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Health Policy > Term 1 > Flashcards

Term 1 Flashcards

1
Q

Consensus

A

Involves policymakers working to balance cost and benefits and resolve common problems (ie. Day to day problems). nuts and bolts!

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2
Q

Critical

A

this approach sees policy as a reflection of power struggles: looks at societal and political dimensions, people are different and see policy differently, power is not equal.

Policy debates are influenced by social class politics and inequalities in influence and power including gender, race, class, disability, etc.

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3
Q

Positivism

A

Only authentic knowledge is scientific
Strict adherence to the scientific method
Hypothesis is testing and identifying relationships

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4
Q

Structural Functionalism (social theory)

A

Views society as an organism, a system of parts whose function together creates overall societal effectiveness
Shared norms and values; cooperation
Herd immunity

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5
Q

Interpretevism

A

understanding the meaning of social phenomena from the perspective of those experiencing it
This theory contrasts with positivism, which seeks to uncover universal laws through objective data and emphasizes empirical evidence.
this is SUBJECTIVE

Critique of positivism
Hermeneutics: how individuals understand themselves through shared systems of meaning
All views considered equally valid

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6
Q

Episteme means…

A

Knowledge or understanding

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7
Q

Logos

A

account or argument or reason

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8
Q

Ontology

A

the study of existence - what exists, what kinds of things exist, and what it means for something to exist

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9
Q

World View

A

Comprehensive - collection of deeply held beliefs about how we interpret and experience the world
Identification of your worldview indirectly identifies your greatest weakness
A worldview is a set of assumptions about physical and social reality that may have powerful effects on cognition and behavior
Schiff, 1968: cognitive, affective, behavioural

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10
Q

Decision Theory

A

On any given occasion, a person is guided by beliefs and desires and values
A theory of beliefs, desires and other relevant attitudes and a theory of choice: what matters is how these various attitudes (call them ‘preference attitudes’) meld together

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11
Q

Bias

A

All people are inherently biased
The concept of implicit bias, also termed unconscious bias, and the related implicit association test rests on the belief that people act on the basis of internalized schemas of which they are unaware and thus can, and often do, engage in discriminatory behaviour without conscious intent.

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12
Q

Ideology

A

(ex. liberal vs conservative) “A set of beliefs or principles, especially one on which a political system, party or organization is based”
Ideology is an admixture of political and socio-economic beliefs, values and symbolism that provides explanatory coherence

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13
Q

Define Buse’s Version of Policy

A

Broad statement of the goals, objectives, and means that create the framework for activity. Often takes the form of explicit written documents, but may also be implicit or unwritten

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14
Q

least well of people find it ___x harder to get the healthcare they need

A

3x

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15
Q

What are the policy goals

A

Security, Liberty, Equity, Efficiency

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16
Q

Policy Analysis Triangle

A

(what) Content: Policy objectives, operational policies, legislation, regulations, guidelines etc.

(why) Context: systematic factors such as social, economic, political, cultural and other environmental conditions

(how) Process: The way in which policies are initiated, developed, or formulated, negotiated, communicated, implemented and evaluated.

(who) stakeholders

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17
Q

what is “rethink your drink”, Canada’s first SSBT?

A

In 2022, Newfoundland launched a tax on sugar sweetened beverage types with the goal to encourage healthier lifestyles. Revenues will fund the Physical Activity Tax Credit, prenatal infant nutrition supplement, and lunch programs

(container size/L) x tax rate

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18
Q

Where does the SSBT tax NOT apply

A

Exports
Retailers on an Indian Reserve
Anything containing alcohol
yogurts, milks, choc milk, RTDB under 75 mL, medical or Thera drinks like nutritional supplements

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19
Q

Canadian Public Health Ethics Framework

A

1) identify the issue and gather the relevant facts in order to clearly understand the problem
2) identify and analyze ethical considerations
3) identify and assess options in light of the Values and principles
4) select best course of action and implement
5) Evaluate

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20
Q

Normative Ethics

A

what is right and wrong, what is a good decision and a bad decision
(consequentialism, deontology, virtue ethics)

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21
Q

Ethical Principles

A

Prescriptive: offer recommendations for moral action
They are NOT values- “permanent, universal,and unchanging”.
Health care professions operate on a set of ethical principles that are morally established

22
Q

Virtue Ethics - Aristotle

A
  • Cultivation of virtuous habits: person-based rather than action- based
  • Character is determining factor in deciding if someone is a good person
  • Good people create good societies and good decisions
    In health care: compassion, honesty, morally correct actions
23
Q

Consequentialism or Teleology

A

Wrong things could be right if there is a morally good reason
e.g. Utilitarianism
Moral (correct) decisions are identified based on extent to which they promote more happiness than unhappiness for the greatest number of people
Ratio of happy: unhappy is not consistent
Options initially accepted as moral may be rejected in specific circumstances
Health care: professionals make decisions based on best interest of a particular collective of patients (e.g. quarantine)
Often lead to further moral issues/conflict

