Week 3 Flashcards
(35 cards)
surveillance defintion
the ongoing systematic collection, collation and analysis of data and the prompt dissemination of the resulting information to those who need to know so that action can result
surveillance cycle
Public health event -> collection -> collation -> analysis and interpretation -> dissemination -> application -> back to public health event
Why do surveillance?
- early warning of changes of incidence
- early detection of outbreaks
- evaluation of effectiveness of interventions
- notification of adverse outcomes
- identification of at-risk groups
- assistance in planning resource allocation
- estimation of the magnitude of a health problem
- understanding of natural history
criteria for identifying high priorities for chronic disease surveillance
- national/international regulatory and prevention programs
- incidence
- severity
- socioeconomic burden
- preventability
- risk perception
- necessity of public health response
- appearing to increase in incidence or change patterns over the past 5 years
Practical considerations: 1 simple
- simplicity is important to consider when designing a surveillance system
- when designing a surveillance tool (questionnaire), it is tempting to ask for info that “might be useful one day”
- if we ask too many “nice to knows” we may not get the need to knows
- when designing a system, for every data point collection: will I ever analyse this? will the info lead to action?
Practical Considerations: 2 acceptable SLIDE NOT DONE LOOK AT VIDEO
Acceptability reflects the willingness of persons and organisations to participate and it greatly affects the quality of the surveillance system
How to determine if your surveillance method is acceptable:
practical considerations: 3 data collected are of high quality
- data quality reflects the completeness and validity of the data
- data whose quality cannot be assured may be worse than no data at all (garbage in = garbage out)
- good decisions cannot be made on bad data (examining the percentage of unknown or blank responses to items on surveillance forms is a straightforward and easy measure of data quality)
Chronic disease surveillance SLIDE NOT DONE
Mortality
Advantages:
Disadvantages:
Chronic disease surveillance - morbidity (hospital discharge data)
Advantages:
- appears closer in time to exposure
- good for monitoring hospital activities: patient load, services needed, length of stay, etc.
Disadvantages:
- case definition is not as certain as for mortality (diagnosis may not be correct, multiple diagnoses)
- number of discharges does not equal number of patients
- many conditions do not have effective preventive or treatment interventions
- many patients with a particular diagnosis are not admitted (less severely ill, better home support, availability of bed)
Chronic disease surveillance: other morbidity data
Registries (i.e. Cancer):
- requirement for reporting
- clear case definitions
- accurate diagnosis
- identified reporters and collectors
- (require lots of work to initiate)
Physician data:
- diagnoses are not standardized
- information is not available
Non-physician “use” data (ambulance, pharmacy, insurance):
- do not give specific or complete picture of chronic disease in the population
- can provide information re patterns of use for more rigorous follow-up
health surveys
Risk factors:
Behaviour
- smoking
- physical exercise
- nutrition
Preventive actions
- mammogram
- PAP tests
Physical measures
- weight
- blood pressure
Laboratory measures
- serum cholesterol
- blood glucose
Recent illness
Knowledge
Quality of life:
Physical functioning
Emotional well-being
How do you feel about your health?
Attitudes
Behavioural risk factor surveillance - strengths
Behavioural risk factor surveillance - weaknesses
- the risk factor may not be a good predictor of the disease (that is, it may not progress to morbidity or mortality. then changing the prevalence of the risk factor may not have a significant effect on the disease)
- sampling and surveying requires skill and additional cost (often info is lacking, need improved quality, standardisation, no ‘gold’ standards)
- self-report biases
- requires expertise to develop questions and sampling frame and to carry our survey and analyse information
- costly
Qualitative data SLIDE NOT DONE
Face to face interviews
Advantages:
- assurance of person answering
- completion rate
- clarification of information
- can do physical and laboratory measurements
Disadvantages:
- costly
- may prejudice questions
- burdensome for individual
Telephone surveys
Advantages:
- cheaper
- faster
- good completion rate
Disadvantages:
- less valid answers?
- smapling problems: no telephone, no telephone in directory, not in household
Mailed questionnaires
Advantages:
- cheap
Disadvantages:
- very low response rates
- uncertain who is answering the questions
- requires mail system
Online surveys
Advantages:
- cheapest
- easier data management
- accessed anywhere
Disadvantages:
- limited accessibility
characteristics of unnecessary/unfair health differences
- health-damaging behaviour where the degree of choice of lifestyles is severely restricted
- exposure to unhealthy, stressful living and working conditions
- inadequate access to essential health and other public services
Health inequity - gender
differences in material and social resources that unfairly affect the health of men and women
Health inequity - income
differences in income can be linked to other factors that influence health, such as access to food, shelter, employment and even health services
Health inequity - geography
the unfair distribution of resources between urban and rural locations can constitute unnecessary inequities
Health inequity - ethnicity
much like gender, ethnicity can describe inequitable differences in material and social resources that influence the health of particular groups
Health inequity - education
when people are denied opportunities for education that can increase their health awareness or facilitate their socio-economic mobility, health inequity increases
