REVISION DECK Flashcards
(73 cards)
1
Q
what are the disciplinary approaches to health
A
Behavioural: focuses on personal and individual actions. (e.g being physically active, using sunscreen)
Social: focuses on personal and individual actions. For example: don’t be poor, being born into a nice family
Biomedical: biology and medicine
Biological: what we are born with
2
Q
PH in society
A
Public health strives for a fairer, more just, healthier, kinder world
- Subjective, PH means different things to different people
- PH covers a wide scope meaning its meanings and values are diverse
3
Q
Primary secondary and Tertiary prevention
A
Primary: implementing programs and services to prevent disease from occurring
Secondary: early effective treatment to stop progress and shorten duration of disease
Tertiary: stabilising the disease process; preventing after effects of long-term impairments/disabilities
4
Q
how has public health improved overtime
A
- The development of sanitary practises
- Quarantine: separating people who are sick from people who are not sick
- Eyam and the plague: was a quarantined town separated from the plague. They didn’t let anyone in or out in an attempt to reduce disease.
- Cholera quarantine: people who came from a town with cholera were quarantined, ships weren’t allowed to dock. Sick people were separated in buildings and ships. Cholera pandemics consecutively occur, the disease is still around today as is quarantine
- Leprosy: there was leper colonies, an attempt to quarantine: a slowly progressing bacterial infection, affects the skin, nose, eyes as the nerve endings in the body are destroyed. People who had the disease were shunned, it was a dreaded disease. People are still living in these colonies
5
Q
theories of disease causation
A
Miasma Theory: inhaling bad smells from filth. An obsolete theory; on the right track to how diseases are caused - bad airs and poisonous vapors cause diseases.
Supernatural theory: gods wrath
Germ or contagion theory: waterborne or airborne pathogens
6
Q
Edward jenner
A
(1749-1823)
Developed the worlds first vaccine/discovered vaccinations
7
Q
Charles winslow
A
1877-1957
- had a broader and more realistic expectation of public health and disease. His definition involves:
- Preventing disease
- Prolonging life ‘promoting health and wellbeing
- Sanitization of the environment
- Education
- Standard of living adequate
- Emphasized education, sanitation and socially aware approaches
8
Q
edwin chadwick
A
(1800-1895)
Believed getting rid of smells and filth would keep you healthy.
He investigated sanitation to show the link between living conditions and disease and life expectancy
9
Q
john snow
A
(1854)
Showed a direct relationship between disease and germs
- Investigated cholera
- Removed handle on broad street to diminish cholera cases
10
Q
Rudolph Virchow
A
Virchow (1821-1902)
Father of modern pathology. Demonstrated that disease isn’t purely biological but is influenced by social factors
- the founder of social medicine
11
Q
fredrick Engels
A
(1820-1895)
Researched and wrote about working and living conditions between health
12
Q
Robert Koch
A
(1843-1910)
Founder of bacteriology. Discovered and developed new research methods to isolate bacteria
13
Q
Kochs postulates
A
Kochs postulates: all four have to be met to prove something is caused by a specific organism
- The microorganism must be found in abundance in all organisms suffering from disease but should not be found in healthy organisms
- The micro organism must be isolated from a diseased organism and grown in pure culture
- The cultured microorganism should cause disease the introduced into the healthy organism
- The microorganism must be re-isolated from the inoculated, diseased experimental host ad be identified as being identical to the original causative agent.
14
Q
the old public health
A
Living conditions sanitation water disposal quarantine access to clean food and water
15
Q
the new public health
A
Moving from a Moving from a behaviorists point of view to a social point of view
- Social and political approach to health
- Action on social determinants
- Intersectional action
- Healthy public policy
- Environments for health
- Sustainable development
- Equity in health
- Housing, income, employment are key determinants of health and wellbeing. Outside the health system but are still linked to health.
16
Q
The NHPA’s
what are they
A
Established in responce to who for all 2000 Include: Injury prevention and control (1996) Mental health (1996) Cancer control (1996) Cardiovascular health (1996) Diabetes mellitus (1997) Asthma and respiratory conditions (1999, 2016) Arthritis & musculoskeletal conditions (2002) Obesity (2008) Dementia (2012) Eye health (2016)
17
Q
Injury prevention and control
A
- A major source of health care costs
- 500 000 people were injured severely enough to warrant hospital admission in 2013-2014.
- Leading cause of mortality, morbidity and permanent disability in Australia
18
Q
mental health
A
- Stigmatisation
- 45% of Australian’s between 16-85 will experience a mental disorder at some time
- high direct and indirect costs
- leading cause of non fatal BOD and injury
19
Q
cancer control
A
- These eight cancers accounted for 53% of all cancer deaths in 2005.
