Theme 9: Growth and Development Flashcards
What are the tasks of the GGD?
- to protect by offering vaccinations, providing protection against infectious diseases, covering sexual health, and take notice of environmental standards noise, heat, and air pollution
- to monitor epidemiological data at population level and youth health care
- promote health by health policies and interventions (examples?)
Which steps does the municipal health cycle entail?
step 1: problem identification with focus on (high-risk) subgroups and determinants
step 2: policy analysis by asking what you can do to address the problem and what do you expect from the policy (influence on the health situation, the costs and benefits and feasibility)
step 3: stategy and policy development by translation of the solution to the local situation (what is the context? What is needed? who is needed for this?)
step 4: policy enactment to ensure policies are rolled out by checking what the procedures are and what kind of legislations are necessary or need to be adapted
step 5: implementation by determining the guidelines, coordinate the rollout, determine indicators for monitoring and evaluate policy
What is the definition of public health?
the science and art of preventing diesease, prolonging life and promoting physical health and efficiency trough organized community efforts
When did modern public health practices begin to develop?
Modern public health practices began to develop around 1900.
How did public health efforts change in terms of scale around 1900?
Public health efforts expanded dramatically in terms of scale, moving from small, localized initiatives to large-scale programs that reached entire cities, regions, and countries.
What does “integration” in public health refer to around 1900?
Integration in public health refers to different public health organizations and sectors working together more effectively, coordinating efforts among various entities, including government agencies, non-governmental organizations (NGOs), and the private sector.
Why is the period around 1900 significant in public health history?
The period around 1900 is significant in public health history because it marks the beginning of modern public health practices with the establishment of extensive preventative infrastructures and the integration of various organizations into a cohesive system dedicated to improving public health on a broad scale.
GGD founded in 1893/1901 functions:
- food inspection
- disinfection
- public hygiene (clean water, maintaining public baths and toilets)
- medical care of the poor
The Accident Act
(1901) provided workers with financial and medical support in the event of workplace accidents to ensure social protection and welfare for citizens
Morality Acts
(1911) were a set of laws aimed at regulating behaviors and activities deemed immoral or harmful to society. trend of linking public morality with public health. what they entail:
- banning specific activities
- brothels (STD) and trafficking in women
- sale of contraceptives: traditional views on procreation and family structure
- pornography to maintain public decency and morality
- abortion: Abortion was criminalized, aligning with the moral and religious views of the time regarding the sanctity of life.
- sexual contact with minors or the same sex
- ball games on sundays (presevere sabbath)
- public drunkenness
- illegal bars and gambling
- by regulating these activities the government aimed to reduce the spread of diseases, protect vulnerable populations, and promote overall social well-being
porter’s statement “the ship of state took health on board”
encapsulates the significant shift in the role of the state and the approach to health during the 20th centiry
- state: resources, power, money, logistics of the state used for building the infrastructure of public health.
- This included the establishment of hospitals, clinics, laboratories, sanitation systems, and other facilities aimed at promoting community health and preventing diseases.
- The state played a central role in coordinating and funding these efforts, leveraging its authority and resources to implement public health interventions on a national scale.
- health: shift from combating diseases to optimizing health by preventive measures, helath promotion and addressing the underlying social determinants of health
- also shift to the health of entire populations or social groups and addressing broader, social, economic and environmental factors that influence health
late 19th c.: the ‘social issue’
downsides of industrialisation (poor living conditions, overcrowding, pollution and inadequate access to healthcare)
late 19th/early 20th c.: the eugenics movement
which believed that high fertility among the unfit and low fertility among the fit were leading to the degeneration of the nation
first world wars as catalyst:
fighting fit population: for military readiness. this led to initiatives to improve public health, nutrition, and fitness levels among citizens
crisis 1930s/producer and consumer economy:
highlighted the importance of the productivity of the opulation for economic stability and growth. Governments recognized that investing in public health and social welfare could improve the productivity and resilience of their populations, leading to the expansion of public health programs and social policies.
pathological model disease definition + diagnostics
- Based on ‘symptom, sign, pathology’
➢ ‘1st and 2nd person perspectives’
➢ Binary distinction between health/disease
pathological model: place
- Localisation of disease in ‘3-D’ body
➢ Underlying ‘lesion’ or pathophysiological
process/defect
➢ Within hospital / clinical population
pathological model: time
- Directed at the ‘here and now’
➢ Acute / static
➢ Patho(physio)logy is already present
surveillance model: disease/risk factor definition + diagnostics
- Statistical deviations in/from population
➢ ‘3rd person perspective’
➢ Continuum between normal/abnormal
surveillance model: place
- Increasingly detached from physical body
➢ Wider community / whole population
➢ Or: individual risk factors + statistical
correlations
surveillance model: time
- Directed at the future
➢ Initially: chronic diseases and linear time
model (latent – early – late stage)
➢ Later: risk factors +‘splintered time’
(e.g. ‘prediabetes’)
Preventive youth healthcare (JGZ) tasks
- strong focus on local government
- free of cahrge
- 1 euro spend in preventive measures provides 11 euro back
- oterh types of preventive care for children:
- youth care (youth act)
- pediatricians and GPs: rotujen medical checkups and immunizations
- private organizations
- Information on health and dvelopment including nutrition, safety and parenting
- immunization
- screening for developmental delays, growth disorders
- identifying care needs
- providing support
basic principles JGZ
- biopsychosocialecological model that considers the interplay of biological, psychological, social and environmental factors
- joint assessment: professionals work together with parents
basic JGZ
- described in public health act (2008)
- Strengthening and preserving the health and
development of children - National Vaccination Programme
- National screening programmes
- Advice on the prevention of accidents in and around the
home - Healthy lifestyle and parenting issues
- Policy advice to municipalities and schools
special preventive JGZ
- Extra attention to children with increased risk of health
problems - Evidence-based interventions and health-promoting
programmes aimed at specific groups - Substantial further support through the deployment of
non-regular interventions to vulnerable groups
Preventive JGZ funding
- basic via municipalities, receive funding via central government
- special care for vulnerable groups not structurally financed by central government → municipalities free up funding from own resources
Cost-effectiveness of CYH/JGZ:
Investing in prevention that leads to important health gains throughout life: preventing mortality, preventing chronic conditions, and promoting healthy functioning.
