Public Health Flashcards
what is the main determinant of population health
extent of income division
measured with the Gini coefficient
lower coefficient = more equality
3 responses to health inequalities
the black report 1980
the acheson report 1998
proportionate universalism
3 theories of causation
psychosocial factors
neo-material factors
life-course factors
4 domains of public health
health protection
improving services
health improvement
addressing wider determinants
what is meta-ethics
exploring fundamental questions of what is right and wrong
what is applied ethics
ethical investigation in specific areas e.g. medical/environmental
a deductive ethical argument suggests
there is 1 general ethical theory for all medical problems
an inductive ethical argument suggests
settled cases of the past offer a guide/theory for medical practice
structural determinants of illness (5)
social class poverty unemployment discrimination gender
negative of biomedical model
neglects social and psychological dimensions of disease
only disclose patient info if
required by law
patient has consented
for public interest
3 main notifiable diseases
yellow fever
cholera
plague
health behaviour definition
aimed to prevent disease
illness behaviour definition
aimed to seek remedy
sick role definition
aimed at getting well
5 lifestyle factors promoting mortality
smoking obesity sedentary lifestyle excess alcohol poor diet
4 principles of the health belief model
individuals must believe:
- they are susceptible
- it has serious consequences
- taking action reduces risk
- benefits of action outweigh costs
transtheoretical model
- pre-contemplation
- contemplation
- preparation
- action
- maintenance
- relapse
morality definition
concerned with good/evil right/wrong
ethics defintion
system of moral principles defines what is good for individual/society
what is utilitarianism/consequentialism
act evaluated solely on consequence
greatest good for greatest number
criticisms of utilitarianism
could cause harm to some
cant predict all consequences of actions
wrong actions can lead to right consequences
what is kantianism
features of the act determine goodness of that act
involves being motivated by duty
prescribes to categorical imperatives e.g. do not kill
criticisms of kantianism
not everybody has the same judgement of good and bad actions
what is virtue ethics
focus on the kind of person who is performing the act
good character or not?
we become virtuous by practicing virtuous actions
criticisms of virtue ethics
no clear decision model
cannot determine good actions only good character traits
what are the 4 principles of medicine
autonomy
benevolence
non-maleficence
justice
what does the mini mental state examination (MMSE) test
- orientation and immediate memory
- short term memory
- language functioning
define acute illness
disease of short duration that starts quickly and has severe symptoms (often can be cured)
define chronic illness
persistent or recurring condition, may or may not be severe, start gradually with slow changes (no cure but can be treated)
define polypharmacy
use of multiple medications/administration of more medication than are clinically indicated
what are the key challenges of an ageing population
- strains on pension/social security
- increase demand for healthcare
- bigger need for trained workforce
- increase demand for longterm care
what are the causes of an ageing population
- improvements in living conditions/nutrition/medicine
- life expectancy rising
- falls in fertility = higher age of birth
- decline in premature mortality
- more people reaching older/imbalance with children being born
key facts about ageing population in UK
- same number of over 65s than under 15s
- by 2025 more people 65+ than under 20
- by 2025 proportion of 85+ will increase by 60%
what is intrinsic ageing
natural/universal/inevitable
what is extrinsic ageing
dependent on external factors = UV/smoking/air pollution
visual decline in ageing
need 3x more light
depth/colour perception
narrowing of visual field
hearing decline in ageing
lose high frequency sound
lose speech comprehension 20%
taste and smell decline in ageing
50% loss of taste buds
gender bias in ageing
more old women than men
20% biological = premenopausal protected from heart disease by hormones
80% environmental = men more lifestyle risks
consequences of higher life expectancy
- lose pensions earlier than expected
- chronic conditions
- rising inequalities for less affluent people
3 most common types of dementia
alzheimers
vascular
mixed
alternatives to hospital admission for older people
- supporting discharge
- providing alternatives for acute care in the community
- supporting chronic disease management in the community
what percentage of people die in hospital
60%
what does the medicalisation of death mean
prolonging life at any cost - pharmaceutical/biomedical
4 awareness contexts for dying
- closed awareness
- suspicion awareness
- mutual pretence
- open awareness
what is social death
people die in social and interpersonal terms before their actual biological death - lonely/impersonal
what is a good death
palliative care as a specialty
what is death in a hospice way
open awareness
multi-disciplinary
emotion/relationships
holistic
a doctor as a dying person
the other side (novel)
hashtag hello my name is
what is the chain of infection
susceptible host causative micro-organism reservoir portal of entry/exit mode of transmission
what makes a susceptible host
low immunity
low white cell count
imbalance in normal flora
invasive procedures
what is a reservoir
patients/visitors/stuff - where the spread originates
2 modes of transmission
exogenous = direct/indirect contact, vector, airborne endogenous = self spread
why wash your hands
remove transient hand flora
reduce number of resident flora
when do you wash your hands
before and after anything in hospital
types of handwashing
type 1 = routine
2 = hygienic hand antisepsis
3 = surgical scrub
alcohol handgel effectiveness
destroys most transient organisms (MRSA) but not norovirus/Clostridium difficile
antimicrobial liquid soap effectiveness
removes all transient organisms
what are the standard infection control precautions
gloves/apron/hand hygiene
correct sharps manipulation
correct clinical waste/linen handling
physiological effects of nicotine
activation of nicotinic ACh receptors in brain
cause of dopamine release
stimulant, tolerance, withdrawal
impact of smoking
greatest single cause of illness/premature death in UK
cancers/COPD
great economic impact
how many deaths per year due to smoking
100,000
name some health problems connected to smoking
CVS problems other cancers stomach ulcers impotence diabetes oral health cataracts
what happened in 1908
children act = banning sale of tobacco to under 16s
what happened in 1950
Doll and Hill = smoking a and lung carcinoma study
what happened in 1965
parliament band cigarette advertising
what happened in 2007
smoking in public banned + legal minimum age becomes 18
what happened in 2015
smoking with children in the car banned