public health - medlearn Flashcards
health
a resource for everyday life, not the object of living
positive concept - emphasising social and personal resources as well as physical capacities
public health
the science and art of preventing disease, prolonging life and promoting health through organised efforts of society
what is health proportion
empowering people for health
enable people to increase control over and improve their health
improve control over determinants of health
social and political process
strengthen skills and capabilities of individuals
change the social, env and economic conditions to alleviate their impact on public and individual health
what is involved in health promotion
clinical intervention
health education
health public policy
community development
clinical intervention
biomedical
prevention
health education
traditional health promotion
knowledge = attitudes = behaviour = practice
health public policy
legal, fiscal, regulatory (HIA, European directive
community development
radical individuals setting their own agenda
how many levels of prevention are there
4
primordial prevention
prevention of factors that prevent the emergence of lifestyles, behaviours, exposure patterns which contribute to increased risk of disease
primary prevention
actions to prevent onset of disease limit exposure to risk factors individual behaviour change actions in community health promotion - health education and prescriptive diets specific protection - vaccination
secondary prevention
halt progression when illness is already established
early detection
effective treatment
special consideration of asymptomatic individuals
tertiary prevention
rehabilitation of people with established disease to minimise residual disability and complications
QOL action even if disease cannot be cured
high risk prevention
identifying those in special need
then controlling exposure or provide protection against exposure - vaccination
population prevention
recognition that occurrence of common conditions reflect behaviour and circumstances of society as a whole
describe the prevention paradox
many people exposed to a small risk may generate more disease than the few exposed to a small risk
when many people receive a small benefit the total benefit may be large
individual inconvenience may be high to the many when benefit may inly be to a few
strength of high risk approach
effective - high motivation efficient - cost effective benefit:risk ratio is favourable appropriate to the individual easy to evaluate
weakness of high risk approach
palliative and temporary - misses a large amount of disease
risk prediction - not accrate
limited potential - misses out on spill over of info
hard to change individual behaviours
strength of population approach
equitable - attributable risk may be high where risk is low if a lot of people are exposed to the low risk
radical
large potential for the population
behaviourally appropriate
weaknesses
small advantage to the individual
poor motivation of the subject
poor motivation of the physician
benefit:risk ratio worrisome
where can health promotion operate
internationally
nationally - government, advertising, media
locally - GP, hospital, local authority, police, schools etc
individually- support groups, neighbourhood schemes, communities
may impact at level of
population
community
individual
smoking cessation and drs working with individuals
smoking cessation guidelines MI support for cessation prescription of nicotine replacement therapy and bupropion referral to specialist services
broader health promotion of drs
advocacy eg higher taxds, NRT on prescription, ban on tabacco advertising, smoke free public and work places
how do drs cause broad health promotion
write/speak to politicians (lobbying)
letters to the press- media advocacy
influencing decision makers
wanless report
wanless 1 2 and 3
disease burden
fully engaged scenario
focus on prevention and wider determinants of health
cost effectiveness of actions to improve health and reduce inequalities
Marmot review
give every child the best start to life
enable all children, young people and adults to maximise their capabilities and have control over their life
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
key public health programs
smoking cessation alcohol harm reduction strategy sexual health - national chlamidyia screening program tackling teenage pregnancy tackling obesity immunisation programs
