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PH111 > Module 2 > Flashcards

Module 2 Flashcards

1
Q

what are the five steps of the public health framework?

A
  1. Define the problem
  2. Identify risk and protective factors
  3. Develop and test prevention strategies
  4. Assure widespread adoption
  5. Monitor and evaluate
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2
Q

What are the causes for low life expectancy within an impoverished community?

A
  • Hi prevalence of health endangering behaviour such as imbalance to diet smoking alcohol and sedentary lifestyle
  • Poor access to education lack of primary healthcare increased access to alcohol and processed foods
  • Cultural disintegration and poverty
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3
Q

Why can’t causality be approved for complex relationships and human studies?

A

It is not practical or ethical

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4
Q

what are the seven components of the Bradford Hill criteria

A
  1. Temporality – first the cause then the disease
  2. Strength of association – the stronger and association the more likely to be causal in absence of known biases
  3. Consistency of association – ability to replicate
  4. Biological gradient – incremental changes and disease rate in relation to exposure
  5. Biological plausibility
  6. Specificity of association – one cause leads to a single affect
  7. Reversibility – the demonstration that under control conditions changing the exposure can change the outcome
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5
Q

What are the three different causes of Rothmans causal pies

A
  1. Sufficient cause – this is all of the component and necessary causes
  2. Component cause – affected that contributes to the disease but is not sufficient enough to cause the disease on its own
  3. Necessary cause –Affective or component cause that must be present for disease to occur
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6
Q

What are 3 advantages of population based strategies for prevention?

A
  1. Radical – addresses underlying causes
  2. Large potential benefit for whole population
  3. Behaviourally appropriate
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7
Q

What are 3 disadvantages of population based strategies for prevention?

A
  1. Small benefit to individuals
  2. Poor motivation of individuals
  3. Less favourable benefit to risk ratio
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8
Q

What are 4 advantages of individual based strategies for prevention?

A
  1. Appropriate to individuals
  2. Individual motivation
  3. Cost effective use of resources
  4. Favourable benefit to risk ratio
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9
Q

What are 4 disadvantages of individual based strategies for prevention?

A
  1. Cost of screening
  2. Temporary affect
  3. Limited potential
  4. Behaviourally inappropriate
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10
Q

What were the 7 Prerequisites for health under Alma Ata 1978

A
  1. Peace and safety from violence
  2. Shelter
  3. Education
  4. Food
  5. Income and economic support
  6. Stable ecosystem and sustainable resources
  7. Social justice and equity
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11
Q

What were the four acknowledgements from the Ottawa Charter?

A
  1. Health is a fundamental right
  2. Health requires both individual and collective responsibility
  3. The opportunity to have good health should be equally available
  4. Good health is an essential element of social and economic development
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12
Q

What were the three basic strategies of the Ottawa Charter?

A
  1. Enable – provide opportunities for individuals to make healthy choices
  2. Advocate – to create favourable political economic social cultural and physical environments that promote health
  3. Mediate - to facilitate or bring together individuals groups and parties with opposing interests to work together to aid health
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13
Q

What are the five priority action areas of the Ottawa Charter

A
  1. Develop personal skills
  2. Strengthen community action
  3. Create supportive environments
  4. Reorient health services toward primary health care
  5. Build healthy public policy
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14
Q

What is the benefit of primary screening?

A

Limit the occurrence of disease by controlling specific cause and risk factors

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15
Q

what is the benefit of secondary screening?

A

Reduces the more serious consequences of disease

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16
Q

what is the benefit of tertiary screening?

A

Reduces the progress of complications of established disease

17
Q

what are three aspects of health protection?

A
  1. Risk/hazard assessment – environmental epidemiology
  2. Occupational health and monitoring
  3. Risk communication
18
Q

What is the difference between health promotion disease prevention and health protection?

