Public health strategies pop based/high risk Wk12

Question 1

What are the objectives of Epidemiology? (5)

Answer 1

1. Identify the etiology or cause (we need to know the true cause otherwise there is no justification for intervention program)
2. Establish burden of disease and risk factors
3. Describe natural history of disease (biological onset to death)
4. Evaluate effectiveness of prevention and program interventions
5. Inform public health strategies by developing public health strategies

Question 2

What is primary prevention?

Answer 2

Intervention given to a healthy individual, before the onset of the disease
address social determinants of health (root cause)
- **Population based **approach promote health and well-being at a population level.
- Immunization, health promotion

• Health promotion targeting lifestyle risk factors
  * Immunization programs
• Creating supportive environments: improving air and water quality, safe spaces for kids to play,
  safe bike lanes, implementing workplace safety measures, etc.
• **Policy **Development: smoking bans, food labeling, food fortification, etc.

Question 3

What is secondary prevention?

Answer 3

• Early detection and intervention to control and manage disease at an eary stage
• population screenign for breast cancer, colorectal cancer,
• Early diagnosis - classified as high-risk and eligible for early intervention
  4 components of secondary prevention
  1. Screening
  2. early diagnosis
  2. Intervention
  3. Monitoring

Question 4

Geoffrey Rose - what did he come up with?

Answer 4

Prevention paradox - where do you get the best bang for your buck, do you intervene at a pop level or at high risk level.
Large number of people **at a small risk ** may give rise to more
cases of disease or death than the small number of people who are at high risk.

Question 5

What is population based prevention approach?

Answer 5

**Primary prevention needs a population health approach:
The principle of the population health approach is to shift the distribution of a risk factor in the population. By doing so, one reduces the burden of disease in the population. Shift the distribution by upstream actions within society

• Health promotion targeting lifestyle risk factors
  * Immunization programs
• Creating supportive environments: improving air and water quality, safe spaces for kids to play,
  safe bike lanes, implementing workplace safety measures, etc.
• **Policy **Development: smoking bans, food labeling, food fortification, etc.

Question 6

What is high-risk approach?

Answer 6

The ‘high-risk approach’ is ‘a targeted rescue operation for individuals at high risk with the aim to reduce their
exposure level’** “find and treat individuals medically”**
* generally accommodated in the health care system
* therefore often viewed as the ‘medicalization’ of prevention
* tends to have a high level of acceptance
* relative invasive and costly when expressed as cost per patient
* the contribution to the reduction of the societal burden of a disease may be small
* this approach may be behaviorally and culturally inadequate and unsustainable

Question 7

What is prevention paradox?

Answer 7

the greatest benefit for a population
comes from interventions that target individuals at lower risk rather than focusing solely on those at high risk

Question 8

High-risk appraoch paradox

Answer 8

an intervention that targets
only high risk individuals may benefit only a small number of cases because there are fewer high risk individuals in the population

Question 9

Population approach paradox

Answer 9

If the same intervention
targets the entire population, the number of cases prevented may be higher because the more individuals are at low risk, even though the relative risk reduction is
smaller.

Question 10

Will a population approach
address health inequity?

Answer 10

The answer is ‘generally not’. Frohlich et al. made the point that a
population health approach may in fact increase inequity: An approach
that attempts to shift the distribution to the left (towards a lower level
of risk exposure) will have early adopters and late adopters. This will
stretch and flatten the distribution and create more inequity.

Question 11

What are public health strategies?

Answer 11

Public health strategies: the planned and organized efforts and actions by governments, organizations, interest groups, and communities to improve the health of populations by promoting health, preventing diseases, and addressing disparities in health.

Grouped into Primary and Secondary prevention strategies, involves combination of policies and program across sectors not just health. –sports, agriculture…