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87 Cards in this Set
- Front
- Back
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Definition of Health |
Health is a state of complete physical, mental and social well-beign and not merely the absence of disease or infirmity |
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Public Health Definition |
Science and art of preventing disease, prolonging life and promoting health through the organized efforts of society |
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Mission of Public health |
Fulfill society's interest in assuring conditions in which people can be healthy |
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Epidemeiology definition |
Study of distribution and determinants of health related to states or events in population and the application of this study to the prevention and control of health problems Epi: Befall, upon, on Demo: People Ology: study Study of health an disease in a pop |
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Health promo def |
Educate the public, having available resources for people. Giving tools to jeep healthy and keep community healthy |
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Health policy def |
Rules put in place to keep the community healthy - interest of the group |
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Health protection def |
Control over things to keep people healthy ei: water treatment, food quality, PPE |
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1867-1909 |
Gathering information on brith and death rates started - used for legislation Anti-vax movement due to lack of understanding |
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1910-1919 |
WW1 Outbreaks of TB,Polio and Rabies Creation of Canadian Public Health GORDON BATES- Pasteurized milk, founder of health league in Canada Aboriginal health x5 worse than all of country National TB plan made Social hygiene program - use condoms |
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1920-1929 |
Focus on maternal/child services Introduction of PbH nurses 1924- PbH nurses available all over Establishment of health infrastructure: Immigrant screening, mandatory vaccines ALPHONSE LESSARD- developed health movement in QB and improved health admin |
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1930-1939 |
Milk Pasteurization mandatory Free treatment for TB in sask Due to great depression - free treatment now charged for Accidental deaths increasing |
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1940-1949 |
Nutrition and food safety: Food guide Margarine ban Physical fitness and education rise - $ provided Penicillin discovered in 1929* DR.BROCK CHISOLM - created the deffiniton of health and the objectives of the WHO Stats for national senses created: Birth, marriage and death |
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1950-1059 |
Polio peaked Preventable injuries spiked Food sanitation increased due to food poisoning 1954 food and drug act: create food drugs and cosmetics under sanitary conditions Polio Vaccine SALK and SABIN Water treatment for dental Infant mortality decrease due to delivery in hospitals vs home |
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Demography def |
Study of people population, distribution, characteristics of population(birth, death) |
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John Graunt |
Father of modern demography First indicator of life expectancy Could not devise rates because did not have info on disease |
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Census |
way to get a characteristic of a population but its a snap of that given time of collection - first one in 1871 by British, mandatory for all Canadians |
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Vital registration |
Married, birth, death, name change More day to day long term vs snapshot |
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Population Survay |
More targeted: agencies collecting info vs. Govt. |
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Observable Phenomena |
SIZE: number of people STRUCTURE AND COMPOSITION: Comparing countries DISTRIBUTION: concentration of people in areas |
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Healthy immigrant effect |
New arriving immigrants much healthier than Canadian's then after 10 years are much less healthy than average Canadian |
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5 Factors influencing Population |
1. Fertility: live birth/pop*1000 2. Mortality Rate: # death/pop *1000 3. Mariage: stability of union, which effects fertility rates and death rates 4. Migration 5.Education and social mobility |
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Rate |
Ration between two measurements with different units Time involved ei: diseases in population of 100 ppl/year |
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Miasma |
Disease can be transferred through smell Hippocrates |
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Germ Theory |
Spread through germs, want to isolate diseased people so they can't spread their illness Hippocrates |
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James Lind |
First clinical trial for scurvy Naval Hygiene |
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William Farr |
Institutionalized epi in England System for vital stats |
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John Snow |
father of Epi Looked at the start of an outbreak of cholera made the spot map |
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Ratios |
One number divided by another - does not need to be related to one another ei: teacher to student |
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Proportion |
One number divided by another but these are related ei: female CVD death to all CVD deaths Always *100 |
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Prevalence |
ALREADY HAVE IT Number of people with the disease at the time/total population at the same time *1000 |
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Incidences |
Number of new cases Number of new cases/total pop *1000 |
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Descriptive study |
