Public health Flashcards
What are the three domains of public health
- Health protection (eg. from infectious diseases, occupational health, envmtal health)
- Health services (eg health systems, care groups)
- Health improvement (psychosocial aspects, health determinants)
Name 5 social determinants on health
- Income
- Housing
- Education
- Access to affordable health services
What is health policy
- Decisions, plans, and actions that are undertaken to achieve specific health goals within a society
What are the benefits and drawbacks of using targets
Benefits
- Formulating targets can give INSIGHT into the health of the population and reveal GAPS in knowledge
- Support PRIORITY setting process and supply concrete milestones for evaluation
- Increase the TRANSPARENCY of health policy
Drawbacks:
- society is not completely malleable - people have FREE WILL
- TIME lag between action and outcome
- Not ambitious enough
- Overambitious
- Too many
- Tick-box culture
What is health promotion
The process of enabling people to increase control over, and to improve, their health. Moves beyond individual behaviour and towards a wide range of social and environmental interventions.
Health education on the other hand focuses more on individual behaviour change
APPROACHES TO HEALTH PROMOTION
- Discuss the population vs high risk approach in impacting health
- Shifting the whole population into a lower risk category has greater impact than shifting high risk individuals into a lower risk category
- Eg pneumococcal vaccine
Provide examples of upstream and downstream approached
Upstream - policy (eg. local employment programme, tax, neighbourhood renewal)
Downstream - individual behaviour (eg. health education, behaviour change programmes)
What are some of the harms of using scary messages?
- Can lead to people becoming fearful and over-anxious about hazards in daily life - sense of powerlessness
- Stigmatising and victimbkaming
- Activity may sound exciting
- The surrender - “everything causes cancer so why bother”
- Increase health inequalities
- Imaginary peers
Campaigns that do not use fear are effective if they: are positive, empower people
How does the tobacco industry impact on government’s financially?
While it is a source of givernment revenue through tobacco taxes and additional profit for those countries with state-owned tobacco companies –> Ultimately it is a financial burden on govmts and health care systmes of countries
Eg. in China the tobacco industry contributes over 7% of the central givmt;s revenue eveyr year
What has been the most effective intervention to reduce demand for tobacco?
- Tax increases
Other factord/approaches:
- Improvements in quality/extent of info, comprehensive bans on tobacco advertising and promotion, prominent warning labels, restrictions on smoking in public places, increased access to NRT
–> However. note that LMIC will need support to change to another type of farming
–> But economic losses offset by gains from improved health at household/national level
Tobacco control in LMIC
- Spending on tobacco reduces money available for food
- Linked to increased risk of malnutrition in the family
- In the country where poor people are likely to smoke, tobacco taxes can be regressive
- However if increasing taxation = smokers quitting = tax increase will reduce family’s overall tax burden
What responsibility can individuals vs environment/policy take on reducing obesity?
INDIVIDUAL
- Limit energy intake from total fats/sugars
- Eat more veggies etc
- Physical activity
ENVIRONMENT/POLICY
- Make healthier choices more accessible, especially for the poorest individuals
- Educate
- Legislate for the above
- Transport policy
- Legislate the food industry
- ENgage with media
- Sport in schools
- Safe cycling
WHO recommendations
- Promote breastfeeding
- Limit portion and package size to reduce energy intake
- Implement subsidies to increase the intake of fruits and veg
- Replace trans fats + saturated fats with unsaturated
Define equity
The abscence of avoidable differences among groups of people, whether the groups are defined socially, geographically, demographically or economically
Define gender equality and gender equity
Gender equality = the equal rights, responsibilities and opportunities of women + men, girls/boys
Gender equity = fairness of treatment for women and men, according to their respective needs
What are some recommendations for tacking the gender dimensions of NTDs
- Account for how gender-related division of labour, everyday practices, social norms and beliefs within and beyond the household impact NTD risk
- Account for how gender impacts the accessibility and acceptability of treatment
- Preventative chemotherapy
- MDA
- Intensified case mx - Address gender-related STIGMA and mental health impacts (marriage prospects etc)
- Collect and use gender-sensitive and sex-disaggregated data and implementation research to continuously improve NTD programming and ensure equity
- Take a health systems approach
What is an outbreak
An unusual number of cases of a disease for that time period in a specific geographical area
What are the 10 steps of an outbreak ix
- Preparation
- Establish existence of outbreak
- Verify diagnosis
- Define & identify cases
* Construct working case definition (CD)
* Find systematically cases & record information - Perform descriptive epidemiology
* Time, place, person - Develop hypotheses
- Evaluate & refine hypotheses
* studies (epi, lab, environmental) - Implement control & prevention measures
- Initiate/reinforce surveillance actvities
- Communicate findings
