Term 2 Flashcards
Proactive Policy
taking information research best practice from elsewhere in the world and making policy changes to create a health outcome that you wish to achieve proactively
1 in __ in the world are considered obese
8
CIHI Roles
Canadian Institute for Health Information is responsible for health data and analysis, they understand the nature of health problems
DAD is?
Discharge Abstract Database: health record is created every time a patient in the Canadian healthcare system is an inpatient and treated for a condition. DAD is completed upon discharge
NACRS
similar to DAD but for ambulatory conditions such as emergency surgery
ICD-10 is?
an international standard to classify disease and classify healthcare interventions. Used both in DAD and NACRS
CCI code
tells you what was done if you have a surgery
HALE
health adjusted life expectancy: standardized tool that adjusts for health conditions and diagnoses by providing each patient with # of complete years of life with perfect health
PYLL
potential years of life lost: Take the same person with many conditions and looks at the burden of that illness or combination on a person or population and how many years of life lost because of those things
___% of the leading causes of death are related to obesity
50%
What is the number 1 cause of death that relates to obesity
Malignant Neoplasms
What BMI is considered obese
30.0 and over
what is an issue with using BMI?
It doesn’t work on a lot of non-white populations
___% of Canadian children are overweight or obese
30%
Top Nation for prevalence of obesity is…
USA
what is framing?
demonstrates how the same set of facts can be used to present different messages
Scope of Conflict
who is involved, what are the terms, who is at the table
Population Health
Pockets in a country with higher rates, health influenced by social, economic and physical environments. Ex. you may find pockets of an area that experience worse health
Visibility
information about the potential policy problem (such as the transparency of the CUPE workers debate - this was not visible)
Direction
agenda of interest groups or stakeholders
Intensity
attachment of group to policy problem
Demography in Population Geo
Observing trends and predicting for the future for example trends in elderly people living in london
Tim Hortons Cup Population Pyramid
skinny at the bottom and wide at the top = a declining population (boomers when they die)
Barrel (more cylinder like)
the number of people being born is equal to the # aging
Triangle
More people in the bottom then top (we have more people being born)
Built Environment
how we design our cities, work and home. Ex. lower end of Hamilton has a higher prevalence of health problems and lower SES.
T/F? They are opportunity structures because they each have both health promoting and health damaging structures
True
Gentrification
low income neighborhoods become fashionable and trendy so landlords will remove existing renters from the property, fix them up, sell them for higher income families = cause of housing crisis!
ex. old north
Food Swamp
ready access to poor quality food (close by) (fast food)
Food Desert
Poor access to good quality food
Opportunity Costs
“The true cost of something is what you give up to get it.”
Redistributive Policy
Aims to shift resources from one group to another, typically to reduce inequities. Ex. the SSBT tax is redirecting the revenue generated from the tac toward health programs
Regulatory Policy:
impose rules or restrictions to influence behaviour. With SSBT, the tax’s role is to discourage the consumption of sugary drinks and make healthier choices more appealing
Allocational Policies
fund strategies that produce longer-term health benefits for the population… fund things now that will make things better.
Trade-Offs
between the importance of protecting the health of the population, respecting individual liberties, and controlling health expenditures ex: can be financial or political cost
A policy maker will determine the importance of protecting or promoting the health of people at the same time, making sure people are still free and able to do what they want but controlling health expenditures
Exhortation
→ governments encourage stakeholders to act in a particular way (truth and rec day)
Expenditure
$$ → government provides funds for a specific purposes (ex. smoking tax)
Regulation
→ rules are established to encourage or penalize certain types of actions
Public Ownership
→ government owns and directly runs an activity (LCBO)
What is a logic model
The chain of expected effects that link a public policy to a health problem it aims to solve
What are street level bureaucrats
the people who meet citizens at the interphase between them and the government. Those who apply the regulations. Ex. teacher, police, social worker etc.
Who is sometimes referred to as the ultimate policy makers due to their quick need to apply concepts they were taught?
street level bureaucrats
what changed in policy after lipskey published his book
n the welfare systems area regarding social workers: it has changed from being grant-related to the expectation that people will work, look for work, get a job, and contribute to society
Who is Stan Koebel/What happened in Walkerton
Outbreak of water-borne disease between May and June 2000 left at least seven people dead and hundreds ill. Years of falsified tests on the water system
His boss encouraged him to do it - this was normal practice for them
Complacency
What year did the walkerton case occur
2000
Define Environmental Health
The theory and practice of assessing, correcting, controlling and preventing those factors in the environment that can potentially affect adversely the health of present and future generations” (WHO)
Why did this walkerton situation occur
The policy to water checking wasn’t legally binding, it was framed as voluntary guidelines
4 policies of genetic testing
Autonomous
Confidential
Private
Equitable
Genetic Testing
Applies to individuals who are seen as having a higher probability of having a particular condition; determine presence and absence (once you have symptoms you are no longer screening)
Genetic Screening
performed in the general population; early detection, monitor risk
Specificity
with the testing you can rule out disease (true negative)
Sensitivity
with the testing you can correctly pick up the positive case (true positive)
To identify how screening tests are selected in Ontario
Identify objective: reason for genetic testing
Feasible: done in an integrated program, people to counsel etc
Propensity: high risk individual (ex. Someone who smoked for 20 yrs is eligible for the lung cancer screening)
Significance of disease
Benefit of treatment: treatment should work
Consent: individual should be autonomous
Regulation: the outcome/impact of screening programs should be monitored and evaluated; program should be modified if required
What is an incidental finding
discoveries about individuals DURING research that was not previously included in the study objective
Any findings related to their welfare should be identified
Ex. you find an unexpected mass on a CT or MRI
Report if valid, significant, actionable
what 3 things does an incidental finding need to be to be disclosed
- valid
- significant
- actionable
Moral Hazard
insulating people from risk may make them less concerned of the potential consequences of that risk
The product of the Walkerton case
The O’Connor Report:
Lab accreditation
Water systems must be continuously monitored
A public good: Non-rivalry
When consumed, it doesn’t reduce the amount available for others
ex. benefiting from a street light doesn’t reduce the light available for others but eating an apple would.
A public good: Non-excludability
it is not possible to provide a good without it being possible for others to benefit from.
ex. a dam to stop flooding protects everyone, whether they contributed or not
Free Rider Problem
incentive to avoid paying for public goods knowing they will still benefit if others are paying
What is an Externality
An externality is an unpriced, unintended side effect of one agent’s actions that affects another’s welfare.
4 policies of genetic testing
autonomy
confidentiality
privacy
equity
Negative Externalities
Costs imposed on society and the environment not accounted for by producers or consumers.
Example: Traffic congestion caused by increased vehicle use leads to longer commute times for everyone, not just the drivers.
Positive Externalities
Benefits that affect others but aren’t reflected in market transactions.
Example: Vaccination not only protects the individual but also helps create herd immunity, benefiting the entire community
