Flashcards in INTRO + Health determinants, equity and interventions Deck (23):
What is public health?
The science and art of preventing disease, prolonging life and promoting health through organised efforts of society
What are the 4 determinants of health?
- Lifestyle factors
- Health care (access..etc)
What is the difference between equality + equity?
Equity is about what is fair + just
Equality is concerned with equal shares
What is horizontal equity? Give an example
Equal treatment for equal need
E.g. individuals with pneumonia (with all other things being equal) should be treated equally
What is vertical equity? Give an example
Unequal treatment for unequal need
E.g. individuals w/ common cold vs pneumonia need unequal treatment
E.g. areas with poorer health may need higher expenditure on health services
What are the dimensions of health equity?
Social (age, gender, class [socioeconomic], ethnicity)
What 7 things can you examine in health equity?
1. Supply of healthcare
2. Access to healthcare
3. Utilisation of health care
4. Health care outcomes
5. Health status
6. Resource allocation (health services, education, housing...)
7. Wider determinants of health (diet, smoking, healthcare seeking behaviour, socioeconomic + physical environment)
What are the 3 domains of public health practice?
1. Health improvement
2. Health protection
3. Improving services (healthcare)
What is health improvement concerned with?
Societal interventions aimed at: education, housing, employment, lifestyle improvement, reducing inequalities, family health
What is health protection concerned with?
Measures to control infectious disease risks, environmental hazards, chemical hazards, radiation, emergency response
What is improving services (healthcare) concerned with?
The organisation and delivery of safe, high quality services for prevention, treatment, and care
How might improving services occur?
- Audit + evaluation
- Service planning
- clinical governance
What types of interventions may be used to improve public health?
- Health service/public health interventions
- Non-health interventions which have an impact on public health (e.g. education)
How can public health / non-health interventions be delivered?
- Individual level
- Community level (more local)
- ecological (population) level
Exam Q: explain the difference between primary, secondary and tertiary prevention giving an example for each.
Primary prevention: aims to prevent the onset of disease (reduce its incidence). E.g. Immunisation or statins to prevent CVD
Secondary prevention: 2 definitions -->
- aims to detect and treat the disease (already established) early on (asymptomatic stage) (i.e. via screening). E.g. breast cancer screening (Early stages)
- Also aims to prevent the recurrence of disease e.g. Statins and aspirin after an MI...
Tertiary prevention: Minimise disability and prevent complications of the disease E.g rehabilitation post-stroke
Exam Q: Explain the difference between horizontal + vertical equity
Horizontal equity: Equal treatment for equal need. E.g. individuals with pneumonia (with all other things being equal) should be treated equally
Vertical equity: unequal treatment for unequal need. E.g. individuals w/ common cold vs pneumonia need unequal treatment. OR areas with poorer health may need higher expenditure on health services
vertical equity shows inequality but is still equitous (fair/just)
Horizontal equity argues that everybody with the same needs should receive the same treatment/access to health care – so two people with diabetes in two different parts of the country should receive the same level of health care. Vertical equity argues that some people have greater needs than others and so should receive unequal treatment, for example it would be equitable for someone with a chronic disease to have more GP appts than someone who is generally healthy.
Exam Q: Explain the difference between public health interventions delivered at the population (ecological) and individual levels, using one example for each to illustrate your answer.
Was covered in health psychology lecture
Health interventions at population level are aimed at health promotion. It involves enabling people to exert control over the determinants of health, thereby improving health. It is done by public health england. E.g. Change 4 life campaign (or Stoptober)
Individual level interventions is based upon a pt centred approach. it is care responsive to individual needs. E.g., smoking cessation clinics, statin, vaccination?
Give an example of a public health intervention delivered at:
1. An individual level
2. Community level
3. ecological (population level)
1. Individual level: smoking cessation clinics
2. Community/local: Local alcohol sale times capped, AA meetings
3. Change 4 life (campaigns), stoptober, vaccinations, taxing (sugar tax), cigarette packets/advertising regulations, public smoking ban, congestion charges...
What is epigenetics?
the effect of the environment on the expression of genes
What is allostasis?
Stability through change (our physiological systems have adapted to react rapidly to environmental stressors)
What is allostatic load?
Long-term overtaxation of our physiological systems leads to impaired health (stress)
Give some example of how to improve services
- audit + evaluation
- clinical governance
- service planning