Public Health Flashcards
What is Public Health ?
The science and art of preventing disease, prolonging life and improving health through organised efforts of society
What is Equity ?
Giving people what they need to achieve equal outcomes
What is equality ?
giving everyone the same rights, opportunities and resources
what is horizontal equity ?
equal treatment for people with equal health care needs
(e.g. same treatment used for penuomina in different patients in same severity)
what is vertical equity ?
Unequal treatment for unequal health care needs
(Different treatments used in less severe vs. more severe pneumonias)
what is the inverse care law ?
availability of health care tends to vary inversely with its need
What acronym can be used for determinants of health ? what are these ?
PROGRESS
- Place of residence
- Race
- Occupation
- Gender
- Religion
- Education
- Socio-economic
- Social capital
What are the 3 domains of public health practice ? expalin bit
- Health improvement (preventing disease, promoting health)
- Health protection (control infectious disease)
- Improving services (safe and high quality services)
What 2 systems can be used to assess quality of healthcare ?
- maxwells dimensions of the quality of healthcare
- structure, process, outcome
What 3 factors contribute to a health needs assessment ?
- Need (ability to benefit for an intervention)
- Demand (what people ask for)
- Supply (what is provided)
What is an epidemiological perspective of health needs assessment ?
looks at size of pop, services available
What is a comparative perspective of health needs assessment ?
compares services/outcomes received by a population with others (could compare different areas or patients or ages)
What is a corporate perspective of health needs assessment ?
ask local population what their health needs are (use focus groups, interviews)
What is an egalitarian medical mindset ? pros ? cons?
Provide all care that is necessary and required for everyone
- Pros: equal
- Cons: too expensive
What is an Maximising medical mindset ? pros ? cons?
act is evaluated solely in terms of its consequences
- pros: resources allocated to those who are most likely to benefit form it
- Cons: those who don’t make the cut receive nothing
What is an Libertarian medical mindset ? pros ? cons?
Each is responsible for their own health
- Pros: promotes positive engagment
- Cons: most diseases are not self inflicted
What is primary prevention ? example
preventing the disease form occurring in the first place
(vaccine)
what is secondary prevention ? example
early identification of th eidsease to alter disease course
(screening)
what is tertiary prevention ? example
limit consequences of established disease
(prevent worsening renal function in CKD)
Disadvantages of screening ? (3)
- exposure of well individuals to distressing diagnostic tests
- Detection and treatment of sub-clinical disease that wouldn’t have caused a problem
- preventive interventions that may cause harm to individual
What are the 5 young people and adult screening programmes ?
- AAA screening
- Bowel cancer screening
- Breast cancer screening
- Cervical screening
- Diabetic eye screening
What criteria used to determine to screen something ? describe this criteria
Wilson and Junger Criteria (INASEP - In Exam Season NAP)
- Important disease
- Natural history of disease understood (eg known disease marker)
- Acceptable to public (not too invasive)
- Simple, safe precise test
- Effective treatment (early outcome has better outcomes)
- policy agreed on who to treat
What is sensitivity ?
proportion of those with disease who are correctly identified
what is specificity ?
proportion of people without disease who are correctly excluded by screening test
What is the hierarchy of evidence ? what are at the top ?
- systematic reviews and meta analysis
- RCT
- Cohort studies
- Case controlled studies, cross sectional studies
- case series
- expert opinions
What is a case-control study ? advantage? disadvantage ?
retrospective, observational study looking at cause of disease. compares molar participation with dies to controls without
- pros: good for rare outcomes, can investigate multiple exposures
- cons: difficultés finding control to match with case, prone to selection bias
What is cross-sectional study ? pros ? cons?
retrospective observational collects data from a population at a specific point intake “snapshot)
- Pros: quick and cheap, provide dat on preveane at single point
- cons: risk of reverse causality, cannot measure incidence
What is a cohort study ? pros? cons ?
Prospective longitudinal study looking at separate cohort with different treatments of exposures
- pros: can follow up group with a rare exposure
- cons: takes a long time, people drop out
What is a randomised control trial ? pros ? cons ?
prosecute study, all participants randomly assigned exposure or control intervention
- pros: low risk of bias and confounding, can infer causality
- cons: time consuming, drop outs, inclusion criteria may exclude some populations
What is an ecological study ?
look sat the prevalence of the disease over time (population data rather than individual)
- shows prevelance and association but not causation
What is the Bradford-hill criteria ? describe
group of nine principles that can be useful in establishing epidemiologic evidence of a causal relationship between a presumed cause and an observed effect
What are the factors in the Bradford-hill criteria ? (9)
- strength (stronger association between exposure and outcome)
- Temporality ( exposure prior to outcome)
- coherence
- consistency (same results from various studies)
- Plausibility
- Analogy
- Dose response
- Reversibility
- Specificity
What is incidence ?
Number of new cases over a certain time period
what is prevalence ?
the number of people iwht a disease at a certain point in time
What is health behaviour ?
aimed to prevent disease
(regular exercise)
what is illness behaviour ?
aimed to seek remedy
(going to the doctor)
what is the sick role behaviour ?
aimed at getting well
(taking medication)
name some models of behaviour change ? (5)
- health belief model
- theory of planned bahaviour
- stages of change/trantheoretical model
- social norms theory
- motivational interviewing
What is the health belief model
example of model of behaviour change
- Indiciduals change their behaviour if: believe susceptible to the condition, there are serious consequences, taking carton reduces susceptibility, benefits of action outweigh cost
What is the theory of planned behaviour ?
example of model of behaviour change
- takes into account: person attitude, perceived social pressure (subjective norm) and their perceived behavioural control
What are the stages of change (trans theoretical model) ?
- pre-contemplation
- contemplation
- preparation
- Action
- Maintenance
- Relapse
what is in mallows hierarchy of needs ?
TOP
- self actualisation
- esteem need
- belongingness and love needs
- safety needs
- physiological needs
BOTTOM
