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17 Cards in this Set
- Front
- Back
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5 key data elements of DALY's * despite non fatal |
average duration incidence of cases |
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What epidemiological characteristics of a risk factor makes it important for action at a population level? |
To identify leading risk factors: Involves examining PAR Comparative risk assessment - comparing with risk factor and without risk factor Assuming association is causal, PAR is the amount of the disease burden that we could theoretically remove if we removed the risk factor |
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Key factors influencing risk burden |
strength of causal association
how common is exposure to this risk |
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Changes in burden caused by changes in risk factor distributions |
T ( don't need to memorize changes in risk factors?) |
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Demographic transition |
The decline in fertility and mortality rates observed in most deveoped and many developing countries population |
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Epidemiologic transition |
Characteristic shift in common causes of death and disability from perinatal and communicable infectious disease to non communicable Causes of death |
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Risk transition |
In many parts of the world,especially middle-income countries, previouslycommon risks for perinatal and communicable(infectious) diseases now co-exist with increasinglycommon risks for non-communicable (chronic)diseases. These countries face a “double burden”of risks and consequent diseases. |
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Myths of NCD/chronic diseases |
Affect mostly high income/rich countries Primarily affect old people Developing countries should control infectious diseases first Chronic diseases cant be prevented |
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Realities of NCD/chronic diseases |
80% in low and middle income countries concentrates among poor Almost half in under 70, still alot in older people Double burden requires double response Premature heart disease, stroke, cancer, diabetes CAN BE PREVENTED |
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Smoking was used as a proxy even for income |
T |
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Why have inequalities in tobacco use persisted or increased in NZ despite overall falls in smoking? "Tyranny of averages" |
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What role does commercial sector play in unequal NCD epidemics? |
1. Caused changes in social norms as smoking became popular among other social groups Smoking - glamorous in the past 2. Lead to a greater emphasis on downstream compared with upstream strategies. This has put equity in public health at risk. Downstream interventions focused on individual behaviours and interventions 3. industries actively exploited difficulties with behaviour change |
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How is the commercial sector a driver of NCD inequalities |
Market unhealthy commodities and promote unhealth consumption >>> NCD Marketing seeks vulnerable targets and exploits difficulties in behaviour chage Reinforces power inequalities, and changes environments |
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How should public health respond to commercial sector driving NCD inequalities |
Tackling broader determinants of health Developing effective health policy - requires us to recognize tension between health and commercial objectives |
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Tobacco control strategies |
• Increases in price / tax • Legislating smoke-free environments • Banning tobacco advertising &sponsorship (e.g., sports) • Health warnings on packs • Plain packaging • Anti-smoking media campaigns More downstream option: • Smoking cessation support |
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Density of outlets are randomly distributed |
F pokie machines, liquor stores fastfood |
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Industrial epidemics summary |
Diseases arising from overconsumption of unhealthy commercial products Industry acts as vector in driving consumption of its product (agent) by manipulating behaviour of individuals (host)
This situation requires us to shift focus fromindividual behaviours to broader environmentand upstream drivers of unhealthy productconsumption |
