Risk Factors
wide range of exposures; those with a high probability of developing disease are heavily concentrated among those with exposure.
Determinants
identify these underlying factors, or "causes of causes" that ultimately bring about disease. Looks beyond the known contributory causes of disease to factors that are at work often years before a disease develops. BIG GEMS (behavior, infection, genetics.
High risk vs. improving the average
high risk- focuses on those with the highest probability of developing disease and aims to bring their risk close to the levels experienced by the rest of the population.
Improving the average- focuses on the entire population and aims to reduce the risk
common definitions of health
used to be "the absence of disease" but now is health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity
disease prevention
the planning for and the measures taken to forestall the onset of a disease or other health problem before the occurrence of undesirable health events.
wellness
...
health disparity
difference in health between populations often caused by two health inequities- lack of access to care and lack of quality care.
levels of prevention (primary, secondary, and tertiary)
primary - prevent or delay the onset of a disease
secondary- efforts to prevent or detect the progression of a disease once it occurs (scanning)
tertiary- efforts are made to improve the quality of life (reeducate or rehabilitate)
modifiable vs. non-modifiable risk factors
modifiable - changeable and controllable
non-modifiable - non changeable and non controllable
epidemiology
study past and current trends in health status or levels of disease and establishes etiology or causes of disease. defines risk factors and determinate's of disease and determines needs for health services. identifies prevention's and strategies while pre
epidemiological data
information gathered when measuring health at the local, state, and national levels to assist with the prevention of disease outbreaks or control those in progress and to plan and assess health education programs.
crude vs. adjusted vs. specific
crude- for total population
adjusted - for total population but statistically adjusted
specific - for particular subgroup (can be specific to racial or ethnic groups, disease, or age group)
endemic vs. epidemic vs pandemic
endemic - occur regularly in a population as a matter of course
epidemic - unexpectedly large in number of cases
pandemic- outbreak over a wide geographical area
years of potential life lost
age at death - 75
health related quality of life
a person or group's perceived physical and mental heath over time.
healthy day core questions
health field concept (1974)
focused on treatment of disease like medicine and immunizations. a shift from infectious to chronic disease late 1900s. New perspective on health of canadians or Lalonde report.
Health care organization- health care delivery
Human biology- bodily systems,
Chain of infection
used to explain the spread of a communicable disease from one host to another.
Infectious agent, human reservoir, portal of exit, transmission, portal of entry, establishment of disease in new host
participation
active involvement of those in the priority population in helping identify, plan and implement programs to address the health problems they face.
creates support and ownership
Advocacy
the actions or endeavors individuals or groups engage in order to alter public opinion in favor or in opposition to a certain policy
ex: advocate for a smoke free campus
Healthy people 2020 4 goals
1. attain high quality longer lives free from disease
2. high equity, eliminate disparities between groups
3. create environments that promote health
4. promote quality of life and healthy behaviors across all life stages
Prevalence
the number of individuals who have a disease at a particular time divided by the number of individuals who could potentially have the disease.
tells us the proportion of people who have the disease at a point in time.
ex: lung cancer is common, the preval
incidence
number of of new cases of a disease that develop during a year divided by the number of people in the at-risk population
morbidity vs mortality
morbidity - means illness, shift from infectious disease to chronic disease.
mortality- means death
primary vs secondary data
primary- an active process of collecting information through research
secondary- previously collect or archived information
cross- sectional studies (primary data)
a "snapshot of a group of people"
- one time data collection effort by survey or other means and uses a self report format
- also called prevalence study
- cross-sectional describes sample; a cross section of the population is selected
Cohort studies (primary data)
cohort (group with something in common) of healthy people is followed through time to see if they develop a specific disease of interest
- also called incidence studies
- incidence rate can be commuted
- allow comparisons of incidence rates between people
case-control studies (primary data)
a specific disease is generally the focus of the research
objective: discover how/why the disease occurs
-group of people with the disease = case
- group of people without the disease = control
(should be similar on other characteristics)
- groups recall
experimental studies (primary data)
can determine the cause or effectiveness of a disease
- participants are randomly selected and randomly assigned
- difference in the groups are analyzed in order to determine the cause or efficacy of the intervention
relative risks
probability of developing the disease if the risk factor is present compared to the probability of developing the disease if the risk factor is not present.
Prioritizing Prevention and Control Efforts
number of people who will die from a disease
number of years of potential life lost
economic cost associated with the disease
active versus passive immunity
passive - provide effective short term protection, acquired through transfer of antibodies or activated T-cells from an immune host, and is short lived
active- induced in the host itself by antigen and lasts much longer, sometimes lifelong
herd immunity
when 70 to 90% of the population is vaccinated so the susceptible people rarely get sick
acute vs chronic disease
acute- happens rapidly and worse quickly as in a heart attack
chronic - develops and worsens over time such as arthritis
natural vs. artificial immunity
natural - occurs through contact with a disease causing agent, when the contact was not deliberate
artificial -develops only through deliberate actions such as vaccination
Shifting focus in health from late 19th century
to mid-20th century
...
Case-fatality
...
Association versus causality
...
Necessary versus sufficient cause for disease
...
Primary versus secondary data
...
Communicable versus non-communicable
disease
...
Prioritizing Prevention and Control Efforts
(criteria used to judge importance of a disease
to a community)
...
Primary, secondary, and tertiary prevention of
communicable versus non-communicable
disease
...
The Community Guide - what it is and how we
can use it
...
Computing prevalence and incidence of
communicable and non-communicable diseases
...