Topic 2: Life Expectancy and SMPH Flashcards
What is LE?
How is it calculated?
When would you use it?
How long a person can expect to live based on past death rates.
Using Life Tables.
used when following -up an outcome over time e.g. survival of breast cancer patients.
What are the limitations of hospital data?
Only tell us about patients who have a disease and have decided/able to access care, not about those who have disease and cant/wont.
What are the main advantages of SMPH?
- Combine MR’s and non-fatal health outcomes to give a view of the overall health of a population
- They are a single measure
- Allow to compare populations
- allows to assess health ineqs within populations
- Provide attention to non-fatal health outcomes in pop
- Inform debates on policy
- Inform debated on resource direction
- Improve curriculum for HP training
- Allows to analyse benefits of health interventions for CEA’s .
Name 2 broad categories of SMPH:
1.Health expectancy : SMPH telling us how long a person can expect to live in different health states
EXample : HALE
- Health Gap : SMPH that quantify differences between actual pop health and a stated norm or a goal for population health. E.g DALYs
What is HALE?
How is it data normally collected?
What are its limitations as a measure?
Health Adjusted Life years
Self-Reported Data ie. pop health survey
Mathers (2003) - Women tend to rport worse health than men, Not applicable across groups because men and women use response categories differently, etc.
What is DALY?
What does it represent?
Name the study aiming to quanitfy DALYs across the world?
Disability Adjusted Life year
Represents 1 life year lost to disability
Global Burden of Disease Programme (WHO)
Name the three main methods of conduction this study?
What did each method result in?
- Weighting against each condition
- Result: Non-fatal conditions that were disabling ranked higher than conditions from MR data alone - Weighting against year of life
- Result: controversial. Young adult life years had the hightest weighting, reducing BOD from INfant Mort. - Gathered SMPH from countries that had no data
- Result: Used model life tables to estimate data from such countries which included variables they thought matched etc.
Describe the main results/findings of the GBD?
- Grouped countries into HIC, MIC, LIC based on GNP per capita
- the contribution of different conditions to the BOD varies greatly with GENDER and REGION
- 70% of BOD comes from SE Asia, Africa, West Pacific bear the highest burden of disease (61% of worlds population)
- Large variations among sub-regions: high income subregions mainly concerned with NCDs accounting for highest proportion of BOD, Low income sub-regions concerned with CDs, materal, perinatal and nutrition issues accounting for highest BOD.
What could the GBD say about the underlying causes of disease burden?
Not much - complex to pin down because for any one condition there are multiple risk factors.
What did the Global Health Risk Report detail?
What broad categories did they span?
24 global health risk factors
Psychosocial, Behavioural, Socioeconomic, Environ.
What are some results from the GHRR? ie Patterns (5)
- 1/3 of all global deaths are attributed to a small set of risk factors
- The 24 RF’s outlined in GHRR account for 34% of DALYs and 44% of deaths globally
- 33% of deaths attributed to top 10 RF’s
- Dual burden of nutritional diseases: Combo of micronutrient and malnutrition problems and the chronic NCDs of adults. Means that LICs and MICs but now combat both sets of diseases.
- Understanding these RF’s can lead to an improvement in PH interventions
What are the Top 5 Risks to Health Globally?
(Note: Report also details different ones for HIC, LIC, MIC’s).
- High Blood Pressure
- Tobacco Use
- High Blood Glucose
- Physical inactivity
- Obesity
What are the 3 leading global risks for BOD’s?
Which type of income level do they effect most?
What types of conditions do these exacerbate?
- Unsafe sex and underweight
- Alcohol use
- Unsafe water, sanitation and hygiene`
Mostly effecting LIC’s.
Exacerbate CDs, laregly effecting SE Asia and Africa.
What is the Causal Chain? What does the GHRR mean by this?
What does it suggest we need to do to have fundamental and sustained effects on health?
To prevent disease and injury we need to ID and address the causes.
It is a complex chain of events whereby the causes of the risk factors also have causes etc.
Offers many entry points for interventions - modifying background causes (although not direct causes of a condition) is likely to have knock-on, amplifying effects
We need to modify multiple distal factors in the chain to have sustained impact on health.
What is the Risk Transition?
Name 3 Reasons for this?
As a country develops the types of diseases that effect a population also changes. Example:
Lics- IDs primarily, maternal death etc.
HIC - NCDs primarily
- Better Health Care - children don’t die from treatable diseases such as Diarrhea
- People Living longer - NCDs primarily effect older people
- PH interventions like vaccines, water etc decreases incidence of IDs.
