Social Determinants of Health

Question 1

Define: Necessary cause

Answer 1

Presence is required for the occurrence of the event

i.e. you can’t have the disease without exposure to the cause but exposure does not always lead to outcome

Question 2

Define: Sufficient cause

Answer 2

A factor whose presence leads to an effect

i.e. the exposure alone would induce the outcome but other exposures may also induce the same outcome

Question 3

A cause that is necessary but not sufficient

Answer 3

Pathogenic disease e.g. virus

Question 4

A cause that is sufficient but not necessary or neither necessary nor sufficient

Answer 4

Smoking for lung cancer

Question 5

Define: Inequalities in health

Answer 5

• Variation in health status, life expectancy, mortality and morbidity between different groups
• They are avoidable by reasonable action

Question 6

Give examples of: Determinants of health

Answer 6

1. Health services/medical care - access/health literacy
2. Social environment - income, culture
3. Physical environment - where a person lives

Question 7

What are: the 3 Ps of public health

Answer 7

1. Health improvement - promotion prevention
2. Health protection – infectious diseases, emergency responses
3. Improving health services – organising and commissioning, policy

Question 8

Define: Public Health

Answer 8

The science + aart of preventing disease, prolonging life + promoting health through organised efforts + informed choices

Question 9

When was the NHS established?

Answer 9

1948

Question 10

Who was Semmelweis and what did he achieve?

Answer 10

• Observed death of pregnant women due to doctors failing to wash their hands between surgery and labour wards.
• He introduced hand washing
• Mortality fell to below 1%

Question 11

Who was Robert Koch?

Answer 11

He postulated about microorganisms + disease

Question 12

Who were the 3 founders of microbiology?

Answer 12

Robert Koch
Louis Pasteur
Ferdinand Cohn

Question 13

Name the 8 steps on the Intervention Ladder

Answer 13

1. Do nothing or simply monitor the situation
2. Provide information - campaign for 5 a day
3. Enable choice - stop smoking programmes; cycle lanes; free fruit in schools
4. Guide choices through changing the default policy - restaurants make healthy option the norm with chips as an option
5. Guide choices through incentives
6. Guide choices through disincentives
7. Restrict choice - remove unhealthy ingredients form food in shops
8. Eliminate choice

Question 14

What fraction of variance in health status can be explained by individuals?

Answer 14

1/4

Question 15

Malaria: What are the health determinants?

Answer 15

Money - nets + insecticides
Education level - early treatment requires people to recognise signs
Geography - access to healthcare