Lecture 22 Flashcards
(21 cards)
Importance of preventing disease
Preventing disease (injury) by:
1. unravelling the causal pathway
2. directing preventative action
3. Evaluation of effectiveness
Population based (mass) strategy
Focuses on the whole POPULATION
Aims to reduce the health risks/improve the outcome of ALL individuals in the population
Useful for a common disease or widespread cause
Examples: immunisation, programmes etc
High risk (individual) strategy
Focuses on INDIVIDUALS perceived to be a high risk
The intervention is well matched to individuals and their concerns
Examples: intervention targetting obese adults, intravenous drug users
Strategies for prevention: Population-based (mass) strategy - advantages
Radical - addresses underlying causes
Large potential benefit for whole population
Behaviorally appropriate
Strategies for prevention: Population-based (mass) strategy - disadvantages
Small benefit to individuals
Poor motivation of individuals
Whole population is exposed to downside of strategy (less favourable benefit-to-risk ratio)
Strategies for prevention: high-risk (individual) strategy - advantages
Appropriate to individuals
Individual motivation
Cost effective use of resources
Favourable benefit-to-risk ratio
Strategies for prevention: high-risk (individual) strategy - disadvantages
Cost of screening, need to identify individuals
Temporary effect
Limited potential
Behaviourally inappropriate
Health promotion
Acts on the determinants of wellbeing
Focus:
Health/wellbeing
Actions:
- Acts on determinants of wellbeing
- Enables/empowers power to increase control over and improve their health
Involves:
Whole population in everyday contexts
Example:
- Push play
- 5+ a day
Alma Ata 1979: decleration for primary health care
Protect and promote health of all
Advocate a health promotion approach to primary care
Prerequisites for health
- Peace and safety from violence
- Shelter
- Education
- Food
- Income and economic support
- Stable ecosystem and sustainable resources
- Social justice and equity
Ottawa Charter for health promotion (WHO)
Health is:
1. A fundamental right for everybody
2. That it requires both individual and collective responsibility
3. The opportunity to have good health should be equally available
4. And that good health is a essential element of social and economic development
Ottawa Charter 3 basic/core strategies
- Enable
- Advocate
- Mediate
Ottawa Charter: enable
To provide opportunities for all individuals to make healthy choices through access to information, life skills and supportive environment
An individual level strategy
Ottawa Charter: advocate
To create favourable political, economic, social, cultural and physical environments by promoting/advocating for health and focusing on achieving equity in health
Systems level strategy
Ottawa Charter: mediate
To facilitate/bring together individuals, groups and parties with opposing interests to work together/come to a compromise for the promotion of health
Individuals + groups + systems strategy
Ottawa Charter 5: priority action areas
- Develop personal skills
- Strengthen community action
- Creative supportive environments
- Reorient health services towards primary health care
- Build healthy public policy
Disease prevention
Focus:
Disease
Actions:
- Looks at particular disease (or injuries) and ways of preventing them
- Ways of preventing the incidence, prevalence, risk factors or impacts
- 3 levels
Examples:
- Immunisation
- Air bags in cars
Prevention strategies: primary
Limit the occurence of disease by controlling specific causes and risk factors
Reduces disease incidence
Prevention strategies: secondary
Early detection to reduce the more serious consequences of disease
Reduces prevalence
Prevention strategies: tertiary
Reduce the complications of established disease
Health protection
Focus:
Environmental hazards
Actions
1. Risk/hazard assessment
2. Occupational health and monitoring
3. Risk communication
Example:
Safety regulations on work sites
