Public Health - Healthy and Unhealthy Communities Flashcards
What does the social model of health address
The social, economic, and political conditions in which people grow, live, work and age and the structural drivers of those conditions.
Social model of heath
Age, sex, hereditary factors Individual lifestyle factors Social and community networks Structural factors General socioeconomic, cultural and environmental conditions
What does individual lifestyle factors look at
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
What does social and community networks influence
Influence our individual actions e.g. drinking culture
What are health inequalities
Unjust and avoidable differences
Examples of health inequalities
Differences in mortality rates between people from different social classes, or
The impact of income groups on school readiness, vocabulary, and behaviour
Overarching recommendations of WHO CSDH
Improve daily living conditions
Tackle the inequitable distribution of power, money and resources
Measure and understand the problem and assess the impact of actions
Marmot review policy objectives
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
National marketing campaigns
Stoptober
Regional marketing campaigns
UCLH Pathway programme
UCLH Pathway Programming
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
Local marketing campaigns
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’
What is screening
Testing people who do not suspect they have a health problem (without symptoms)
Why do we have screening
Reduce risk of future ill health by earlier detection and treatment
Provide information to help make choices
NHS national cervical screening programme
Cervical cancer Breast cancer Bowel cancer Abdominal aortic aneurysms Antenatal and neonatal testing Diabetic eye disease
NHS general health check
Screen adults 40-74 for early signs of stroke, kidney disease, T2DM or dementia
GP management of risk factors
Cardiovascular risk factors
Bp Cholesterol Obesity (BMI) Glucose (or HbA1c) Smoking
National Diabetes Prevention Programme
Based on glucose (or HBA1c) testing in health check
Diagnosis of prediabetes –> lifestyle interventions
Diagnosis of diabetes –> GP
Stages of screening
Screening phase
Dx phase
Intervene
Outcomes of screening
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
Components of a screening programme
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
Drawbacks of screening
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
False -ve
Has disease and screening test -ve
False +ve
Does not have disease and screening test +ve