primary prevention
- to prevent new cases of a disease by eliminating or reducing the causes of a disease
mostly universal prevention
Secondary prevention
- focuses on the early detection of disease so that early treatment is possible or worsening of the condition can be prevented, increasing in healthy years of life
- screening
- pregnancy
- after birth: heel prick test and hearing test
- cancer: breast, cervical, colon
- preventive youth healthcare
- screening
Tertiary prevention
- is aimed at limiting the consequeces of a disease. reducing the number and/or consequences of complications, minimizing suffering, and maximizing the number of high-quality years of life
- screening of diabetic patients for diabetic retinopathy to prevent blindness
- prevention of infections in HIV patients
- prevention of recurrence or complication of a condition through physical therapy
universal prevention
entire population (universal prevention): involves large group of people
selective prevention
targets groups with an increased risk
high-risk approach/indicated prevention
individuals with an increased risk easy to identify (known health problems)
care related prevention
prevention in individual with a disease
health protection
- aims to protect the population from exposure to risk factors in the environment, such as physical factos (radiation), chemical factors (harmful pesticides), or biological factors (microorganisms)
- often outside the healthcare sector
- drinking water and sewers
- workplace prevention
- accident prevention by bicycle helmet mandatory
Health promotion
- primary prevention through health promontion is aimed at promoting healthy behavious, such as not smoking. achieved by:
- health education
- environmental intervention to encourage healthy behavior
- legislation and regulations such as a law for smoke-free
- financial such as pricing measures
e.g. earplugs at festivals
disease prevention
- focuses on preventing specific diseases or identifying them at an early stage
e.g. prevention of infectious diseases
measures in this regard:
- providing clean, safe drinking water
- information about hygiene, STDs or behaviour during outbreak
- vaccinations
e.g. prevention of mental illness by suicide prevention, prevention of stress at work, anti-bullying school programmes and early identification of child abuse
Public health (wet publieke gezondheid):
- all aimed at preventione.g.
- setting up and implementing a programme aimed at preventing alcohol abuse
- providing vaccinations
social support (wet maatschappelijke ondersteuning):
- offering support or care that ensures that more serious care can be prevented
- arranging home adaptation
- promoting accessibility to facilities
youth act:
prevent problems through the early provision of help and care
- promoting parenting skills of parents
- promoting the safety of young people in the home setting
healthcare Insurance act
- indicated and care-related prevention required for treatment must be reimbursed through the standard package
- preventive dental check-ups for young people
- giving up smoking
long-term care act:
prevention within the WLZ focuses on preventing a worsening of the situation
- preventing decubitus ulcers
- preventing falls
focuses on individual requests for care three parts:
- Curative care: is arranged through the Zvw, which obliges every Dutch person to take out basic insurance with a health insurer2;
- Long-term care: includes 24-hour care that is laid down in the Long-term Care Act (Wlz), such as care for the disabled or care in nursing homes;
- Supplementary care: individuals can choose to insure themselves for care that is not reimbursed through the Zvw or Wlz, such as dental care for adults.
this is different from the public health care which is to prevent disease in entire population
Access to care: the AAAQ model
- availability: sufficient public health and healthcare facilities are available
- accessibility
- non-discrimination
- physically
- economically
- informationally
- acceptability: all medical facilities, goods, and services work on the basis of medical ethics are appropriate for the culture, gender and stage of life
- quality
What form of prevention does this screening for cervica cancer involve?
secondary prevention
quit-smoking support and cardiovascular risk managment are
high risk approach = indicated prevention
handy in a easily identifiable risk group
when is it preferable to use a population approah
slightly increases the relative risk of the disease and affect a large group of people
e.g. too much salt consumption
support DM patient in self-management is
tertiary prevention
Tobacco policy (including information about health risks), what is the
point of intervention:
health promotion
Preventive measure or provision including: ex: infection disease control:
including Qu vaccination, detection of tbc
target group: population (selective and universal) and high risk approach
Preventive measure or provision including: example: social support
tertiary prevention
How can health protection be achieved
By eliminating exposure to environmental risk factors
What is the primary focus of health promotion?
Encouraging healthy behaviors such as hygiene and nutrition.
In the Netherlands, what is the greates successes of prevention in the past 50 years ?
improving road safety and tobaco control
Preventive measure or provision including: example: social support :
what is the approach?
high risk approach
ensuring good air and water quality is part of health protection or
health promotion?
health protection
healthy food supply in school cantens is part of health protection or health promotion?
health promotion
what doesn’t belong to the surveillance model? (concept)
continuum between normal/abnormal