Public Health

Question 1

Define health

Answer 1

a state of complete physical, social and mental wellbeing, and not merely the absence of disease or infirmity

Question 2

Define epidemiology

Answer 2

the study of the distribution and determinants of diseases among populations
concerned with frequency + pattern of health events

Question 3

Define primary prevention

Answer 3

pre-pathologic

reduce disease incidence + prevalence

Question 4

Define secondary prevention

Answer 4

screening + treatment

Question 5

Define tertiary prevention

Answer 5

rehabilitation
reduce suffering
prevent complications

Question 6

What is meant by frequency and pattern of health events?

Answer 6

frequency = number of health events (rate = with regards to size of population, allowing for comparison)

pattern = occurrence of health-related events by time, place + person

Question 7

What is a reservoir of infection?

Answer 7

any person, animal, arthropod, plant, soil, or

substance in which the disease agent normally lives or multiplies

Question 8

What is a transmission pathway?

Answer 8

mechanism by which a infectious agent is spread from a source (reservoir) to a susceptible individual

Question 9

Describe 4 methods to prevent community-acquired infection

Answer 9

reduce susceptible population = immunisation

reduce infectious population = diagnosis + treatment of infected individuals

reduce person-to-person spread = handwashing, food hygiene, safe sex

preventing animal-to-human spread = pasteurise milk, killing of infected livestock, treat animals

Question 10

What does surveillance allow us to do?

Answer 10

describe burden of disease
detect sudden changes in disease occurrence + distribution
monitor changes in disease prevalence over time
identify priorities
inform programmes + policies
evaluate prevention + control efforts
develop hypotheses + stimulate research

Question 11

Define incidence

Answer 11

rate of occurrence of new cases

conveys info about risk of contracting disease

Question 12

Define prevalence

Answer 12

proportion of cases in the population at a give time

indicates how widespread disease is/burden

Question 13

Define mortality rate

Answer 13

measure of frequency of occurrence of death in a defined population during a specified interval

Question 14

Define case fatality rate

Answer 14

measure of deaths assigned to a specific cause during a given time interval, relative to the total number of cases

Question 15

Define outbreak

Answer 15

sudden increase in occurrences of a disease

Question 16

Define endemic

Answer 16

habitual presence (usual occurrence) of a disease within a given geographical area

Question 17

Define pandemic

Answer 17

an epidemic which is spreading around the world affecting many people across many countries

Question 18

Define epidemic

Answer 18

a serious outbreak in a single population, community or region

Question 19

What is ICD?

Answer 19

international classification of diseases

Question 20

What is GBD?

Answer 20

global burden of disease

study that summarises global surveillance data

Question 21

Benefits of physical activity

Answer 21

increased cardiovascular health
increased cognitive performance
increased bone health
reduced stress
increased confidence + self-esteem

Question 22

What are the UK guidelines for physical activity for children and adults?

Answer 22

children = active 60 mins/day
adults = active 150 mins/week moderate intensity (can talk, but not sing) OR 75 mins/week vigorous intensity (can barely talk)
adults should do physical activity to increase muscle strength at least 2x/week
limit sedentary behaviour

Question 23

What is sedentary behaviour?

Answer 23

waking behaviour where sitting/lying = dominant posture
energy expenditure very low
eg. screen time, motorised transport, sitting to work/read
can be sedentary + active, sedentary + inactive, active + not sedentary, and inactive + not sedentary

Question 24

Why should physical activity be promoted in healthcare?

Answer 24

large population reach
trusted source of health advice
primary + secondary prevention

Question 25

What is a national and global policy for physical activity?

Answer 25

national = 'everybody active, every day' | global (WHO) = 'more people active for a healthier world'

Question 26

What are the 5A's of assessment + counselling?

Answer 26

``` assess advise agree assist arrange ```

Question 27

What parts of the global action plan are relevant to physical activity?

Answer 27

action 1.4 = increase training of professionals to increase knowledge about promoting an active society action 3.2 = strengthen patient assessment + counselling to increase physical activity

Question 28

Define health inequalities

Answer 28

unjust + avoidable differences in people's health across the population and between specific population groups

Question 29

What are the public health england goals with respect to reducing health inequalities?

Answer 29

``` strengthen impact of ill health prevention good start in life being in control of your life good/fair employment healthy standard of living safe home + good community ```

Question 30

What are examples of national, regional and local strategies to reduce health inequalities?

Answer 30

``` national = stoptober regional = UCL hospitals homelessness project local = decrease rates of smoking in deprived areas + in pregnancy (online training for midwives) ```

Question 31

Define screening

Answer 31

testing people who do not suspect they have a health problem to decrease the risk of future ill health + provide info to help them make choices

Question 32

What are some examples of NHS national screening programmes?

Answer 32

``` cervical cancer (smear tests) breast cancer (mammograms) bowel cancer AAA antenatal + neonatal testing diabetic eye disease ```

Question 33

What is involved in a health check?

Answer 33

screening adults 40-74 | screens for signs of: stroke, kidney disease, heart disease, type 2 diabetes, dementia

Question 34

What are 4 outcomes of a screening process?

Answer 34

outcome better because of early detection outcome good but early detection made no difference condition would have no impact, intervention unnecessary outcome poor + early detection made no difference

Question 35

What are the components of a screening programme?

Answer 35

``` register of eligible people system of invitation + recall screening tests confirmation of diagnosis treatment/interventions information + support for patients staff training standards + quality assurance ```

Question 36

What are potential harms of screening?

Answer 36

over-diagnosis false positive tests false negative tests (false sense of security) unnecessary treatment (might never have progressed to severe disease/death) costs of screening, testing + treatment

Question 37

Define sensitivity

Answer 37

percentage of people with a disease who test positive | most important for screening

Question 38

Define specificity

Answer 38

percentage of people without disease who test negative | most important for diagnostic testing

Question 39

What are some potential sources of bias in screening evaluation?

Answer 39

healthy screening effect = those who take part tend to be healthier than those who don't length-time bias = disease more likely to be detected in people with longer-lasting + slowly progressive types of disease - better outcomes anyway lead-time bias = earlier detection makes duration of survival after diagnosis longer, even if treatment is ineffective

Question 40

Give some examples of environmental hazards to health

Answer 40

``` water + sanitation chemical safety housing occupation noise transport air quality extreme weather events climate change ```

Question 41

Give some examples of occupational hazards to health

Answer 41

risks in workplace eg. falls, chemical hazards | changes can be made eg. wet floor signs, PPE, manual handling training

Question 42

Give some exaples of transport hazards

Answer 42

speeding, collisions, carbon emissions | changes = seatbelts, drink driving laws, safe crossings, airbags

Question 43

How can climate change affect health?

Answer 43

climate change = shift in the average weather conditions of a geographical area increase greenhouse gases, increases global warming, increases extreme weather events which can kill people or affect the ability of the health services to help (eg. floods blocking roads so ambulances cannot reach patient)

Question 44

List some notifiable diseases

Answer 44

acute meningitis, mumps, measles, COVID-19, TB, scarlet fever, acute encephalitis