Population health Flashcards
What is Epidemiology?
Epidemiology is the study of the distribution, determinants, and deterrents of morbidity and mortality in human populations
What is Mortality?
the number of deaths that occur
What is Morbidity?
the state of being unhealthy
What is Behavioral Epidemiology?
- Behavioral Epidemiology is a subset of epidemiology
- Focuses on health related behaviors in populations. Uses patterns and their influence on population wide disease prevention/health
What is the aim of behavioural epidemiology?
to understand and influence healthful behavior patterns as part of population-wide initiatives to prevent disease and promote health
What are the key components of the Behavioural Epidemiology Framework?
The framework includes:
○ Health Outcomes
○ Measurement
○ Determinants or correlates
○ Interventions (what can be done)
○ Translation of research into practice (application)
What is the WHO definition of “health?”
According to the World Health Organization (WHO), health is the state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity
What is a “population” in the context of population health?
A group of people or individuals with a common characteristic
Ex. Age, race, gender, Geography, life events…
What are the two main types of populations?
○ Fixed Population
○ Dynamic (or Open) Population
What is Population Health?
Population health is an approach that aims to improve the health of the entire population and to reduce health inequities among population groups. It considers and acts upon the broad range of factors and conditions that have a strong influence on our health
Role of Physical activity and Health Behaviors
The prevention of chronic disease over a lifetime and within populations
Medical model
- Narrow understanding of health
- focuses on the absence of disease/disability
- looks at the body as an isolate (not outside factors)
- Heavily based on science/ Expert knowledge
- Puts the responsibility of health on the individual
Social Model
- Uses a complex understanding of health
- Incorporates a wider range of factors including, social and mental dimensions of health
- Considers the environmental impacts
- Uses Common (lay) knowledge (less science based)
- Puts the responsibility of health on the society
What is a fixed population
The population membership size cannot be changed because it is based on a permanent event.
Ex. your birthdate (this cannot be changed)
Ex. WW2 Survivors (you cannot become a WW2 Survivor cuz the war is over)
What is a dynamic population
A population that can increase or decrease (is changable)
what is a steady state in the context of a dynamic population
When the amount of people entering a population is equal to the amount of people leaving. There is a Net Change of ZERO
What is “basic” health research?
Looks at Cells and tissues in a lab setting to understand disease mechanisms and toxic substances
What is clinical health research
Working with patients in health care facilities in order to improve a condition or for treatment
What is Population Health Research
Looks at the health of a population/community with a focus on disease prevention and health promotion.
Ottawa Charter for Health Promotion (5 parts)
A framework for health promotion for all peoples. Focuses on Social, economic, and environmental factors
3 Strategies - Ottawa Charter for Health Promotion
- Advocate
- Enable
- Mediate
Action areas of the Ottawa Charter
- Developing personal skills
- Creating Supportive Environments
- Strengthening community action
- Reorienting health services
- Building healthy public policy
ottawa charter
Disease
Abnormally medically defined changes in structure/function of the body
Illness
an individual’s experience or subjective perception of lack of physical or mental well-being and consequent inability to function normally in social roles
What are the two primary types of disease?
◦ Infectious or communicable disease.
◦ Non-infectious or non-communicable or chronic disease
Infectious Disease
- a disease that can be spread (communicable)
- An infectious agent that is transmitted from an infected person to susceptible hosts
- Has a low Risk of Mortality (death) in developed countries
- Mortality most common in the very young/old/ people with pre-existing conditions
- 3 categories: Outbreak, Epidemic and Pandemic
Outbreak (Infectious Disease)
The occurrence of new cases in a local area (a city)
vaccine-preventable diseases do recur
Epidemic (Infectious Disease)
The occurrence of new cases in a country (or countries)
Pandemic (Infectious Disease)
The occurrence of cases internationally. The diseases crosses many international boundaries.
Non-Infectious Disease
a disease that CANNOT be spread/is chronic to an individual (non-communicable)
Zika Virus (Epidemic)
- a disease transmitted by aedes mosquitoes
- causes brain abnormalities during pregnancy
- Northern Brazil/Americas
Influenza (Pandemic)
a highly contagious viral infection, killing millions worldwide.