A

Health promotion acts on the determinants of well-being for example 5+ a day

Disease prevention focuses on preventing disease for example immunisation occurs in three levels (Primary secondary and tertiary)

Health protection focuses on environmental hazards and example is safety regulations on worksites

19
Q

What are the 4 key tasks for Te Pae Mahutonga

What are the 4 Central star or key tasks for Te Pae Mahutonga?

A

Mauriora- Access to Te reo

Waiora- Environmental protection

Toiora- Healty Lifestyle

Te oranga - Participation is society

20
Q

What are the 2 prerequisites for Te Pae Mahutonga?

A

Ngā Manukura- Leadership (in health and comunity)

Te Mana whakahaere- Autonomy; Self governance, community control and political environment

21
Q

What are those four components of screening criteria?

A
  1. Suitable disease
  2. suitable test
  3. suitable treatment
  4. suitable screening program
22
Q

What makes a suitable disease for screening?

A
  1. An important health problem

Early detection must result in a better outcome and it needs to be relatively common the only example of uncommon screening is PKU in newborns

  1. Knowledge of the natural history of disease this increases the pre-clinical phase
23
Q

What are the six components that make up a suitable test for screening?

A
  1. Reliable (sensitivity/specificity)
  2. Safe
  3. simple
  4. affordable
  5. acceptable
  6. accurate
24
Q

How do you calculate sensitivity?

A

True positive / Everyone with disease x 100 = %

25
Q

How do you calculate specificity

A

True negatives / Everyone with out disease x 100 = %

26
Q

How do you calculate the positive predictive value

A

True positive / Everyone who tests positive x 100 = %

27
Q

How do you calculate the negative predictive value

A

True negatives / Everyone who tests negative x 100 = %

28
Q

What is required for a suitable treatment for screening? (3)

A

Evidence that early treatment leads to a better outcome.

Effective, acceptable and accessible treatment.

Evidence based policy is covering who should be offered treatment in the appropriate treatment to be offered.

29
Q

What are the 6 requirements for a suitable screening program?

A
  1. Benefits Must outweigh harm
  2. Randomised control trial evidence that the screening program will result in reduced mortality and increased survival time
  3. Adequate resources in and agreed policy for testing
  4. Cost-effective
  5. The health care system must be able to support all elements of screening
  6. Needs to reach all of those who are likely to benefit from it
30
Q

what is leadtime bias?

A

And increase in the amount of time between diagnosis and outcome giving the appearance of increased life expectancy rather than just earlier diagnosis

31
Q

what is length time bias?

A

Slow progressing diseases appear to be more common in the population at certain points in time when compared to rapidly progressing diseases giving the appearance that more harm is caused by the slow progressing disease.

32
Q

Why do we need to prioritise in health?

A

There is not enough money to fund all healthcare related costs

33
Q

what are the three evidence based measures required for establishing a population health priority?

A
  1. Descriptive
  2. explanatory
  3. evaluative
34
Q

What is meant by descriptive for evidence based measures of health priority?

A

Describes the problem and who is most or least affective. It also asks where have we come from and where are we going in regard to disease or health outcomes over time

35
Q

What is meant by Explanatory for evidence based measures of health priority?

A

What explains what has occurred?

what are the determinants?

what are the risks?

is it getting better or worse?

why are different populations having different health outcomes?

this is related to identifying risk and protective factors

36
Q

What are the three epidemiological measures used in health prioritisation?

A
  1. Years of potential life lost (YLL)
  2. Years lived with a disability (YLD)
  3. Population attributable risk (PAR) = PGO- CGO
37
Q

What is meant by Evaluative for evidence based measures of health priority?

A

What can improve health outcomes and in who? This relates to the last three steps of the public health framework

The 5 main focuses

  1. Target population
  2. Expected number in population who will be reached
  3. evidence of effectiveness
  4. cost
  5. Community expectations

Consider opportunity cost*

38
Q

What are 4 community expectations

A
  1. Access to necessary care
  2. confidence in the health system
  3. culturally appropriate
  4. good information about options

PH111 (2 decks)

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