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YEAR 1 > Public Health > Flashcards

Public Health Flashcards

1
Q

What is the WHO definition of health?

A

Health is a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity

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2
Q

What are strengths of the WHO definition of health?

A

Not just looking at physical illnesses, but takes into social and mental well-being too.

Takes into account that heath is not only the absence of disease

Holistic approach

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3
Q

What are limitations of the WHO definition of health?

A

Broad definition, no basis on ‘complete health’

Striving for perfection, is that possible?

Having disease and feeling healthy are no longer mutually exclusive

Alienating to those with disabilities, chronic diseases but still lead normal healthy lives.

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4
Q

What is primary disease prevention?

A

Focus on incidence

E.g. mass immunisation, use of condoms and health education… to prevent new cases

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5
Q

What is secondary disease prevention?

A

Focus on prevalence

Regular screening… for early identification to reduce cases.

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6
Q

What is tertiary disease prevention?

A

Focus on impact.

To reduce suffering and prevent complications.

E.g. uptake and maintenance of skills training

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7
Q

What are basic principles of controlling communicable disease?

A

Reduce susceptible population - immunisations

Reduce infectious population - diagnosis and treat

Improve hygiene behaviour - safe sex, hand washing, needle exchange, masks

Preventing animal to human spread - pasteurise milk, cull animals

Preventing environmental transmission - latrines

Disaster response

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8
Q

What is a reservoir of infection?

A

any person, animal, arthropod, plant, soil or substance in which the disease agent normally lives or multiples

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9
Q

What is the transmission pathway?

A

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

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10
Q

What are direct person to person routes of infection?

A

Respiratory droplet spread – larger particles – influenza, covid
Aerosol transmission – smaller particles – TB, covid
Faecal/oral spread – dysentery
Close contact – meningitis
Sex – gonorrhoea

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11
Q

What are indirect person to person transmission routes of infection?

A 
Foodborne – staph
Waterborne – cryptosporidium
Via fomites – dysentery
Via needles – Hepatitis B
Vector borne – malaria
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12
Q

What are examples of animal to human transmission routes of infection?

A

Livestock – food – salmonella, e coli
Domestic pets – campylobacter(dogs), toxocariasis(faeces in soil)
Wild animals – ticks(Lyme disease), rabies

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13
Q

What are examples of environment to human transmission routes of infection?

A

Built – legionnaires – stagnant water

Natural – estuary syndrome (pfiesteria piscicida), naegleria meningitis

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14
Q

What is the F diagram for enteric infections?

A

Faeces to…

Fingers
Flies
Fields
Fluids

go into food… into new host

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15
Q

What is the procedure for notifying for notifiable disease?

A

Statutory duty to inform PHE via notification form immediately
on diagnosis or suspicion within 3 days by form, or verbally within 24 hours.

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16
Q

Under what circumstances should a doctor notify the proper office of infectious disease?

A

Suspecting a patient has…

  • Has a notifiable disease
  • Has an infection which in the view of the professional, presents or could present significant harm to human health
  • Is contaminated in a manner which in the view of the professional, presents or could present significant harm to human health
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17
Q

What factors should be considered when deciding how urgent a notifable disease is?

A

Nature of suspected disease, infection or contamination

Ease of spread of that disease, infection or contamination

Ways in which the spread of the disease, infection or contamination can be prevented or controlled

The patients circumstances - age, sex, occupation

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18
Q

What is disease surveillance defined as?

A

The ongoing, systematic collection, analysis, and interpretation of health-related data essential to planning, implementation and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control

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19
Q

What is the rationale of disease surveillance?

A

Allows us to…

  • Describe the burden of potential diseases
  • Detect sudden changes in disease occurrence and distribution
  • Monitor changes in disease prevalence over time
  • Monitor changes in health behaviours
  • Identify priorities
  • Inform programmes and policies
  • Evaluate prevention and control efforts
  • Develop hypotheses and stimulate research
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20
Q

What are the 5 steps of disease surveillance?

A
  1. Detect- the health event, normally in a hospital
  2. Code and store the data
  3. Analyse
  4. Disseminate the data to the right people
  5. Action – to prevent further outcomes
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21
Q

What is the International classification disease (ICD)?

