Population health Flashcards
What is pubic health?
It is response of society to protect and promote health and to prevent illness
What is lifestyle approach?
It essentially based on the idea that healthy behaviours are shaped by social environment
A public health problem must…
- Be widespread or serious
- Sever consequences to individuals and societies
- High costs to individuals and societies
- Effective methods have to be available to prevent or reduce the impacts
Public health strategies must…
- Use evidence to support the need for intervention
- Use evidence to support the effectivness of interventions
- Have public acceptability and professional support
- Have an economic benefit
What are the three key dimensions of public health?
- Disease prevention
- Health Promotion
- Health protection
Who is involved in Public health?
- Government
- Private sector
- NGO’s (non-govenment organisation)
- All sectors of society
What is epidemiology?
Epidemiology is the study of the distribution and determinants of health-related states or event in specifed populations, and the application of this study to the control of health problems.
What is a directed acyclic graph?
It is a graph that can be used to describe the task of epidemiologly.
Essentially a C (confounding) is a cause that influences both dependent (Y) and independent variable (X)
What is descriptive epidemiology?
It is part of epidemiology that looks and tries to describe the dependent variable (Y).
Y could be anything, for example dental caries.
Descriptise epidemiology tries to find out how much caries is there in a given poopulation.
What is predictive epidemiology?
It is part of epidemiology that asseses the independent variable in order to predict potential outcomes of the dependent variable.
This aspect of epidemiology caould be used for target interventions.
What is the third task of epidemiology?
To investigate causes and corelations.
For example: does the independent variable (baby formula) really cause a dependent variable to change (dental caries in children).
What is an important distinction that needs to be made when assesing disease in an individual and population?
The causes at the individual level might be different from the causes at the populaiton level.
What are the advantages of high risk approach?
- It is beneficial for individuals
- Important in adressing the inequalities
What are the disadvantages in high risk approach?
- Does not change population levels of disease
- Issues in identifying who is at risk
- Does not change the drivers in population
Continue the phrase by Geoffrey Rose: “Instead of simply focusing on those at high risk we must consider the fact that…”
…a large number of people at a small risk may give rose to more causes of disease than the small number who are at high risk.”
What are the are the advnatages of population health approach?
- Triying to remove the reason why the disease is common
- Almost everyone benefits
What are the disadvantages of population health approach?
- May not address health inequalities
- Does not represent a large benefit to the individual
What is the best approach to health?
Combining both high-risk and the population approaches
What are the three levels of prevention and how do they evolve from population to individual?
- Primary - mostly population approach
- Secondary - mostly population with little bits of individual
- Tertiary 1 - population and individual equally
- Tertiary 2 - mostly individual
What is the common risk factor approach?
It is an integrated approach that allows multiple disciplines to target similar risk factors in order to obtain a reduction in disease prevelence in multiple systems.
E.g.
- Most oral conditions share risk factors with general health conditions
- Must focus on the social determinants of health
- Integration of high-risk and population approaches for prevention
- Inclusion of oral health prevention stratetgies in idfferent settings
What is surveillance?
It is the ongoing, systematic collection, analysis and interpretation of outcome-specific data, essential to the planning, implementation, and evaluation of public health practive, closely integrated with the timely dissemination of these data to those responsible for prevention and control
What are the types of measurnments of disease occurence?
- Counts (prevalence and incidence)
- Proportions (prevalance)
- Rates (incidence)
- Means
What is a count measurnment? Give examples of each type.
It is an amount at one point of time or over a paeriod of time
Prevelance - an estimated 1.2 million australians had diabetes in 2017-2018
Incidence - There were 2800 total new cses of type 1 diabetes in australia in 2018
What are proportions measures? Give an example.
It is a measurnment that is always expressed in %.
E.g. 4.9% of the total population had diabetes in 2017-2018
What are rates measurnment? Provide an example.
A unit of preson-time.
