Public Health Flashcards
Define Public Health and its scope
WHO - Health is a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity
Public Health is the science and art of preventing disease, prologing life, and promoting health through the organised efforts and informed choices of society, organisations and individuals
Define problem, identify risk and preventive factors, develop and test prevention strategies and assure widespread adoption
Provides maximum benefit for largest numbers of people
Improve health and safety by addressing underlying risk factors for disease
By
Health Protection - Occupational Health, Environmental Health and Infectious Diseases
Health Promtotion - Health Education, Supportive Environments, Behaviour Change interventions
Health Services - Healthcare Systems, Health Policy, Evidence Based Medicine
Involves Epidemiology, Biostatistics, Inequalities, Clinical Trials, Law and Ethics, Monitoring and Surveillance
Discuss Primary, Secondary and Tertiary prevntion and give examples of each
Primary Prevention - pre-pathologic, reduce disease incidence and prevalence
Secondary Prevention - screening and treatment, find and treat disease early
Tertiary Prevention - rehabilitation, reduce suffering, prevent complications and help people get better
Discuss the basics of communicable disease control
Identification - surveillance Treatment of Case Case contact tracing and treatment/prophylaxis Prophylaxis Hygiene advice Exclusion Closure of premises Communicationwith individuals, medical team, wider communities and government
Define and give examples of reservoirs of infection, routes of acquiring infections and transmission pathways
Modes of transmission:
Contact: DIRECT contact eg Chlamydia, INDIRECT - survives on surface eg RSV, rhinovirus DROPLET by sneezing etc eg measles, pertussis
Non-contact: Airborne (Chicken pox), Vehicle (eg food poisoning), Vectors (eg malaria)
List notifiable diseases and explain process of notification
Explain the definition, rationale and general principles of disease surveillance
Definition:
Ongoing, systematic collection, analysis and interpretation of health-related data essential to planning, implemetation and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control.
Allows: Describe the burden of disease Detect sudden changes in disease occurrence and distribution Monitor changes in prevalence over time Monitor changes in health behaviours Identify priorities Inform programmes and policies Evaluate prevention and control effects Develop hypotheses and stimulate research
DETECT, CODE, ANALYSE, DISSEMINATE, ACTION
Describe how to measure the health of a population and the epidemiological techniques used
Mortality, Excess Deaths and Life Expectancy
Quality of Life
Infection rates, Notifiable diseases
Health access/Take up of screening or immunisation
Aggregating health data
Surveillance
Define incidence, prevelance, epidemic curves, fatality rates, mortality rates and frequency patterns
Incidence - rate of occurrence of new cases - risk of contracting disease
Prevelance - the proportion of cases in the population at a given time - how widespread
Epidemic Curves - shows progression of illness in an outbreak over time
Mortality rates - measure of the frequency of occurrence of death in a defined population during a specified interval
Fatality Rates - measure of deaths assigned to a specific cause during a given time interval, relative to the total number of cases
Frequency Patterns
Endemic - usual presence of disease within a specific geographical area
Outbreak - sudden increase in occurrence
Epidemic - serious outbreak in a single population or region
Pandemic - epidemic spreading around the world affecting hundreds of thousands across many countries
Describe the health benefits of physical activity
Reduces dementia (up to 30%) Reduces all-cause mortality (up to 30%) Reduces Hip Fractures (up to 68%) Reduces Depression (up to 30%) Reduces Cardiovascular Disease (up to 35%) Reduces Type 2 Diabetes (up to 40%) Reduces Colon cancer (up to 30%) Reduces Breast Cancer (up to 20%)
Discuss the national physical activity guidance and how this can be implemented by clinicians, organisations and governments
Children 60 minutes active each day
Adults at least 150 minutes moderate intensity activity per week -moderate intensity = moderate effort and noticeable increase in heart rate, able to talk but not sing
Adults should undertake physical activity to improve strength on at least 2 days per week
Adults should minimise the amount of time spent sedentary and break up periods of inactivity with light physical activity
High sedentary time = 7 hours a day
% Uk population who are active enough Boys 23%, Girls 20%, Men 66%, women 58%
UK 3rd most inactive country in Europe and 10th globally
Promote physical activity to all patients/prescribe movement - toolkits to help
Moratlity related to activity and sedentary time - lowest in active, lowest sedentary and highes in least active, sedentary
Outine the rationale, principles, properties and criteria for screening tests
Screening - testing people who do not suspect they have a health problem (without symptoms) so reducing risk of future ill health (by earlier detection and treatment) and provide information (to help make choices)
Effectively sieve whole population being tested to screen out those with low risk. Remaining have further test to confirm diagnosis and then treatment
Register eligible people System invitation and recall Screening tests Confirmation of diagnosis Treatment or other intervention Information and support for patients Staff training Standards and quaity assurance
Screening imperfect - can cause harm (over diagnosis, false positives, false negatives, unnecessary treatment, costs of screening, further testing and treatment) as well as benefits
Sensitivity vs Specificity
What screening tests exist in the UK
National Screening Programmes: Bowel Cancer Breast Screening Cervical Screening Diabetic eye screening Sickle Cell and Thalassaemia Pregnancy screening Fetal anomaly screening programme NIPE (Newborn and Infant Physical Examination) screening programme Newborn Blood Spot screening Newborn hearing screening programme
Screening within other NHS programmes:
Health Check 40-74 - looks for any signs of stroke, kidney disease, Type 2 Diabetes, Dementia
National Diabetes Prevention Programme:
HbA1c,
Diagnosis of prediabetes with lifestyle interventions
Diagnosis of diabetes - GP treatment
Describe the concept of health inequalities and give examples from the UK and globally
See next slide
Describe how health inequalities affect different populations
Determinants of health - social, economic and political conditions
Health inequalities = difference in health status or distribution of health determinants between different population groups
- difference in mortality rates in different social classes
- impact of income group on school readiness, vocabulary and behaviour
- many national, regional and local measures to reduce health inequalities
eg campaigns promoting healthy actions and access to health programmes, local programmes eg programmes addressing obesity (healthy eating and execise)
Describe how the environment and human health interact at different levels
Environment = Einstein says ‘everything that isn’t me’ - natural world, built - cities, towns, infrastructure
Socio-ecological model (layers - 1. individual lifestyle factors, 2. social and community networks, 3. general socio-economic, cultural and envoironmental conditions. 3 impacts on 2 which impacts on 1
General socio-economic, cultual and environmental conditions - agricultural food production, education, work environment, unemployment, water and sanitation, health care services, housing
Negative impacts
- Water and sanitation
- Chemical safety
- Air quality
- Extreme Weather events - eg earthquakes, floods
- Climate Change
- Housing
- Noise
- Occupation
- Transport
