Public Health and Epidemiology

Question 1

What is epidemiology?
What is its purpose?

Answer 1

1. Study of the distribution and determinants of health and disease in populations.
2. Involves descriptive and analytical approaches.
3. Descriptive epidemiology focuses on patterns of disease occurrence.
4. Analytical epidemiology aims to investigate causes and effects.
5. Essential for public health planning and disease prevention.

Question 2

Define public health.

Answer 2

1. The science and art of preventing disease.
2. Prolonging life and promoting health.
3. Done through organised efforts of society.
4. Also involves organisations and public bodies where appropriate.
5. Addresses both individual and population health.

Question 3

Explain the ‘clinical iceberg’ phenomenon.

Answer 3

1. Concept where known disease cases are visible (like the tip of an iceberg).
2. Majority of cases remain unreported or undiagnosed.
3. Represents the challenge of underestimating disease prevalence.
4. Highlights the importance of comprehensive surveys.
5. Influences public health strategies and resource allocation.

Question 4

What are the key biological, clinical and social elements and consequences of asthma?

Answer 4

1. Biological: airway narrowing and chronic inflammation.
2. Clinical: symptoms like wheeze, breathlessness, and cough.
3. Social: impacts on school/work attendance and social isolation.
4. Variable responsiveness to treatment.
5. Potential progression to chronic obstructive pulmonary disease (COPD).

Question 5

Describe the primary prevention of coronary heart disease (CHD).

Answer 5

1. Aim to prevent the onset of CHD.
2. Involves removing causal factors (e.g., smoking cessation).
3. Enhancing host resistance (e.g., through diet and exercise).
4. Includes public health measures (e.g., reducing saturated fat intake).
5. Focuses on reducing incidence in the population.

Question 6

What is secondary prevention, and what are the key features? Give examples.

Answer 6

1. Preventing recurrence or progression of early disease.
2. Early detection through screening.
3. Immediate treatment to halt disease progression.
4. Reducing risk factors in diagnosed individuals.
5. Examples include regular monitoring and medication adherence.

Question 7

Discuss the value of studying health and disease in populations.

Answer 7

1. Identifies common and important diseases.
2. Determines affected populations and risk factors.
3. Investigates causes of diseases.
4. Develops prevention and treatment strategies.
5. Optimises health service organisation and delivery.

Question 8

Explain the concept of ‘rate’ in epidemiology.

Answer 8

1. Measures the occurrence of events in a population. 2. Incidence rate: new cases in a specific time period. 3. Prevalence rate: all existing cases at a given time. 4. Mortality rate: deaths in a population over time. 5. Rates help in understanding the burden of disease.

Question 9

What are the potential pitfalls of geographic studies?

Answer 9

1. Differences in disease ascertainment. 2. Variations in diagnostic practices. 3. Discrepancies in recording data. 4. Differences in population structures (age, gender). 5. Confounding factors affecting results.

Question 10

How can migration studies help in understanding disease causes?

Answer 10

1. Compare disease risks before and after migration. 2. Distinguish between environmental and genetic factors. 3. Observe changes in disease risk over generations. 4. Provide insights into the role of early vs. later life exposures. 5. Identify high-risk populations for targeted interventions.

Question 11

What is the significance of the ‘period effect’ in epidemiology?

Answer 11

1. Societal changes affecting all age groups at a specific time.
2. Helps in understanding temporal trends in disease.
3. Examples include changes in healthcare practices.
4. Differentiates from cohort effects linked to birth years.
5. Important in interpreting time trends in disease data.

Question 12

Describe the relationship between air pollution and asthma.

Answer 12

1. Air pollutants like PM2.5 and ozone trigger asthma attacks. 2. Increased asthma prevalence in polluted areas. 3. Indoor allergens like dust mites contribute to asthma. 4. Air quality improvement can reduce asthma incidence. 5. Policies targeting air pollution can benefit asthma control.

Question 13

What are the main strategies for preventing CHD?

Answer 13

1. Primary prevention: reducing risk factors in the general population. 2. Secondary prevention: managing risk in those with early disease. 3. Tertiary prevention: limiting complications in established disease. 4. Health behaviour changes: diet, exercise, smoking cessation. 5. Pharmacological interventions: statins, antihypertensives.

Question 14

Explain the role of clinical trials in disease prevention.