A

A diagnostic tool that is used to classify and monitor causes of injury and death and maintains information for health analyses, such as study of death and illness trends. It is designed to promote international compatibility in health data collecting and reporting.

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22
Q

What is the global burden of disease study?

A

Largest study in the world that summarises global surveillance data, analysing over 250 causes of death, 370 diseases and injuries, 87 risk factors through 204 countries. Gives us a picture of the health status of the world at a global, regional, national, and even local level.

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23
Q

Define incidence.

A

The rate of occurrence of new cases – information about the risk of contracting the disease.

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24
Q

Define prevalence.

A

The proportion of cases in the population at a given time – indicates how widespread the disease is.

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25
Q

Define mortality rates.

A

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

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26
Q

Define case fatality rate.

A

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

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27
Q

Define frequency patterns.

A

Specific datatype that is used to represent the frequency of an occurrence.

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28
Q

Define epidemic curves.

A

A statistical chart used in epidemiology to visualise the onset of a disease outbreak.

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29
Q

What are the 4 groups of social determinants of health

A
  • Social
  • Economic
  • Environmental
  • Political
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30
Q

Define health inequalities.

A

Health Inequalities are unjust and avoidable differences in people’s health across the population between specific population groups.

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31
Q

What are general socio-economic, cultural and environmental conditions affecting health inequalities.

A 
Living and working conditions 
Work environment 
Housing
Healthcare services
Water and sanitation
Unemployment 
Education
Agriculture and food production
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32
Q

What is a link between family income and school readiness in the UK?

A

Low income more likely to have behavioural problems

Low income more likely to be behind in vocabulary and school readiness

33
Q

High levels of area deprivation produced increased incidence of…

A
  • Lung cancer

- Teenage Pregnancy

34
Q

High levels of area deprivation produce higher levels of mortality in relation to…

A
  • Ischaemic heart disease
  • Lung cancer
  • Stroke
  • Infant deaths and stillbirths
35
Q

What is the rationale for screening tests?

A

Testing people who do not suspect they have a health problem
To reduce risk of future ill health - by earlier detection and treatment
To provide information - and to help make choices
To screen correctly need to know: Natural history of disease - stages & progression

36
Q

What is the rationale for screening tests?

A

Testing people who do not suspect they have a health problem
To reduce risk of future ill health - by earlier detection and treatment
To provide information - and to help make choices
To screen correctly need to know: Natural history of disease - stages & progression

37
Q

What are properties of screening programmes?

A
  • Register of eligible people
  • System of invitation and recall
  • Screening tests
  • Confirmation of diagnosis
  • Treatment or other interventions
  • Information and support for patients
  • Staff training
  • Standards and quality assurance
38
Q

What are disadvantages of screening programmes?

A

Over diagnosis
False positive tests
False negative tests - false sense of security
Unnecessary treatment - may never have progressed to serious disease
Costs of screening, further testing and treatment

39
Q

Is sensitivity or specificity more important in screening?

A

Sensitivity - correctly identifying people with the disease testing positive

40
Q

Is sensitivity or specificity more important in diagnostics?

A

Specificity - the ability of a test to correctly identify people without the disease.
People without disease who test negative

41
Q

What are the stages of the screening process?

A

Whole population
Screening phase
Diagnostic phase
Interventions

42
Q

What are 4 outcomes of the screening process?

A

Outcome better because of early detection
Outcome good but early detection made no difference
Condition would have no impact, intervention was unnecessary
Outcome poor and early detection made no difference

43
Q

What are sources of bias in screening evaluation that can alter the effectiveness of screening data

A

Healthy screening effect - healthier people tend to take part
Length time bias - slower progressive disease likely to be detected by screening, may have had better outcomes anyway
Lead time bias - earlier detection makes duration of survival after diagnosis longer, even if treatment ineffective

44
Q

Who are eligible for cervical cancer screening programmes and how is it done?

A

For women aged 25-49 every 3 years
For women ages 50-64 every 5 years
How: Smear test

45
Q

Who are eligible for breast cancer screening programmes and how is it done?