- All cancers – 19% of BoD
- Direct cost $2.8 billion 00/01
20
Q
cardiovascular disease
A
- The largest cause premature death in Australia in 2012 (30% of all deaths)
- 1 in 5 Australian adults reported cardiovascular disease in 2011-2012
21
Q
diabetes
A
- Contributes significantly to ill health, disability, poor QoL and premature deaths
- Accounted for 10% of deaths in 2012
- 5.4% of adults had diabetes in 2011-12
22
Q
asthma
A
- Affects people of all ages – particularly young children
- Poorer ratings of health
- High levels of psychological distress
23
Q
arthritis and musculoskeletal conditions
A
- More than 100 forms
- Highly prevalent
- Large contributors to pain, illness & disability
- 2001 6+million
- Direct costs - $4.7bill 00/01
24
Q
obesity
A
- One in four Australian adults are obese
- Obesity causes a range of health problems
- Costs taxpayers $1.5 billion in direct health care costs each year
25
dementia
- An umbrella term which covers more than 100 different brain disorders
- One in ten Australians ages 65 and older had dementia in 2015
- 3 in 10 Australians ages 85 and older has dementia in 2015
- 342,800 Australians had dementia in 2015. It is estimates that there will be approximately 900,000 by 2050
- Costly indirectly and directly
26
aims of the NHPA's
1. To reduce burden of disease (75% of BoD in Australia is due to the NHPA)
2. Target areas that impose high social and financial costs
3. Collaborative action to achieve significant and cost-effective advances
27
themes of the NHPA's
- Chronic diseases of lifestyle
- Develop & progress continuously
- Do not resolve spontaneously
- Rarely ‘cured’
- Require ongoing management
28
define epidemiology
Definition: ‘The study of the distribution and determinants of health - related states or events in specified populations and the application of this study to the control of health problems’
In short
- Looks at health at a population level
- Describes patterns of disease in terms of who gets what, where and when
29
The three main goals of epidemiology
- Describe disease patterns in human population
- Identify causes of diseases (aetiology)
- Provide data for the management, evaluation and planning of services for the prevention, control and treatment of disease
30
The biological determinants
age
sex
genetics
31
what are the behavioural determinants (main ones)
tabaco/smoking
alcohol consumption
physical activity
healthy eating
32
smoking
The most preventable cause of disease, disability and death in Australia
Global:
- reduction in smoking prevalence
- peak of smoking age is middle aged
Australia:
- increase in never smokers
- decrease in ex smokers
- occasional and daily smokers stayed the same
Victoria:
- smoking rates declining due to interventions eg tax
33
alcohol consumption
- Harmful use of alcohol kills 3 million people worldwide each year (1 out of 20 deaths)
- More than 75% of these are among men
- Alcohol linked to 5% of global disease burden
linked to chronic disease, accidents, mental health issues, traffic injuries, and things such as epilepsy
34
physical activity
Active VS Inactive
· 30% ↓ risk mortality
· 33% ↓ risk CVD
· 40% ↓ risk type 2 diabetes
35
healthy eating
food is related to energy imbalances
| - food is hard to moderate and measure
36
strengths and limitations of an individual health behaviour focus
if we focus on an individual approach we may not be addressing the issues of the whole population
37
distal determinants
Include the national, institutional, political, legal, and cultural factors that indirectly influence health by acting on the more proximal factors. Distal factors are the most difficult to change yet have the most profound influence on population health.
38
intermediate determinants
can be thought of as the origin of those proximal determinants, and include community infrastructure, cultural continuity and health care systems.
39
proximal determinants
include the conditions that have direct impact on physical, emotional, mental or spiritual health and include employment, income and education
40
inequality
refers to the uneven distribution of health or health resources as a result of genetic or other factors of the lack of resources
41
inequity
refers to unfair, avoidable differences that arise from poor governance, corruption, cultural exclusion etc
42
marginalisation
- to be distanced from power
- individuals, groups, populations who are outside of mainstream society
definition:
"a process by which a group or individual is denied access to important positions and symbols of economic, religious, or political power within any society…a marginal group may actually constitute a numerical majority…and should perhaps be distinguished from a minority group, which may be small in numbers, but has access to political or economic power”. (Marshall, 1998)
43
intersectionality
definition: “Intersectionality is a theoretical framework for understanding how multiple social identities…intersect at the micro level of individual experience to reflect interlocking systems of privilege and oppression at the macro social structural level” (Bowleg, 2012)
44
social exclusion
RESTRICTION OF OPPORTUNITY:
· Multidimensional – extends beyond material poverty (extends beyond whether you have family, friends, money etc or not)
· A process – dynamic and changing
· Context specific – influenced by societal norms and culture
· Individual and collective
· Relational
45
social inclusion
```
OPPORTUNITY TO: …you are able to:
· Participate in society
· Connect with people
· Deal with crises
· Be heard
```
46
marginalised populations and social determinants
- low SES
- non heterosexual
- women
- person of colour
```
Low SES
• Access to education
• Housing
• Unemployment
Non-heterosexual
• Homophobia
• Social support
• Stress
Woman
• Work
• Income
• Safety? (Violence)
Person of colour
• Racism
• Access to culturally appropriate healthcare
• Social exclusion
```
47
primary care
‘Front line’ health services in communities
Focussed on:
- Diagnosis
- Treatment
- Rehabilitation
Examples: Nurses, doctors, paramedics, allied health professionals, optometrist, pharmacist, radiographers/radiologists, Ayurvedic…culturally based
48
primary health care principles
```
equity
acceptability
cultural competence
affordability
universalism
community and health development
```
49
primary health care
focuses more on the determinants of health
50
Declaration of Alma ata
- 1978 Primary Health Care
A conference convened by WHO & UNICEF
First international declaration
that stated what primary health care is and what it involves
- displayed health as a fundamental human right
- focused on health inequalities
- showed that governments needed to start taking responsibility for their countries health
51
comprehensive health care
All encompassing
- Multidisciplinary
- links with civil society
- about positive wellbeing
- involved the community and the individual
- empowerment
52
selective health care
A more narrow and targeted approach
- links professional bodies with other services
- about the absence of disease (particularly aims to tackles the main diseases in poorer countries
- medical interventions
- doctors etc
53
community based preventions
does not focus on changing individual characteristics but on population health
- all members of the population must have access to this type of intervention
- designed to affect the environmental and social conditions that clinical services cannot.
