HLTH 1025 Exam Notes PDF

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Review notes for future exam including week one and two...

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SINGH, UDAYVIR - SINUY009

University of South Australia – Health and Society [HLTH 1025] – Exam Notes 2021 Week One – Measuring and Monitoring Population Health What is Population Health In population health, we are looking at differences in the distribution of values of some health/well-being outcome between populations • And we look at the mean values between populations. What do we do when we see differences? We want to explain them so we can do something about them! Different approaches: Individual vs. Population Health. This gets us back to wanting to understand the determinants of health issues at a population level: what is it that determines that one population has a much higher mean blood pressure value than another? Population Health, Public Health and Epidemiology The field of population health encompasses the sub-disciplines of public health and epidemiology. The difference between population and public health is often the subject of heated debate in this area; however, there is little debate about epidemiology being the "science of public/population health”. In this course, we define and distinguish between population health, public health and epidemiology as follows: Population Health in Day-to-Day Life Although many of you may not have come across the term 'population health' before, you are affected by research and practice in this field in your everyday life. Take seatbelts, for instance. The legislation (laws) requiring us all to wear a seatbelt each and every time we travel in a car is the result of work done in the field of population health. First, epidemiological studies would have been undertaken using data (information) about the health impacts of car accidents when seatbelts were and were not in use. Eventually there was enough evidence to clearly show that if people travelling in vehicles were not wearing seatbelts, then their risk of injury and death were much greater than for those who were wearing seatbelts. This evidence led to public health action (in this case changing laws) to protect the health of the population by making it compulsory to wear a seatbelt when travelling in a motor vehicle, could also think about regular tap water. Scientific evidence showed that fluoride was protective of dental caries. So, a very large epidemiological study was conducted in two Australian states several decades ago to determine whether adding fluoride to the water supply could protect from dental caries at the population level (rather than, say, making everyone take fluoride tablets or something similar). Health Inequality and Inequality – Definition - https://lo.unisa.edu.au/mod/book/view.php?id=2294899&chapterid=291862 and examples https://lo.unisa.edu.au/mod/book/view.php? id=2294899&chapterid=291864 Population Pyramids - https://lo.unisa.edu.au/mod/book/view.php?id=2294899&chapterid=291865 Life Expectancy - https://lo.unisa.edu.au/mod/book/view.php?id=2294899&chapterid=291863

SINGH, UDAYVIR - SINUY009

University of South Australia – Health and Society [HLTH 1025] – Exam Notes 2021 Week Three – Evidence, Risk and Casualty in Health Research What is a Risk Factor? What does it mean to be “at risk” of an event/condition and what would it mean if I said you were at risk of developing diabetes? Risk has many meanings: Possibility of an event, Cause of an effect, Probability, or likelihood of an event (in a statistical sense) The World Health Organisation defines “A risk factor is any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury”. People with the risk factor are more likely to experience the outcome than people without the risk factor. Epidemiological Research and Determinants Determinants of health can be either positive or negative. Determinants positively associated with a disease outcome are risk factors. For example, obesity is a risk factor for cardiovascular disease. Determinants negatively associated with a disease outcome are protective factors. For example, healthy eating is a protective factor for cardiovascular disease. Types of epidemiological studies - Descriptive studies aim to describe occurrence of outcome, for example measure the prevalence of a disease. Cross-sectional studies such as the Australian Health Survey are descriptive studies. Analytical studies have a clear research hypothesis to be tested such as: What is the association between an exposure (e.g., disease risk factors or treatment) and an outcome (e.g., healthrelated events such as heart attack or survival) There are two types of analytical studies: experimental studies and observational studies. Experimental studies are controlled trials or lab-based experiments. They involve manipulating independent variables to easily determine the cause-and-effect relationship. They have a a clear hypothesis to be tested and the exposure is assigned usually randomly. For this reason, they provide a higher strength of evidence than observational studies. Experimental studies are suitable to assess the effect of a new medicine on a group of people. They are not feasible to assess risk factors in a population. Relative Risk Ratio (RR) - https://lo.unisa.edu.au/mod/book/view.php?id=2294955&chapterid=291897 Odds Ratio (OR) - https://lo.unisa.edu.au/mod/book/view.php?id=2294955&chapterid=291899 Causality in Health Research - https://lo.unisa.edu.au/mod/book/view.php?id=2294956

Week Four– Introducing the “Determinants of Health” Health Determinants The diagram depicts "levels of influence" of a variety of determinants of health. The inner-most level, or layer, are the biomedical, genetic, and intergenerational influences on health. These are the factors that directly impact on health and illness.

