Public health and health promotion interventions

Question 1

what are the indicators of health

Answer 1

Life expectancy at birth. Deprivation and mortality. Employment/occupation. Deprivation and behaviour – e.g. smoking and drinking. Age& Gender. Education

Question 2

what are the causes of mortality and disease risk factor

Answer 2

Underweight. Overweight. Smoking. Alcohol consumption. Hypertension. Sexual behaviour, i.e. unsafe sex. Iron deficiency. Cholesterol. Low intake of fruit and vegetables. Physical inactivity

Question 3

what are the wider determinants of health

Answer 3

These influence the causes/risk factors for disease and mortality: General socioeconomic, cultural and economic conditions. Living and working conditions. Social and community influences. Individual lifestyle factors. Age, sex and hereditary factors

Question 4

what do approaches to health promotion take into account

Answer 4

The broad definition of health. The scope of prevention. Limitation of health services. Role of individuals, groups and governments

Question 5

what does health promotion involve

Answer 5

Clinical intervention: Biomedical prevention; screening, immunisation.
Health education: Traditional e.g. education about smoking etc.
Health public policy: Legal, fiscal and social measures - Makes individual healthy choices easier - E.g. seatbelt legislation, smoking ban.
Community development - Individuals/groups setting their own agenda

Question 6

what is the Tannahill Model

Answer 6

A simple and practical framework which advocates 3 health promotion approaches: 1. Health Education- influences knowledge 2. Health protection- legislative, fiscal and social measures 3. Prevention- medical interventions to reduce risk

Question 7

what are the four levels of prevention

Answer 7

primordial, primary, secondary and tertiary

Question 8

what is primordial prevention

Answer 8

Prevention of factors promoting the emergence of lifestyles, behaviours, exposure patterns which contribute to increased risk of disease

Question 9

what is primary prevention

Answer 9

Actions to prevent the onset of disease, Limit exposure to risk factors, Includes health promotion and specific protection e.g. vaccines

Question 10

what is secondary prevention

Answer 10

To halt progression once the illness is already started; early diagnosis and treatment

Question 11

what is tertiary prevention

Answer 11

Rehabilitation to minimise residual disability and complications

Question 12

what are the 2 main approaches to disease prevention

Answer 12

high risk and population

Question 13

what is high risk disease prevention

Answer 13

Identifying those in special need (target rescue operation), e.g. screening among SCA patients - Controlling exposure or providing protection against effect of exposure

Question 14

what are the pros of high risk disease prevention

Answer 14

Effective (high motivation of individual and physician) - Efficient (cost-effective use of resources) - Appropriate to individual - Easy to evaluate

Question 15

what are the cons of high risk disease prevention

Answer 15

Palliative and temporary (misses a large amount of disease) - Risk prediction not accurate - Limited potential- misses out on info about relatives and friends - Hard to change individual behaviours

Question 16

what is population disease prevention

Answer 16

recognition that the occurrence of common diseases and exposures reflects the behaviour and circumstances of society - Idea that small changes lead to a bigger influence

Question 17

what is the prevention paradox

Answer 17

many people exposed to a small risk may generate more disease than the few exposed to a large risk. therefore, when many people receive a small benefit the total benefit may be large. however, individual convenience may be high to the many when benefit may only be to a few

Question 18

what are the pros of population disease prevention

Answer 18

Equitable (attributable risk may be high where risk is low if a lot of people are exposed to that low risk) - Radical - Large potential for population - Behaviourally appropriate

Question 19

what are the cons of population disease prevention

Answer 19

small advantage to individual. poor motivation of subject. poor motivation of physician. benefit:risk ratio worrisome

Question 20

where can health promotion operate

Answer 20

internationally. nationally. locally (GP, hospitals, local authority, police, schools etc). individual

Question 21

who can health promotion impact on

Answer 21

population, community, the individual

Question 22

health promotion role of doctors working with individuals

Answer 22

smoking cessation guidelines. motivational interviewing. support for cessation. prescription of nicotine replacement therapy (NRT). referral to specialist services

Question 23

what wider health promotion

Answer 23

advocacy e.g higher taxes, nrt on prescription, ban on tobacco advertising, smoke-free public and work places by: writing, letters to the press, influencing to decision makers

Question 24

give an example of a current public health initiative

Answer 24

the wanless report. wanless 1,2 and 3. the disease burden. fully engaged scenario. focus on prevention and the wider determinants of health. cost effectiveness of actions to improve health and reduce inequalities

Question 25

the marmot review

Answer 25

Give every child the best start in life. Enable all children young people and adults to maximise their capabilities and have control over their lives. Create fair employment and good work for all. Ensure a healthy standard of living for all. Create and develop healthy and sustainable places and communities. Strengthen the role and impact of ill health prevention

Question 26

what are the key public health programmes

Answer 26

smoking cessation, alcohol harm reduction strategy, sexual health- national chlamydia screening programme, tackling teenage pregnancy, tackling obesity, immunisation programmes

Question 27

commission on social determinants of health

Answer 27

improve the conditions of daily life – the circumstances in which people are born, grow, live, work, and age. Tackle the inequitable distribution of power, money, and resources – the structural drivers of those conditions of daily life – globally, nationally, and locally. Measure the problem, evaluate action, expand the knowledge base, develop a workforce that is trained in the social determinants of health, and raise public awareness about the social determinants of health.

Question 28

three key policy documents regarding health promotion

Answer 28

Ottawa Charter
Jakarta Declaration
Bangkok Charter