Answer 14

1. Evaluate effectiveness of interventions.
2. Provide evidence for clinical guidelines.
3. Help in understanding treatment outcomes.
4. Ensure safety and efficacy of new treatments.
5. Contribute to the body of medical knowledge.

Question 15

What are the key risk factors for coronary heart disease?

Answer 15

1. High LDL cholesterol levels. 2. Hypertension. 3. Smoking. 4. Physical inactivity. 5. Poor diet (high in saturated fats and low in fibre).

Question 16

Define the terms ‘incidence’ and ‘prevalence’.

Answer 16

1. Incidence: number of new cases in a specific time period. 2. Prevalence: total number of cases at a given time. 3. Incidence measures risk of developing disease. 4. Prevalence indicates overall burden of disease. 5. Both are crucial for public health planning.

Question 17

What are the main causes of hypertension?

Answer 17

1. Genetic predisposition. 2. High salt intake. 3. Obesity. 4. Sedentary lifestyle. 5. Excessive alcohol consumption.

Question 18

Discuss the impact of socioeconomic status on health.

Answer 18

1. Lower socioeconomic status linked to higher disease risk. 2. Limited access to healthcare services. 3. Poor living conditions and higher exposure to risk factors. 4. Greater prevalence of unhealthy behaviours. 5. Need for targeted public health interventions.

Question 19

What is the significance of the ‘cohort effect’ in epidemiology?

Answer 19

1. Disease patterns linked to birth cohorts. 2. Reflects influence of early life exposures. 3. Helps in understanding temporal trends. 4. Example: rise and fall of smoking-related diseases. 5. Useful in predicting future disease patterns.

Question 20

How do time trends help in disease prevention?

Answer 20

1. Identify patterns and changes in disease incidence. 2. Highlight the impact of public health interventions. 3. Provide evidence for policy changes. 4. Help in understanding environmental influences. 5. Aid in planning future health strategies.

Question 21

Describe the pathogenesis of asthma.

Answer 21

1. Chronic inflammation of the airways. 2. Bronchial hyperresponsiveness to stimuli. 3. Airway narrowing leading to wheezing and breathlessness. 4. Exacerbations triggered by allergens and pollutants. 5. Potential progression to irreversible airway changes.

Question 22

What are the primary prevention strategies for asthma?

Answer 22

1. Reducing exposure to allergens. 2. Improving indoor air quality. 3. Promoting vaccination against respiratory infections. 4. Encouraging breastfeeding to enhance immunity. 5. Public education on asthma triggers and management.

Question 23

Explain the importance of disease surveillance.

Answer 23

1. Continuous monitoring of disease patterns. 2. Early detection of outbreaks. 3. Assessment of intervention effectiveness. 4. Provides data for health policy development. 5. Essential for resource allocation and planning.

Question 24

What are the challenges in asthma management?

Answer 24

1. Identifying and avoiding triggers. 2. Ensuring adherence to medication. 3. Managing comorbid conditions. 4. Providing patient education and support. 5. Addressing social and environmental factors.

Question 25

How does smoking contribute to cardiovascular disease?

Answer 25

1. Increases blood pressure and heart rate. 2. Promotes atherosclerosis. 3. Reduces oxygen supply to the heart. 4. Increases risk of blood clots. 5. Associated with higher mortality in cardiovascular patients.

Question 26

What are the benefits of regular physical activity?

Answer 26

1. Reduces risk of chronic diseases (e.g., heart disease, diabetes). 2. Improves mental health and mood. 3. Helps in weight management. 4. Enhances cardiovascular fitness. 5. Strengthens muscles and bones.

Question 27

Describe the role of diet in chronic disease prevention.

Answer 27

1. High fibre diet reduces risk of colorectal cancer. 2. Low salt intake prevents hypertension. 3. Healthy fats (e.g., omega-3) reduce heart disease risk. 4. Antioxidant-rich foods protect against cellular damage. 5. Balanced diet supports overall health and immunity.

Question 28

What are the key findings from the Seven Countries Study?

Answer 28

1. Linked dietary fat intake to coronary heart disease risk. 2. Highlighted the benefits of a Mediterranean diet. 3. Showed the importance of unsaturated fats in heart health. 4. Demonstrated geographical variations in CHD incidence. 5. Provided evidence for dietary guidelines.

