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POPLHLTH 111 - My Deck > Module 4 > Flashcards

Module 4 Flashcards

1
Q

Population public health aim is what?

A

Maximum benefit for the largest number of people

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2
Q

Why worry about priorities?

A
  • Resources are finite
  • each prioritise has an opportunity cost
  • rationing involves ethical as well as evidence based judgement
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3
Q

Reasons for the GBD project?

A
  • available data largely focused on deaths

- lobby groups can give a distorted image of which problems are most important

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4
Q

Aims of the GDB project ?

A
  1. To use a systematic approach to summarise the burden of diseases & injury at the population level based on epidemiological principle and best available evidence
  2. To take account of deaths as well as non fatal outcomes when estimating the burden of disease
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5
Q

What does DALY mean?

A

A summary measure of population health that combine data on premature mortality & non-fatal health outcomes to represent the health of a particular population as a single number

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6
Q

How to calculate DALY?

A

YLD + YLL

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7
Q

Years of life lost (YLL) ?

A

Represents mortality by counting the years lost due to premature death or non fatal health

  • number of deaths from a disease in a year
  • years lost per death relative to ideal age
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8
Q

Years lived with disability ?

A

Represents morbidity by counting the years lived with the disease

  • number of causes with non- fatal outcome with the disease
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9
Q

DALY enables comparisons between ?

A

Disease by using one measure that considers premature death & disability

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10
Q

What are the trends of NCD & CD in NZ and globally?

A

CD are decreasing

NCD are increasing

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11
Q

Major gains of the DALY approach?

A
  1. Drew attention to hidden burden of mental health

2. Recognises NCD as a major & increasing problem in low-middle income countries

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12
Q

Challenges of DALYS?

A
  • who should decided which weights should be assigned to each disability?
  • how does the physical and social environment influence disability experiences ?
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13
Q

Medical model of disability?

A
  • Disabled people are defined by their illness
  • It is an individual problem
  • Controls resides with professionals
  • Disabled person is the problem not society
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14
Q

Increasing risk factors for NCD in which countries?

A

High income countries

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15
Q

Increasing risk factors for CD in which countries?

A

Low income countries

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16
Q

Epidemiological transition ?

A
  • Characteristic shift in common causes of death & disability from perinatal & communicable disease to non communicable disease
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17
Q

Risk transition?

A

Changes in risk factor profiles as countries shift from low to high income countries where CD is replaced by risks for NCD

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18
Q

Double burden of disease?

A

Middle/ low income countries where CD coexists with NCD

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19
Q

Commercial sector drives NCD inequities by?

A
  • Shaping preferences & changing social norms
  • Promoting unhealthy consumption among vulnerable groups
  • Create uneven distribution
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20
Q

Industrial epidemics?

A
  • Disease arising from unhealthy over consumption of unhealthy commercial products
    E.g tobacco, alcohol, fast food
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21
Q

Who control strategies for the right to health approach?

A

M - monitor tobacco use & prevention policies

P - protect people form tobacco use

O - offer help to quit tobacco use

W - warn dangers of tobacco

E - enforce bans on tobacco advertising, promotion, sponsorship

R - raise taxes on tobacco

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22
Q

NCD are more prevalent amount LMIC. Yes or no?

A

Yes

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23
Q

NCD mostly affects poor. Yes or No?

A

Yes

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24
Q

Double burden requires double response. Yes or no?

A

Yes

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25
Q

NCD affects just the elderly. Yes or No?

A

No

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26
Q

Significant proportions of NCD can be prevents. E.g stroke, cancer, diabetes, CVD. Yes or no?

A

Yes

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27
Q

What is the right to health?

A

It is a fundamental right of the govts to enable individuals to attain the highest level of health

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28
Q

What is the right to be healthy?

A

It is an individual perspective

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29
Q

Right to health - Tobacco examples.

A

Respect - respect for people regardless of their smoking status

Fulfill - govts must fulfil people’s right to health

Protect - tobacco industry must not interfere with our goals of becoming smoke free in 2025

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30
Q

3 obliges by states enshrined in international law are ?

A
  1. Respect - no discrimination
  2. Protect - no 3rd party interference
  3. Fulfil - Adopt measure to achieve equity
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31
Q

Right to health in NZ? Acts

A

The code of health & diability
Te Waitangi
UN declaration on rights of indigenous peoples

32
Q

Daly enables comparison between disease to?

A 
Prioritise health interventions
Monitor health interventions
Assess changes of disease burden over time
Communicable diseases are decreasing 
No communicable diseases are increasing
33
Q

Trends over time for communicable and noncommunicable in NZ and globally ?

A

CD are decreasing

NCD are increasing

34
Q

Social model of disability ?

A

Disability is no longer seen as an individual problem but a social issue caused by policies, practice attitudes and the environment

35
Q

Increasing risk factors for NCD are high I which countries?

A

High income countries

36
Q

Increasing risk factors for CD are high in?

A

Low income countries

37
Q

Commercial sector drives NCD inequities by?

A
  1. Shaping preferences & changing social norms
  2. Promote unhealthy consumption among vulnerable groups
  3. Create uneven distribution risks
  4. Unequal distributions of NCDs
38
Q

To address industrial epidemics we need to?

