social determines of health

Question 1

what is the difference between necessary and sufficient cause

Answer 1

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

Question 2

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

Answer 2

necessary but not sufficient
sufficient but not necessary
both necessary and sufficient
neither necessary nor sufficient

Question 3

what is quick way to remember necessary and sufficient

Answer 3

necessary - if A then B

sufficient - A, only if B (if b doesn’t occur then a won’t)

Question 4

what are some determinants of health

Answer 4

socioeconomic, cultural, environmental (total ecological) (most important) 
living and working conditions 
social and community networks 
life style factors 
age, sex (least important)

Question 5

what is the glasgow effect

Answer 5

difference between best and worst off districts by life expectancy - increasing difference

Question 6

what are health behaviours

Answer 6

behaviours that affect health ie smoking

Question 7

what is health inequity

Answer 7

unjust distribution of health and HC - systematic differences in health that are judged to be avoidable by reasonable action

Question 8

what is the aim of PHOF

Answer 8

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

Question 9

what are indicators for health

Answer 9

directs attention to particular health issues within a population that warrant further investigation but not necessarily immediate action

Question 10

what is the prevention paradox

Answer 10

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

Question 11

describe the intersalt study

Answer 11

association between causes of obesity and clinically significant problems as a result of obesity - strong correlation between high BMI and clinically significant problem

Question 12

define life course

Answer 12

interaction and influence of risk factors across lifetime that lead to certain health indicators relevant to an individual such as chronic diseases

Question 13

describe the steps in the intervention ladder

Answer 13

eliminate choice 
restrict choice 
guide choice by disincentives 
" incentives 
" changing the default policy 
enable choice
provide information 
do nothing

Question 14

what did wilson and junger decide about principles and practice of screening for disease

Answer 14

new screening plan 
condition must be important 
acceptable treatment 
should be a test or examination 
an understood disease

Question 15

describe the theory of planned behaviour and the three sub categories

Answer 15

why people act the way they do
attitude towards behaviour
social norms
control over the situation

Question 16

what is the purpose of screening

Answer 16

identify those who are more likely to be helped than harmed by further tests or treatment

Question 17

what is test sensitivity

Answer 17

proportion of people with the disease who are identified as having it by a positive test result

Question 18

what are the benefits and disadvantages of a test with high sensitivity

Answer 18

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

Question 19

what is test specificity

Answer 19

proportion of people without the disease who correctly re-assured by a negative test

Question 20

what are the benefits and disadvantages of a test with high sensitivity

Answer 20

few false positives lots of false negatives

miss people who are at risk of the disease

Question 21

what is the difference between the positive and negative predictive value

Answer 21

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

Question 22

describe the table of screen testing

Answer 22

true positive - false positive
false negative - true negative
^sensitivity - ^ specificity

Question 23

what is lead time bias

Answer 23

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

Question 24

what is length time bias

Answer 24

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)

Question 25

what are the 4 principles for screening of a disease

Answer 25

condition - health problem
test - simple safe precise
treatment - effective
screening programme - reduces mortality