social determines of health Flashcards
what is the difference between necessary and sufficient cause
necessary - so if x is necessary for y then the presence of y indicates presence of x but presence of x doesn’t mean y will occur
sufficient - if x is sufficient cause of y then the presence of x implies the presence of y (inevitable) but another cause z may cause y - thus the presence of y does not imply the presence of x
what are sufficient or necessary about these diseases and accuses M. tuberculosis and TB decapitation and death trisomy 21 and downs smoking and lung cancer
necessary but not sufficient
sufficient but not necessary
both necessary and sufficient
neither necessary nor sufficient
what is quick way to remember necessary and sufficient
necessary - if A then B
sufficient - A, only if B (if b doesn’t occur then a won’t)
what are some determinants of health
socioeconomic, cultural, environmental (total ecological) (most important) living and working conditions social and community networks life style factors age, sex (least important)
what is the glasgow effect
difference between best and worst off districts by life expectancy - increasing difference
what are health behaviours
behaviours that affect health ie smoking
what is health inequity
unjust distribution of health and HC - systematic differences in health that are judged to be avoidable by reasonable action
what is the aim of PHOF
public health outcome framework
improve and protect the nations health and improve those poorer first
based off healthy life expectancy, reduced differences in life expectancy and health life expectancy between communities
what are indicators for health
directs attention to particular health issues within a population that warrant further investigation but not necessarily immediate action
what is the prevention paradox
we should focus on the ones at highest risk in the group but more total cases occur among people at lower rusk
focussing on all parts of the distribution we can change a social norm which affects behaviours of those at higher risk
describe the intersalt study
association between causes of obesity and clinically significant problems as a result of obesity - strong correlation between high BMI and clinically significant problem
define life course
interaction and influence of risk factors across lifetime that lead to certain health indicators relevant to an individual such as chronic diseases
describe the steps in the intervention ladder
eliminate choice restrict choice guide choice by disincentives " incentives " changing the default policy enable choice provide information do nothing
what did wilson and junger decide about principles and practice of screening for disease
new screening plan condition must be important acceptable treatment should be a test or examination an understood disease
describe the theory of planned behaviour and the three sub categories
why people act the way they do
attitude towards behaviour
social norms
control over the situation
what is the purpose of screening
identify those who are more likely to be helped than harmed by further tests or treatment
what is test sensitivity
proportion of people with the disease who are identified as having it by a positive test result
what are the benefits and disadvantages of a test with high sensitivity
relativity few false negatives but lots of false positives - maximise identification of a disease screened in that population
good sensitivity if dangerous to patient or the community as can treat quicker - need confirmation by other tests
what is test specificity
proportion of people without the disease who correctly re-assured by a negative test
what are the benefits and disadvantages of a test with high sensitivity
few false positives lots of false negatives
miss people who are at risk of the disease
what is the difference between the positive and negative predictive value
p - probably that a person with a positive test result actually has the disease - increase when prevalence of a disease increases
n - probability that a person with a negative result does to have the disease - increases when prevalence decreases
describe the table of screen testing
true positive - false positive
false negative - true negative
^sensitivity - ^ specificity
what is lead time bias
early diagnosis doesn’t change the time of death but as you were diagnosed earlier prognosis was longer so screening process appears effective even though it may not
what is length time bias
those picked up by the screening process have a better prognosis because the cancer is less aggressive compared to the ones showing symptoms which a more aggressive one (nothing to do with ability of the programme)
what are the 4 principles for screening of a disease
condition - health problem
test - simple safe precise
treatment - effective
screening programme - reduces mortality