- lowered the average life expectancy in the US by 10 years
Covid-19 (Pandemic)
Causes severe acute respiratory syndrome.
Chronic Disease
;a form of non-communicable disease (NCD)
- cannot be passed from one person to another
- has a long duration with slow progression
Caused mainly by these 4 risk factors:
1. Tobacco
2. Unhealthy Diet
3. Lack of Physical Activity
4. Harmful Alcohol Usage
Life-Course Approach
Aging as a marker of the accumulation of modifiable risk factors for chronic disease risk factors. Increasing over the course of someone’s life.
- Chronic disease is most shown in older adults based on long term unhealthy habits
- Intervention/promotion of good behavior patterns early in life can prevent chronic disease
What is the global impact of Chronic Disease?
Chronic diseases are the leading causes of death globally, killing more people each year than all other causes combined, with a large percentage of deaths occurring in low- and middle-income countries
Risk Transition
The shift from infectious disease to chronic disease based on a countries development
Non-Developed: More infectious disease
Developed: More chronic disease
—–
Caused by __________ in developed countries
* Improved Health Care
* greater intervention
* Longer life expectancy (leads to greater prevalence of chronic disease due to the “life-course approach”)
Infectious vs Chronic Disease in a country is inversely related based on development (Less infectious, more Chronic. Vise Versa)
Describe the Epidemiological Transition
The epidemiological transition describes the shift from the age of deadly diseases and famine to the age of receding epidemics, then to the age of degenerative and human-caused diseases, and finally to the age of delayed degenerative diseases. This shift moves from infectious diseases being the main concern to chronic diseases
What are the 3 levels of prevention
primary, secondary, tertiary
all contribute to protect and promote health
Define Primary Prevention
> The maintenance of health so a disease never develops through individual or community efforts.
> Focuses on health before a person gets a disease.
> targets the general population.
Define Secondary Prevention
focuses on the early detection of disease to reduce its expression and severity.
It involves screening and early interventions in an attempt to delay onset and duration, typically targeting subgroups
Define Tertiary Prevention
aims to reduce the complications of existing diseases by slowing progression, reducing impairments and preventing further issues.
It is implemented after a clinical diagnosis and targets diseased subgroups with symptoms
What are the two main approaches to prevention?
◦ High-Risk Approach: Focuses on identifying and protecting susceptible individuals.
◦ Population-Based Approach: Focuses on controlling the causes of disease in the whole population
What are the advantages of the High-Risk Approach?
◦ Intervention is appropriate for the individual.
◦ Individuals are often motivated to change.
◦ Physicians are often motivated to help.
◦ Cost-effective use of resources by focusing where there is need
What are the disadvantages of the High-Risk Approach?
◦ Difficulties and costs of screening.
◦ Palliative and temporary; does not alter the underlying cause.
◦ Limited potential for the individual and population; poor ability to predict the future of disease.
◦ Can be behaviorally inappropriate and constrained by social norms
What are the advantages of the population-based approach to prevention?
- Radical; remove underlying cause of the disease
- large potential for the population; small individual changes can lead to larger effect at the population level
- Behaviourally appropriate; change in social norms and environment
What are the disadvantages of the population-based approach to prevention?
- Small benefit to individual; “prevention paradox”
- Poor motivation of individual; no immediate reward
- Poor motivation of physician; small benefit to the individual patients
According to Geoffrey Rose, what is the priority of concern?
The discovery and control of the causes of incidence should be the priority. Both individual-based and population-based approaches are often necessary, and competition between them is usually unnecessary
What did the Conference Board of Canada find regarding the impact of small shifts in physical activity?
Small shifts in physical inactivity and sedentary behavior levels of Canadians from 2015 to 2040 could reduce the incidence rates for major chronic diseases substantially. This includes fewer cases of hypertension, diabetes, heart disease, and cancer. Also, Canada’s GDP would increase and health care spending would decrease
What are some examples of chronic diseases that can be reduced with a population health approach?
Hypertension, diabetes, heart disease, and cancer
