Topic 1 – Public health and elements of epidemiology – Flashcards
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Define public health
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the efforts organised by society to protect, promote and restore the people's health. It is the combination of sciences, skills and beliefs that is directed to the maintenance and improvement of the health of all the people through collective or social actions" (Last, 2001).
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Describe public health
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- A multidisciplinary set of activities which look to protecting and promoting health in communities as well as the delivery of services to the communities - Based on scientific principles, using epidemiology, bio statistics, biology and biomedical sciences in it's analysis of health problems
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What is the aim of public health?
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To prevent disease, illness and injury, together with promoting the quality of life for human populations.
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How and why does health mean different things to different people?
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Personal definitions of health can be influenced by culture, social, spiritual and psychological aspects
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Why do you need to consider the different ways that health is defined?
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To understand the nature and scope of public health in our society
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Define health
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Health is a state of complete physical, mental and social well-being and not merely the absence of disease.
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What are the 5 core functions of public health?
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Health monitoring and surveillance, disease prevention and control, health protection, health promotion, healthy policy, planning and management.
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What are the common themes that go to the heart of public health practice
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collaborative action across sectors, multidisciplinary approaches, establishing partnerships, reducing inequality, and enhancing political support for public health policy.
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Describe the relationship between public health and other disciplines
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Health professionals work with many other professionals outside and inside the health sector from a multisector perspective - that public health needs to work with government education, housing and transport departments to ensure that these services are available to the population in an equitable manner.
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The nature and scope of public health
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is influenced by the organisation that employs you, the nature of the position, the organisational philosphy, the governance structure of the organisation, whether it is for profit or not-for-profit, state-based or non-government, all impact on the nature and scope of the public health work.
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Who is the public work force?
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Anyone from a health discipline who is involved in some form of public health activity
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List and describe the varying workforce roles and functions of the public health workforce
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- understand the context for public health - Clarity around political impacts on health - Ability to apply a range of methodological approaches to understand data - Understand a range of skills around surveillance, prevention, promotion and restoration of the population's health - Development and analysing policy - Planning, implementation and evaluation - Evidence based practice - Advocacy, communication and negotiation skills - Working intersectorally and with multidisciplinary groups - Ethical practice
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The role of the public health practitioner is said to include which of the following three important elements per van der Maesen and Nijhuis (2000)?
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- improve social conditions that stimulate health - prevent social conditions that threaten health - neutralise existing social conditions that cause ill health
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List and briefly describe the issues that will be facing public health in the twenty-first century.
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the emergence of 'new' infectious diseases, the ongoing presence of HIV/AIDS and the impact that overweight and obesity have on a range of health issues. Also global climate change and ecological sustainability.
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Primary prevention
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focuses on maintaining health programs, seat belt in motor vehicles, anti-smoking campaigns and physical activity and nutrition programs
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Secondary prevention
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aims to minimise the extent of a health problem by focusing on early intervention, such as prostate, bowel and breast cancer screening.
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Tertiary prevention
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Intervention to reduce symptoms, disability and prevent premature death
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What factors impact on health and public health?
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globalisation, emergence of new virulent infectious diseases, an increase in chronic disease such as diabetes, the ageing population and the ever-increasing cost and the expanding technological sophistication of health care.
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Equity
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is central to public health activity. Addressing health issues across population subgroups is essential to work towards equity.
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Who is sometimes described as the father of public health in the United States?
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Winslow (1920)
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How did Winslow (1920) define public health?
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Both a science and an art
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Lawson and Bauman (2001) describe the traditional values of public health as doing what?
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Using scientific evidence as a basis for action; focussing on the health of all sections of the population; and emphasising a collective action dimension
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Biomedical model
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Model of health which focuses on the diagnosis of disease while virtually discounting the roles of social factors and disease prevention.
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What determines morbidity and mortality?
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- The social and spacial organisation of a population - The individuals genetic endowment and exposure to a range of risk factors - The physical environment, including patterns of relationships
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Who supported the environmental theory of disease and pushed for sanitary reform in nineteenth-century Britain?
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Edwin Chadwick
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During the Industrial Revolution of the nineteenth century, the greatest triumphs of public health occurred in relation to what?
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The physical environment and occupational hazards (e.g., water, sewage, food, working conditions, housing)
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What is Old public health
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This model of public health is based on the discipline of epidemiology as well as the biomedical and behavioural sciences; it analyses causes of disease in terms of factors found in the individual as well as in the social and physical environments.
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What are the important influences on the development of public health in Australia?
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- The government's promotion of national efficiency and national development - The bureaucratic ascendancy of Australian society Incorrect - The existence of a well-organised and politically sophisticated medical profession
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**Define new public health **
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Strong focus on prevention, health promotion and using public health policy
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List 4 National Health Priorities in Australia
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Asthma, cancer, diabetes and injury
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What is an example of redistributive policy?
