MOD 2- Lect 13-15

Question 1

what are Causes of Causes

Answer 1

Individuals - any events characteristics or other entities that bring about a change for better or worse

Question 2

downstream meaning

Answer 2

interventions operate at the proximal level eg treatment systems and disease management- lifestyle nutrition and smoking

Question 3

Upstream meaning

Answer 3

interventions at macro level, government policies and international trade agreement- this CAN not be changed overnight

Question 4

Dahlgren and WHitehead model (DWM) components

Answer 4

General socioeconomic cultural and environment conditions- living and working conditions
society and community network
Individual lifestyle factors

Question 5

Decribe Level 1 of DWM

Answer 5

the individual
life values
learned behavior

Question 6

Describe level 2 of DWM

Answer 6

Community ‘who you know’

influence friends - family

Question 7

What are structural determinants of healthcare

Answer 7

social and physical environment conditions/ patterns (social determinants) that influence choices and opportunities available

Question 8

What are Agency within healthcare

Answer 8

capacity of an individual to act intently and make free choices

Question 9

What is individual healthcare

Answer 9

Clinicians deal with individuals aim to treat disease= restored health

Question 10

What is population heath

Answer 10

concerned with groups of individuals and context of their environment

Question 11

What is Causes of the problem

Answer 11

establishing casual relationship to provide evidence based practice
Determines the relationship of association between given exposure and disease outcomes in population

Question 12

Can preventative action be before the cause is identified

Answer 12

YES

Question 13

WHat is epidemiologies association with causal effect

Answer 13

suffient amount of studies which are diverse- limiting confounding and random error- to find the relationship between exposure and outcome

Question 14

Describe Bradford hills framework ‘aid to thought’

Answer 14

1. temporality
2. strength of association
3. consistency of A
4. Biological gradient (dose response)
5. Biological plausibility of A
6. Specific of A
7. Reversibility

Question 15

Describe temporality

Answer 15

1st cause then disease- essential to establish causal relation
eg. smoking and lung deaths

Question 16

Strength of Association

Answer 16

stronger an association the more likely to be absence of bias
eg: RR greater than 10

Question 17

Consistency of association

Answer 17

replication of finding in multiple studies

eg: multiple studies have shown similar results

Question 18

Biological grandient

Answer 18

Incremental change in diesease rate in conjuction with changes in exposure
eg as Exposure goes up so does diesease

Question 19

Specificity of Association

Answer 19

acknowledging

health issues have many causes and many outcomes share causes

Question 20

reversibility

Answer 20

demonstration that’s under controlled conditions changing exposure causes change in outcome

Question 21

what is a cause of a disease

Answer 21

Event condition characteristic which plays an essential role in producing the disease

Question 22

Sufficient cause

Answer 22

whole pie
minimum set of conditions without any one disease would not occur
not a single factor often 7

Question 23

Component Cause

Answer 23

a factor that contributes towards disease but is not sufficient to cause disease on its own

Question 24

Necessary cause

Answer 24

factor that must be present if a specific disease is to occur

Question 25

WHat is ROTHMANS casualty pie

Answer 25

given disease can be caused by more than 1 causal mechanism | every causal mechanism always has some environment component causes

Question 26

Effects of changing causal pie

Answer 26

clocking/ removing component= prevention of disease no need to identify all causes to prevent INTERVENTION possible at anytime

Question 27

WHAT is Te PAE mahutonga 4 key tasks

Answer 27

1. mauriora- access to te ao maori 2. waiora- environmental protection 3. toira- healthy lifestyle 4. te oranga- participation in society

Question 28

WHAT is Te PAE mahutonga 2 prerequisites

Answer 28

Nga Marukura- | Te Mana Whakahaere

Question 29

Maori Health Benefits

Answer 29

Mainstream health have been less effective Health population needs to determine determinants not just surface causes One size does not fit all. as maori have different history/ social and cultural context

Question 30

Describe the structure of the Dahlgren and Whitehead model

Answer 30

1. age, sex and constitutional factors 2. Individual lifestyle factors 3. Social and community networks 4. general socioeconomic, cultural and environmental conditions

Question 31

N

Answer 31

N

Question 32

What is the Public/Population health framework aim to do

Answer 32

Provide maximum benefit to the largest number of people at the same time reducing inequities in distribution and wellbeing

Question 33

what is Nga Manukura

Answer 33

leadership, health professional and community leadership

Question 34

what is Te mana whakahaere

Answer 34

capacity for self governance | community control and enabling political environment

Question 35

What is the relationship between maori and mainstream health

Answer 35

Mainstream health is less effective for Maori - does not take in Maori social, histiral, cultural contents - MAori health may be applicable to whole population and have beneficial effects