Public Health

Question 1

What is population health?

Answer 1

Health of defined group of people

Question 2

What is public health?

Answer 2

Organised activity of society to promote, protect, improve + restore health of individuals, groups or population

Question 3

What is epidemiology?

Answer 3

Study of distribution of determinants of disease, health related states + events

Question 4

6 core functions of public health

Answer 4

1) Health protection
2) health surveillance
3) disease + injury prevention
4) population health assessment
5) health promotion
6) emergency preparedness + response

Question 5

What is health equity vs equality?

Answer 5

Equity = when all people have opportunity to attain full health potential 
Equality = populations have equal health status

Question 6

What is a handicap vs disability?

Answer 6

Handicap = disadvantage arising from impairment or disability 
Disability = any restriction or lack of ability to perform an activity

Question 7

What is the Ottawa charter for health promotion?

Answer 7

Charter states that government should be involved in health promotion:

1) building healthy public policy
2) creating supportive environments
3) strengthening community action
4) developing personal skills
5) re-orienting health services

Question 8

What are vulnerable populations + why?

Answer 8

Indigenous = low SES, violence, unemployment, homelessness
Black population = low SES
Isolated seniors = isolation, institutionalisation, inactivity, polypharmacy
Children in poverty
People with disabilities
New immigrants = exposure to disease
Homeless people = low income, mental illness, substance abuse
Refugee = PTSD, disease from country of origin

Question 9

Traditional indigenous approaches to healing

Answer 9

Balance in 4 realms of spiritual, emotional, mental + physical health
Ideas represented by medicine wheel (First Nations), Learning Blanket (Inuits) + Metis Tree (holistic lifelong learning)

Question 10

What is passive prevention?

Answer 10

Measures that operate without the persons’ active involvement (i.e. airbags)

Question 11

What is primary, secondary + tertiary disease prevention?

Answer 11

1’ = protect disease onset, reduce exposure to RF 
2’ = early detection of disease 
3’ = Tx + rehab to prevent progression

Question 12

Types of screening

Answer 12

Universal = all members of population
Selective = screening targeted sub-groups
Multiphasic screening = use of many measurements to look for multiple diseases

Question 13

Types of bias in screening

Answer 13

Lead time bias = overestimation of time between detection via screening vs clinical detection
Length time bias = overestimation of survival time due to screening including more stable cases

Question 14

What is the difference between disease prevention + health promotion?

Answer 14

Disease prevention: health is absence of disease, aimed at specific pathology, medical model
Health promotion = participatory model of health, aimed at population

Question 15

What is incidence vs prevalence?

Answer 15

Incidence = number of new cases/ people at risk (measures the rate of new infection)
Prevalence = number of existing cases/ people at risk (measure frequency of disease)

Question 16

What is the health belief model?

Answer 16

Psych model to explain + predict behaviours
Someone will adopt beneficial health behaviour if 3 beliefs are present:
Negative health outcome is avoidable
Expects health outcome can be prevented if recommended health behaviour is adopted
Individual can be successful in adopting behaviour

Question 17

Top 5 causes of mortality in Canada for women

Answer 17

Cancer
Heart disease
Stroke 
Chronic lower respotary disease 
Accidents

Question 18

Top 5 causes of mortality in Canada for men

Answer 18

Cancer
Heart disease
Accidents
Chronic lower respotary disease 
Stroke

Question 19

What is PYLL?

Answer 19

Potential years of life lost

Calculated using difference between actual age of death + expected age of death

Question 20

What is DALY?

Answer 20

Disability adjusted life year

Life expectancy weighted by amount of disability experienced

Question 21

What is Berkson’s bias?

Answer 21

Can occur in case control study using hospitalised controls as they may not be representative of population

Question 22

What is a confounder?

Answer 22

Variable related to exposure + outcome but is not a mediator

Question 23

What is pre vs post test probability?

Answer 23

Pre = probability that pt has given disease before test results are known 
Post = probability that pt has disease after hx/ exam

Question 24

What is number needed to test vs number needed to harm?

Answer 24

NNT = number needed to treat to achieve one additional favourable outcome 
NNH = number who, if received tx, would lead to 1 pt being harmed

Question 25

What are the types of observational study design?

Answer 25

Ecological Cross-sectional Case control Cohort

Question 26

What is per-protocol analysis?

Answer 26

Strategy of analysis in which only pts who complete entire study are counted in

Question 27

What is intention to treat analysis?

Answer 27

Groups are analysed exactly as they existed upon randomisation

Question 28

What is a type 1 + 2 error?

Answer 28

Type 1 = null hypothesis is falsely rejected – stating there is an effect when there is not Type 2 = null hypothesis is falsely accepted – stating intervention is not effective when it is

Question 29

Difference between Pearson + Spearman correlation?

Answer 29

Pearson is for continuous + normal data | Spearman is for ordinal or non-normal data

Question 30

What is the criteria causation (Sir Bradford Hill)?

Answer 30

``` Strength of association Consistency Specificity Temporal relationship Biological gradient Biological plausibility Coherence ```

Question 31

What is quality improvement?

Answer 31

Means of evaluating + improving processes

Question 32

What is quality assurance?

Answer 32

Process to guarantee quality of healthcare through improvement 5 stage process: 1) formulation of working goals 2) procedural changes to implement those goals 3) regular comparison of current performance + original goals 4) development of solutions to bring performance closer to goals 5) documentation of quality assurance acitivities

Question 33

What is the precede-proceed model?

Answer 33

Tool for designing, implementing + evaluating health interventions Precede = identify issues Proceed = implement

Question 34

What is cost-benefit vs cost-effectiveness analysis?

Answer 34

``` CBA = compared total expected cost with total expected benefit CEA = ratio of change in cost to change in effect in response to new strategy ```

Question 35

What is an outbreak, endemic, epidemic, pandemic?

Answer 35

``` Outbreak = increase in usual frequency of disease Endemic = consistent existence of infectious agent in population Epidemic = increase in cases of disease above what is usually expected Pandemic = epidemic that has spread internationally ```

Question 36

What is active vs passive surveillance?

Answer 36

``` Active = outreach such as visits or calls by public health to detect unreported cases Passive = public health depends on others to report cases ```