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Public health
The totality of all evidence-based public and private efforts that preserve and promote health and prevent disease, disability, and death. TERM 2
Population health approach
DEFINITION 2 An evidence based approach to public health that considers a full range of possible interventions*, including health care, traditional public health, and social interventions.Population health requires us to define four specific components:Health issuesPopulation of interestSocietys shared health concerns Societys vulnerable groups TERM 3
High-risk approach
DEFINITION 3 Focuses on those with the highest probability of developing disease. Aims to bring high-risk groups closer to the levels of the the general population. TERM 4
Improving the average
approach
DEFINITION 4 Focuses on the entire population Aims to reduce the risk for the entire population TERM 5
Determinants
DEFINITION 5 underlying factors that ultimately bring about the disease i.e., the causes of causes or stream of causes
General determinants of disease (BIG GEMS)
B ehavior I nfection G enetics G eography E nvironment M edical care S ocioeconomic-cultural TERM 7
Demographic transition
DEFINITION 7 The impact of falling childhood death rates and extended life spans. TERM 8
Epidemiologic transition
DEFINITION 8 As socioeconomic development occurs, different types of diseases become more prominent. TERM 9
Nutritional transition
DEFINITION 9 Countries frequently move from poorly balanced diets (deficient in nutrients, proteins, and calories) to a diet of highly processed food, including fats, sugars, and salt. TERM 10
What is the difference between public health
and medical care?
DEFINITION 10 In medicine, the patient is the individual; in public health, the patient is the community Public health diagnoses the health of the community using public health sciences Treatment of the community involves new policies and interventions Goal of medicine is cure; goal of public health is prevention of disease and disability
Incidence
the chance of developing a disease over a period of time. TERM 17
Prevalence
DEFINITION 17 the percentage of a population that is affected with a disease at single a point in time. TERM 18
Case-fatality
rate
DEFINITION 18 the chance of dying from a disease once its diagnosed. TERM 19
Burden of disease
DEFINITION 19 commonly expressed as the occurrence of disability and death due to disease. TERM 20
Group level association
DEFINITION 20 Epidemiologists investigate factors such as person , time , and place to search for patterns or associations in the frequency of disease. We call such associations Group Associations
Individual level association
Individuals with disease have an increased chance of exposure to the risk factor. TERM 22
Risk indicator
DEFINITION 22 a factor that occurs more frequently among groups with a disease. TERM 23
Ancillary criteria or supportive criteria for
establishing contributory cause
DEFINITION 23 strength of relationship, dose-response relationship,consistency of the relationship,biological plausibility TERM 24
strength of relationship
DEFINITION 24 The risk for those with the risk factor is greatly increased compared to those without the risk factor. TERM 25
dose-response relationship
DEFINITION 25 Higher levels of exposure or longer duration to the cause is associated with increased probability of the effect.
What are three explanations for changes in
the distribution of disease?
Interest in identifying the disease Ability to identify the disease Definition of the disease TERM 32
Apply the evidence-based recommendation
classifications
DEFINITION 32 Evidence-based recommendations combine the score for the quality of the evidence with the score for the impact of the intervention These two aspects are combined to produce an index for the strength of the recommendation, graded as: A (must) B (should) C (may) D (dont) I (indeterminate) TERM 33
Data
DEFINITION 33 facts or representation of facts. TERM 34
Information
DEFINITION 34 Implies that data is organized or summarized in a way that is meaningful and interpretable. TERM 35
Sentinel monitoring
DEFINITION 35 monitoring of rate occurrence (e.g., influenza rates)
Syndromic surveillance
surveillance (collection and analysis) of health data about a clinical syndrome (collection of signs & symptoms) to alert about a potentially new disease. TERM 37
Infant mortality
rate
DEFINITION 37 Infant a child in the first year of life Live birth - an infant exhibiting any signs of life at birth. Neonatal (aka newborn infant) pertaining to the newborn period, specifically the first 4 weeks after birth. Infant mortality rate (IMR) - estimates the rate of death in the first year of life. Defined as: no. of infant deaths per 1,000 live births per year TERM 38
Life expectancy
DEFINITION 38 The average no. of years that a person may expect to live. The measure incorporates the probability of dying age each age of life in a particular year. Commonly expressed as life expectancy at birth. TERM 39
Under-5 mortality
DEFINITION 39 Under-5 mortality rate (IMR) - estimates the rate of death in the first five years of life. Defined as: no. of under-5 deaths per 1,000 live births per year Once a child survives 5 years, there is a high probability of surviving into adulthood. TERM 40
Health-adjusted life expectancy
(HALE)
DEFINITION 40 HALE = Quality of life measurement life expectancy In most countries, quality of life measurements range from 85-90%. A quality of life measurement of 90% indicates that the average person in the country loses 10% of full health over a lifetime to one or more disabilities.Life expectancyquality of life measurement = HALE score. HALE = the average no. of years a person can expect to live in full health.Adjusts life expectancy with quality of health measures; e.g.,Mobility, Cognition, Self-care, Pain, Mood, Sensory organ function
Expected
utility
Utility is commonly used as part of a formal method for decision making called decision analysis. Decision analysis uses decision trees and utility to drive decision making TERM 47
Discounting
DEFINITION 47 concept of favoring benefits expected to occur in the immediate future compared to benefits expected to occur in the distant future. TERM 48
Risk taking attitude
DEFINITION 48 decision making attitude consistently favor: taking actions that differ from recommendations of a decision analysis; or avoiding actions that differ from recommendations of a decision analysis TERM 49
Inform of decision
DEFINITION 49 clinician has all the essential information and can make decisions that are in the patients best interest. TERM 50
Informed consent
DEFINITION 50 patients give their permission before intervention.
Shared decision making
clinician provides information to the patient for patient to make a decision. TERM 52
What are five population health status
measures?
DEFINITION 52 Population health status measures- measurements that summarize the health of populations Infant mortality rate Under-5 mortality Life expectancy Health-adjusted life expectancy (HALE) Disability-adjusted life year (DALY) TERM 53
Interventions
DEFINITION 53 full range of strategies to protect health and prevent disease, disability and death. e.g., nutrition, antibiotics, surgery, chemotherapy, physical therapy TERM 54
Contributory causes
DEFINITION 54 immediate causes of disease. e.g., HIV and cigarette smoking are established contributory causes of disease, disability, and death. A considerable amount of research, experimentation, and evidence is required to establish contributory cause TERM 55
Problem in PERIE
DEFINITION 55 How can we describe the health problem (disease)? BurdenCourse Distribution
RE-AIM
Critical to measure the impact of the intervention and how much of the problem remains. A new approach, called the RE-AIM framework, is increasingly being used to evaluate interventions work and their acceptance in practice R each Evaluate interventions potential E ffectiveness A doption Evaluate interventions acceptance I mplementation M aintenance
