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POPLHLTH 111 > Module 2 (Lectures 12-18) > Flashcards

Module 2 (Lectures 12-18) Flashcards

(96 cards)

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1
Q

Step of Public Health Framework

A

Define Problem, Identify Risk / Protective Factors, Develop / Test Prevention Strategies, Assure Widespread Adoption

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2
Q

Determinants in Individuals

A

an events that causes a change in health in an individual

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3
Q

Determinants in Populations

A

includes characteristics of the popl itself

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4
Q

Downstream Interventions

A

at micro level, treatment systems and disease management

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5
Q

Upstream Interventions

A

at macro level, govn policies and international trade agreements

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6
Q

Proximal Determinants

A

‘near’, closely / directly associated with change in health status (eg lifestyle and behavioral factors related to exposure

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7
Q

Distal Determinants

A

distant in time / place from the change in health status (eg national, political, legal, cultural factors that indirectly influence health by acting on proximal factors)

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8
Q

Dahlgren and Whitehead Level 1 (includes 4 factors)

A

The Individual, age sex, constitutional factors, individual lifestyle factors

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9
Q

Dahlgren and Whitehead Level 2

A

Community, social / community networks and living / working conditions

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10
Q

Dahlgren and Whitehead Level 3

A

Environment, general socioeconomic, cultural and environmental conditions

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11
Q

Structure

A

social and physical environmental conditions and patterns (social determinants) that influence choices and opportunities

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12
Q

Agency

A

capacity of individual to act independently and make free choices

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13
Q

Aim of Epidemiology

A

find cause of disease, by looking at relationship between exposure and outcome (then judge against framework to see if causal)

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14
Q

Bradford Hill Framework Step 1

A

Temporality

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15
Q

Temporality

A

first cause then disease

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16
Q

Bradford Hill Framework Step 2

A

Strength of Association

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17
Q

Strength of Association

A

stronger association = more likely to be causal in absence of known biases

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18
Q

Bradford Hill Framework Step 3

A

Consistency of Association

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19
Q

Consistency of Association

A

replication of findings by different investigators, times, places, methods

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20
Q

Bradford Hill Framework Step 4

A

Biological Gradient

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21
Q

Biological Gradient

A

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

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22
Q

Bradford Hill Framework Step 5

A

Biological Plausibility of Association

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23
Q

Biological Plausibility of Association

A

does association make sense biologically?

