Concept Of Health And Disease

Question 1

1)Define health

2) Spectrum of health

Answer 1

1)A state of complete physical , mental , social well-being and not merely an absence of disease or infirmity .

2) positive health ( highest point )
|
Better health
|
Freedom from sickness
|
Unrecognised sickness
|
Mild sickness
|
Severe sickness
|
Death ( lowest point )

Question 2

Changing concept in health

Answer 2

1) BIOMEDICAL CONCEPT - germ theory of disease
2) ECOLOGICAL CONCEPT - effect of environment on health
3) PSYCHOSOCIAL - effect of social , psychological , cultural , economic , political factors on health
4) HOLISTIC APPROACH

Question 3

Indirect way of measuring health

Answer 3

1) PQLI
2) HUMAN DEVELOPMENT INDEX

Question 4

PQLI ( Physical quality of life index)

Answer 4

1) does not consider INCOME
2) PARAMETERS
✓infant mortality rate
✓ literacy rate
✓ life expectancy at 1 year
3) scale 0 ( best) - 100 ( worst)

Question 5

HDI ( HUMAN DEVELOPMENT INDEX)

Answer 5

1) PARAMETERS
✓ life expectancy at birth ( Highest in Japan )
✓ per capita income ( highest in qator )
✓ knowledge
* Mean year of schooling - Czech republic
* Expected year of schooling
2) scale 0 - 1

3) < 0.55 - LOW HDI countries
0.56 - 0.69 - MEDIUM HDI
0.70 - 0.79 - HIGH HDI
>_0.8 - VERY LOW HDI

Question 6

Indicator of health

Answer 6

✓ ideal indicator - valid , reliable, sensitive, specific, feasible, relavant

1) MORTALITY INDICATORS
✓ crude death rate
✓ case fatality rate
✓ expectation of life
✓ infant mortality rate
✓ child mortality rate
✓ under 5 mortality rate
✓ adult mortality rate
✓ maternal mortality rate
✓ disease specific mortality rate
✓ proportional mortality rate
✓years of potential life lost

2) MORBIDITY INDICATOR
✓ incidence
✓ prevalence
✓ notification rate
✓ attendance rate in OPD
✓ admission, readmission, discharge rate
✓ duration of stay in hospital
✓ frequency of sickness or absence from work or school

Question 7

Disability indicators

Answer 7

1) DALY( disability adjusted life year )
2) SULLIVANS INDEX ( life expectancy free of disability)
3) HALE ( health adjusted life expectancy)
✓ life expectancy at birth including time spent on poor health
4) QALY ( quality adjusted life year )
✓ no of yrs of life added by intervention

Question 8

DALY ( Disability adjusted life year )

Answer 8

1) indicates DISEASE BURDEN
2) 1 DALY = 1 YR OF HEALTHY LIFE LOST
3) DALY = yrs of life lost ( premature death) + yrs of life with disability

Question 9

Disease burden indicators

Answer 9

1) DALY
2) PROPORTIONAL MORTALITY RATE

Question 10

Health care delivery indicators

Answer 10

1) doctor population ratio ( 1: 1000)
2) population ASHA ratio (1:1000)
3) population bed ratio
4) population subcenter ratio ( 1:5000)

Question 11

Health services utilisation rate

Answer 11

1) % of children fully vaccinated
2) % of ANC MOTHER with minimum 4 checkup
3) bed occupancy rate
4) bed turnover ratio
5) average length of stay
6) % of population using family planning methods

Question 12

1) Epidemiological triad

2) Epidemiological triangle

3) advanced triangle of epidemiology

Answer 12

1) agent , host , environment

2) agent , host , environment, time

3) causative factor , groups or population characteristics, environment social cultural factors

Question 13

Multifactorial causation given by

Answer 13

Pentenkoffer

Question 14

Web of causation given by

Answer 14

Mac mohan & pugh

Identify vulnerable area for prevention of disease

Question 15

Natural history of disease

Answer 15

1) period of pre pathogenesis
✓ primordial prevention - prevention prior to onset of risk factor
✓ primary prevention -
Prevention prior to onset of disease

2) period of pathogenesis
✓ disease onest —> early complications —–> late complications —-> outcome
✓ include secondary and tertiary prevention

Question 16

What is Intervention

Answer 16

Any attempt to interrupt usual sequence of disease
1) health promotion - 1 ° prevention
2) specific protection - 1° prevention
3) early diagnosis & treatment - 2 ° prevention
4) disability limitations - 3 ° prevention
5) rehabilitation - 3° prevention

Question 17

Example of health promotion

Answer 17

1) Health education in schools

2) Environment modification ( prevent accumulation of stagnant water )

3) Nutritional intervention( mid day meal , ICD in anganwadi

4) Life style modification ( weight reduction, smoking cessation)

Question 18

1)Disease control

2) disease elimination

3) disease eradication

Answer 18

1) reducing the disease to such level that it will not be major public health problem

2) interruption of chain of transmission at regional level
Eg ) guinea worm , leprosy , yaws , neonatal tetanus

3) extermination of infection agent global level
Eg ) small pox

Question 19

Last case of small pox occured in

Answer 19

Birmingham ( accidental exposure )(1978)

Somalia ( natural occuring ) ( 1977)

Question 20

India was declared small pox free on ?

Answer 20

24 may 1975

Question 21

India was declared small pox free on ?

Answer 21

24 may 1975

Question 22

Small pox was eradicated globally on

Answer 22

8 th may 1980

Question 23

What is surveillance ? Types?

Answer 23

Continuous scrutiny of factors that determine the occurrence and distribution of disease and other conditions of ill health .

Types
1) ACTIVE SURVEILLANCE
2) PASSIVE SURVEILLANCE
3) SENTINEL SURVEILLANCE

Question 24

Ice berg phenomenon of disease

Answer 24

✓Tip of ice berg - symptomatic disease
✓Submerged part - asymptomatic,latent , inappropriate cases
✓ NO ICE BERG PHENOMENON
* measles
* Tetanus
* Rabies

Question 25

International statistical classification of disease published by WHO

Answer 25

✓Usually 10 yrs once ✓ICD - 26 chapters ✓ type of coding used - alpha numerical coding