E.g. The incidence of type 1 diabetes remained relatively stable between 2000 and 2018, flactuating between 11 and 13 new cases per 100000 population each year
What are means? Provide an example.
Basically the average number for a given population.
E.g. Australian adults aged 15 years and over had an avergae of 11.2 decayed, missing and filled teeth in 2017-2018
What measurnment scale can we use to measure dental caries?
Teeth: DMFT (decayed, missing and filled teeth), ranges between 1 to 32 in adults, depedning on the 3rd molar included in scoring
Surfaces DMFS (decayed, missing and filled surfaces), ranges from 0 to 128 or 148. Surfaces: occlusal, lingual/palatal, mesial, distal, buccal
How is DMFT recorded?
- When carious lesion(s) or both carous lesion(s) and a restoration are present, the tooth is recorded as D
- When a tooth has been extracted due to caries, it is recorded as an M
- When permanent or temporary filling is present, or when a filling is defective but not decayed, it is counted as an F.
What does the DMFT scale able to asses?
- Severity of disease (M component)
- Access to treatment (F and D relationship)
- Delayed access to treatment (M components)
What is the Community Periodontal Index of Treatment Needs (CPITN)?
- 6 index teeth reprsenting sextants (4 first molars, one maxillary and one mandibular anterior incisor)
- Shallow and deep periodontal pockets (4-5mm and 6+mm, respectively), dental calculus and bleeding on probing
What is the disease control and prevention (CDC) and American Academy of Periodontology (AAP) periodontal disease case definition?
- Examination of six sites per tooth in all teeth present, excluding third molars
- Sever periodontal disease defined as the presence of at least 2 teeth with 6+ mm of clinical attachment loss in interporximal sites with pocket depth of 5+ mm.
What are the definitions relating to Tooth Loss?
- Edentulism: Complete tooth loss
- Functional dentition: Presence of 21 teeth or more
- Severe tooth loss: Presence of 10 teeth or less
- Mean number of missing teeth: mean number of “M” / “m” component of the DMF / dmf index
What is the global prevalence of oral conditions in the population?
Nearly half of the world population suffer disability from oral conditions
What is the prevalence of dental caries in the primary dentition (age 5 -10) in Australia?
41.7%
What is the prevalence of untreated dental caries in primary dentition age 5-10?
27.1%
What is the mean DMFT for primary dentition age 5-10?
1.3
What is the caries prevalence in the permanent dentition age 9-14?
23.5%
What is the prevalence of untrated decay in permanent dentition age 9-14?
10.9%
What is the mean DMFT for permanent dentition age 9-14?
0.7
What are the three major oral health surveys and when were they conducted?
- National Oral Health Survey - 1987-88
- The National Survey of Adult Oral Healh 2004-06
- National Study of Adult Oral Health 2017-18
In general how can we summarise the findings of the 3 oral health surveys?
- Dental Caries is highly prevalent
- Socioeconomic gradients in caries experience are profound
- Improvements in caries experience are observed over time, mainly for childer and young adults
Wht was consdered moderate periodontitis in the National Oral Health Surveys?
2 or more interproximal sights with attachment loss equal or above 4 mm on 2 different teeth,
or
2 interproximal sites with pocket depth equal or above 5mm on 2 different teeth
What was considered severe periodontitis in the National Oral Health Surveys?
2 or more interproximal site with attachment loss of 6mm or above on 2 different teeth
and
1 or more interproximal site with pocket depth of 5 mm or more
What is the prevelence of moderate or severe periodontitis?
30.1%
How can we summarise the finding of the 2017-18 survey in regards to periodontitis?
- Prevalence of periodontal disease (moderate or severe) in Australian populatio was 30% in 2017-18
- Periodontal disease was strongly associated with age
- Prevalence of periodontal disease was greater among those of lower socioeconomic background
How can we summaries the key points from the 2017-2018 survey in regards to tooth loss?
- 4% of the australian adult population are edentulous
- 10% of the australian adult population are having <21 teeth
- Socioeconomic gradient in tooth loss
