public health ethics Flashcards
Why was the intervention ladder introduced?
It is believed that public health issues arise from the lifestyle action of individuals, e.g. people are responsible for their health to relieve NHS pressure.
Is the intervention ladder useful?
Yes if used correctly. For example, the intervention ladder has been used for tobacco. It started with informing the public of the risks, then offering participation into stop smoking programmes, then increasing tax on cigarettes, making them hidden in supermarkets, having graphic advertising to put people off buying them, as well as restricting where people can smoke. Now we have come to a point where the last option is to eliminate smoking altogether, for which the Government has plans to do in a short amount of time. This gives people the time to realise and stop smoking before it becomes completely eliminated. If the government just decided to eliminate smoking altogether then there would be a lot of suffering and uproar, however taking smaller steps using the intervention ladder allows greater acceptance by the public and ease of implementation.
What are Hill’s tests and why are they used?
Ultimately, to determine whether there is evidence for something being caused by something else, we must be able to identify causation. We can use Hill’s tests for this which look at:
the strength of the association
the consistency (if repeated)
the specificity
the temporality (does effect occur after onset)
the dose-response curve (does dose affect outcome)
biological plausibility (is there a possible mechanism?)
the coherence (cause and effect doesn’t conflict with already known information)
the availability of experimental evidence
analogy with previously established causal relationships
