Flashcards
Week 2
Cards in this deck (31)
- 1Definition of health according to WHOA state of complete physical, mental and social well-being
- 2Biological determinants of health?-age
-sex
-genetic - 3Lifestyle determinants of health?-tobacco
- (mal/over-) nutrition
-alcohol
-physical action
-risky behaviour - 4Environmental factors of health?-physico-chemical (air/water/radiation)
-biological (microbes)
-socioeconomic/sociopolitical (inequality, employment,education, political stability, over-abundance of food, public transport etc) - 5What has the health service contributed?-Decrease in mortality due to fall in infectious disease
-Had the smallest effect on improvement of health (social factors have played a larger role) - 6What is the role of the health service?-Prevents death (preventing disease occurrence is more important than treatment)
-Improving length and quality of survival in fatal/non-fatal conditions
-Preventing and treating genetic disorders
-Care for the elderly, mentally ill and mentally disabled - 7What are health beliefs?Ideas people believe about a health situation
- 8Why do we measure the health of the population?-find out prevalence/incidence
-identify longitudinal trends in disease
-identify differences in disease patterns between different population groups/locations
-service planning
-are interventions/policies having any effect - 9What are the different sources of measuring health status?-Census
-Death certification
-Health Survey for England (HSE)
-General Lifestyle Survey
-Hospital Episode Statistics (health service usage)
-General practice research database
-National/regional/local audits or surveys - 10What are the key methods of measuring health and disease?-birth/fertility rates
-incidence
-prevalence
-mortality rate - 11Define: birth rate general fertility rate total fertility rate-Number of live births per 1000 population
-Number of live births per 1000 women aged 15-44
-Average number of children that a woman would bear if they experienced the age-specific fertility rates at that point in time - 12Define prevalence Equation? Useful for?The proportion of people in a population of known size who have a particular disease at a specified point in time.
X% or X/100,000 population
Planning services - 13Define incidence Equation? Useful for?The number of new cases over a period of time in a population of known size.
X/100,000 population per year
Comparing how common diseases are - 14Equation for infant mortality rateNo. of deaths in children aged<1yr
------------------------------------------------ X 1000
All live births - 15Why do we measure infant mortality?-Highly correlated with expectation of life, and with overall economic status
-Amenable to change through public health measures - 16Equation for crude mortality rate?Total no. of deaths in 1 year
----------------------------------------------
Total mid-year population - 17Equation for disease specific death rateNo. of deaths from disease
------------------------------------------------- x 1000
Total mid-year population - 18What are the ads/disads from using mortality data as a measure of population health?+legal requirement in UK to register each death
+little delay in collection of data
+International classification of diseases ensure comparability
+cheap source of health data
-potential for error
-multi-morbidity
-some diseases have high mortality rate/death occurs quickly. Others are long-term, resource intensive but rarely cause death (like arthritis) - 19What is direct standardisation?Age-specific death rates from a study population are applied to a standard population structure
- 20How do you carry out direct standardisation?-Calculate age-specific rates for X
-Multiply rates by the number of people in each age-band in the UK to give expected number of cases, if the UK had the same mortality rates as X
-Sum the expected number of cases (all age bands)
-Result: age-standardised mortality rate for X - 21Ads/Disads of direct standardisation+Can be used to compare disease rates across areas/time
+Can be used to assess the relative burden of different diseases in a population
-Requires age-specific rates which are not always available at a local level
-Rates may not be stable for small number of events (<100) - 22What is indirect standardisation? Equation?Age-specific rates from a standard population are applied to s study population structure (standardised mortality ratio-SMR)
Observed deaths for X
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Expected deaths for X - 23How do you carry out indirect standardisation?-Calculate age-specific death rates for the UK
-Multiply these rates by the number of people in each age-band in X to give the expected number of cases if X had the same rates as the UK
-Sum the expected number of cases in X (all age bands)
-Divide the actual number of cases by the expected number of cases in X - 24Ads/Disads of indirect standardisation+Does not require local rates, only absolute number of events
+Easier to interpret rates
+Useful for countries with poor recording methods
-Areas cannot be directly compared (only compared back to the UK)
-Does not give an idea of the burden of disease - 25How do we use SMRs?-Compare SMRs for a disease with the national average
-Identify diseases that have higher than national rates
-Consider preventive measures
-Raise hypotheses about the cause of a disease - 26What are the 5 theories for why health is associated with socioeconomic deprivation?-Artefact
-Social selection
-Behavioural/cultural
-Psychosocial
-Material/structural conditions - 27Describe: artefact social selection-Observed associations are co-incidences, they exist because of the ways in which we measure health and deprivation
-Health determines socio-economic status rather than the other way round - 28Describe: behavioural/cultural psychosocial material-People in deprived areas are likely to smoke, eat poor diets etc
-Stress of working in poorly paid, low status jobs with little autonomy creates biological changes in the body which create patho-physical changes (ie. stress causes illness)
-direct effects of poverty (ie. damp house affecting health) - 29What is a differential diagnosis?Same disease with different symptoms
- 30What is iatrogenesisEffects on a person that are not beneficial, that result from healthcare eg. side effects
- 31How can health be considered a social construct?-Not everyone experiences symptoms in the same way
-Different societies have different methods of diagnosis and treatment
-Illness is not randomly distributed
*Therefore health and illness cannot be objective, scientific or have absolute facts
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- Determinants of health How can we measure the health of the population? Health as a social construct
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- Dolu Falowo
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