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mod2 Flashcards

everybody get rich (84 cards)

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1
Q

what is the definition of epidemiology

A

epidemiology is the study of the distribution and determinants of health-related states or events in specified populations’

and the application of this study to the control of health problems

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2
Q

what is the difference between individual and population health care

A

clinicians deal with individuals- they treat disease- to restore health

Population health is concerned with the health of groups of individuals- in the context of their environment

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3
Q

What is the goal of the public/population health framework

A

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

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4
Q

What are the 4 steps of the pophealth framework

A

1define the problem
2identify risk and protective factors
3develop and test prevention strategies
4 assure widespread adotion

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5
Q

why is it important for epidemiologists to seek the cause of dis-ease

A

appropriate preventive measures can be introduced

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6
Q

epidemiology does not determine the cause of a disease in a given individual .instead,

A

it determines the relationship or association between a given exposure and dis-ease in populations

they look for links between Exposure and outcome

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7
Q

Bradford Hill criteria are meant for

A

an aid to thoght

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8
Q

what are the 7 bradford hill criteria

A

tommy shot cassey’s big green bum so recklessly

temporality
strength of association
consistency of association
biological gradient
biological plausibility of association

specificity of association

reversibility

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9
Q

temporality

A

first the cause then the disease

essential to establish a causal relation

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10
Q

Strength

A

the stronger an association, the more likely to be causal

this excludes biases ( selection, information and confounding)

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11
Q

biological graident

A

incremental change in disease rates in conjunction with corresponding changes in exposure

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12
Q

biological plausibility

A

does it actually make sense

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13
Q

specificity of association

A

a cause leads to a single effect

weakest of all Bradford Hill stuff

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14
Q

Reversibility

A

The demonstration that under controlled conditions-changing the exposure causes a change in the outcome

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15
Q

What is a cause of disease

A

an event, condition, characteristic which play an essential role in producing the disease

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16
Q

what is a sufficient cause

A

a cause that will inevitably produce the specific dis=ease

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17
Q

what is a component cause

A

a factor that contributes towards dis-ease causation but is not sufficient to cause disease on its own

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18
Q

what is a necessary cause

A

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

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19
Q

why is a causal pie used

A

we use the association and other factors to infer causation and intervene to prevent disease]

and we can intervene at any number of points in the pie

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20
Q

Why do we need to prevent disease

A

there are limitations in curing diseases and as costs of medical care escalates

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21
Q

what is the population based strategy

A

focuses on the whole population

aims to reduce the health risks and improve the outcome of all individuals in the population

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22
Q

what is the population based strategy useful for

A

useful for a common disease or a widespread cause

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23
Q

What is high risk individual strategy

A

focuses on individuals perceived to be a high risk

the intervention is well matched to individuals and their concerns

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24
Q

what are the advantages of a population based mass strategy

A

radical- meaning that it addresses underlying causes

large potential benefit for whole population

behaviorally appropriate ( meaning that it causes people to act like others in their environment)

