module 2

Question 1

7 aspects of bradford hill criteria

Answer 1

temporality
strength of association,
consistency of association,
biological gradient,
biological plausibility of association, specificity of association,
reversibility

Question 2

what is temporality

Answer 2

first cause then disease - establish a causal relationship

Question 3

what is strength of association

Answer 3

stronger an association - more likely to be causal in absence of known bias

Question 4

reversibility

Answer 4

under controlled conditions the change in exposure = change in outcome

Question 5

biological gradient

Answer 5

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

Question 6

biological plausibility of association

Answer 6

does the association make sense biologically

Question 7

consistency with association

Answer 7

replicate findings by different investigators at different times in different places with different methods so multiple studies show similar results

Question 8

specificity of association

Answer 8

cause leads to single effect and effect has single cause

Question 9

what is a causal pie for

Answer 9

showing multicausality

Question 10

what is sufficient cause

Answer 10

min set of conditions for a disease to occur - one of these missing = disease does not occur

Question 11

component cause

Answer 11

each slice is a factor that contributes to disease causation but doesnt cause it on its own but through interactions with other components

Question 12

necessary cause

Answer 12

must be present for disease

Question 13

blocking/removal of any component cause

Answer 13

result in prevention in some cases

Question 14

nearly every causal mechanism has

Answer 14

one environmental cause

Question 15

problems with causal pie model

Answer 15

assumes that all causes are deterministic so A causes B - fails to capture dose-response as a continuum

Question 16

probabilistic concept of causation

Answer 16

cause increases chance that its effect will occur - does not include the necessary, component and sufficient causes

Question 17

sufficient cause raises probability to

Answer 17

1

Question 18

necessary cause raises probability

Answer 18

from 0

Question 19

each component cause contributes towards probability from

Answer 19

0 to 1

Question 20

counterfactual

Answer 20

a makes difference to b

Question 21

deterministic

Answer 21

a causes b

Question 22

probabilistic

Answer 22

a increased chances of b occurring

Question 23

social gradient

Answer 23

step wise increase - people in less deprived areas do better than people in more deprived

Question 24

level 1 of dalhgren and whitehead

Answer 24

individual non mod and lifestyle

Question 25

level 2

Answer 25

social and community networks + living and working conditions - social norms

Question 26

level 3

Answer 26

environment - physical, built, cultural, biological, ecosystem and political

Question 27

living standards framework

Answer 27

individual and collective wellbeing - resources and aspects of our lives important for individual and family wellbeing institution and government - role that institutions play in safeguarding and building our wealth wealth of nz - how wealthy we are as a country

Question 28

four capitals of nz

Answer 28

natural capital human capital social capital physical/financial capitatl

Question 29

what is the natural capital

Answer 29

all aspects of the natural environment

Question 30

what is the human capital

Answer 30

shared values, knowledge, skills and health

Question 31

social capital

Answer 31

- social norms, the trust law and crown relationship

Question 32

what is physical or financial capital

Answer 32

houses roads and buildings - physical assets

Question 33

difference between structure and agency

Answer 33

agency = the capacity of an individual to act independently and make free choices whereas structure is the influence of physical and social determinants on someone's choices and opportunities so structure = outer levels affecting proximally whereas agency = inner levels 1 and 2

Question 34

how to measure socio economic status sep

Answer 34

objective measurable and meaningful - based on level of inequality between societies

Question 35

ways to measure sep

Answer 35

education, income, occupation, housing and assets

Question 36

how to measure sep for populations

Answer 36

area based measures - deprivation and access deciles opposite to schooling population measures - income inequality, literacy rates, gdp per capita

Question 37

how to see area based measures of sep

Answer 37

nz index of deprivation - imd - explore drivers of area deprivation

Question 38

what is gch

Answer 38

geographical classification for health - urban 1 to 2 and rural 1 to 3

Question 39

variables in nz imd

Answer 39

- communication - access to internet - income - 18-64 age with means benefit - income below threshold - employment - 16-64 unemployed - qualifications - 18-64 no qualifications - owned home - support - single parent - living space - bedroom occupancy - living conditions - a4 mold

Question 40

global determinants of sep

Answer 40

- income inequality - national income gdp - literacy rates - free trade agreements

Question 41

what does the preston curve show

Answer 41

relationship between life expectancy and gdp per capita

Question 42

ppp

Answer 42

purchasing power parity - compare economic productivity and standards of living between countries

Question 43

commercial determinants of health

Answer 43

structures, roles, norms and practices by which business activity is designed to generate wealth and profits influences health and disease across populations - commercial = outer level

Question 44

strategies used by commercial industry

Answer 44

lobbying - employing narratives and framing techniques - social responsibility shaping research and funding opportunities financing uni programms and chairs constituency building - partnerships with charities and education related companies policy substitution, development and implementation - partnerships with govt eg health ratings

Question 45

5 a's of access

Answer 45

availability accessibility accomodation affordability acceptability

Question 46

what is availability

Answer 46

relationship between the volume and type of service and resources to the clients volume and type of needs

Question 47

what is accessibility

Answer 47

geographical barriers - the relationship between the location of supply and the location of clients, taking into account transportation, distance, cost and resources

Question 48

what is accomodation

Answer 48

relationship between the manner in which supply resources are organised and the expectations of clients eg wait time and convenience

Question 49

affordability

Answer 49

cost of provider services in relation to the client's ability and willingness to pay for the services

Question 50

acceptability

Answer 50

psychosocial barriers - relationship between clients' and providers' attitudes to what constitutes appropriate care