Public Health Flashcards by pardis hejazi

Population health refers to:

Health of defined groups of people

Their health determinants

Trends in health

Health inequalities

Broader scope vs public health

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Public health refers to:

Efforts organized by society to:

Protect, promote, restore people’s health

Prevent mortality and morbidity

Aim: to achieve desired state of population health

Refers to: practices, programs, policies, institutions, disciplines to achieve the aim

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Epidemiology scope

Study of distribution of:

determinants of disease

Health-related states

Events in populations

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Public health and preventive medicine study

Goal:

To identify and address health problems

To evalute the extend to which health services and others address these issues

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Providing programs and activities for health protection, promotion, disease prevention at local and regional levels is the duty of:

Public health services

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Essential activities of public health

Health protection

Health surveillance

Disease/injury prevention

Population health assessment

Health promotion

Emergency preparedness and response

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Emergency preparedness and response is the duty of

Public health services through:

Protocols and infrastructures for natural and man-made disasters

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Health promotion is the duty of

Public health services:

Advocating for improved health through Broad community and government measures

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Disease and injury prevention is the duty of

Public health services by addressing infectious disease through preventive and control measures reduce morbidity through lifestyle improvement.

E.g.: vaccination, droplet protection, quarantine

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Population health assessment is the duty of

Public health services by: studying and engaging with a community to understand their needs and produce better policies and services

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Health surveillance is the duty of

Public health services by monitoring and predicting health outcomes and determinants with systematic and systematic data collection

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Health protection is the duty of

Public health services by: measures taken to address potential risks to health (at the population levels), including through regulations and advising government

E.g. safe water and food supply

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Health Canada

Federal

Health service to: First nations, aboriginals, military, veterans.

Approves new drugs and medical devices

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Canadian Food Inspection Agency

Federal

Monitors food products

Deals with animal-related infections

Regulates food labeling

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Public health agency of Canada

Federal

Strengthens public health capacity

Focus: 
Prevention of chronic diseases
Preventing injuries
Responding to public health emergencies
Responding infectious diseases outbreaks

Oversees: immigration screening

Protects: borders

Liaises with WHO

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Provincial legislation and public health

In the form of Acts and Regulations

Designates the creation of geographic areas for provision of public health services

Gives powers to the Chief Medical Officer of Health hazards

Specifies infectious diseases to be reported

The ability to mandate programs addressing public health, environmental health, chronic disease prevention.

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Local boards of health duties

Municipal level

Delivers mandated programs

Delivers most public health services:
Infectious disease control
F/U of reported diseases
Management of outbreaks
Inspection of food premises (in hospitals, nursing homes, restaurants…)
Family health services
Tobacco control legislation enforcement
Assessment and management of local environmental health risks
Collection and dissemination of local health status reports
Public dental health seevices

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Health equity

All people have the opportunity to attain their full health potential, and no one is disadvantaged because of their social position or other socially determined circumstances

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Health inequities

Systematic differences in the health of individuals/groups which are considered unjust

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Health equality:

Where populations have equal or similar health status

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Health inequalities

Systematic differences in the health of groups that do not necessarily carry a moral judgment

Cultural safety

Interactions with people from different cultures that treat them respectfully in a manner that acknowledges relevant differences but does not create a sense of discrimination

Cultural sensitivity

Being aware of (and understanding) the characteristic values and perceptions of your own culture and the way in which this may shape your approach to patients from other cultures

New immigrants to Canada

Complete medical examination

CXR + report for persons 11 yr and older

U/A for 5 yr and over

Syphilis for 15 yr and over

HIV for 15 yr and over and children who have received blood or blood products, have a known HIV-positive mother or have an identified risk. (ELISA HIV 1 &2)

Serum Cr if HTN (resting BP > 140/90), a Hx of treated HTN, DM, AI disorder, persistent proteinuria, kidney disorder

Population specific interventions for aboriginals

Mental health awareness Aboriginal-specific DM initiatives Substance abuse treatment programs

Population-specific interventions for isolated seniors

Aging in place of choice Falls and injury prevention Mental health promotion Preventing abuse and neglect

Population-specific interventions for children in poverty

Improvement in family income: most significant Early childhood education

Population-specific interventions for people with disabilities

Transportation support Multidisciplinary care Unique support for individuals with specific disabilities

Population-specific interventions for new immigrants

Women’s health Mental health Infectious diseases Dental and vision screening Vaccinations Cancer screening

Population-specific interventions for homeless persons

Safe housing Addictions support Mental health

Population-specific interventions for refugee health

Vaccination Women’s health Mental health Infectious diseases Dental/vision screening Political advocacy

Level of disease prevention in seatbelt use

Primary

Level of disease prevention in smoking cessation

Primary

Level of disease prevention in mammography

Secondary

Level of disease prevention in Pap smear

Secondary

Level of disease prevention in HbA1c monitoring in DM

Tertiary

Level of disease prevention in foot exam in DM

Tertiary

Level of disease prevention in eye exam in DM

Tertiary

Level of disease prevention in administering medication

Tertiary

Passive vs active preventions

Passives are more effective

Length-time bias

Overestimation of survival time due to screening at one time point including more stable cases than aggressive vases of disease, who may have shorter survival times.

Disease prevention approach

Health= absence of disease Passive role medical model Aimed mainly at high-risk groups in the population One-shot strategy aimed at a specific Pathology Directive and persuasive strategies enforced in target groups Focused mostly on individuals and groups of subjects Led by professional groups from health disciplines

Health promotion approach

Health= positive and multidimensional concept Participatory model of health Aimed at the population in its total environment Diverse and complementary strategies aimed at a network of issues/determinants Facilitating and enabling approaches by incentives offered to the population Focused on a persons health status and environment Led by non-professional organizations, civic groups, local, municipality, regional and national government

Risk reduction vs harm reduction

Risk reduction: Lower the risk to health without eliminating it (avoiding sun) Harm reduction: Tolerance of some degree of risk behavior, while aiming to minimize the adverse outcomes associated with these behaviors (needle exchange programs)

DALY

One DALY can be thought of as one lost year of "healthy" life. The sum of these DALYs across the population, or the burden of disease, can be thought of as a measurement of the gap between current health status and an ideal health situation where the entire population lives to an advanced age, free of disease and disability. DALYs for a disease or health condition are calculated as the sum of the Years of Life Lost (YLL) due to premature mortality in the population and the Years Lost due to Disability (YLD) for people living with the health condition or its consequences

QALY

The quality-adjusted life year or quality-adjusted life-year (QALY) is a generic measure of disease burden, including both the quality and the quantity of life lived. It is used in economic evaluation to assess the value for money of medical interventions. One QALY equates to one year in perfect health. If a person lives in perfect health for one year, that person will have 1 QALY. ... If a person lives in perfect health but only for half a year, that person will have 0.5 QALYs.

Life expectancy

The expected number of years to be lives by newborn

Crude death rate

Mortality from all causes of death per 1000 in the population

Infanta mortality rate

Number of deaths among children <1 yr of age reported during a given time, Divided by the number of live births reported during the same time. And expressed per 1000 live births per year.

Maternal mortality rate

Number of deaths of women during pregnancy and due to pueperal causes per 1000 live births in the same year.