POPH192 - Lecture 14 and 15 Flashcards
define public health
the health outcomes of a group of individuals including the distribution of such outcomes within the group
what are the 2 axes of the distribution of health in nz?
socioeconomic status:
- people of low SES have poorer health
ethnicity:
- Maori and Pacific have poorer health
what are ways to assess SES?
- occupation
- income - household or individual
- education - qualification
- living standards measures - economic living standard index
- by deprivation - NZi Dep (individual), NZ Dep (Area based)
what does NZ Dep measure?
area based measure of deprivation
- access to internet
- qualifications
- employment
- income
- access to car etc
how is NZ dep categorised?
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)
what are the 2 types of poverty?
- absolute poverty
- relative poverty
define abolute poverty
- 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
define relative poverty
- 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
which type of poverty is high in nz?
relative poverty
what is the social gradient of health?
- 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
define social determinants of health?
factors which determine health outcomes in a population
what are examples of social determinants of health?
- individuals lifestyle factor
- social and community influences
- living and working conditions
- general SES, cultural and environmental conditions
what is indivuals lifestyle factor?
does person smoke and drink? or have a healthy lifestyle
what is social and community influences?
how common is smoking in the community?
what is living and working conditions?
- insulation of house
- employment and type of work (factory, office, etc)
what is general SES, cultural and environmental conditions?
smog/weather in a country
what is burden of disease?
impact of a health problem as measured by financial cost, mortality, morbidity or other indicators (DALY, YLL, YLD)
what are the two types of disease that contribute to burden?
- communicable disease
- non-communicable disease
what is communicable disease?
infectious diseases that can spread from person to person (HIV, Influenza)
what is non-communicable disease?
- internal diseases suffered by an individual - they cannot be transmitted from person to person (cancer, heart disease)
is the burden of disease the same everywhere?
no, it differed between countries.
what type of disease is higher in low income countries?
communicable
what type of disease is higher in high income countries?
non-communicable
what are DALY’s?
- Disability adjusted life year
- use DALY to measure burden of disease
how do DALY’s measure burden of disease?
sum of DALY’s across population can be thought of as a measurement of the gap between health status and ideal health situation
what are the two transition theories?
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
what is being shown in demographic transition?
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
what is being shown in epidemiological transition?
- 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)
what is shown in the red circle?
in developing countries (e.g. India) there is a double burden of both communicable and non-communicable disease
what is the overall pattern of epidemiological transition?
as a country becomes more developed, there is a decrease in communicable disease and an increase in non-communicable disease.
what is an ageing population?
as a country becomes more developed, people tend to live longer
links between transition theories and ageing population?
- 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)
what is the compression of morbidity?
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