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Medicare is an example of redistributive policy.
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What is the aim of the National Health and Hospitals Network, as part of the federal government's agenda?
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Alter the funding arrangements of public hospitals so that the commonwealth government became the majority (60%) funder of public hospitals
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The success of Australia's National HIV/AIDS Strategy and subsequent policy development was attributed to what unique approach?
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The inclusion of those most affected by the virus in the development of the strategy
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What is epidemiology?
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The study of diseases, their distribution in populations and geographically and what factors influence these distributions.
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What factors influence disease distribution?
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Factors which relate to the physical and social environments and genetic inheritance - the nature-nurture argument.
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What are social environments?
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The social environment of the nuturing is known as "social determinants of disease".
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What are the objectives of epidemiology?
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Describing the disease patterns, analysing how and where they occur and who suffers from them, and interpretation of health status of populations.
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Who is known as the father of epidemiology and why?
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John Snow - He investigated an outbreak of cholera in London and plotted the cases on a map and found the source of the outbreak to be a water pump in Broad Street. The outbreak is said to have been stopped when he removed the handle of the pump
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What did Hippocrates do in 500-400BC?
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Hippocrates connected the environment and disease and mentioned the concept of disease causation
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In 1747, James Lind....?
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conducted the first known clinical trial on the sailing vessel Salisbury and discovered that scurvy could be cured by eating two oranges and one lemon everyday for 6 days.
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Who found an association between cancer and chimney sweep?
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Percival Potts
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How does epidemiology differ from clinical practice?
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...
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How does epidemiology benefit clinicians?
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Epidemiology enables clinicians to measure the occurrence of disease and death to make correlations and have a better understanding of "the iceberg of disease".
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What is meant by "the iceberg of disease"?
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With any disease, only the tip of the iceberg which is those with the clinical manifestation of the disease are seen, while often many more sub-clinical, un-identified disease sufferers are hidden below the surface of the disease.
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What the key indicators measuring disease's incidence?
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Prevalence, incidence, cumulative incidence and mortality rate etcetera.
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What are the two types of epidemiological studies?
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Observational or experimental
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What are examples of observational studies?
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- cross-sectional studies - case control studies - cohort studies
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What are examples of experimental studies?
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- randomised controlled trials - community/field trials
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For what reasons do we monitor health and disease?
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- To determine priorities for public health programs (e.g., burden of disease) - To understand change over time in causes of death and disease (e.g., pandemic influenza, motor vehicle accidents, suicide) - To measure the positive or negative effects of community health programs and services (e.g., community health promotion, expansion of paramedic services) - To improve the quality of the science underlying clinical medicine, nutrition, emergency health care, nursing, and allied health care
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What are the definitions, respectively, of the following three terms: mortality, morbidity, and disability?
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Death; sickness or disease; and a significant loss of function that impairs daily life
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What does cumulative incidence refer to?
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The entire population that was determined to be at risk at the beginning of a study period has been followed for the entirety of the specified time period
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What is confounding?
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The technical term used by epidemiologists to describe the situation that occurs when a third factor influences the relationship between an exposure and a disease.
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Define incidence
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The number of new cases of disease, injury or death in a population during a specified time period.
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Why are genetic determinants important factors that affect individual health?
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Nearly every disease has constitutive or acquired genetic components.
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Turrell′s model of upstream, midstream, and downstream, which is presented in the figure, is a mechanism for?
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Determining the range of factors that may contribute to ill health
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What are upstream factors?
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Upstream factors involve government policies and investment in population health research.
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What are the implications of the integration of genetics into public health?
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- Treatment for affected high-risk individuals - Prevention for at-risk individuals - Health-promotion activities among the general population - Crop modification, pharmaceuticals, and the cloning of animals
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The National Mental Health Strategy (NMHS) is a commitment by the Australian federal, state, and territory governments to improve the lives of people with mental illnesses. What aims are part of this strategy?
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- Promoting the mental health of the Australian community - Where possible, preventing the development of mental disorders - Reducing the impact of mental disorders on individuals, families, and the community
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What is social capital?
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People's trust and sense of belonging to networks and communities, which can strengthen social cohesion within communities.
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What are the implications of social and economic disadvantages on the emotional health of children?
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- Children from low-income families are more likely to manifest cognitive development problems (Najman et al, 2004). - Socioeconomic disadvantages during the early years have the potential to have deleterious effects on adult health. - There should be an emphasis on public health and health-promotion programs during the early years of life.
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There is evidence to suggest that people's health is produced and sustained by.....
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social and economic circumstances that they experience differentially throughout their life.
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What are contextual effects?
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The effects of geographical location or place that are significantly connected to health and well-being.