SINGH, UDAYVIR - SINUY009

University of South Australia – Health and Society [HLTH 1025] – Exam Notes 2021 The outer layers describe those broader social, structural, and economic factors that act to shape behaviours and psychological factors, and subsequent health outcomes. They are the most indirect influences, or determinants, of health. Biomedical Determinants of Health - https://lo.unisa.edu.au/pluginfile.php/3014555/mod_resource/content/1/Biomedical%20determinants%20of%20health.pdf Behavioural Determinants of Health - https://lo.unisa.edu.au/mod/book/view.php?id=2294978&chapterid=291923

Week Five – Determinants of Health 2 – Socioeconomic Socioeconomic Determinants of Health - https://lo.unisa.edu.au/mod/book/view.php?id=2294998 What is Health Literacy Health literacy is a key determinant of health. The World Health Organisation (Nutbeam 1998) defines health literacy as follows: “Health literacy has been defined as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Health literacy means more than being able to read pamphlets and successfully make appointments. By improving people's access to health information and their capacity to use it effectively, health literacy is critical to empowerment." How is this different to plain old “literacy” - "Literacy refers to basic skills needed to succeed in society while health literacy requires some additional skills, including those necessary for finding, evaluating and integrating health information from a variety of contexts. It also requires some knowledge of health-related vocabulary as well as the culture of the health system." Health Literacy Motion graphic - https://lo.unisa.edu.au/mod/book/view.php?id=2295000&chapterid=291937 Health Literacy: Australian facts The Australian Bureau of Statistics (ABS) some years ago published information on health literacy levels among Australians using the 2006 Adult Literacy and Life Skills Survey (ALLS) results. The ALLS assessed the functional aspects of health literacy such as finding information in documents, understanding text etc. The following figure shows that almost 60% of Australians have an inadequate level of health literacy (Level 1 or 2):

A more recent publication by ABS about health literacy in Australia includes the National Health Survey: Health Literacy, 2018. This survey uses the Health Literacy Questionnaire which was developed from a conceptual model integrating the daily lives of its participants and assesses nine domains of health literacy. This report indicates 33% of people always found it easy to actively engage with healthcare providers, 56% usually easy while 12% found it difficult.

SINGH, UDAYVIR - SINUY009

University of South Australia – Health and Society [HLTH 1025] – Exam Notes 2021 It should be noted that the data in the National Health Survey: Health literacy 2018 report is not directly comparable to the 2006 ALLS health literacy skills report as the two assess health literacy using different models and criteria. The importance on improving health literacy. Health literacy is an important determinant of population health as has been highlighted by the recent COVID-19 pandemic. Health literacy is vital in slowing down the spread of the virus and minimising its health impact. The ability of a population to readily understand and access reliable health information in order to improve their health outcomes can be confounded by the vast amount of unverified material that is digitally available. The confusion around reliable COVID-19 health literacy information is highlighted in the following article: The Health Wrap: beyond finger pointing, focus on health literacy, a paradox, and questions for the research community. SMOG Index The SMOG index is a measure of "readability" that estimates the years of education needed to understand a piece of written material. The acronym SMOG stands for Simple Measure of Gobbledygook. This journal article (Fitzsimmons et al. 2010) assesses the readability of health information on Parkinson's disease using the SMOG index alongside several other "readability" measures. This should help you in thinking about the relevance of health literacy to health conditions.

Week= Six - Determinants of Health 3 – Enviromental Factors

SINGH, UDAYVIR - SINUY009

University of South Australia – Health and Society [HLTH 1025] – Exam Notes 2021

SINGH, UDAYVIR - SINUY009

University of South Australia – Health and Society [HLTH 1025] – Exam Notes 2021...