POPH192 - Lecture 14 and 15

Question 1

define public health

Answer 1

the health outcomes of a group of individuals including the distribution of such outcomes within the group

Question 2

what are the 2 axes of the distribution of health in nz?

Answer 2

socioeconomic status:
- people of low SES have poorer health

ethnicity:
- Maori and Pacific have poorer health

Question 3

what are ways to assess SES?

Answer 3

• occupation
• income - household or individual
• education - qualification
• living standards measures - economic living standard index
• by deprivation - NZi Dep (individual), NZ Dep (Area based)

Question 4

what does NZ Dep measure?

Answer 4

area based measure of deprivation

• access to internet
• qualifications
• employment
• income
• access to car etc

Question 5

how is NZ dep categorised?

Answer 5

areas of ~100 people categorised into deciles.

decile one = area with least deprived score (highest SES)

decile 10 = area with most deprived score (lowest SES)

Question 6

what are the 2 types of poverty?

Answer 6

• absolute poverty
• relative poverty

Question 7

define abolute poverty

Answer 7

• income level below which a minimum nutritionally adequate diet plus essential non-food requirements in not affordable. amount of income a person, family or group needs to purchase an abolute amount of the necessities of life

Question 8

define relative poverty

Answer 8

• the amount of income a person, family or group needs to purchase relative amounts of basic necessities of life; these basic necessities are identified relative to each society and economy

Question 9

which type of poverty is high in nz?

Answer 9

relative poverty

Question 10

what is the social gradient of health?

Answer 10

• the poorest of the poor have the worst health
• the social gradient of health shows that with increasing levels of deprivation, poor health outcomes increase
• e.g. could be due to poor housing conditions (mold) leading to health conditions such as rheumatic heart disease

Question 11

define social determinants of health?

Answer 11

factors which determine health outcomes in a population

Question 12

what are examples of social determinants of health?

Answer 12

• individuals lifestyle factor
• social and community influences
• living and working conditions
• general SES, cultural and environmental conditions

Question 13

what is indivuals lifestyle factor?

Answer 13

does person smoke and drink? or have a healthy lifestyle

Question 14

what is social and community influences?

Answer 14

how common is smoking in the community?

Question 15

what is living and working conditions?

Answer 15

• insulation of house
• employment and type of work (factory, office, etc)

Question 16

what is general SES, cultural and environmental conditions?

Answer 16

smog/weather in a country

Question 17

what is burden of disease?

Answer 17

impact of a health problem as measured by financial cost, mortality, morbidity or other indicators (DALY, YLL, YLD)

Question 18

what are the two types of disease that contribute to burden?

Answer 18

• communicable disease
• non-communicable disease

Question 19

what is communicable disease?

Answer 19

infectious diseases that can spread from person to person (HIV, Influenza)

Question 20

what is non-communicable disease?

Answer 20

• internal diseases suffered by an individual - they cannot be transmitted from person to person (cancer, heart disease)

Question 21

is the burden of disease the same everywhere?

Answer 21

no, it differed between countries.

Question 22

what type of disease is higher in low income countries?

Answer 22

communicable

Question 23

what type of disease is higher in high income countries?

Answer 23

non-communicable

Question 24

what are DALY’s?

Answer 24

• Disability adjusted life year
• use DALY to measure burden of disease

Question 25

how do DALY’s measure burden of disease?

Answer 25

sum of DALY’s across population can be thought of as a measurement of the gap between health status and ideal health situation

Question 26

what are the two transition theories?

Answer 26

demographic transition
- showing changes in death and birth rates and total population over time

epidemiological transition
- showing changes in disease patterns overtime

*both occur together as population develops

Question 27

what is being shown in demographic transition?

Answer 27

there are 3 lines

• high birth and high death rates, low population initially
• death rate decreases, followed by birth rate
• total population increases, birth and death rates stabilise

*this happens in a country that is developing

Question 28

what is being shown in epidemiological transition?

Answer 28

• in least developed countries, high levels of communicable disease
• low levels of non-communicable diseases (e.g. don’t live long enough to develop cancer)

Question 29

what is shown in the red circle?

Answer 29

in developing countries (e.g. India) there is a double burden of both communicable and non-communicable disease

Question 30

what is the overall pattern of epidemiological transition?

Answer 30

as a country becomes more developed, there is a decrease in communicable disease and an increase in non-communicable disease.

Question 31

what is an ageing population?

Answer 31

as a country becomes more developed, people tend to live longer

Question 32

links between transition theories and ageing population?

Answer 32

• in a more developed country people have a longer life expectancy, but also lower fertility (demographic), and older people contribute more to non-communicable diseases (epidemiological)

Question 33

what is the compression of morbidity?

Answer 33

prolonging life to elderly ages by suppressing communicable diseases has it’s disadvantages - can lead to unpleasant non-communicable diseases e.g. diabetes

• diabetes can eventually turn chronic disease to a severe disability.
• want to minimise the time people have the ‘morbid’ disabled condition for.
• compression of morbidity aims to slow the progression from chronic disease to morbidity