public health Flashcards
what is public health
science and art of preventing disease prolonging life and promoting health through organised efforts of society
3 domains of public health
improvement/promotion - lead healthier life
protection - communicable disease and emergency
services/care - management evaluate efficiency, audit
What are the indicators of health
life expectancy - universal indicator - epidemiological shift, N S divide kensington and Chelsea 9 years longer than Blackpool, occupation - unemployment = lower LE, heart disease - risk factors mean interventions not simple
infant mortality
obesity - diet and life conditions, N S divide, area deprivation - scores into index, level increase with age and deprivation - people deprived can’t make healthy food decisions
alcohol - higher earning=more drinking - distribution of risk factors are complex
sexual behaviour - war men came back with STI, swinging 60s, 80s = AIDS - people scared so STIs reduced
how do causes and risk factors come about
social determinants of health
What is Health Promotion / Improvement?
enable people to increase control over and improve their health
action towards social, economic and environmental conditions
strengthen skills of individuals and communities
takes account of: broad definition of health, scope of prevention, limitations of health services, role of individuals, groups and governments
focus on health rather than disease
What does Health Promotion / Health Improvement involve?
clinical intervention - screening for cancer
knowledge transfer and health literacy - traditional health promotion
healthy public policy - legal - smoke outside, tax on salt and sugar, alcohol price - start with public health campaign
community development
overlap
what are the levels of prevention
primordial -prevent factors that cause unhealthy lifestyles
primary - action to prevent onset fo disease - health promotion and specific protection
secondary - halt progression once illness already established
tertiary - rehabilitate people - prevent disability
difference between high risk and population prevention
high risk - at most risk, target, control exposure, efficient, willing to do it because worried
population - diseases reflect action of society as a whole, low risk but a lot of people = high percentage of disease - need universal screening program
High risk strength
high motivation efficient - cost effective risk ratio favourable appropriate to individual easy to evaluate
high risk weakness
palliative and temporary - misses a large amount of disease
risk prediction not accurate
difficulty and costs of screening
hard to change individual behaviours
describe the prevention paradox
many people with small risk = more disease than few people big risk
many people, small benefit = large total benefit
individual inconvenience large to people who don’t benefit
a matter of degree - alcohol
people injured/fall back in school
have to address whole of society - strict age and cost
part of culture
small incremental change = reduced drinking
increase intensity depending on deprivation
population approach strengths
equitable
radical
large potential for population
behaviourally appropriate
population approach weaknesses
small advantage to individual
poor motivation of subject
poor motivation of physician
benefit : risk ratio can be questioned
The Wanless report
national sickness survey
focus on prevention and wider determinants of health
cost effective - actions to improve heath and reduce inequalities
