused
• Risk/Hazard assessment
• Monitoring
• Risk communication
• Occupational health