preventative medicine and population health

Question 1

what is life expectancy?

Answer 1

the average number of years a new born baby can expect to live given that the mortality rates at birth are the same throughout their life - it is growing as medicine develops

Question 2

what are improvements of heath and associations to mortality?

Answer 2

much of the mortality reduction over the last 100 years is due to vaccination., antibiotics and other medical treatments

Question 3

what is primordial prevention?

Answer 3

it is action to prevent the development of disease risk factors

Question 4

what compromises primordial prevention?

Answer 4

change in the social and environmental conditions that are known to cause risk factors, and identifying and taking early action to prevent the later development of risk factors

Question 5

what is primary prevention?

Answer 5

action to modify the existing risk factors developing into disease in healthy people

Question 6

what comprises primary prevention?

Answer 6

protection from pathogenic disease, altering risky substances and banning substances that are known to be associated with disease

Question 7

what is secondary prevention and what does it comprise?

Answer 7

actions to detect disease early and prevent the emergence of symptoms or complications. This includes screening for asymptomatic disease and prophylactic treatment to prevent recurrence

Question 8

what is tertiary prevention?

Answer 8

action to improve the quality of life and reduce symptoms of those with established disease - reducing the impact of lifelong conditions and minimising impairment

Question 9

what are non-modifiable risk factors for cardiovascular disease?

Answer 9

gender, genetics, ethnicity, socio-economic level and family history

Question 10

what are modifiable risk factors for CVD?

Answer 10

smoking, alcohol, high cholesterol, uncontrolled hypertension or diabetes, inactivity, diet, obesity, uncontrolled CRP and stress, anger and depression

Question 11

why is intervention needed?

Answer 11

a large number of people at low risk may give rise to a higher number of cases than a small number of people at high risk, and the causes of population prevalence and individual risk are not the same

Question 12

what does the population mean predict?

Answer 12

the prevalence of cases

Question 13

what is a high end approach?

Answer 13

it is when you identify and act on the top end of the population distribution and target those at most risk. The intervention is weighed up on an individual risk benefit, and is through screening or case findings

Question 14

what is the population approach?

Answer 14

when the mean of the whole distribution is shifted to the left and risk factors are identified for the community. Policies are put in place irrespective of the individual risk and it is a risk benefit balance for the whole community

Question 15

what is the difference between individual and population risk?

Answer 15

individual is their own risk factors whereas population is a average of individual disease risks

Question 16

how is there cross over between individual and population risk?

Answer 16

societal factors may influence both the individual and population risk - e.g. socio-economic gradient

Question 17

what are the characteristics of a targeted approach?

Answer 17

the individuals are identified, there are large potential benefits for the individual and small for the population and there is a good understanding of effects - proximity in causal chain

Question 18

what are the characteristics of a population intervention?

Answer 18

individuals are not identified, there is a small potential benefit for individuals but large for population and the understanding of effects is poor

Question 19

what did the Wanless report call for?

Answer 19

a rebalancing of policy away from healthcare - sickness to health