A
  1. Shift focus from individual behaviours to broad environment
  2. Tackle the broader determinants of health
  3. Develop effective health policy
39
Q

The who control strategies ?

A

M - monitor tobacco use & prevention policies
P - protect people from tobacco use
O - offer help to quit tobacco
W - warn about dangers of tobacco
E - Enforce bans on tobacco advertising, promotion, sponsorship
R - raise taxes on tobacco

40
Q

Right to health concept?

A

Protect
Respect
Fulfill

41
Q

80% of NCDs are in where?

A

Low income countries

Mostly affect poor

42
Q

What is CDC ?

A

Centre for disease control

43
Q

What is FDA?

A

Food & drug agency

44
Q

What we know about HIV?

A
  • Several modes of transmission identified
  • cheap reliable screening now
  • caused by a virus
  • no vaccine
45
Q

Most prevalent areas of HIV?

A
  • Sub Saharan Africa

- Young people account for majority

46
Q

HIV dominant form of transmission?

A

Heterosexual transmission

47
Q

HIV affects high income or low income more?

A

Low income countries

48
Q

15-24 years account for what percentage of HIV infections?

A

39%

Majority female in sub Saharan Africa

49
Q

Feminisation of HIV means?

A

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

60% of Africans living with HIV are women

50
Q

Gender inequities in HIV?

A

1 - rules governing sexual relationships, negotiating condom use

  1. Sexual abuse
  2. Problems with HIV disclosure
51
Q

HIV prevention & control?

A

Safer sex
Safer products
Increase access to health care

52
Q

Mother to child transmission of HIV?

A
  • Without treatment 1/3 children are born with HIV from there mother
  • 91% of Africa mothers need treatment
53
Q

HIV/ AIDs in NZ?

A
  • A low prevalence country
  • Most HIV suffers in NZ are gay men
  • routine antenatal screening
54
Q

Lessons from the HIV pandemic?

A

Treatment does not replace importance of prevention

55
Q

Globally is homosexual transmission the dominant mode of transmission??

A

No

56
Q

Gender inequality is a major social determinants of HIV/AIDS?

A

True

57
Q

3 major challenges for the future of HIV?

A
  1. Global resources for prevention & care of HIV fall well short of the needs
  2. Successful efforts for prevention need to combat stigma & discrimination
  3. Inequities in resources & access to health care make it essential to address social determinants of health & human rights especially among women
58
Q

5 measures used in DALY?

A

YLL:

  • No. of deaths from the disease in a year
  • Years lost per death relative to an ideal age

YLD:

  • Number of cases with non-fatal outcome with the disease
  • Average duration of non-fatal outcome until recovery/ death
  • Disability weight
59
Q

Demographic transition?

A

The changing of the population demographics as a result of fertility $ mortality rates

60
Q

Number of people living with HIV continues to rise due to?

A

Increased life expectancy due to treatments

61
Q

Human rights women and HIV?

A

Women’s rights to safe sexuality & to autonomy in all decisions relating to sexuality is intimately related to economic dependence

Unless the human rights scope is fully extended to economic security - women’s right to safe sexuality is not going to be achieved

62
Q

Road traffic injuries since 1990 has ?

A

Increased

63
Q

LMIC account for what percentage of RTI?

Despite having only half the worlds vehicles

A

90%

64
Q

Vulnerable road users are?

A

Motorised 2-3 wheelers
Pedestrians
Cyclists

65
Q

Key risk factors to target for road safety In LMIC?

A

Seat belts
Helmets
Alcohol
Speed

66
Q

Less than what percentage have policies to protect vulnerable road users?

A

33%

67
Q

RTI is an equity issue.

What does this mean?

A

Both in LMIC & HIC disadvantaged socioeconomic groups are at a greater risk of being killed by a RTI

68
Q

Road safety strategy global framework?

A
  1. Road safety management
  2. Safer roads & mobility
  3. Safer vehicles
  4. Safer road users
  5. Post crash response
69
Q

WHO Commision on social determinants of health ?

A
  1. Improve daily living conditions
  2. Tackle the inequitable distribution of power, money & resources
  3. Measure and understand the problem and assess the impact of action
70
Q

Uses of epidemiology in obesity ?

A

Descriptive - current trends
Predictive - future burden
Evaluative - effectiveness of interventions
Explanatory - changes over time differences between populations

71
Q

In NZ who is fatter?

A

Women

72
Q

Least deprived quintiles in obesity v most deprived shows what?

A

Least deprived have less obesity than most deprived

73
Q

Consequences of obesity?

A
  • mechanical problems
  • metabolic problems
  • psych issues
  • social consequences
74
Q

Obesity shaped by local environments ?

A

Economic environments - income, income disparities

Physical environments - food, physical activity

Socio-cultural environments - food, pa, body size

Policy environments - market regulations

75
Q

Deficiencies in road environments?

A
  1. Influence of choice of transport
  2. Poorly funded public transport system
  3. Compel children to be unaccompanied
  4. Poor road designs
  5. Vulnerable road users less protected

POPLHLTH 111 - My Deck (7 decks)

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