Place - environment Person - age, gender Time- trends |
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Analytic |
How and why of certain questions found in descriptive Done in RTC, Lab studies and observational Used for testing hypothesis Tells us about the strength of a relationship Two kinds: Observational and Interventional |
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EPI answers |
Who has it How to prevent and control it How fast is it spreading |
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Case study Report - descriptive |
Detailed report on one person - looks at one person to apply to population -- Blood transfusion aids from one to another |
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Case series - descriptive |
Detailed report on a group with the same problem looks at age, detail of group No comparison group = no hypothesis just info given is all |
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Observational Study |
Anylitical - see in natural environment |
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Case Control |
Comparing two groups: Exposed and non See relationship between two - look back retrospectively - good for rare conditions - less time needed since its occurred already - looks for multiple factors Bad for - Problems with data - memory - not good for evaluating diagnostic tools |
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Cohort |
Group of things Take group and half is exposed and half is not and see who has it and who doesnt have it testing one exposure only naturally exposed - not applied |
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Interventional Studies |
Clinical trials and community trails |
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Health Inequity |
Unjust and unfair differences in health status between population groups that are socially produces, systematic in their unequal distribution across the population, avoidable and unfair |
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Health inequality |
Preventable and unjust differences in health Seen between people of diff groups differences in health status between population groups |
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Material Deprivation |
More stuff you have the healthier you are: more money - better housing, food etc |
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Psychosocial framework |
We are effected bys ome social determinant of health. ei: Psych impacts, biological reaction, unhealthy coping, poor health and higher mortality |
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Life course perspective |
Health disparities that come into prominent view at mid and late life are undoubtedly present from birth |
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Protective Factors |
Health, exercise, social network, family , positive coping mechanism |
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Latency |
If something happens in early development it will have implications later in life. Exposures during critical or sensitive times cause biological changes that will impact disease outcomes |
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Cumulative model |
Over the time of life yo have all these exposures that can effect health and cause long term health problems AKA Accumulation or risk Model |
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Cumulative Model A: |
Independent factors Ei: Poor mental health<- car accident, cant work, spouse dies - all accumulated which leads to poor mental health |
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Cumulative Model B: |
A bunch of exposures than an outcome plus a confounder. One big thing and what filters into it - Bad childhood: Low birth weight, poor nutrition, no money |
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Chain of risks pathways |
Chain of good or bad things over the life which are linked to certain exposures. Based on the idea of chain reactions to explain the continuity between life exposures and adult health outcomes AKA pathway model |
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CoRP Model C |
Pileup which any can lead to the outcome, like a domino Ei: out of work, drinking, no money all can lead to divorce |
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CoRP Model D: |
Last thing is a trigger and for sure will lead to the outcome. |
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Prevention strategies |
an ounce of prevention is worth a pound of cure 1. Clinical intervention- one on one dr. to patient 2. Health promotion - encourage population to see positive in health topic 3. Health protection - change physical or social environment 4. Health public policy - Social or economic policy |
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Key elements of a Population Health approach |
1. Focuses on the health of the pop not person 2. Invest upstream 3. Base decisions on evidence 4. Apply multiple strategies and act on the determinants of health 5. collaborate across various levels and sectors 6. Employ mechanisms to engage citizens 7. Increase accountability for health outcomes |
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Public health approach |
1. define a problem: Who what where why how 2. identify risk: preventable or not, controllable or not, priority 3. implement and evaluate: Plan, Champion, Method,Will and funding 4. put on grand scale- Did it work, can you expand if not try again |
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Levels of prevention |
1. Primary: before disease has occured - safe water, immunization, prenatal care, family planning PREVENTION 2. Secondary: efforts to detect early disease for outcome to decrease progrerrion or minimize negative effect:Used after disease progress has begun - SCREENING 3. Tertiary: efforts to limit complication, disability caused by a disease - rehab programs, development of treatments TREATMENT |
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12 Great achievements of public health |
1. Acting on the social determinants of health 2. Control of Infectious disease 3. Decline in deaths from coronary heart disease and stroke 4. Family Planning 5. Healthier Environments 6. Healthier mothers and babies 7. Motor Vehicle safety 8. Recognition of tobacco as health hazard 9.Safer and healthier foods 10. Safer work place 11. Universal policies 12. Vaccines |
