Public Health (from Revision document) Flashcards
What is the gini coefficient?
a statistical representation of nation’s income distribution amongst its residents - the lower the coefficient, the greater the equality amongst people. UK has a rather high inequality coefficient compared to Scandinavian countries (Denmark etc)
What were the key findings of the Black Report (1980)?
i Material (environmental causes, might be mediated by behaviour) ii Artefact (an apparent product of how the inequality is measured) iii Cultural/behavioural (poorer people behave in unhealthy ways) Iv Selection (sick people sink socially and economically)
What were the key findings of the Acheson Report (1998)?
i income inequality should be reduced
ii give high priority to the health of families with children
What is proportionate universalism?
i Focusing on the disadvantaged only will not help to reduce the inequality
ii Action must be universal but with a scale and intensity proportional to the disadvantage (hence the name)
iii Fair distribution of wealth is important
What is the psychological theory of causation?
i stress results in inability to respond efficiently to body’s demands
ii impact on blood pressure, cortisol levels and on inflammatory and neuroendocrine responses
What is the neo-material theory of causation?
i more hierarchal societies are less willing to invest into the provision of public goods (this is the fundamental issue in societies such as the United States, hard to justify public goods)
ii poorer people have less material goods, quality of which is generally lower
What is the life-course theory of causation?
i a combination of both Psychosocial and Neo-material explanations
ii critical periods - possess greater impact at certain points in the life course (childhood)
iii accumulation - hazards and their impacts add up -> hard work leads to injuries resulting in disabilities that may lead to more injuries
iv interactions and pathways - sexual abuse in childhood leads to poor partner choice in adulthood
What are the 4 domains of public health?
Health Protection: infectious diseases, chemicals and poisons, pollution, radiation, emergency response
Improving services: clinical effectiveness, efficiency, service planning, equity
Health Improvement: lifestyles, family & community, education, employment, housing, surveillance and monitoring
Addressing the wider determinants of health: seeing the big picture - making sense of data
What are meta-ethics?
exploring fundamental questions:
right/wrong/defining the good life
What are ethical theories?
philosophical attempts to create ethical theories: i virtue ii categorical iii imperative iv utilitarianism v 4 principles
What are applied ethics?
a recent emergence of ethical investigation in specific areas (environmental, medical, public health)
What is a deductive ethical argument?
(one general ethical theory -> all the medical problems)
What is an inductive ethical argument?
(settled medical cases -> generate theory or guides to medical practice)
What is meant by considering what we believe in?
(General ethical theory -> institutions/feelings -> medical problem)
What are the ethical fallacies?
Ad hominem: responding to arguments by attacking person’s character rather than the content of their argument (Latin for: “to the man”)
Authority claims: saying a claim is correct because authority has said so
Begging the question: petitio principii - assuming the initial point of the argument
Dissenters: identifying those who disagree does not itself prove the claim is not valid
Motherhoods: inserting a soft statement to disguise the disputable one: “All humans are equal (so we shouldn’t stop PVS patient treatment). Confusing necessary & sufficient
No true Scotsman: modifying the argument:
i “No Scotsman would do such thing.”
ii “But this one did.”
iii “Well, no true Scotsman would.”
When can confidentiality be disclosed?
- Required by law: Notifiable Disease, Court/judge/police
- Public at risk:
Serious crime
Serious communicable disease
Research/education - Individual is vulnerable to exploitation:
Disabled etc - Patient consent:
-
What is the criteria for disclosure of confidential info?
Anonymous if practicable
Kept to necessary minimum
Meets current laws (data protection)
Patient’s consent
What are the 3 main notifiable diseases?
Yellow Fever, Cholera, Plague
What are 5 lifestyle factors that increase mortality?
Smoking Obesity Sedentary Lifestyle Excess Alcohol Poor diet
What are structural determinants of illness?
i social class ii material deprivation/poverty iii unemployment iv discrimination/ racism v gender and health
What is the biomedical model of health?
i Mind and body are treated separately
ii Body, like a machine, can be repaired
iii This privileges use of technological interventions
iv It neglects social and psychological dimensions of disease
What is health behaviour?
aimed to prevent disease (eating healthily)
What is illness behaviour?
aimed to seek remedy (going to the doctor)
What is sick role behaviour?
aimed at getting well (compliance, resting)