Public Health Flashcards
What is population health?
Health of defined group of people
What is public health?
Organised activity of society to promote, protect, improve + restore health of individuals, groups or population
What is epidemiology?
Study of distribution of determinants of disease, health related states + events
6 core functions of public health
1) Health protection
2) health surveillance
3) disease + injury prevention
4) population health assessment
5) health promotion
6) emergency preparedness + response
What is health equity vs equality?
Equity = when all people have opportunity to attain full health potential Equality = populations have equal health status
What is a handicap vs disability?
Handicap = disadvantage arising from impairment or disability Disability = any restriction or lack of ability to perform an activity
What is the Ottawa charter for health promotion?
Charter states that government should be involved in health promotion:
1) building healthy public policy
2) creating supportive environments
3) strengthening community action
4) developing personal skills
5) re-orienting health services
What are vulnerable populations + why?
Indigenous = low SES, violence, unemployment, homelessness
Black population = low SES
Isolated seniors = isolation, institutionalisation, inactivity, polypharmacy
Children in poverty
People with disabilities
New immigrants = exposure to disease
Homeless people = low income, mental illness, substance abuse
Refugee = PTSD, disease from country of origin
Traditional indigenous approaches to healing
Balance in 4 realms of spiritual, emotional, mental + physical health
Ideas represented by medicine wheel (First Nations), Learning Blanket (Inuits) + Metis Tree (holistic lifelong learning)
What is passive prevention?
Measures that operate without the persons’ active involvement (i.e. airbags)
What is primary, secondary + tertiary disease prevention?
1’ = protect disease onset, reduce exposure to RF 2’ = early detection of disease 3’ = Tx + rehab to prevent progression
Types of screening
Universal = all members of population
Selective = screening targeted sub-groups
Multiphasic screening = use of many measurements to look for multiple diseases
Types of bias in screening
Lead time bias = overestimation of time between detection via screening vs clinical detection
Length time bias = overestimation of survival time due to screening including more stable cases
What is the difference between disease prevention + health promotion?
Disease prevention: health is absence of disease, aimed at specific pathology, medical model
Health promotion = participatory model of health, aimed at population
What is incidence vs prevalence?
Incidence = number of new cases/ people at risk (measures the rate of new infection) Prevalence = number of existing cases/ people at risk (measure frequency of disease)
What is the health belief model?
Psych model to explain + predict behaviours
Someone will adopt beneficial health behaviour if 3 beliefs are present:
Negative health outcome is avoidable
Expects health outcome can be prevented if recommended health behaviour is adopted
Individual can be successful in adopting behaviour
Top 5 causes of mortality in Canada for women
Cancer Heart disease Stroke Chronic lower respotary disease Accidents
Top 5 causes of mortality in Canada for men
Cancer Heart disease Accidents Chronic lower respotary disease Stroke
What is PYLL?
Potential years of life lost
Calculated using difference between actual age of death + expected age of death
What is DALY?
Disability adjusted life year
Life expectancy weighted by amount of disability experienced
What is Berkson’s bias?
Can occur in case control study using hospitalised controls as they may not be representative of population
What is a confounder?
Variable related to exposure + outcome but is not a mediator
What is pre vs post test probability?
Pre = probability that pt has given disease before test results are known Post = probability that pt has disease after hx/ exam
What is number needed to test vs number needed to harm?
NNT = number needed to treat to achieve one additional favourable outcome NNH = number who, if received tx, would lead to 1 pt being harmed
What are the types of observational study design?
Ecological
Cross-sectional
Case control
Cohort
What is per-protocol analysis?
Strategy of analysis in which only pts who complete entire study are counted in
What is intention to treat analysis?
Groups are analysed exactly as they existed upon randomisation
What is a type 1 + 2 error?
Type 1 = null hypothesis is falsely rejected – stating there is an effect when there is not
Type 2 = null hypothesis is falsely accepted – stating intervention is not effective when it is
Difference between Pearson + Spearman correlation?
Pearson is for continuous + normal data
Spearman is for ordinal or non-normal data
What is the criteria causation (Sir Bradford Hill)?
Strength of association Consistency Specificity Temporal relationship Biological gradient Biological plausibility Coherence
What is quality improvement?
Means of evaluating + improving processes
What is quality assurance?
Process to guarantee quality of healthcare through improvement
5 stage process:
1) formulation of working goals
2) procedural changes to implement those goals
3) regular comparison of current performance + original goals
4) development of solutions to bring performance closer to goals
5) documentation of quality assurance acitivities
What is the precede-proceed model?
Tool for designing, implementing + evaluating health interventions
Precede = identify issues
Proceed = implement
What is cost-benefit vs cost-effectiveness analysis?
CBA = compared total expected cost with total expected benefit CEA = ratio of change in cost to change in effect in response to new strategy
What is an outbreak, endemic, epidemic, pandemic?
Outbreak = increase in usual frequency of disease Endemic = consistent existence of infectious agent in population Epidemic = increase in cases of disease above what is usually expected Pandemic = epidemic that has spread internationally
What is active vs passive surveillance?
Active = outreach such as visits or calls by public health to detect unreported cases Passive = public health depends on others to report cases
