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Public Health Flashcards

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1
Q

3 domains of public health

A

Health improvement
health protection
improving services

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2
Q

What is health improvement?

A

social interventions aimed at preventing disease, promoting health + reducing inequalities
e.g. education, employment, housing

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3
Q

What is health protection?

A

measures to control infectious disease risks + environmental hazard
e.g. infectious disease, radiation, chemicals + poisons, environmental hazards

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4
Q

What is improving services?

A

organisation + delivery of safe, high quality services for prevention, treatment + care
e.g. clinical effectiveness, efficiency, service planning, audits, clinical governance

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5
Q

What are the determinants of health?

A

genetic, environmental, healthcare, lifestyle

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6
Q

inverse care law

A

availability of medical or social care tends to vary inversely with need of population served

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7
Q

equality

A

treating everyone the same, giving equal shares

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8
Q

equity

A

being fair, giving what they need to be successful

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9
Q

PROGRESS

A

place of residence
race or ethnicity
occupation
gender
religion
education
socio economic status
social capital or resources

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10
Q

horizontal equity

A

equal treatment for equal need

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11
Q

vertical equity

A

unequal treatment for unequal need

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12
Q

Bradford-Hill criteria

A

DR BC ST
dose-response
reversibility
biological plausibility
consistency
strength
temporality

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13
Q

bias

A

systematic error that results in deviation from true effect of exposure on outcome

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14
Q

confounding factors

A

factor is associated with exposure of interest + independently influences outcome

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15
Q

selection bias

A

systematic error in selection of study participants or allocation of participants to different study groups

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16
Q

information bias

A

systematic error in measurement or classification of exposure or outcome

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17
Q

public bias

A

studies with negative results less likely to be published

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18
Q

health definition

A

state of complete physical, mental + social wellbeing, not merely the absence of disease

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19
Q

3 types of health needs assessment

A

epidemiological, comparative, corporate

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20
Q

need definition

A

ability to benefit from an intervention

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21
Q

felt need

A

individual perceptions of deviation from normal health

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22
Q

expressed need

A

seeking help to overcome variation in normal health

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23
Q

normative

A

professional defines intervention for expressed need

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24
Q

comparative need

A

comparison between severity, range of interventions + cost

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25
Maxwell's dimensions
3 As + Es access appropriate, relevant to need acceptability equity efficient effective
26
health behaviour
aimed at preventing disease e.g. going for a run
27
illness behaviour
seeking remedy e.g. going to GP
28
sick role behaviour
activity aimed at getting better e.g. taking abx
29
transtheoretical model stages
PC PAM pre contemplation contemplation preparation action maintenance
30
medical negligence
was there a duty of care? was there a breach in that duty? was patient harmed? was harm due to breach in care?
31
Bolam rule
would reasonable doctor do the same?
32
Bolitho rule
would that be reasonable?
33
sloth error
lazy e.g. inadequate documentation
34
system error
inadequate built in safeguards
35
lack of skill
not having appropriate training
36
fixation
focus on 1 Dx only
37
bravado
working beyond competency
38
playing odds
deciding it's common disease + turns out to be rare disease
39
poor team working
communication breakdown
40
ignorance
unconscious incompetence
41
screening
identifying apparently well individuals who have or are at risk of having particular disease
42
primary prevention
prevent disease from occurring
43
secondary prevention
detection of early disease to alter chances + improve outcomes (screening)
44
tertiary prevention
slow down progression of disease
45
Wilson-Junger criteria
condition should be important health problem accepted Tx facilities for Dx + Tx available recognisable latent or early stage suitable test or exam test acceptable to population natural Hx understood agreed who to treat cost-benefit balance case finding continuous process
46
sensitivity
people with disease correctly identified
47
specificity
people without disease correctly excluded
48
PPV
people who test positive who have disease
49
NPV
people who test negative without disease
50
cross-sectional study
snapshot of those with + without disease to find associations at single point in time + cheap + quick + few ethical issues - prone to bias - no time reference
51
case-control
retrospective observational study looks at certain exposure + compares similar participants with + without disease + good for rare diseases + inexpensive - only show association (not causation) - unreliable due to recall bias
52
cohort
longitudinal prospective study which takes population of people recording their exposures + conditions they develop + can show causation + less chance of bias - large amount lost to follow up - expensive
53
RCT
similar participants randomly controlled to intervention or control groups to study effect of intervention + can infer causality + less risk of bias/confounders - time consuming + expensive - ethical issues can interfere
54
health needs assessment cycle
planning implementation evaluation
55
seedhouse ethical grid layers
4 layers core rationale deontological layer consequential layer external considerations
56
4 quadrants
medical indications patient preferences quality of life contextual features
57
virtue ethics
virtuous habits, live life of moral character
58
consequentialism
whether action is right by judging consequences
59
utilitarianism
greatest good for greatest number
60
hedonism
it's good if consequence produces pleasure or avoids pain
61
deontology
follow rules + do duty
62
satiation
bring eating occasion to end - control meal size
63
satiety
suppresses hunger after eating occasion - control snacking between meals
64
health equity
equal expenditure for equal need equal access for equal need equal utilisation for equal need equal healthcare outcome for equal need equal health
65
dimensions of health equity
spatial - geographical social - age, gender, socioeconomic class, ethnicity
66
perceptions of risk
no personal experience with problem belief that preventable by personal action belief that if not happened by now, it won't happen belief that problem infrequent
67
health needs assessment - epidemiological approach
looks at evidence base, defines problem + size of problem, looks at current services, recommends improvements + provide info on incidence + prevalence of disease + existence + utilisation of services - data available may be poor - may be inadequate evidence base - doesn't consider felt need
68
health needs assessment - comparative approach
compares services received by 1 population to another (spatial/social) - data available may vary in quality or unavailable - may be hard to find comparable population - comparison may not be perfect
69
health needs assessment - corporate approach
takes into account views of any group that may have an interest e.g. patients, doctors, media, politicians interviews, focus groups, meetings - may be hard to distinguish need from demand - groups have vested interest - leads to bias - dominant individuals may have undue influence - may be influenced by political agendas
70
lead time bias
early identification appears to prolong survival time
71
length time bias
less aggressive cancers more likely to be identified by screening - makes it appear screening prolongs life
72
theory of planned behaviours - what determines intention?
ASP attitudes to behaviour subjective norms perceived control over behaviour
73
theory of planned behaviours - what bridges the gap between intention + behaviour
P-PAIR preparatory actions perceived control anticipated regret implementation intentions relevance to self
74
theory of planned behaviour advantages
can be applied to wide variety of health behaviours useful for predicting intention takes into account importance of social pressures
75
theory of planned behaviour disadvantages
no temporal element, direction or causality doesn't consider emotions assumes attitudes can be measured relies on self-reported behaviour
76
transtheoretical model advantages
acknowledges individual stages of readiness accounts for relapse temporal element
77
transtheoretical model disadvantages
some individuals skip stages or move backwards change may be continuous or not discrete doesn't consider values e.g. cultural + social factors
78
health belief model - what determines likelihood of action?
perceived susceptibility perceived severity health motivation perceived benefits perceived barriers
79
health belief model advantages
can be applied to wide variety of health behaviours cues to action unique component longest standing model
80
health belief model disadvantages
other factors may influence outcome doesn't consider emotions doesn't differentiate between 1st time + repeated behaviours cues to action often missing in HBM research
81
nudge theory
changing environment to make preferred option easiest - weak evidence to support this
82
motivational interviewing
counselling approach for initiating behaviour change by resolving ambivalence

3a (4 decks)

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