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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
Define mortality rates.
A measure of the frequency of occurrence of death in a defined population during a specified interval
26
Define case fatality rate.
A measure of deaths assigned to a specific case during a given time interval, relative to the total number of cases.
27
Define frequency patterns.
Specific datatype that is used to represent the frequency of an occurrence.
28
Define epidemic curves.
A statistical chart used in epidemiology to visualise the onset of a disease outbreak.
29
What are the 4 groups of social determinants of health
- Social - Economic - Environmental - Political
30
Define health inequalities.
Health Inequalities are unjust and avoidable differences in people’s health across the population between specific population groups.
31
What are general socio-economic, cultural and environmental conditions affecting health inequalities.
``` Living and working conditions Work environment Housing Healthcare services Water and sanitation Unemployment Education Agriculture and food production ```
32
What is a link between family income and school readiness in the UK?
Low income more likely to have behavioural problems | Low income more likely to be behind in vocabulary and school readiness
33
High levels of area deprivation produced increased incidence of...
- Lung cancer | - Teenage Pregnancy
34
High levels of area deprivation produce higher levels of mortality in relation to...
- Ischaemic heart disease - Lung cancer - Stroke - Infant deaths and stillbirths
35
What is the rationale for screening tests?
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
What is the rationale for screening tests?
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
What are properties of screening programmes?
- 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
What are disadvantages of screening programmes?
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
Is sensitivity or specificity more important in screening?
Sensitivity - correctly identifying people with the disease testing positive
40
Is sensitivity or specificity more important in diagnostics?
Specificity - the ability of a test to correctly identify people without the disease. People without disease who test negative
41
What are the stages of the screening process?
Whole population Screening phase Diagnostic phase Interventions
42
What are 4 outcomes of the screening process?
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
What are sources of bias in screening evaluation that can alter the effectiveness of screening data
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
Who are eligible for cervical cancer screening programmes and how is it done?
For women aged 25-49 every 3 years For women ages 50-64 every 5 years How: Smear test
45
Who are eligible for breast cancer screening programmes and how is it done?
For women aged 50-70 every 3 years | How: X-ray
46
Who are eligible for bowel cancer screening programmes and how is it done?
For everyone aged 60-74 every 2 years For 56 years olds How: Stool Sample - FIT kit
47
Who are eligible for Abdominal Aortic Aneurysm screening programmes and how is it done?
For men turning 65 | How: Ultrasound of abdomen
48
What are common work-related conditions?
Back injuries and other musculoskeletal problems Respiratory conditions such as asthma and bronchitis, Work-related dermatitis Psychological conditions - stress, depression, anxiety
49
What are Public health Approaches to occupational hazards?
Safety signs Safety equipment Safety training and procedures Standing desks
50
What are hazards to human health in healthcare?
``` Risk of exposure to needles Chemicals, disinfects Biological hazards - blood, bacteria, bodily fluids Electrical risks Physical hazards Stress Aggression and violence ```
51
What are hazards to human health in healthcare?
``` Risk of exposure to needles Chemicals, disinfects Biological hazards - blood, bacteria, bodily fluids Electrical risks Physical hazards Stress Aggression and violence ```
52
What are 10 most common workplace hazards?
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
What are Climate Change Hazards?
- Worsening droughts - More intense storms - Extreme rainfall and flooding - Greater sea level rise - Islands disappearing under rising seas - Mass extinction of species
54
How do Climate Change Hazards affect human health?
Increase in... Vector-borne infectious diseases Malnutrition - famine Gastroenteritis, cholera and other food/water borne infectious diseases Cardiovascular, cerebrovascular and respiratory diseases
55
What are public health approaches to climate change?
Renewable energy sources - solar and wind Energy efficient buildings Sustainable transport - electric vehicles
56
What are direct impacts of Climate Change on Health?
Stress on the individual by the environmental problem | Physical effect on the individual by the environmental problem
57
What are indirect impacts of Climate Change on Health Services?
Power outages Delayed response delayed Insufficient ambulances Increased demand for healthcare
58
What are transport hazards?
``` Carbon emissions Speeding Vehicle collisions Pedestrian collisions with vehicle Car problems ```
59
What are public health approaches to transport hazards
- Seatbelts - Safe crossing - Drink-driving regulations - Lower speed limits - Cars - brake systems, airbags
60
LGBT Youth have increased risk of...
``` Violence Victimization Harassment School Bullying Smoking, alcohol, substance abuse Homelessness ``` ...Which increases risks for depression and suicide
61
Why are LGBT more likely to have emotional and substance misuse problems?
``` 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
What are recommendations for improvement to suit the health needs of LGBT people?
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
What are some barriers to health care faced by LGBT people?
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
Physical health of LGBT members...
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
What are traditional risks for the determinants of health and disease?
``` Undernutrition Unsafe sex Unsafe water Poor sanitation and hygiene Indoor smoke from solid fuels ``` (Mainly associated with infectious diseases)
66
What are modern risks for the determinants of health and disease?
Smoking Alcohol Poor diet Physical inactivity (Mainly responsible for non-communicable disease)
67
What are the 3 group classes causing disease and death?
Infectious disease Non-communicable disease Injuries and other
68
What is the epidemiological transition?
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
What are 3 factors underlying the epidemiological transition?
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
What is the inverse care law?
the availability of good medical or social care tends to vary inversely with the needs of the population served
71
What is the concept of WHOs sustainable development goals?
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
What are 2 key features for determinants of global health and disease?
Geographical location of residence | Social-economic status - education, employment, housing
73
What are organisational levels of barriers to health care faced by BAME people?
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
What are general barriers to health care faced by the BAME population
- 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
In terms of mental health, the BAME population have...
- Higher rates of psychotic illness admissions for Black ethnic groups - Higher suicide rates - Higher rates of drug induced death
76
Cancer in the BAME population...
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
Physical health of the BAME population...
- 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
Socially, the BAME population are...
- 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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