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MBBS - Year 1 > Public Health - Healthy and Unhealthy Communities > Flashcards

Public Health - Healthy and Unhealthy Communities Flashcards

1
Q

What does the social model of health address

A

The social, economic, and political conditions in which people grow, live, work and age and the structural drivers of those conditions.

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2
Q

Social model of heath

A 
Age, sex, hereditary factors 
Individual lifestyle factors
Social and community networks 
Structural factors 
General socioeconomic, cultural and environmental conditions
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3
Q

What does individual lifestyle factors look at

A

Personal behaviour and way of living that can promote or damage health e.g. smoking, whether or not we are physically active, the foods we choose to eat, alcohol consumption

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4
Q

What does social and community networks influence

A

Influence our individual actions e.g. drinking culture

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5
Q

What are health inequalities

A

Unjust and avoidable differences

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6
Q

Examples of health inequalities

A

Differences in mortality rates between people from different social classes, or
The impact of income groups on school readiness, vocabulary, and behaviour

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7
Q

Overarching recommendations of WHO CSDH

A

Improve daily living conditions
Tackle the inequitable distribution of power, money and resources
Measure and understand the problem and assess the impact of actions

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8
Q

Marmot review policy objectives

A

Give every child 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 healthy standard of living for all
Create and develop healthy and sustainable places and communities
Strengthen the role and impact of ill health prevention

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9
Q

National marketing campaigns

A

Stoptober

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10
Q

Regional marketing campaigns

A

UCLH Pathway programme

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11
Q

UCLH Pathway Programming

A

For homeless patients admitted to hospital. Involves hospital GP’s and nurses working with others to address the social determinant’s of housing, financial and social issues of patients. After its introduction, A&E attendance by supported individuals fell by 38% with a 78% reduction in bed days

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12
Q

Local marketing campaigns

A

PHE support local areas on risk factors e.g. smoking
Published ‘Smoking Cessation: A briefing for midwifery staff’ and launched an online training module, ‘Very brief advice on smoking for pregnant women’

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13
Q

What is screening

A

Testing people who do not suspect they have a health problem (without symptoms)

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14
Q

Why do we have screening

A

Reduce risk of future ill health by earlier detection and treatment
Provide information to help make choices

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15
Q

NHS national cervical screening programme

A 
Cervical cancer 
Breast cancer 
Bowel cancer 
Abdominal aortic aneurysms 
Antenatal and neonatal testing 
Diabetic eye disease
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16
Q

NHS general health check

A

Screen adults 40-74 for early signs of stroke, kidney disease, T2DM or dementia
GP management of risk factors

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17
Q

Cardiovascular risk factors

A 
Bp
Cholesterol
Obesity (BMI)
Glucose (or HbA1c)
Smoking
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18
Q

National Diabetes Prevention Programme

A

Based on glucose (or HBA1c) testing in health check
Diagnosis of prediabetes –> lifestyle interventions
Diagnosis of diabetes –> GP

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19
Q

Stages of screening

A

Screening phase
Dx phase
Intervene

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20
Q

Outcomes of screening

A

Outcome better because of early detection
Outcome good but early detection made no difference
Condition would have no impact, intervention was unnecessary
Outcome poor and early detection made no difference

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21
Q

Components of a screening programme

A 
Register of eligible people 
System of invitation and recall 
Screening tests 
Confirmation of dx 
Treatments of other interventions 
Info and support for patients
Staff training 
Standards and quality assurance
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22
Q

Drawbacks of screening

A

Over dx
False +ve
False -ve – false sense of security
Unnecessary treatment – might never have progressed to severe disease/ death
Costs of screening, further testing and treatment

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23
Q

False -ve

A

Has disease and screening test -ve

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24
Q

False +ve

A

Does not have disease and screening test +ve

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25
Q

Sensitivity

A

% of people with disease who test +ve. Screening tests should be highly sensitive

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26
Q

Specificity

A

% of people without disease who test -ve. Diagnostic tests should be highly spp

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27
Q

Evidence about effectiveness of screening

A

RCTs provides best evidence
Time trends in disease incidence and outcomes – compared to countries/ regions without screening
Case control studies
Systematic reviews of evidence
Modelling (combining a variety of evidence)

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28
Q

Common sources of bias in screening evaluation

A

Healthy Screening effect
Length time bias
Lead time bias

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29
Q

Healthy Screening effect

A

People who take part tend to be healthier than those who don’t

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30
Q

Lead time bias

A

Earlier detection makes duration of survival after diagnosis longer, even if treatment is ineffective

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31
Q

Length time bias

A

Disease is more likely to be detected in people with longer lasting and slowly progressive types of the disease —> have better outcomes anyways

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32
Q

Common chemical hazards

A 
Arsenic 
Asbestos 
Benzene 
Vinyl Chloride 
Alpha-naphtylamine 
Hydrocarbons 
Nitrates
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33
Q

Which cancer site does arsenic affect

A

Lung

34
Q

Which cancer site does asbestos affect

A

Lung

35
Q

Which cancer site does benzene affect

A

Leukaemia

36
Q

Which cancer site does vinyl-chloride affect

A

Liver

37
Q

Which cancer site does alpha-napthylamine affect

A

Bladder

38
Q

Which cancer site does hydrocarbons affect

A

Scrotum

39
Q

Which cancer site does nitrates affect

A

Stomach

40
Q

Vector for malaria

A

Anopheles Mosquito (female)

