Public Health and Pharmacy

Question 1

What are the two public health outcomes?

Answer 1

1) Increased healthy life expectancy

2) Reduced differences in life expectancy and healthy life expectancy between communities

Question 2

What are the 4 domains of public health?

Answer 2

1) Improving the wider determinants of health
2) Health improvement
3) Health protection
4) Healthcare, public health and preventing premature mortality

Question 3

Name some areas in the 1st domain of public health…

Answer 3

IMPROVING WIDER DETERMINANTS OF HEALTH

• Child poverty
• Pupil absence
• Youth offending
• Employment
• Violent crime

Question 4

Name some areas in the 3rd domain of public health…

Answer 4

HEALTH PROTECTION

• Chlamydia diagnoses
• Vaccine coverage
• Plans for health protection incidents and emergencies

Question 5

Name some areas in the 2nd domain of public health…

Answer 5

HEALTH IMPROVEMENT

• Breastfeeding
• Teenage pregnancies
• Excess weight
• Self harm
• Diabetes
• Alcohol related admissions
• Cancer screening
• Falls in over 65’s

Question 6

Name some areas in the 4th domain of public health…

Answer 6

HEALTHCARE, PUBLIC HEALTH AND PREVENTING PREMATURE MORTALITY

• Infant mortality
• CVD mortality
• Cancer mortality
• Suicide rates
• Emergency readmissions
• Winter deaths

Question 7

WHO state 5 key principles to health promotion, what are they?

Answer 7

1) Involve population as a whole
2) Directed towards determinants of health to ensure environment promotes health
3) Combines different methods e.g communication, education, law etc…
4) Support public participation and self awareness to encourage to find own way to manage health
5) Health professionals role = promote health

Question 8

Health and Social Care Act 2012 looks to…

Answer 8

• Make public healthier
• Encourage discussions and advise government
• Support action by local government, NHS and other organisations

Question 9

Healthy Living Pharmacies must have a…

Answer 9

Healthy Living Champion

Question 10

What does the Medical approach to health promotion consist of?

Answer 10

• Health defined as absence of disease
• Aim to reduce morbidity and premature mortality
• FOCUS ON PREVENTION

PRIM PREVENT: Prevent onset of disease (immunise)
SEC PREVENT: Identify early to prevent disease progression e.g cervical screening
TERT PREVENT: Reduce further disability and suffering in those already ill e.g rehab

Question 11

What are the 5 approaches and models to health promotion?

Answer 11

1) Medical
2) Behaviour change
3) Educational
4) Empowerment
5) Social change

Question 12

What does the behavioural change approach to health promotion consist of?

Answer 12

1) Encourage to adopt healthy lifestyles
2) Can be seen as expert led - blame individual
3) Motivational interviewing

Question 13

What does the educational approach to health promotion consist of?

Answer 13

1) Provide knowledge and information so can make informed choice
2) Doesn’t try to persuade
3) Mass media campaigns
4) Knowledge -> Attitude -> Behaviour

Question 14

What does the empowerment approach to health promotion consist of?

Answer 14

1) Identify own concerns and gain skills to act
2) Individual or community
3) Health promotor ‘gets things going’ e.g support healthy eating initiatives

Question 15

What does the social change approach to health promotion consist of?

Answer 15

1) Focus on policy/environmental level
2) Focus on causes ill health
3) Changes in physical, social and economic environment
4) Difficult to bring about
5) Smoking ban in pubs, banning vending machines in schools

Question 16

What is the Standardised Mortality Ratio?

Answer 16

• Death rate taking into account differences in age structure compared to what would be expected in this group if national averages applied
• ## Overall avg for England = 100

Question 17

What is Infant Mortality Rate? (IMR)

Answer 17

• Number of deaths in first year of life per 1000 live births

Question 18

Name 4 objective measures of health:

Answer 18

1) Health measures (height, weight, teeth missing)
2) Health behaviour indicators (smoking, drinking)
3) Environmental measures (air and water, housing)
4) Socio-economic indicators (wealth, services, crime)

Question 19

Name 4 subjective measures of health:

Answer 19

1) Functional ability (everyday activities)
2) Health status (SF-36 questionnaire, QALY life expectancy and quality of years gained)
3) Psychological well-being (depression, mental state, life satisfaction)
4) Social networks and social support (degree to which function as a community)

Question 20

What are PROMs?

Answer 20

• Patient reported outcome measures
• Standardised, validated questionnaires
• Completed by patients to measure perception of own functional status and well-being

e.g before and after elective surgery

Question 21

List 5 factors that can have protective or pro development involvement in mental health…

Answer 21

1) Individual factors (morals, social skills, nutrition, health, self esteem, illness)
2) Family factors (Supportive, small fam size, single parent, violence, supervision)
3) School (belonging, bullying, behaviour, peer group)
4) Life events (partner, economic stability, divorce, abuse, illness, death)
5) Community/cultural (Connectedness, identify, community group, violence, housing, isolation)

Question 22

Experiencing __ or more stressful life events e.g family bereavement, divorce, serious illness puts you at higher risk of poor mental health and well being.

Answer 22

3

Question 23

What is the pharmacists role in prevention of poor mental health..

Answer 23

• recognise signs and symptoms of at risk groups
• referral/signposting if worried
• promote good MH lifestyle (exercise, diet, positivity, mindfulness)
• medicines education
• non-pharmacological therapies (CBT etc…)
• support groups (dementia friends, arthritis.org etc…)