Flashcards in Lecture 22: Prevention, Promotion, Protection Deck (48)
How does epidemiology play an important role in preventing disease?
It unravels the causal pathway
It directs preventative action
It evaluates the effectiveness of the intervention
Why is disease prevention needed?
Because of the growing limitations in curing disease and the escalating costs of medical care
What are three population health actions?
1. Health promotion
2. Disease prevention
3. Health protection
What are the two types of strategies that all population health actions can divide into?
1. Population based (mass) strategy
2. High risk individual strategy
What is the focus of population based (mass) strategy?
The whole population
What are the aims of population based (mass) strategy?
To reduce health risks/improve the outcome of all individuals in a population
What is population based (mass) strategy useful for?
A common disease or widespread cause
What are examples of population based (mass) strategy?
Low-salt foods in supermarkets
Who are the focus of high risk individual strategy?
Individuals perceived to be at high risk
What is the purpose of the high risk individual strategy?
To move these individuals towards the rest of the population
What are high risk individual strategy interventions like?
Well matched to individuals and their concerns
What are examples of high risk individual strategies?
Interventions targeting obese adults, intravenous drug users, those with systolic bp >160mmHg
What's a specific NZ example of a high risk individual strategy?
The Needle exchange programme, introduced to reduce risk of HIV among drug users- involved decriminalisation of sale of needle/syringes, provided buyers involved in needle swap. Extremely effective
3 advantages of population (mass) strategy?
1. Radical, addresses underlying cause
2. Large potential benefit for whole population
3. Behaviourally appropriate (eg no smoking on airplanes)
3 disadvantages of population (mass) strategy
1. Small benefit to individuals (eg legislation use of seat belts)
2. Whole population is exposed to downside of strategy (less favourable benefit to risk ratio)
3. Poor motivation of individuals
4 advantages of high risk individual strategy?
1. Appropriate to individuals
2. Individual motivation
3. Cost effective use of resources
4. Favourable benefit to risk ratio
4 disadvantages of high risk individual strategy?
1. Cost of screening to identify group
2. Temporary effect (eg annual breast screening)
3. Limited potential (ie Down syndrome baby screening)
4. Behaviourally inappropriate (cultural norms)
4 key concepts of health promotion?
1. Acts on determinants of wellbeing
2. Health/wellbeing focus
3. Enables/empowers people to increase control over, and improve, their health
4. Involves whole population in every day contexts
Examples of health promotion?
Define tertiary care?
Hospital based care, rehabilitation
Define secondary care?
Specialist care eg dermatologist
Define primary care?
First point of contact, ie the GP, physio, pharmacist - community based
What was the declaration for primary health care, established at the international co defence on primary health care in Kazakhstan, called?
Alma Ata 1978
What were the aims of the Alma Ata?
1. Protect and promote health of all
2. Advocate a health promotion approach to primary care
What were the 7 Alma Ata prerequisites for health?
1. Peace and safety from violence
5. Income and economic support
6. Stable ecosystem and sustainable resources
7. Social justice
What campaign began at the first international conference on health promotion in 1986?
The Ottawa Charter for health promotion (WHO)
What was the Ottawa Charter phrase?
"Mobilise action for community development"
What does the Ottawa charter acknowledge?
1. That health is a fundamental right for everybody
2. Health requires individual and collective responsibility
3. The opportunity to have good health should be equally available
4. Good health is an essential element of social and economic development
What are the three basic strategies of the Ottawa Charter?