Public Health Flashcards
Population health refers to:
Health of defined groups of people
Their health determinants
Trends in health
Health inequalities
Broader scope vs public health
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
Epidemiology scope
Study of distribution of:
determinants of disease
Health-related states
Events in populations
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
Providing programs and activities for health protection, promotion, disease prevention at local and regional levels is the duty of:
Public health services
Essential activities of public health
Health protection
Health surveillance
Disease/injury prevention
Population health assessment
Health promotion
Emergency preparedness and response
Emergency preparedness and response is the duty of
Public health services through:
Protocols and infrastructures for natural and man-made disasters
Health promotion is the duty of
Public health services:
Advocating for improved health through Broad community and government measures
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
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
Health surveillance is the duty of
Public health services by monitoring and predicting health outcomes and determinants with systematic and systematic data collection
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
Health Canada
Federal
Health service to: First nations, aboriginals, military, veterans.
Approves new drugs and medical devices
Canadian Food Inspection Agency
Federal
Monitors food products
Deals with animal-related infections
Regulates food labeling
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
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.
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
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
Health inequities
Systematic differences in the health of individuals/groups which are considered unjust
Health equality:
Where populations have equal or similar health status
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.
