Hbs 32 - Karim

Front 1

Health of People = Health Of Populations

Back 1

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Front 2

2 persepctives on health

Back 2

1) individual
2)population

Front 3

individual

Back 3

That taken in clinical medicine which views health of individual and manages them without looking at their environment... problem = within person... genetics, etc

Front 4

population perspective

Back 4

health = dependant on 2 forces:
1) Environmental Factors which determines absolute risk (getting to that in a sec)
2)individual factors (increasing the person's risk relative to the environment)

Front 5

absolute risk

Back 5

risk that something will occur based on incidence in population (eg. if you're american you're 99% likely to be overweight and pompous because 99/100 people are like that)

Front 6

relative risk

Back 6

risk of one person or group, relative to another, measured with the baseline = 1 ... (eg. if I were to move to america today, my chance of being ignorant, pompous and obese is pretty low, cause I'd be an american immigrant, so my relative risk =1, while vik's relative risk, him being born there, is about 9... in health of population terms, this is like we have an X% chance of getting CVD and my relative risk is a 12 because I have familial hypertriglyceridaemia)

Front 7

Risk Interpretation

Back 7

You can't interpret relative risk without knowing absolute risk (eg. relative risk for something could be 5 compared to 1, but the absolute risk could be 0.001% so a 5-fold increase takes me to a 0.005% chance... not a big deal)

Front 8

How do we think of health

Back 8

A product in individual risk factors... but we forget to take into account absolute risk

Front 9

What Risk is largely a factor of

Back 9

Absolute = largely a factor of environment
relative risk = largely a factor of individual characteristics
... hence why the same individual characteristics will give a different absolute risk in different populations

Front 10

High Risk Paradox - a Product of the Population Perspective of Health

Back 10

people at really high risk for a dz (eg. familial Hypercholesterolaemia) would benefit a lot fom therapy, but they don't really matter on a population scale, it's actualy the people at moderate risk who make up so much more of the population, who are more important, because in the population, there are way more of them with heart disease (say 15% or so) than the total number of people with familial hypercholesterolaemia (say 0.01%)... ie. even though the high risk group is a much higher risk, they are way less in the population, so they don't really matter...you're better allocating resources for billboard ads against people eating fatty foods

Front 11

funding wars

Back 11

most of healthcare budget goes to treatment at hospitals, not the prevention... but paradigm shift is starting to occurs... eg. Alzheimer's disease group is looking to fund prevention right now, more that a cure (Cause, Care, and cure Redress)
-people have a right to be cared for while they're healthy too
-while funding for high-quality care is good for the individual, it's totally depleting funds that could be used for population-based preventative measures