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25
what are the disadvantages of population based strategy
small benefit to individuals poor motivation of individuals whole population is exposed to downside of strategy
26
what are the advantages of high risk strategy
appropriate to individuals individuals are motivated cost effective use of resources favourable benefit to risk ratio
27
what are the disadvantages of high risk strategy
cost of screening, need to identify individuals temporary effect limited potential behaviorally inappropriate
28
what do health promotion act on
acts on determinants of wellbeing health and focus enables people to increase control over and improve their health involves whole population in every day contexts
29
what is primary care
community based- i.e, regular source of healthcare- your GP, pharmacist, physioterapist and community based
30
what is in secondary care
specialist care- neurologists dermatogologists
31
what is in tertiary care
hospital based care- rehab
32
what is gotten out of alma Ata
Alma ata is a declaration for primary health care it achieved lots of things- establishing that it is a human right to enjoy primary health care- and advocated the prerequisites of health 1) protect and promote health of all 2) advocate a health promotion approach to primary care 3) peace and safety from violence 4) shelter 5) education 6) food 7) income and economic support 8) stable ecosystem and sustainable resources 9) social justice and equity
33
what is the ottawa charter for health promotion
it is the first international conference for health promotion its goal is to "mobilise action for community development"
34
what does the ottawa charter acknowledge health as
a fundamental human right requires both individaul and collective responsibility that the opportunity to have good health should be equally available good health is an essential element of social and economic development
35
what are the 3 basic strategies of the ottawa charter
1) enable 2) advocate 3) mediate
36
ottawa charter | enable
to provide opportunities for all individuals to make healthy choices through access to information, life skills and support environments this is an example of An individual level strategy
37
ottawa charter advocate
to create favourable political, economic, social, cultural and physical environments by promoting and advocating for health
38
ottawa charter mediate
facilitate and bring together individuals, groups and parties with opposing interests to work together and come to a compromise for the promotion of health
39
what are the 5 priority action areas
develop personal skills strengthen community action create supportive environments reorient health services towards primary health care
40
in thw natural history of disease and prevention scheme, what is the goal of primary care
limit the occurrence of disease by controlling specific causes and risk factors
41
in the natural history of disease and prevention scheme, what is the goal of secondary care
reduce the more serious consequences of disease
42
in the natural history of disease and prevention scheme what is the goal of tertiary care
reduce the progress of complications of established disease
43
health protection is
predominantly environmental hazard focused
44
what is done in health protection
risk/hazard assessment monitoring risk communication occupational health
45
What are the causes in individuals
any event, characteristic or other definable entity that brings about a change for better or worse in health ``` these include income employment education housing and neighborhoods societal characteristics ``` autonomy and empowerment
46
What are determinants of health for populations?
the concepts are similar as for individuals but the nature of determinants is often different as its not just application of the individual perspective to whole population, but includes characteristics of the population itself any event, characteristic or other definable entity that brings about a change for better or worse in health Determinants of health in populations are also related to the context in which the population exists
47
What is the definition of downstream
interventions that operate at the micro level (proximal level) including treatment systems and disease management
48
What is the definition of upstream interventions
upstream interventions operate at the macro level, suchas government policies and international trade agreements
49
What is the definition of proximal determinants
a determinant of health that is proximate or near to the change in health status near generally refers to any determinant that is readily and directly associated with the change in health status- lifestyles, behavioral factors etc
50
what is the definition of distal determinants
a determinant of health that is either distant in time and or place from the change in health status distal determinants of health are referred to as upstream factors things that influence health by acting on the proximal factors
51
What is level 1 of the Dahlgren and whitehead model (rainbow model)
the individual includes the age, sex and constitutional factors and individual lifestyle factors
52
what are the non modifiable determinants in the Dahlgren and whitehead model
genes and biology
53
What are some examples of environmental impacts in level1 of the Dahlgren and whitehead model
food, exercise, risky behaviors, relation to health outcomes the choices you make as an individual will have an impact on the likelihood of whether you have good or bad health
54
What is habitus, and which part of Dahlgren and Whitehead model is it on
it is on level 1 this is the lifestyle, values, dispositions and expectations of particular social groups learned through everyday activities ability to change behaviors may vary by social group
55
What is level 2 of the Dahlgren and whitehead model
the community social and community networks and living and working conditions this is cuz the attitudes and behaviours of people living and working in the local community influences the sense of what is normal and acceptable
56
What is social capital
the value of social networks that facilitates bonds between similar groups of people provides an inclusive environment for people from diverse backgrounds examples include civic participation, volunteerism, supportive communities
57
What is level 3 of the Dahl Gren and whitehead model
The environment- general socioeconomic, cultural and environmental conditions ``` this includes physical environments built environments cultural environments biological environments the ecosystem political environments ```
58
What are the 4 capitals
they are the interdependent factors that work together to support wellbeing they include natural capital human capital social capital financial or physical capital
59
natural capital
refers to all aspects of the natural environment needed to support life and human activity.
60
human capital
encompasses people's skills, knowledge and physical and menatl health these are things that enable people to participate fully in work, study, recreation and in society more broadly
61
What is social capital
things that underpin society trust, rule of law, crown maori relationship cultural identity connections between people and communities
62
What is financial capital
things like houses, buildings...things which make up the country's physical and financial assets
63
what is structure
social and physical environmental conditions that influence choices and opportunities available
64
what is agency
the capacity of an individual to act independently and make free choices
65
What is age standardisation
The process of converting the different age structures in each population into one standard population age structure and working out the deat rates
66
Why do we age standardize
So you can make meaningful comparisons between the 2 by comparing the same age groups in each population
67
How do we age-standardise data
1) Calculate the age-specific death rates for each age group for each town 2) applying age-specific death rates to the standard population to find the expected number of deaths 3) Sum up all the expected death and divide by the standard population size to get your age standardised death rate
68
how do you calculate age-specific death rate
number of people who die of the dis-ease in the age group over the number of people in that age group
69
how do you find the expected number of deaths
age specific death rate multiplied by standard population
70
Rationale for having Maori Health
Maori health status rights as indigenous peoples and treaty partners Mainstream health promotion interventions have generally been less effective for Maori than for non Maori Maori health is everyone's responsibility
71
What are the 4 systematic inequalities facing Maori health
there's inequalities in health outcomes in exposure to the determinants of health in health system responsiveness in the representation in the health workforce
72
What causes health inequalities
ethnic inequalities in health are fundamentally driven ny the unequal distribution of health risks and opportunities (social determinants)
73
Why don'y we use "conventional" health promotion when addressing Maori health
based on western models universal formula (one size fits all) often simply adapted for Maori Dosen't incorporate Maori values and realities superficial vs structural approach has tended to benefit non-Maori to a greater extent than Maori
74
What are the prerequisites of the ottawa charter
peace, shelter, education, food, income, stable eco-system, sustainable resources, social justice and equity they build healthy public policy create supportive environments strengthen community action develop personal skills reorient health services
75
What are the 3 pre-requisites (strategies) of the Ottawa charter
advocate enable mediate
76
what does advocate mean in the ottawa charter
literally means making the conditions favourable. the conditions are factors that include politcal, economic, social, cultural, environmental and behavioral and biological factors. These conditions can be made facourable through advocacy (arguing in favor of) health
77
what does enabling mean in the Ottawa charter
give people autonomy by giving them opportunities. This one is primarily focussed on the individual level. aims at reducing iniquities to enable people to achieve their fullest health potential
78
what does mediate mean in the Ottawa charter
mediating means getting all the groups to achieve one common goal. also individuals included health put at first priority and even opposing groups are expected to work together in favour of trying to achieve best health outcome
79
What are the health promotion actions
this can be rememberred as you move away from individuals towards the nation like the rainbow model; develop personal skill community empowerment supportive environments reinorienting health services towards primary health care build healthy public policy
80
what is developing personal skills
people need to be educated and empowered doing this gives them more control, and make better choices about health and give them better access
81
community empowerment
the community gotta be empowered to make its decisions autonomous and shit this draws on better resource usage and management and strengthens public participation.
82
Supportive environment
changing patterns of life, work and leisure can have a significant impact on health. The way society organises work should help create a healthy society
83
Reorienting health services
health promotion in health services is shared among individuals they must work together health services suggest to be more holistic than clinical
84
public policy
all agenda of policy makers in all sectors and all levels should be aware of health consequences of their decisions. this includes tax, fiscal measures legislation.

Pophealth Questions (7 decks)

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