A

For women aged 50-70 every 3 years

How: X-ray

46
Q

Who are eligible for bowel cancer screening programmes and how is it done?

A

For everyone aged 60-74 every 2 years
For 56 years olds
How: Stool Sample - FIT kit

47
Q

Who are eligible for Abdominal Aortic Aneurysm screening programmes and how is it done?

A

For men turning 65

How: Ultrasound of abdomen

48
Q

What are common work-related conditions?

A

Back injuries and other musculoskeletal problems
Respiratory conditions such as asthma and bronchitis,
Work-related dermatitis
Psychological conditions - stress, depression, anxiety

49
Q

What are Public health Approaches to occupational hazards?

A

Safety signs
Safety equipment
Safety training and procedures
Standing desks

50
Q

What are hazards to human health in healthcare?

A 
Risk of exposure to needles
Chemicals, disinfects
Biological hazards - blood, bacteria, bodily fluids
Electrical risks
Physical hazards
Stress
Aggression and violence
51
Q

What are hazards to human health in healthcare?

A 
Risk of exposure to needles
Chemicals, disinfects
Biological hazards - blood, bacteria, bodily fluids
Electrical risks
Physical hazards
Stress
Aggression and violence
52
Q

What are 10 most common workplace hazards?

A
  1. Slips, trips, falls
  2. Electrical
  3. Fire
  4. Confined spaces
  5. Physical hazards
  6. Ergonomic hazards - strain on body
  7. Chemical hazards
  8. Biological hazards
  9. Asbestos
  10. Noise
53
Q

What are Climate Change Hazards?

A
  • Worsening droughts
  • More intense storms
  • Extreme rainfall and flooding
  • Greater sea level rise
  • Islands disappearing under rising seas
  • Mass extinction of species
54
Q

How do Climate Change Hazards affect human health?

A

Increase in…

Vector-borne infectious diseases
Malnutrition - famine
Gastroenteritis, cholera and other food/water borne infectious diseases
Cardiovascular, cerebrovascular and respiratory diseases

55
Q

What are public health approaches to climate change?

A

Renewable energy sources - solar and wind
Energy efficient buildings
Sustainable transport - electric vehicles

56
Q

What are direct impacts of Climate Change on Health?

A

Stress on the individual by the environmental problem

Physical effect on the individual by the environmental problem

57
Q

What are indirect impacts of Climate Change on Health Services?

A

Power outages
Delayed response delayed
Insufficient ambulances
Increased demand for healthcare

58
Q

What are transport hazards?

A 
Carbon emissions
Speeding
Vehicle collisions
Pedestrian collisions with vehicle
Car problems
59
Q

What are public health approaches to transport hazards

A
  • Seatbelts
  • Safe crossing
  • Drink-driving regulations
  • Lower speed limits
  • Cars - brake systems, airbags
60
Q

LGBT Youth have increased risk of…

A 
Violence
Victimization
Harassment
School Bullying
Smoking, alcohol, substance abuse
Homelessness

…Which increases risks for depression and suicide

61
Q

Why are LGBT more likely to have emotional and substance misuse problems?

A 
Social exclusion
Attitudes of society
Prejudice/rejection
Intolerent society
Fear of disclosure
Stigma
Poor self regard
Stress of keeping identity a secret
Feelings of shame or guilt as a result of religious or cultural upbringing
62
Q

What are recommendations for improvement to suit the health needs of LGBT people?

A

Development of LGBT friendly health services
Protective factors for youth - family and community support
Increased contact with LGBT patients in teaching
Increased LGBT health teaching within medical training
Interventions to address discrimination, increase resilience and reduce impact on LGBT
Draw on LGBT peoples own expertise
Better collection of data on national and local levels

63
Q

What are some barriers to health care faced by LGBT people?