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Safer foods |
Food and drug act Pasteurization of milk Food fortification Nutritional labeling Food education Tackling food insecurity |
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Control of Infectious Disease |
Syph HIV Polio TB Screening Antibiotics Hand washing |
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Healthier Environment |
Sewage and sanitation Environmental protection act Clean drinking water Community initiatives |
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Tobacco |
Smoking bylaws research education and cessation program |
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MV safety |
Improve highways Driver laws Standards for vehicles Child passenger safety |
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Healthier Moms and Babies |
Stop smoking Using vitamins with folic acid Prenatal care Group B strep screening |
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Acting on Social determinants of Health |
Lalonde frame work Ottawa charter Education Poverty reduction Social Support |
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Universal Policies |
National Healthcare Old age security Family allowances National Employment programs Universal Childcare benefit Health act |
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Safe work Place |
workers compensation act Federal and provincial legislatio WHIMS |
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Family Planning |
Contraceptives Abortion Clinics Morning after pill Sex Ed Fertility options |
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EPI in PbH steps |
1. Identify cause of disease and factors that may increase or decrease 2. Determine the extend of disease in pop 3. Study natural history and prognosis of disease 4. Evaluate preventative measures to develop and advance health care delivery 5. Provide foundation for the development of public policy |
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John Graunt |
Health stats Fertility and Mortality rates |
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Point Prevalence Calculation |
Number of ppl with disease at specific time/total pop at the same time X100 -- Represented as % |
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Incidences Calculation |
Number of new cases of disease in specific time period/total population who is at risk at the same time X1000(per 1000 ppl) |
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Study Design |
Descriptive and Analytic - person place thing/ experimental OR Observational -case study or surveillance/RCT, Lab OR cohort (looks forward), case control (looks back), cross sectional surveys |
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Social Determinants of Health |
Conditions in the social, physical and economic environment in which people are born, grow, work, live and age |
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Biomedical Model |
Looking at it as a machine and isolating the problem due to the object not working properly and not any outside influence or factor |
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Behavioural model |
Something happened due to the lifestyle the person chose to have, their health practices, coping skills etc. |
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Maternal Deprivation Pathway |
Low income= more exposure to negative risk = poor health |
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Psychosocial Pathway |
People who suffer from adverse living conditions experience high levels of stress - can cause adverse feelings = long term health problems SDOH inducing high stress->Psych impact->Biological reaction-> Unhealthy coping-> Poor health and higher mortality |
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SDOH |
Income and Social Status Social Support Networks Education and Literacy Employment and Working Conditions Social Enviro Physical Enviro Personal helaht practices and coping skills Healthy child development Biological and genetic endowment Health services Gender Culture |
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Life Course |
Path a person takes from birth to the end Views health as a product of risk behaviours, protective factors and environmental agents |
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Latency Model |
Biological or developmental life experiences have potential health effects later AKA biological |
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Gold Standard in Life Course Research |
Longitudinal Birth Cohort Studies which follow participants into adulthood and across generations Need to include both biological, social, psychosocial and behavioural measures |
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Health of Children Importance |
Early childhood development is one of the SDOH Vulnerable populations Critical and sensitive developmental periods Victims of even greater social inequality Human right to protect |
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PbH focus on children |
Immunization Nutrition Physical Environment Health issues Child care parenting accidents and injuries access to healthcare |
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Importance of life course to PbH |
Understanding the life course perspective = early intervention Help navigate critical and sensitive periods Moves us away from simply life style pathways to looking at more complex reasons for health outcomes |
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Other possibel approaches to prevention |
1.Setting approach- target particular setting in which ppl live and work and learn 2. Determinants approach - target SDOH 3. Comprehensive disease specific approach- Take specific disease outcome and then focus on a variety of interventions for that particular disease |
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Health Impact Pyramid |
Counselling and Education Clinical intervention Long lasting protective interventions Changing the context to make individuals default healthy Socioeconomic Factors ** Top to bottom - Individual to population impact |
