Week 1 Intro to Epidemiology and public Health PDF

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🥇Week 1 : Intro to Epidemiologyand public HealthLearning Objectives To understand the concepts of Public Health and Epidemiology, and how they relate to each other. To be able to identify ‘upstream determinants’ of health and disease outcomes. To understand the impact of deprivation on health. To co...

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Week 1 : Intro to Epidemiology and public Health Learning Objectives To understand the concepts of Public Health and Epidemiology, and how they relate to each other. To be able to identify ‘upstream determinants’ of health and disease outcomes. To understand the impact of deprivation on health. To consider how interventions to improve education, socioeconomic status and general wellbeing can contribute to population health. To be familiar with some examples of Epidemiology and Public Health interventions

What is the definition of health? Resource Gives people ability to manage and change their surroundings Positive concept

Social and personal resources as well as physical capabilities

What is public health? Science and art of preventing disease, prolonging life, promoting health through the organised efforts of society Informed choices of society , organisation, public, private, communities and individuals What is the definition of epidemiology? The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control health problems. What is the problem, what is its frequency, who is affected, where and when does it occur, why does it occur in this particular population What is a population grp of ppl living in same area , having same condition, who share a demographic characteristic (male, female) What are upstream causes, give examples. ones which affect the wider population such as healthcare availability, socio economic, poverty - financial status, housing, education, sanitation etc, wider social determinants of health What are downstream causes, give examples. U cannot change, genetics, susceptibility to an infection, immediate causes that affect health, exposure to disease, infections What are social determinants of health? Condition in which ppl grow, live, work, age Shaped by distribution of money, power, resources at global, national and local levels Give some examples of social determinants of health Age, Sex, Hereditary factors - cant really change them  Individual Lifestyle Factors (smoking, physical activity) - modifiable  Social and community networks (friends, peers, family)

 Institutional and organisational factors : Education, Agriculture and food production, Work environment, living and working conditions, unemployment, water and sanitisation (ecological), health care services, housing  General socioeconomic cultural and environmental conditions

What is equality? SAMENESS - promotes fairness and justice by giving everyone the same thing, but only works if everyone starts from the same place Making sure everyone has access to same opportunities U didnt give the same thing What is equity? FAIRNESS - making sure ppl get access to the same opportunities (ensure you have equity before you can enjoy equality) Equity in health implies that ideally everyone could attain their full health potential, no one should be disadvantaged because of their social position or other socially determined circumstances absence of avoidable or remediable differences among groups of ppl, whether those groups are defined socially, economically, demographically, geographically Stuff u can change but didn't change - then ppl are in unfair position Why do health inequalities occur?

Upstream causes Leading risk factors - lifestyle : Smoke? HTN? Alcohol? Overweight? Accessibility of health services : Preventative care? Community services? GP? What does public health involve? Surveillance - what is the problem Data collection) Risk factor identification - what is the cause Intervention evaluation - what works Implementation - how do u do it How has public health helped? Vaccinations, safer workspaces, control of infectious diseases, family planning What is the inverse care law availability of good medical care tends to vary inversely with the need for it in the population served What does that mean- Ppl who live in a very wealthy area tend to have better access to health services, better health literacy ( more motivated) What are the 4 levels of prevention? Explain. Primordial prevention Alter societal structures and thereby underlying determinants E.g. Reducing unemployment, providing sanitation, healthy drinking water, good sewage systems Primary prevention Alter exposures that lead to disease E.g. Pollution and unhealthy living environment Secondary Prevention Detect and treat pathological process at an earlier stage when tx can be more effective (preclinical and clinical phase) E.g. Screening ,detection measures for breast cancer so ppl can seek tx earlier, physical activity interventions for ppl with cardiovascular diseases

Tertiary prevention Prevent relapses and further deterioration via follow up care and rehab (post clinical phase)

2 Ways of prevention Only targeting those who are identified as "high risk" Targeting the whole population whether they are exposed to risk factors or not

What is the high risk approach? Identify those in special need then control exposure E.g. If you have a limited number of flu vaccines available, u may want to target the over 70s because they are at high risk of developing complications Other E.g. Needle exchange programmes for injecting drug users BCG vaccination for high risk neonates in the UK What is the strength of the high risk approach? Effective (high motivation of individual and physician) Efficient (cost effective use of limited resources) Benefit Risk ratio is favourable Appropriate to individual Smaller group more likely to modify their behaviour and adopt healthier habits) Easy to evaluate (affects only small subsets of the population) What are the weaknesses of the high risk approach? Expensive to identify and treat those at high risk Doesn't identify public health problems arising from small but widespread risk that may be substantial

Ignores that large group of ppl exposed to a small risk may generate more cases than a small number of ppl exposed to a large risk Hard to change individual behaviours Difficulty and costs of screening Risk prediction (not accurate) misses a large amount of disease doesn't focus on what influences behaviours that leads to the risk What is the population approach? Begins with recognition that the occurrence of common diseases and exposures reflects the behaviour and circumstances of society as a whole E.g. E.g. Mass Drug Administration (e.g. Anti-worming) Mosquito breeding site clearance What are the strengths of the population approach? Fair to all Cost effective if everyone changes their behavior Large potential for population benefit What are the weakness of it? People don't perceive themselves to be high risk and they think there is a small benefit to individual may result in poor motivation Poor motivation leads to poor coverage Benefit to risk ratio may be questionable Hard to implement and evaluate Cuz so many population factors)

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