POPH192 14-16 Flashcards
What is POPH?
Health outcomes of a group of individuals, including distribution of such outcomes within the group
- it is at group level, not individual level
Group of Individuals
Geographical, country, small areas
How is health distributed in NZ (characteristics)
Differing outcomes by sex, age, ethnicity, gender socio-economic status, etc.
Assessing Socioeconomic Status criteria (OILED)
Occupation
Income
Deprivation
Education
Living standards measures
NZDep
Area based, complex measure of relative socioeconomic deprivation that considers range of aspects (not everything)
Low NZDep VS High NZDep
Higher = more deprived w/ 10 being the most deprived and 1 being the least
- NZDep increase = poor health increase
Determinants of Health (5)
- Individual factors
- Individual lifestyle factors
- Social & community influences
- Living & working conditions
- General socioeconomic climate, cultural & environmental condition
DALY (disability-adjusted life year)
Measure of overall disease burden, expressed as number of years lost due to ill-health, disability or early death
One DALY = One year of healthy life lost
YLDs (Years lived w/ disability)
Measure of non-fatal health loss. Takes into account #people in health state of interest (prevalence/incidence times duration) & severity of health state (disability weight)
YLLs (Years of Life Lost)
Measure of fatal health loss. Takes into account # deaths & age at death
Demographic Transition
Changes in pop. death & birth rates over time (growth & change in pop. over time)
Epidemiological Transition
Changes in pop. disease patterns over time (communicable disease & non-communicable diseases)
Defining the Problem…
Determines Health status
Observing trends overtime
Noting impact among diff groups (more accurate theories of causes; most effective interventions; targeting highest risk pop. groups)
Measures of Occurence
Prevalence
Incidence Proportion
Incidence Rate
Prevalence Limitations
- Influenced by disease duration
- doesn’t tell us abt disease development (time)
Incidence Proportion
Proportion of outcome-free pop. that develops outcome of interest in specified time period
- must be at risk (can’t alrdy have condition + must be able to develop
- est. risk of disease development
Incidence Rate
New cases - speed
- Needs person-time - not always available, complex
Prevalence
Proportion of pop. who have disease at one pt. in time
- observation of burden of disease for efficient + effective resource allocation
Prevalence Calculation
no. of ppl w/ disease at given pt. in time
(divided by)
total no. of ppl in pop. at given pt. in time
Measure of Occurrence Reporting (5)
- MEPTV
- Measure of occurrence
- Exposure/outcome
- Pop.
- Time pt.
- Value
e.g., The prevalence/of asthma/in the POPH192 class/on August 15 2022/was 10%.
(incidence rate no time pt)
P = I x D (don’t use as actual formula)
Changes to incidence & duration can affect disease prevalence
- an estimation
Incidence
Occurrence of new cases of outcome in pop. during specified time period
Incidence Proportion Calculation
ppl who develop disease in specified period
(divided by)
#ppl at risk of developing disease at start of period
Incidence Proportion Limitations
- Assumes closed pop. (doesn’t account for ppl coming/going)
- time period dependent (longer time period = higher incidence proportion)
Incidence Rate
Rate at which new cases of outcome of interest occur in pop.
*must be at risk (can’t be a case)
- lost to follow-up (try & maximise full-term participation)
- follow up time ends too early
*person-time
- 12 person-months = 1 person-years
- adding together time of follow-up until exit, death, case (outcome)
Incidence Rate Calculation
ppl who develop disease in specified period
(divided by)
#person-years at risk of developing disease
Incidence Rate Limitations
- person time availability
- complex calculations
Age Standardisation
Used when comparing pop. that differ in age structure + disease risk varies by age
