Module 4 Flashcards
1
Q
Population public health aim is what?
A
Maximum benefit for the largest number of people
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
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
4
Q
Aims of the GDB project ?
A
- To use a systematic approach to summarise the burden of diseases & injury at the population level based on epidemiological principle and best available evidence
- To take account of deaths as well as non fatal outcomes when estimating the burden of disease
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
6
Q
How to calculate DALY?
A
YLD + YLL
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
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
9
Q
DALY enables comparisons between ?
A
Disease by using one measure that considers premature death & disability
10
Q
What are the trends of NCD & CD in NZ and globally?
A
CD are decreasing
NCD are increasing
11
Q
Major gains of the DALY approach?
A
- Drew attention to hidden burden of mental health
2. Recognises NCD as a major & increasing problem in low-middle income countries
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 ?
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
14
Q
Increasing risk factors for NCD in which countries?
A
High income countries
15
Q
Increasing risk factors for CD in which countries?
A
Low income countries
16
Q
Epidemiological transition ?
A
- Characteristic shift in common causes of death & disability from perinatal & communicable disease to non communicable disease
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
18
Q
Double burden of disease?
A
Middle/ low income countries where CD coexists with NCD
19
Q
Commercial sector drives NCD inequities by?
A
- Shaping preferences & changing social norms
- Promoting unhealthy consumption among vulnerable groups
- Create uneven distribution
20
Q
Industrial epidemics?
A
- Disease arising from unhealthy over consumption of unhealthy commercial products
E.g tobacco, alcohol, fast food
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
22
Q
NCD are more prevalent amount LMIC. Yes or no?
A
Yes
23
Q
NCD mostly affects poor. Yes or No?
A
Yes
24
Q
Double burden requires double response. Yes or no?
A
Yes
25
NCD affects just the elderly. Yes or No?
No
26
Significant proportions of NCD can be prevents. E.g stroke, cancer, diabetes, CVD. Yes or no?
Yes
27
What is the right to health?
It is a fundamental right of the govts to enable individuals to attain the highest level of health
28
What is the right to be healthy?
It is an individual perspective
29
Right to health - Tobacco examples.
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
30
3 obliges by states enshrined in international law are ?
1. Respect - no discrimination
2. Protect - no 3rd party interference
3. Fulfil - Adopt measure to achieve equity
31
Right to health in NZ? Acts
The code of health & diability
Te Waitangi
UN declaration on rights of indigenous peoples
32
Daly enables comparison between disease to?
```
Prioritise health interventions
Monitor health interventions
Assess changes of disease burden over time
Communicable diseases are decreasing
No communicable diseases are increasing
```
33
Trends over time for communicable and noncommunicable in NZ and globally ?
CD are decreasing
| NCD are increasing
34
Social model of disability ?
Disability is no longer seen as an individual problem but a social issue caused by policies, practice attitudes and the environment
35
Increasing risk factors for NCD are high I which countries?
High income countries
36
Increasing risk factors for CD are high in?
Low income countries
37
Commercial sector drives NCD inequities by?
1. Shaping preferences & changing social norms
2. Promote unhealthy consumption among vulnerable groups
3. Create uneven distribution risks
4. Unequal distributions of NCDs
38
To address industrial epidemics we need to?
1. Shift focus from individual behaviours to broad environment
2. Tackle the broader determinants of health
3. Develop effective health policy
39
The who control strategies ?
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
Right to health concept?
Protect
Respect
Fulfill
41
80% of NCDs are in where?
Low income countries
| Mostly affect poor
42
What is CDC ?
Centre for disease control
43
What is FDA?
Food & drug agency
44
What we know about HIV?
- Several modes of transmission identified
- cheap reliable screening now
- caused by a virus
- no vaccine
45
Most prevalent areas of HIV?
- Sub Saharan Africa
| - Young people account for majority
46
HIV dominant form of transmission?
Heterosexual transmission
47
HIV affects high income or low income more?
Low income countries
48
15-24 years account for what percentage of HIV infections?
39%
| Majority female in sub Saharan Africa
49
Feminisation of HIV means?
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
Gender inequities in HIV?
1 - rules governing sexual relationships, negotiating condom use
2. Sexual abuse
3. Problems with HIV disclosure
51
HIV prevention & control?
Safer sex
Safer products
Increase access to health care
52
Mother to child transmission of HIV?
- Without treatment 1/3 children are born with HIV from there mother
- 91% of Africa mothers need treatment
53
HIV/ AIDs in NZ?
- A low prevalence country
- Most HIV suffers in NZ are gay men
- routine antenatal screening
54
Lessons from the HIV pandemic?
Treatment does not replace importance of prevention
55
Globally is homosexual transmission the dominant mode of transmission??
No
56
Gender inequality is a major social determinants of HIV/AIDS?
True
57
3 major challenges for the future of HIV?
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
5 measures used in DALY?
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
Demographic transition?
The changing of the population demographics as a result of fertility $ mortality rates
60
Number of people living with HIV continues to rise due to?
Increased life expectancy due to treatments
61
Human rights women and HIV?
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
Road traffic injuries since 1990 has ?
Increased
63
LMIC account for what percentage of RTI?
Despite having only half the worlds vehicles
90%
64
Vulnerable road users are?
Motorised 2-3 wheelers
Pedestrians
Cyclists
65
Key risk factors to target for road safety In LMIC?
Seat belts
Helmets
Alcohol
Speed
66
Less than what percentage have policies to protect vulnerable road users?
33%
67
RTI is an equity issue.
| What does this mean?
Both in LMIC & HIC disadvantaged socioeconomic groups are at a greater risk of being killed by a RTI
68
Road safety strategy global framework?
1. Road safety management
2. Safer roads & mobility
3. Safer vehicles
4. Safer road users
5. Post crash response
69
WHO Commision on social determinants of health ?
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
Uses of epidemiology in obesity ?
Descriptive - current trends
Predictive - future burden
Evaluative - effectiveness of interventions
Explanatory - changes over time differences between populations
71
In NZ who is fatter?
Women
72
Least deprived quintiles in obesity v most deprived shows what?
Least deprived have less obesity than most deprived
73
Consequences of obesity?
- mechanical problems
- metabolic problems
- psych issues
- social consequences
74
Obesity shaped by local environments ?
Economic environments - income, income disparities
Physical environments - food, physical activity
Socio-cultural environments - food, pa, body size
Policy environments - market regulations
75
Deficiencies in road environments?
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
