Public Health Flashcards
Scoping public health problems
- What does scoping mean?
- Identifying all the aspects of the problem that are important before setting priorities for the approach that will be taken
- Preparatory stage of a project - systematic thought
Scoping public health problems
- What are eight useful questions for scoping?
- What is already known about the problem?
- What can different stakeholders and academic disciplines contribute to addressing this problem?
- Which areas are contentious?
- What are the political, social and cultural aspects of the problem?
- Why is this problem on the agenda now?
- What support and resources are available for tackling the problem?
- Which parts of the problem are already well covered and where are the areas of greatest need?
- Where can the most strategic interventions be made?
Ethics and public health prioritisation
- Name 5 parts to an ethical framework in practice
- Equity (people should have access to healthcare on the basis of need, priorities can be given to address health inequalities)
- Need and Capacity to Benefit (healthcare should be allocated fairly according to both need and capacity)
- Clinical effectiveness (best evidence based medicine)
- Cost-effectiveness (value for money for the NHS)
- Cost of treatment and opportunity costs
In England, how do commissioning decisions get made?
- Parliament votes on departmental spending and overall budget for health service
- Department of Health sets national priorities for spending annually
- Allocated money to Public Health England / UKHSA, and NHS England
- In turn, pass responsibility for spending the money to local authorities and CCGs (ICBs)
- Specialist commissioning comes from NHS England
What are key steps of a health needs assessment?
- Why the HNA is being conducted, who it’s for, and what you hope to achieve
- Defining the population clearly
- Comparative to whom (i.e. national, regional data)
- What specific aspects of health are you considering
- Who needs to be involved (i.e. key stakeholders or the public)
- Perspectives on health (professionals, public)
- Identify and assemble data, facts and other information
- Appraise and synthesise the information gathered
- Communicate the results
- Evaluate success
Data for a population health assessment
- Name some types of ‘population’ data
- Currently population
- Age
- Sex
- Ethnicity
- Birth rate
- Projected future population size
Data for a population health assessment
- Name some ‘socioeconomic factors’ data
- Income
- Social class
- Deprivation
Data for a population health assessment
- Name some ‘behavioural risk factors / wider determinants of health’ data
- Smoking status
- Alcohol use
- Housing
- Employment
- Transport
Data for a population health assessment
- Name some ‘burdens of disease’ data (or where to get it from)
- Disease prevalence and incidence from registers or surveys
Data for a population health assessment
- Name some ‘service use’ data sets
- GP appointments
- Prescribed medications
- A&E attendances
- Emergency or planned admissions
Data for a population health assessment
- Name some ‘summary measures of population health’ data sets
- Life expectancy
- Healthy life expectancy
Data for a population health assessment
- Name some ‘quality of life’ data sets
- Surveys of quality of life
- Patient reported outcomes
- Days missed from school or work
Assessing appropriateness and usefulness of data / data sources
- What are some technical issues / questions you can ask yourself?
- Are the definitions clear and appropriate?
- Is the target population clear?
- Is the data collection method clear and sound?
- How complete / accurate / relevant / timely is the data?
- Statistical significance / confidence intervals?
Assessing appropriateness and usefulness of data / data sources
- What are some questions you can ask relating to the conclusion?
- Is the study population representative of the target population?
- Do we need absolute or relative estimates to make a decision?
- What precision is needed for this decision?
- Would simpler or existing data suffice?
- Would qualitative information suffice (or be better)?
When should you use a qualitative approach?
- Meanings different social groups attach to experiences/behaviours
- Subjective perceptions about needs of different social groups
- Barriers to effective implementation and/or uptake of interventions
