Public Health Knowledge Questions Flashcards
Describe a paper you have read recently
AFFIRM-HF
- Multi-centre, double-blind, randomised trial across 121 sites.
- Looked at whether IV iron reduced mortality & hospital admissions in people with significant heart failure
- Found it reduced the incidence of hospitalisation, but not mortality
Talk about a public health issue you are passionate about
• 9/10 people exposed to dangerous levels air pollution
• 7 million die every year from air pollution
• Increases risk of lung cancer by 10% KCH 2019
• Cutting it by 1/5th could reduce risk of lung cancer by 8% in London
- Wood burning stoves single biggest cause of small particle air pollution. 3x more particulate matter than vehicles, and 3x level particulate matter in the home. 8% of UK population responsible.
- Choked up campaign in South London
Related issues: Fuel poverty,
What is the structure for dealing with a new health problem?
1) Investigate - Collect data/information, confirm problem
2) Identify stake-holders and get them involved
3) Procurement – commission to deliver services & community engagement
4) Evaluation – Impact, cost-effectiveness, reduction of health inequality
Health needs assessment
1) What is the problem?
2) What is the size and nature of the problem?
3) What are the current services?
4) What interventions do patients, professionals and other stakeholders want?
5) What interventions does scientific knowledge recommend?
6) What are the resource implications?
7) What are the recommendations and the plan for implementation?
8) Is assessing need likely to lead to appropriate change?
Discuss an ethical issue
Vaccine hesitancy
- Should childhood vaccination be compulsory?
- Benefit of vaccination varies with disease/incidence/level of herd immunity
- Balancing values - Utility, liberty & fairness
- Eliminationism vs Inconveniencing vs contributory models
Talk about air pollution
• 9/10 people exposed to dangerous levels air pollution
• 7 million die every year from air pollution
• Increases risk of lung cancer by 10% KCH 2019
• Cutting it by 1/5th could reduce risk of lung cancer by 8% in London
- Wood burning stoves single biggest cause of small particle air pollution. 3x more particulate matter than vehicles, and 3x level particulate matter in the home. 8% of UK population responsible.
- Choked up campaign in South London, triggered by death of a young girl from asthma
Related issues: Fuel poverty,
Talk about obesity
- 2/3rds adults are above a healthy weight in the UK
- Individuals lose 3-4 disease free years if mildly overweight, and 7-8 if obese
- 20% of 10-11 year olds are obese – doubles the risk of dying prematurely. Global health issue, especially as developing countries enter nutritional transition
- NHS spends 5.1 billion per year on overweight and obesity related ill health
Talk about smoking
- Leading cause of preventable deaths
- ¼ hospital beds taken up by smokers
- E-cigarettes legit replacement
Talk about WASH
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Talk about climate change
- NHS produces 5% of uk Carbon footprint
What do you know about the NHS long-term plan?
- Hails prevention as a way of saving 1/2 million lives over next 10 years
- Ottawa model for smoking cessation -> 1/4 hospital beds taken up by smokers. Intervention for all. Encouraged to switch to e-cigarettes.
- Family intervention to stop smoking in the families of expectant mothers
Discuss health inequalities
- Jubilee line east from Westminster, life expectancy drops by 1-year for each stop. Geographic inequalities linked to poverty.
Give some reflections from your time at public health taster
- Many levers to pull
- Interdisciplinary
- Position in local authority gives lots of freedoms but also restraints
Give some principles of screening
Benefits
- catch disease early
Negative
- False positives, unnecessary worry
- Unnecessary treatment
Sensitivity
How well a test can identify true positives
Specificity
“True Negative Rate” - Measures the proportion of negatives that are correctly identified
