Module 4 Flashcards
What is the GBD?
Global Burden of Disease Project
What were the reasons for conducting the GBD?
Data on the burden of disease (and injury) from many
countries were incomplete
Available data largely focused on deaths; little information
on non-fatal outcomes (disability)
Lobby groups can give a distorted image of which
problems are most important
Unless the same approach is used to estimate the burden
of different conditions, it is difficult to decide which conditions are most important and which strategies may be the “best buys”
What are the aims of the GBD?
1. To use a systematic approach to summarize the
burden of diseases and injury at the population-level based on epidemiological principles and best available evidence
2. To take account of deaths as well as non-fatal
outcomes (i.e., disability) when estimating the burden of disease
What were the key sources of datas for this project?
‘Vital registration data’ (eg, NZ’s national
mortality and hospital discharge databases)
Disease surveillance system
Epidemiologic studies & surveys n Statistical models developed to get bestestimates when data were incomplete
What is a DALY?
DALY = Years of life lost to mortality (YLL) + Years lived with disability (YLD)
Stands for Disability-Adjusted Life Year
Give the DALY for a year of perfect health
0
Give the DALY for a year of life lost due to death
1
Give the DALY for a year with disability
between 0 and 1
What is a communicable disease?
infectious diseases and (The GBD project includes problems during pregnancy, childbirth, or very early life in this group)
What is a non communicable disease?
chronic diseases (e.g, heart disease, strokes, cancer, diabetes)
Explain Demographic transition
decline in fertility and mortality rates
observed in most developed and several developing countries
Explain epidemiological transition
characteristic shift in the composition of
causes of death and disability from communicable to non-communicable diseases
Explain risk transition
Changes in risks factor profiles as countries shift
from low- to higher income countries, where common risks for perinatal and communicable diseases (e.g., unhygienic water) are replaced by risks for non-communicable diseases (e.g., tobacco)
Explain double burden of disease
In many middle-income countries, previously common risks for
perinatal and communicable diseases co-exist with increasing risks for non-communicable diseases.
What are the key factors influencing the risk burden?
- How strong is the ‘causal’ association between the risk factor and health condition(s) (eg, relative risk)
- How common is the exposure to this risk in the population of interest? (eg, the prevalence of the risk factor in the population)
Where are most chronic diseases? high or low income countries
low and middle income countries MOSTLY among poor
What role does the commercial sector play in (unequal) NCD epidemics?
(1) Social norms changed as smoking became popular among other social groups
(2) A greater emphasis on downstream (compared with upstream) strategies has put equity in public health at risk
(3) Difficulties with behaviour change are actively exploited by industries
Explain the development of right to health
- Universal Declaration of Human Rights – 1948
2. International Covenant on Economic, Social & Cultural Rights (ICESCR) – 1966
Explain the rights to health
- Enshrined in International Law
- Extends beyond health care to pre-conditions
- States obliged to respect (e.g. no
discrimination) , protect (e.g. no interference from 3rd parties) and fulfil (e.g. adopt measures to achieve equity)
4.Social epidemiology links health with social justice & thus links to good government
What are the two rights to health acts in NZ?
The Code of Health & Disability Service Consumer’s Rights
NZ Public Health & Disability Act
Te Tiriti o Waitangi
What are the Rights to Health?
- Universal Declaration of Human Rights
- ICESCR
- Other international rights conventions
- Indigenous Rights
- NZ legislation & policies
What are two relatively common situations in which YOU may be screened for HIV, even if you do not belong to a known high-risk group or have any clinical signs or symptoms of HIV/AIDS?
If you are pregnant or are giving blood
What are the high risk groups for HIV + people?
homosexual sex partners heterosexual sex partners sex workers injecting drug users infants born to or breast fed by HIV + mothers Anyone receiving unscreened blood
Explain Feminisation of the HIV epidemic
refers to the observation that increasing proportions of new infections are among women, primarily due to heterosexual transmission of the infection. In Sub-Saharan Africa, about 60% of people living with HIV are women.
What specific social determinants cause Feminisation of the HIV epidemic? or the HIV epidemic in general?
Gender inequalities in who suggests condom use
low social status and therefore lack of education and health services
Problems with disclosure of HIV status, partner notification and confidentiality
Two major challenges to the DALY approach to Disability
- The GBD project criticised for its potential to represent people with disabilities as a ‘burden’
- Disability weights are considered to be the same as the severity of an impairment relating to a disease/health condition, and do not vary with a person’s social position, where they live, their access to healthcare or any other life circumstance
Explain the “Medical Model” of Disability
The disabled person is the problem, not society.
Explain the “Social Model” of Disability
The social model focuses on ridding society of barriers, rather than relying on ‘curing’ people who have impairments.
Explain Youth2000 surveys
Cross‐sectional surveys using random samples ofsecondary school students in 2001, 2007 and 2012
• Anonymous, confidential, self‐report
Define Resilience
‘Resilience’ refers to the ability to spring back despite adversity. This means people with various protective (or resiliency) factors may be less vulnerable to harm despite exposure to risk.
Explain the Haddon matrix
There are 4 columns: Host Agent/Vehicle Physical environment Social environment And three rows: Pre-Event Event Post-Event
x% of global energy obtained
from fossil fuels
85% of global energy obtained
from fossil fuels
What are the gases that make up most of the global warming effect?
carbon dioxide, methane and other gases
What is an example of an indirect effect of global warming?
The zika virus spreads faster as countries become warmer and mosquitos carrying this virus migrate towards these countries
What is an example of a direct effect of global warming on health?
Heat waves can decrease food yields, thus we may not be able to feed ourselves as food prices rise.
How can global warming effect the work capacity of humans?
At higher temps, we work less (labour) thus may be more inefficient on economy.