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24
Q

Bradford Hill Framework Step 6

A

Specificity of Association

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25
Specificity of Association
a cause leads to a single effect or an effect has a single cause. However health issues have multiple interacting causes and many outcomes share causes
26
Bradford Hill Framework Step 7
Reversibility
27
Reversibility
demonstration that under controlled conditions, changing exposure causes change in outcome
28
Bradford Hill Framework Step 8
Judgement
29
Cause of a Disease
an event, condition, characteristic (or combination) which plays an essential role in producing the disease
30
Sufficient Cause
'the whole pie', sum of all conditions needed for disease to occur
31
Component Cause
'each slice', an individual factor that contributes to a disease, but cannot cause it on its own
32
Necessary Cause
factor that must be present for disease to occur
33
Te Pae Mahutonga - 4 key tasks
Mauriora, Waiora, Toiora, Te Oranga
34
Te Pae Mahutonga - 2 prerequisites
Ngā Manukura, Te Mana Whakahaere
35
Mauriora
access to Te Ao Māori (the Māori world)
36
Waiora
environmental protection
37
Toiora
healthy lifestyles
38
Te Oranga
participation in society
39
Ngā Manukura
leadership (health and community)
40
Te Mana Whakahaere
autonomy (capacity for self governance and community control / enabling political environment)
41
Importance of preventing disease
limitations of curing disease, increasing cost
42
Population Health Actions
Health Promotion, Disease Prevention, Health Protection
43
Population Health Actions - 2 strategies
Population (mass) or high risk (individual)
44
Population Based (mass) Strategy - focus, aims, useful for, example
whole popl, reduce health risk / improve outcome for all indiv. in popl, common disease / widespread cause, immunisation programs
45
High Risk (individual) Strategy - focus, advantage, example
individuals perceived as high risk, well tailored to individuals, targeting obese adults
46
Population Based (mass) Strategy - 3 advantages
addresses underlying causes, large potential benefit, behaviourally appropriate
47
Population Based (mass) Strategy - 3 disadvantages
small benefit to individuals, little motivation for individuals, whole popl exposed to downsides (less favourable benefit to risk ratio)
48
High Risk (individual) Strategy - 4 advantages
benefit to individuals, motivation for individuals, cost effective use of resources, good benefit to risk ratio
49
High Risk (individual) Strategy - 4 disadvantages
cost of screening (need to identify individuals), temporary effect, limited potential, behaviourally inappropriate
50
Health Promotion
acts on determinants of wellbeing
51
Alma Act 1978
advocated a health promotion approach to primary care
52
Ottawa Charter - 3 Basic Strategies
enable, advocate, mediate
53
Ottawa Charter - 5 Action Areas
Strengthen community action, develop personal skills, create supportive environments, reorient health services, building healthy public policy
54
Enable
(individual level strategy) provide opportunity for individuals to make healthy choices
55
Advocate
(systems level strategy) favourable political, economic, social, cultural, physical enviro by promoting health, focusing on achieving equity
56
Mediate
(joins indiv / groups / systems) opposing interests to compromise for promotion of health
57
Strengthen community action
getting community to work together to promote health eg soup kitchens
58
Develop Personal Skills
education (what is healthy) and cooking skills etc
59
Create Supportive Enviro
physical social enviro, help indiv make healthy choices
60
Reorient Health Services
focus on supporting needs for healthy lives, help reduce risk factor and enhance protective factors
61
Building Healthy Public Policy
providing the opportunity for indiv to make healthy choices often through regulations
62
Disease Prevention
look at particular disease and ways of preventing it eg incidence, prevalence, risk factors, impacts
63
Primary Disease Prevention
limit occurrence of disease by controlling risk factors
64
Secondary Disease Prevention
reduce the more serious consequences of a disease, slow the progression
65
Tertiary Disease Prevention
reduce progress of complications of established disease
66
Health Protection focus
on environmental hazards (risk assessment, occupational health, risk communication)
67
Primary Screening
for a risk factor
68
Secondary Screening
for more serious complications
69
Tertiary Screening
for complications after clinical diagnosis
70
Screening Criteria
Suitable disease, test, treatment, screening program
71
Suitable Disease
common or uncommon but early detection leads to better outcome; knowledge of natural history of disease
72
Suitable Test
reliable, safe, simple, affordable, acceptable, accurate
73
Sensitivity
ability to correctly identify those who do have the disease from all indiv with the disease (true positives ÷ all with disease x 100)
74
Specificity
ability to identify correctly those who do not have the disease from all indiv without the disease (true negatives ÷ all without disease x 100)
75
Positive Predictive Value (PPV)
probability of having the disease if test positive (true positives ÷ all who test positive x 100)
76
Negative Predictive Value (NPV)
probability of not having the disease if test negative (true negatives ÷ all who test negative x 100)
77
Sensitivity and specificity fixed?
yes, fixed characteristic of the test
78
PPV and NPV fixed?
no, reflect both the test accuracy and prevalence of the disease
79
if prevalence is moderate / low ____
higher false positive test results
80
if prevalence is high ____
higher false negative test results
81
Suitable Treatment
effective, acceptable and accessible
82
Suitable Screening Program
benefits must outweigh harm, result in reduced mortality or increased survival time
83
Lead Time Bias
if screening program evaluated in terms of survival time -> false impression. Does it increase survival after point when they would have had clinical diagnosis
84
Length Time Bias
screening more likely to catch slow progressing disease than fast progressing disease, so will look like survival time is longer than it actually is
85
Why do we need to prioritize?
not enough money to fund everything
86
Establishing Population Health Priorities
Evidence based measures (descriptive, explanatory, evaluative), community expectations and values, human rights and social justice
87
Descriptive Evidence
who is most / least affected? where are we now, come from, going?
88
Explanatory
what are the determinants / risks?
89
YLL
years of potential life lost to death
90
YLD
years lived with a disability
91
PAR
population attributable risk
92
Attributable Risk =
Risk Difference (EGO - CGO), amount of 'extra' disease attributable to a particular risk factor in EG
93
Population Attributable Risk (definition)
amount of 'extra' disease attributable to a particular risk factor in a particular population
94
Population Attributable Risk (formula)
occurrence in total popl (PGO) - occurrence in unexposed popl (CGO) (all positive outcomes ÷ total popl) - (positive outcome for CG ÷ CG)
95
Evaluative Evidence
is the intervention improving health outcomes? how well can problem be solved? economic feasibility
96
Community Expectations / Values and Human rights / Social Justice
will it be accepted? what do communities want?

POPLHLTH 111 (2 decks)

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