A

Attitudes of health professionals - leads to poorer treatment outcomes
- Lack of using appropriate pronouns - creates distrust
- Negative attitude and behaviour
- Experience homophobia, transphobia
- HCP may feel embarrassed
Lack of knowledge and understanding of HCP
More concerns about their safety
Misattribution of their problems to LGBT identity
Assumptions of heterosexuality can lead to inappropriate advice or referrals
Trans patients receiving hormone therapy may ignore side effects of CVD for fear that HCP may discontinue treatment

64
Q

Physical health of LGBT members…

A

Twice as likely to have a history of smoking
More likely to report higher drinking levels and binge drinking
Gay men increased risk of being underweight
Lesbian women increased risk of being overweight
Trans Men - Less likely to attend screenings - which leads to an increased risk of contracting cervical cancer

65
Q

What are traditional risks for the determinants of health and disease?

A 
Undernutrition
Unsafe sex
Unsafe water
Poor sanitation and hygiene
Indoor smoke from solid fuels

(Mainly associated with infectious diseases)

66
Q

What are modern risks for the determinants of health and disease?

A

Smoking
Alcohol
Poor diet
Physical inactivity

(Mainly responsible for non-communicable disease)

67
Q

What are the 3 group classes causing disease and death?

A

Infectious disease
Non-communicable disease
Injuries and other

68
Q

What is the epidemiological transition?

A

As countries increase their level of development, early death and disability from infectious diseases are declining and life expectancies are rising

  • Reduction in traditional risks - reduced communicable diseases
  • Increase in modern lifestyle risks - increased non-communicable diseases

(Modern risks can take different trajectories dependant on policies and regulations)

69
Q

What are 3 factors underlying the epidemiological transition?

A
  1. Improvements in medical care
    • Lower mortality from curable conditions, e.g. diarrhoea
  2. Public health interventions
    • Clean water and sanitation, vaccinations
  3. The ageing of the population
    • Non-communicable diseases affect older adults at the highest rates
70
Q

What is the inverse care law?

A

the availability of good medical or social care tends to vary inversely with the needs of the population served

71
Q

What is the concept of WHOs sustainable development goals?

A

Ending poverty whilst building economic growth

Addressing social health, job opportunities, education, inequalities, enivorment and tackling climate change
- Each goal has a specific target to reach by 2030

72
Q

What are 2 key features for determinants of global health and disease?

A

Geographical location of residence

Social-economic status - education, employment, housing

73
Q

What are organisational levels of barriers to health care faced by BAME people?

A

Macro - institutional - immigration policies, training of our HCP, healthcare education

Meso - regional - local health policies, resources available, proximity of specialist centers

Micro - individual - personal health beliefs and perceptions

74
Q

What are general barriers to health care faced by the BAME population

A
  • Racism and discrimination
  • Language and translation
  • Lack of cultural competency
  • Immigration policies - affects their access to health care
  • Research - lack of data
  • Lack of understanding in navigating the healthcare system
  • Stigma
  • Isolation
  • Not being taken seriously
75
Q

In terms of mental health, the BAME population have…

A
  • Higher rates of psychotic illness admissions for Black ethnic groups
  • Higher suicide rates
  • Higher rates of drug induced death
76
Q

Cancer in the BAME population…

A

Black women diagnosed at later stages than white women
Liver cancer higher is asian descent
Less likely to be satisfied with their care in cancer - Chinese had lowest satisfaction rate

77
Q

Physical health of the BAME population…

A
  • Black ethnic groups less likely to be prescribed ART in HIV than white people
  • Severe maternal mortality rates in black women than white
  • Children of black or asian background more likely to be overweight or obese
  • Poorer blood pressure control
  • Higher rates of diabetes, kidney disease, hepatitis B
  • Black ethnic groups more likely to have higher measures of blood pressure and inflammatory markers compared to whites
  • Highest infant mortality rates in Pakistani groups
  • More likely to visit GP recently
  • Less likely to visit the dentist
78
Q

Socially, the BAME population are…

A
  • More likely to be working in a high-risk occupation
  • Smoking rates - highest rates in Bangladeshi, Pakistani and Irish men
  • Alcohol - non-white minority ethnic groups have higher rates of abstinence and lower levels of frequent, heavy drinking
  • Physical activity and participation in sports - lower amount south asian groups

YEAR 1 (17 decks)

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