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Flashcards in Year 2 I&P Deck (35)
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First step on ladder of intervention

Do nothing, monitor the situation


Give an example of 'providing information', the second step on the intervention ladder

5 a day campaign


Give examples of:
3) Enable choice
4) Guide choice through changing default
5) Guide choice through incentive
6) Guide choice through decentives

3) free fruit in schools
4) salad becomes default side with meals, have to ask for chips
5) tax-free bike to work scheme
6) higher tax on cigarettes


What are stages 7 and 8 on the intervention ladder?

7) Restrict choice e.g. remove unhealthy food items from shops
8) Eliminate choice e.g. isolate those with infectious disease


What did the Marmot review find out about health inequalities?

Not inevitable, result from social inequalities.


What is proportionate universalism?

Cannot focus solely on most disadvantaged


According to the Marmot review, who should tackle health inequalities?

Government, not NHS


What is a necessary cause?

Presence is required for an event to occur. Presence doesn't always lead to event, but event cannot occur without it.


What is a sufficient cause?

Presence always leads to an effect. Presence alone is enough, but is not the only cause of the effect.


What are the 4 determinants of population health, ranked from most to least important?

1. Societal characteristics
2. Health behaviours
3. Medical care
4. Genes and biology


What are the 5 steps on Maslow's hierarchy of need?

Love and belonging


What is a normative need?

Need identified according to a norm


What is a comparative need?

Need stemming from a comparison to others who are not in need


Cross-sectional study

Counts number of people with disease at 1 time
Pros: quick, good for prevalence
Cons: only measures 1 time, can't measure incidence, sampling frame may lead to bias


Ecological studies

Compare one group to another.
Pros: cheap, less bias, easy.
Cons: 'ecological fallacy' - assume population measures are true for individuals, assume average risk / incidence applies to all


Case-control studies

Retrospective comparison for exposure as a potential cause. Diagnosed cases in exposed group compared to control.
Pros: Quick, good for rare disease
Cons: Selection / participation bias, difficult to find control


Cohort study

Set population at risk of but free from disease and follow them through time.
Pros: Can measure many outcomes, low bias
Cons: expensive, time consuming


Randomised controlled trial

Split population randomly into treatment and control groups and compare rates of outcome.
Pros: strongest evidence, no bias
Cons: Expensive, can be unethical


Primary prevention

Preventing disease onset by removing cause


Secondary prevention

Halt disease progression e.g. using screening programmes


Teritary prevention

Treat disease to limit disability and complication


What does Rose's single population theory state?

Instead of only treating "high risk" groups, should shift mean to left and focus more on whole population.


What is the Ottawa Charter?

International agreement organised by WHO aiming to achieve the goal of "health for all" by 2000 by improving health promotion


What are the 5 actions set out by the Ottawa Charter?

1. Develop personal skills
2. Strengthen community
3. Create a supportive environment
4. Build healthy public policy
5. Re-orientate health services towards prevention of illness and promotion of health


What are the 5 approaches to health promotion?

1. Medical: 3 levels of prevention
2. Behaviour change: focuses on individual attitudes
3. Educational: enables choice and avoids persuasion
4. Empowerment: gives people confidence and skills to address their concerns
5. Social: healthier choices normal in physical and social environment


What is the social norms approach?

Addresses misperceptions of the norm by aiming to understand what the perceived norm is and challenge unhealthy aspects.



Set of linked activities required to assess population needs and how to assess them


What are the 3 steps of the commissioning cycle?

Planning --> procurement --> monitoring


What is the King's fund and what are their aims?

Charity working to improve health and care in England.
Integrated care methods
Promote health understanding
Invest in support
Link healthcare and government
Employ patients
Focus on multiple health behaviour
Population based commissioning
Care plans for elderly


What is polypharmacy?

Cost-effective prescribing and reduction of medication errors