Public Health and helath promotion Flashcards
(47 cards)
Define health
“A resource for everyday life, not the objective of living. Health is a positive concept emphasising social and personal resources, as well as physical capacities”.
What are the aims of public health
The science and art of preventing disease, prolonging life and promoting health through organised efforts of society
What are the 3 domains of public health
health improvement (including people’s lifestyles as well as inequalities in health and the wider social influences of health), health protection (including infectious diseases, environmental hazards and emergency preparedness) and health services (including service planning, efficiency, audit and evaluation)
List some indicators of health
Life expectancy at birth Systolic BP Serum Cholesterol Smoking Obesity Drinking patterns Gender, sexual behaviour and STI
What is life expectancy at birth a measure of
Life expectancy at birth indicates the number of years a newborn infant would live if prevailing patterns of mortality at the time of its birth were to stay the same throughout its life.
Life expectancy at birth is also a measure of overall quality of life in a country and summarizes the mortality at all ages. It can also be thought of as indicating the potential return on investment in human capital and is necessary for the calculation of various actuarial measures.
What happens during an epidemiological transition
Indemographyandmedical geography,epidemiological transitionis a phase of development witnessed by a sudden and stark increase in population growth rates brought about by medical innovation in disease or sickness therapy and treatment, followed by a re-leveling of population growth from subsequent declines infertility rates.
What does health and illness follow
The poorest of the poor have high levels of illness and premature mortality. But poor health is not confined to those worst off. In countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health.
Describe the changes in the life expectancy at birth in England and wales
Newborn life expectancy has steadily increased in England and Wales since 1991-93. Life expectancy is higher in England then in Wales, while the gap between both countries has widened over the last 2 decades.
The gap between male and female life expectancy at birth has also narrowed in both countries.
What is meant by period life expectancy
Period life expectancy at a given age for an area is the average number of years a person would live, if he or she experienced the particular area’s age-specific mortality rates for that time period throughout his or her life.
Describe the indices of deprivation
Indices of deprivation combine indicators like education, income, employment, housing, access to services to assign a composite score to an area, which are then ranked in quartiles, deciles or twentieths. Here the SE groups are broadly classified into 3 tiers. There is a clear gradient of illhealth in the 3 groups across both genders. This covers limiting longstanding illness that impairs your ability to work.
Describe the risk factors for ischaemic heart disease
Risk factors for IHD are – Age, sex, ethnicity, family history, and these are the risk factors that cannot be changed. But there are other risk factors that can be modified. The main modifiable risk factors for Ischaemic Heart Disease are: • Elevated blood pressure • Elevated blood cholesterol, High triglyceride with low HDL • Diabetes or Pre-diabetes History of Pre-eclampsia • Smoking • Obesity / Inactivity • Excessive alcohol • Excessive stress
Relate the curves for survivors and deaths from CHD in the distribution of systolic BP
The curves are not so different
It would require a lot of effort for the people from the high BP distribution to move to the other group with benefit only for a few.
But if we are talking millions making up these distributions (and we are) the lives/illness that we save/prevent are huge
To reduce the steepness of the social gradient in health, actions must be universal, but with a scale and intensity that is proportionate to the level of disadvantage. Prof Sir Marmot has called this “proportionate universalism”.
How can we prevent exposure and how has this changed in recent years
To shift the whole distribution of an exposure in a more favourable direction. To lower the mean level of risk factors, to control determinants of incidence. In traditional public health it has sought to change environmental factors on a large scale (the great sanitation movement in the 19th century). In its more modern form it is trying to change / alter society’s norms of behaviour on a large scale….
Describe the factors that can effect your likelihood to smoke
Economic Activity: proportion of smokers among
Unemployed = 29.6%
Employed= 15.5%
Economically inactive = 13.4%
Relationship status: proportion of smokers among Married / in a civil partnership = 9.9% Cohabiting = 22.1 Single = 21.5% Widowed, divorced or separated =17.7%
Education: proportion of smokers among
those with a degree = 7.6%
no qualifications = 29.1%
Ethnicity: current smokers ranged from 8.8% in Chinese respondents to 20.1% in the mixed ethnic group
What is child obesity prevalence closely associated with
Child obesity prevalence is closely associated with socioeconomic status. More deprived populations tend to have higher obesity prevalence.
Obesity prevalence in the most deprived 10% of areas in England is more than twice the prevalence in the least deprived 10%.
Describe the variation of alcohol consumption with age
Young people aged 16 to 24 - less likely to drink than other age group; but consumption on their heaviest drinking day is > than other ages.
Describe the relationship between alcohol consumption and income
A higher income is associated with an increased alcohol consumption.
Why are STI diagnoses preferable to self confessions of STIs as an indicator of sexual health
Sexually transmitted infection diagnoses are amongst the best indicator of sexual risk. They are usually better indicators than self-reported sexual behaviour, which is subject to ‘social desirability bias’, defective recall, and other confounders. Of the STIs, gonorrhoea is seen as the most reliable indicator of unprotected sex in the absence of HIV data, although because it is much more contagious, infections are not so closely correlated with anal intercourse and therefore not concentrated so much amongst gay men.
Describe the proximate causes of health inequalities
The lifestyle factors which influence health inequalities are sometimes referred to as the “proximate” causes of health inequalities, because they are the immediate precursors of disease. They include: smoking, alcohol consumption, nutrition, exercise, drug use, sexual behaviour, stress. This is opposed to the ‘distal’, ‘upstream’ or ‘wider determinants’, such as income, housing, employment, education, social networks, community safety, living and working conditions, which influence healthy behaviours. And are the “causes of the causes”.
Describe the aims of health promotion/improvement
Health Promotion is the process of enabling people to increase control over, and to improve their health
(Ottawa Charter for Health Promotion, 1986)
Action toward social, economic and environmental conditions
Strengthening skills and capabilities of individuals and communities
What is health promotion/improvement an approach for
Health promotion is the process of enabling people to increase control over their health and its determinants, and thereby improve their health. It is a core function of public health and contributes to the work of tackling communicable and non-communicable diseases and other threats to health.
An approach to (action for) health that takes account of :
A broad definition of health
The scope of prevention
Limitations of health services
Role of individuals, groups and governments
Focus is on health rather than disease
What is essential to sustain health promotion action
Participation (both social and political)
What does health promotion involve
Clinical interventions
Biomedical - screening / immunisation
Knowledge transfer and health literacy
Traditional type of health promotion (– e.g. smoking cessation, healthy eating, exercise promotion)
Healthy public policy
Legal, fiscal and social measures to make healthy choices easier
Sustainable policies, actions and infrastructure to address the wider determinants of health
Enabling equal opportunities for health & well-being
Community development
Radical - through groups setting their own agenda
Partnerships with public, private, non-governmental and international organizations and civil society to create sustainable actions
Describe the Tannahill model of health promotion
practical framework that advocated 3 principle health promotion principles; prevention, health education and health protection (legal and fiscal). ▪