24
Q

DEONTOLOGY OR DUTY-BASED

A

it is always wrong to lie, no matter the circumstances
* * Every person has an inherent dignity and value
* What is right or wrong vs. the consequences of the action
* Do the right thing - universal and applicable in all circumstances – even if it produces a bad result (certainty)
* First step is to identify the ‘morally correct’ choice and proceed from there
* The Hippocratic Oath and the Universal Declaration of Human rights are examples of deontology (Kant)

25
Q

Casuistry

A

Essentially the case law of ethics
Precedent-setting situations
Need for similarly salient characteristics and moral issues
Previous cases are a social construct in terms of being reflective of prevailing ideology, popular culture, or societal bias

26
Q

Feminism Approach

A

Skeptical towards traditional ethical concepts like autonomy * Social, political suppression of women
Often care focused and power focused
Compassion, freedom, equality
Distributive justice
In health care – Belmont Report, 1978

27
Q

Ethical Principle: Personalism

A

Emphasis on human dignity and subjectivity cannot be reduced to material objects and natural instincts (Phenomenology)
Everyone should have access to wide possibilities of choice in treatment – therefore, need access to information to promote decision making

28
Q

Dr Charlotte Blease… purpose of her talk

A

Not acknowledging how we think is equally problematic - this is a really critical idea
Genetics loads the gun, environment pulls the trigger. Are there bullets we have not really considered?
Implicit bias sinks into our behaviours

29
Q

TB 1999

A

1999, 200 Tibetans came to the border into canada and asked for refugee status, 5 has active pulmonary tuberculosis.
Policy issues related: screening for communicable diseases, immigration policy, risk perception and federal-provincial relations
Media hyped it up to emphasize the public health risk which worked up anxieties

30
Q

Latent TB

A

is not infectious

31
Q

Active TB

A

infectious and deadly if left untreated

32
Q

MDR-TB

A

a multi drug resistant TBH that costs 250,000 annual to treat

33
Q

TB 2016

A

There were 1796 cases of active TB in 2017, increasing 2.6% from 2016
Incidence rate went from 4.8 to 4.9%
Foreign born individuals made up the majority of the cases
Incidence rate remained highest among indigenous people
IR was higher among males
Majority of cases were between 15 and 44 yrs old
IR was highest among adults over 75 years of age
Of the 2016 cases, 80.4% were treated successfully

34
Q

2021 TB

A

1829 cases of active TB
Foreign and indigenous = most of the cases
One of the lowest TB rates in the world

35
Q

What changes were made after the TB outbreak?

A

Toronto public health: instead of waiting 60 days for immigrants to present, the were identified at the border and sent to immigration officials, TB xray supplemented with TB skin test
Ontario Ministry of health: TB diagnosis and treatment services for uninsured persons (TB-UP)
Federal Gov: canceled health insurance services for refugees - but TB care would have been exempt as it is a risk to PH
Nov. 14 - the federal court of canada determined this was unconstitutional
Dec 2015 - IFHP
April 2016 - program fully reinstated

36
Q

Types of screening

A

Mass Screening
Selective Screening
Multiphasic screening
Surveillance
Case finding
Population Surveys

37
Q

Most cost effective way to handle the TB immigration concern

A

Most cost-effective way to deal with this screening
(not testing) - looks for possible symptoms but doesn’t test and diagnose

38
Q

Screening

A

More likely to screen AT RISK populations than the general population (selective screening - homeless, FN, inuit people)

39
Q

Multiphasic screening

A

might screen for multiple diseases, taking pockets of the population and multiple different points in time

40
Q

Mass Screening

A

Costs of doing something can help save money in the long term (mass screening - pricking childrens feet to see if they have diabetes)

41
Q

Surveillance

A

looking at data to suggest a condition is active in our environment or not (monitoring individuals OR populations)

42
Q

Case Finding

A

actively go out and find them. You find one person who has TB and you connect who they’ve been around to specifically find the people that could have been exposed (food poisoning - find the source through case finding)

43
Q

Institutional Arrangements

A

Institutional arrangements are the policies, systems, and processes that organizations use to legislate, plan and manage their activities efficiently and to effectively coordinate with others in order to fulfill their mandate

44
Q

Canada Health Act 1984

A

Legislation: publicly funded health insurance
Protect, promote and restore wellbeing of Canadian residents, facilitate reasonable access to health care

45
Q

Risk

A

Hazard + Exposure

46
Q

Hazard

A

something that can potentially cause harm

47
Q

Prevalence

A

measure of HOW MUCH of a particular disease exists in a population at a particular point

48
Q

Incidence

A

measures the rate of occurrence of NEW CASES

49
Q

Before a policy decision is made.. What should we do:

A
  • inform a decision maker/stakeholder about the relevance of adopting a particular public policy; bias-free,
  • advocate: aim is to promote the adoption of a public policy; you are an provide information advocate
  • compare public policies to inform the DM process
50
Q

MAIN PROBLEM WITH TB

A

Solving TB isn’t the issue, but multi-jurisdictional boundaries and restrictions complicated it!
Had to use expensive drugs

51
Q

Constitution Act of 1982

A

is the Charter of Rights and Freedoms, includes the “Notwithstanding Clause”, recognizes the rights of Aboriginal peoples; recognizes the equalization payments process

Health Policy (2 decks)

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