41
Q

Environment needed for malaria

A

Needs suitable temperature and rainfall

42
Q

IPCC main risks of climate change

A

Greater risk of injury, disease and death due to more intense heat waves and fires
Increased risk of undernutrition resulting from diminished food production in poor regions
Consequences for health of lost work capacity and reduced labour productivity in vulnerable population
Increased risks of food and water-borne disease and vector-borne diseases

43
Q

IPCC main opportunities of climate change

A

Modest reductions in cold-related mortality and morbidity in some areas due to fewer cold extremes
Geographical shifts in food production
Reduced capacity of disease-carrying vectors due to exceedance of thermal thresholds

44
Q

What does the impact of the environment on human health depend on

A

Vulnerability both at the individual and society levels

45
Q

What can heat and air pollution exacerbate

A

Cardiovascular, cerebrovascular and respiratory issues

46
Q

What can cause GE and cholera

A

Contamination due to floods and disruption of clean water supplies and sewage treatment

47
Q

How can climate change cause more vector-borne infectious

A

Changes in vector number and geographic distribution of clean water supplies and sewage treatment, after heavy rains and other environment disasters

48
Q

How can climate change cause malnutrition

A

Changes in local climate that disrupt crop production

49
Q

Xenobiotics

A

Exogenous chemicals in the environment that may be absorbed by the body through inhalation, ingestion, or skin contact

50
Q

Metabolism of xenobiotics

A

Phase 1: Chemicals undergo hydrolysis, oxidation, or reduction
Phase 2: reactions of glucuronidation, sulfation, methylation, and conjugation with glutathione (GSH). Water-soluble compounds are readily excreted

51
Q

Air pollution

A

Cause of morbidity and mortality
Airborne micro-organisms
Chemical and particulate pollutants found in the air

52
Q

Who does air pollution especially affect

A

Individuals with pre-existing pulmonary or cardiac disease.

53
Q

Air in industrialised nations

A 
Sulfur dioxide
CO
Ozone
Nitrogen dioxide
Lead
Particulate matter
54
Q

How does the ozone affect healthy individuals

A

Decreased lung function
Increased airway reactivity
Lung function

55
Q

How does the ozone affect athletes and outdoor workers

A

Decreased exercise capacity

56
Q

How does the ozone affect asthmatics

A

Increased hospitalization

57
Q

How does NO2 affect healthy individuals

A

Increased airway reactivity

58
Q

How does NO2 affect asthmatics

A

Decreased lung function

59
Q

How does NO2 affect children

A

Increased respiratory infections

60
Q

How does SO2 affect healthy adults

A

Increased respiratory symptoms

61
Q

How does SO2 affect pts w/ chronic lung disease

A

Increased mortality

62
Q

How does SO2 affect asthmatics

A

Increased hospitalisations

63
Q

How do acid aerosols affect asthmatics

A

Decreased lung functions

Increased hospitalizations

64
Q

How do acid aerosols affect children

A

Increased respiratory infections

65
Q

How do acid aerosols affect healthy adults

A

Altered mucociliary clearance

66
Q

How do particulates affect children

A

Increased respiratory infections

Decreased lung function

67
Q

How do particulates affect pts w chronic lung/ heart disease

A

Excess mortality

68
Q

How do particulates affect asthmatics

A

Increased attacks

69
Q

Ozone as pollutant

A

Gas formed by sunlight-driven reactions involving nitrogen oxides
Forms smog
Participates in chemical reactions that generate free radicals, which injure the lining cells of the respiratory tract and the alveoli

70
Q

Sulfur dioxide, particles and acid aerosols

A

Emitted by coal and oil power plants and industrial processes burning fuel
Inhalation causes infl response

71
Q

Sources of carbon monoxide

A

Automotive engines
Fossil fuels
Home oil burners
Cigarette smoke

72
Q

Mechanism of carbon monoxide in body

A

Systemic asphyxiant that binds to haemoglobin and prevents oxygen transport
Systemic hypoxia appears at 20-30%
Unconsciousness and death at 60-70%

73
Q

Damage with bioareosols

A

Can cause pathogenic microbiologic agents, such as those that can cause legionnaires’ disease, viral pneumonia and the common cold

74
Q

What are health inequalities usually dressed in relation to

A

Socioeconomic Factors e.g. income.
Geography
Specific Characteristics
Socially Excluded Groups e.g. those experiencing homelessness

75
Q

What does specific characteristics involve

A

Protected characteristics such as sex, ethnicity, religion and disability.

76
Q

Key measure of population’s health status

A

Life expectancy

77
Q

Avoidable mortality

A

Refers death that can be prevented by timely healthcare and intervention

78
Q

Global examples of health inequalities

A

32-year gap in life expectancy globally - 85 in Japan and 53 in Central African Republic
Children in sub-Saharan Africa are 15 x more likely to die before their fifth birthday
People 60+ make up 94% of COVID-19 deaths in the EU

79
Q

Short term effects of air pollution

A 
Pneumonia 
Bronchitis 
Irritation to nose, throat, eyes or skin 
Headaches 
Dizziness 
Nausea 
Unbearable odours make living difficult
80
Q

How humans impact land and water

A

Contamination of bodies of water
Contamination of soil
Acid rain
Global warming

81
Q

Effect of water and land pollution on human health

A

Breeding ground for illness and disease

Contaminated water is linked to disease transmission

MBBS - Year 1 (93 decks)

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