54
the five principles that underpin health promotion
1. involves the population as a whole in the context of there everyday lives
2. directed towards the action or determinates of health
3. combines diverse but complementary methods and approaches
4. aims at effective public participation and encouraging people to take control of there own health
5. ensuring health professionals are involved. they have a role in nurturing and enabling health promotion
55
the ottawa charter action areas
```
build healthy public policy
create supportive environments
strengthen community action
develop personal skills
reorientate health services
```
56
build healthy public policy
the changes in our environment to make the healthy choice the easy choice
- tax
- legislation
- working conditions
57
create supportive environments
reciprocal maintenance of the environment, each other the the community
- smoke free environments
- urban planning
- support groups
58
strengthen community action
using the various communities within Australia to help make decisons, plan and implement health promotion
- lobbying
- activism
- advocacy
59
develop personal skills
providing information, education for health and enhancing life skills
- health information
- social marketing
- education and empowerment
- translation of materials
60
reorientate health services q
the responsibility for health promotion is shared among individuals, community groups, health services and governments
- changes in professional education
- referral to programs
- provision of health information even within health services
61
the bangkok charter
- advocate for health
- invest in sustainable policies, actions, infrastructure
- build capacity
- regulate, legislate
- partner and build alliances
62
what is a policy
Policy is a long term, continuously used, standing decision by which more specific proposals are judged for acceptability
May be presented as:
- a statement of intentions, objectives and goals
- rules to guide action or inaction
culminating in an issue/situation being defined/redefined or changed
63
how are policies developed
```
agenda building
formulation
adoption
implementation
evaluation
termination
```
64
policies for health
OUTSIDE OF THE HEALTH SECTOR... THESE ARE HEALTHY PUBLIC POLICY
• Value health as a social goal for all people
• Drive health promotion
• Sometimes called healthy public policy
• Integral to creation of supportive environments/conditions for health
• Are necessary for health equity
65
policies about health
dominate the health sector:
| • Financing of hospitals, treatments, technologies, pathology and diagnostics, equipment, services
66
policies for and about health include
- funding of health services and programs
- entitlements and access to services
- methods of delivering services and programs
- health promotion priorities
laws and regulations to control health risks
67
benefits of public health policy
- broad
- powerful
- opperates routinely
- influences our behaviour
- creates an environment in which we make health and life decisions
- addresses a crisis, need or want to do something
68
limitations of public health policy
- don't want to be a nanny state
- vested interests
- funding
- post truth
69
some historical moments in human rights
- universal declaration of human rights (1948)
- international covent of economic, social and cultural rights (1966)
- international covent on civil and political rights (1966)
70
the UDHR
- human rights and dignity are essential for individual and collective wellbeing
Human being shall enjoy
- freedom of speech and belief
- freedom from fear and want
- dignity and worth
- equal rights of men and women
71
rights bases approach
focuses on
- human dignity
- protecting vulnerable groups
- accessibility to services
- anti discriminatory practises
- empowering people in decision making
72
needs bases approach
focuses on
- health status indicators and lifestyle facilitators
- age and sex
- chronic disease status
73
Advocacy responsible in human rights example
· Australian World Action on Salt and Health (AWASH) used a targeted advocacy strategy to influence government policies to reduce salt intake
· Activities
– Media releases
– High-profile events
– Meetings with government officials
– Briefing government committees
– Regular communication with stakeholders
· Outcomes
– Influenced four government policy initiatives
– Government taskforce liaised with industry partners
– NHMRC research grant awarded – Food Authority considered new food labelling and consumer education
