Wk2 Measuring Health of Population Flashcards
Why measure the health of the population?
- Find out how common a disease is (prevalence) and incidence of a disease
- Identify longitudinal trends in disease
- Are interventions or policies to improve health and reduce ill-health having any effect?
- Identify differences in disease patterns between different population groups or locations
- Service planning: do we have the right services, in the right place for the right people
Most common causes of male death in 2018?
- Cerebrovascular diseases
- Chronic lower respiratory diseases
- Dementia and Alzheimers disease
- Influenze and pneumonia
- Ischaemic heart diseases
- Malignant neoplasm of trachea, bronchus and lung
Most common causes of female death in 2018?
- Cerebrovascular diseases
- Chronic lower respiratory diseases
- Dementia and Alzheimers disease
- Influenze and pneumonia
- Ischaemic heart diseases
Top ten causes of deaths in high-income countries in 2016?
- Ischaemic heart disease
- Stroke
- Alzheimer disease and other dementia
- Trachea, bronchus and lung cancers
- Chronic obstructive pulmonary disease
- Lower respiratory infections
- Colon and rectum cancers
- Diabetes mellitus
- Kidney diseases
- Breast cancer
Top ten causes of deaths in low-income countries in 2016?
- Lower respiratory infections
- Diarrhoeal diseases
- Ischaemic heart disease
- HIV/AIDS
- Stroke
- Malaria
- Tuberculosis
- Preterm birth complications
- Birth asphyxia and birth trauma
- Road injury
What data sources are used to measure health status?
- Death certification (legal requirement to register health - includes cause of death - international classification of diseases (ICD-10) codes)
- Census (every 10 years since 1851)
- Health Survey for England (HSE) - Annual population survey since 1990. containing questions on smoking status, self-report info on heath, additional info on key theme every year (e.g. CVD)
- General Lifestyle Survey
- Hospital Episode Statistics (health service usage - details of all admissions to NHS hospitals in England and all outpatient appointments (Started 1989)
- General Practice Research Database :
Clinical Practice Research Database (CPRD)
The Health Information Network (THIN) - Health protection reports of notifiable infectious diseases
- Cancer registration
- National/regional/local audits or surveys
What is the clinical practice research datalink used for?
Anonymised longitudinal data from 625 general practices serving approx 5 million patients.
- Clinical research planning
- Drug utilisation
- Studies of treatment patterns
- Clinical epidemiology
- Drug safety
- Health outcomes
- Health service planning
What does the general lifestyle survey include?
Sample from whole of Britain, formally called General Household Survey
- Demographic information about households, families and people
- Housing tenure and household accommodation
- Access to vehicles
- Employment
- Education
- Health and use of health services
- Smoking and drinking
- Family information, marriage, cohabitation and fertility
What are notifiable diseases?
- Certain infectious diseases notified by doctors
- Laboratory results for some infectious diseases notified
- Cancers registered in cancer registries and linked to mortality data
What are the advantages of mortality data as a measure of population health?
- Legal requirement in UK to register each death
- Little delay in collection of data
- International classification of diseases ensures comparability
- Cheap source of health data
What are the disadvantages of mortality data as a measure of population health?
- Potential for error (diagnosis, certification, coding, processing, interpretation etc.)
- Death may result from many diseases acting in conjunction
- Some diseases have high mortality rate and death occurs quickly - others are long-term, resource-intensive but rarely cause death
How might we use mortality or morbidity rates?
Compare areas:
- To identify areas where people experience poor health
- Identify need for preventative services
- May raise hypotheses about cause of a disease
Look at change over time
What is direct standardisation?
- Direct: age-specific death rates from a study population are applied to a standard population structure
- Used to answer the question - “what would be the death rate in the standard population if it had the age and sex-specific death rates experienced by the population I am looking at?”
What are the advantages of direct standardisation?
- Can be used to compare disease rates across areas and time
- Can be used to assess the relative burden of different diseases in a population
What are the disadvantages of direct standardisation?
- Requires age-specific rates which are not always available at a local level
- Rates may not be stable for small number of events (<100)