Question 29

Explain the concept of ‘health inequalities’.

Answer 29

1. Differences in health status between different population groups. 2. Influenced by social, economic, and environmental factors. 3. Higher prevalence of diseases in disadvantaged groups. 4. Affects access to healthcare services. 5. Targeted interventions needed to reduce inequalities.

Question 30

What are the triggers of asthma attacks?

Answer 30

1. Allergen exposure (pollens, mould, dust mites). 2. Respiratory infections (colds, flu). 3. Air pollution (particulates, ozone). 4. Physical activity and exercise. 5. Emotional stress and anxiety.

Question 31

How can public health policies improve population health?

Answer 31

1. Implementing vaccination programs. 2. Regulating tobacco and alcohol use. 3. Promoting healthy eating and physical activity. 4. Improving access to healthcare services. 5. Addressing social determinants of health.

Question 32

What are the major public health challenges in the UK?

Answer 32

1. Chronic diseases in later life (e.g., coronary heart disease, stroke, cancer). 2. Mental health problems, including depression and social isolation. 3. Accidents, especially road traffic accidents. 4. Infections such as COVID-19, tuberculosis, and HIV. 5. Epidemics of obesity and type 2 diabetes.

Question 33

Explain the concept of ‘confounding’ in epidemiological studies.

Answer 33

1. Confounding occurs when an extraneous variable affects the observed relationship. 2. It can lead to false conclusions about causality. 3. Identifying and controlling for confounders is essential in study design. 4. Common confounders include age, sex, and socioeconomic status. 5. Statistical methods like multivariate analysis help control confounding.

Question 34

What is the ecological fallacy?

Answer 34

1. Incorrectly assuming that relationships observed at the group level apply to individuals. 2. Results from group-level data may not reflect individual-level associations. 3. Can lead to misleading conclusions about causation. 4. Important to use individual-level data to confirm findings. 5. Example: assuming all individuals in a high prevalence area are at high risk.

Question 35

Describe the key features of a cohort study.

Answer 35

1. Observational study design following a group over time. 2. Measures exposures and outcomes at multiple time points. 3. Can establish temporal relationships between exposure and disease. 4. Suitable for studying rare exposures. 5. Examples include the Framingham Heart Study and Nurses’ Health Study.

Question 36

What is the significance of the Framingham Heart Study?

Answer 36

1. Longitudinal study started in 1948. 2. Identified key risk factors for cardiovascular disease. 3. Included factors such as hypertension, high cholesterol, and smoking. 4. Provided insights into the natural history of heart disease. 5. Influenced public health policies and clinical guidelines.

Question 37

Explain the concept of ‘disease burden’.

Answer 37

1. Measurement of the impact of a health problem in a population. 2. Includes mortality, morbidity, and disability. 3. Often expressed in terms of DALYs (Disability-Adjusted Life Years). 4. Helps in prioritizing health interventions and resource allocation. 5. Assists in comparing the relative importance of different diseases.

Question 38

How do randomized controlled trials (RCTs) contribute to medical research?

Answer 38

1. Considered the gold standard for evaluating interventions. 2. Random allocation minimizes bias. 3. Allows for control of confounding variables. 4. Provides strong evidence for causality. 5. Essential for developing clinical guidelines and treatment protocols.

Question 39

Discuss the role of social determinants in health.

Answer 39

1. Conditions in which people are born, grow, live, work, and age. 2. Includes factors like income, education, and employment. 3. Social determinants significantly influence health outcomes. 4. Addressing these can reduce health inequalities. 5. Public health policies should target social determinants to improve population health.

Question 40

What are the primary objectives of public health surveillance?

Answer 40

1. Continuous, systematic collection of health data. 2. Detecting outbreaks and epidemics early. 3. Monitoring trends and patterns of disease. 4. Evaluating the impact of public health interventions. 5. Providing data to guide public health policy and planning.

Question 41

Describe the impact of air quality on public health.

Answer 41

1. Poor air quality is linked to respiratory diseases like asthma and COPD. 2. Increases risk of cardiovascular diseases. 3. Long-term exposure can lead to lung cancer. 4. Affects vulnerable populations, especially children and the elderly. 5. Improving air quality can significantly reduce health care costs and improve quality of life.