Summary Class notes - International Public Health

Course
- International Public Health
- -
- 2018 - 2019
- Vrije Universiteit Amsterdam
- Biomedische Wetenschappen
141 Flashcards & Notes
1 Students
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Summary - Class notes - International Public Health

  • 1554674400 Health determinants, measurements and trends

  • What are, besides the individual (genetics, sex, age), determinants of health?
    • Physical environment (water, sanitation, air pollution)
    • Employment and working conditions
    • Access to health services
    • Healthy behaviors and coping skills
    • Healthy child development
    • Social environment (socio-economic status, education, social capital, culture, gender norms)
  • What is the difference between equity and equality?
    Equity means getting different support to reach the same goal, equality means getting the same support.
  • Give an example of equity and equality in health care.
    Everyone can go to the GP 5 times a year = equality
    Everyone can go to the GP as often as they need = equity
  • What are indicators of health status?
    • Frequency of disease (incidence rate, prevalence)
    • Severity of disease (mortality, case-fatality ratio, morbidity)
    • Life expectancy
  • What is meant with the incidence rate and prevalence, what type of indicator of health status is it?
    Incidence rate is the amount of new cases of a disease. Prevalence is the total amount of people with the disease.
    These are indicators of the frequency of disease.
  • What is meant with the mortality, case-fatality, and morbidity, what type of indicator of health status is it?
    Mortality is the number of deaths. Case-fatality is the number of deaths because of  a certain disease. Morbidity is the disability caused by a disease.
    These are indicators of the severity of disease.
  • What is the difference between mortality and case-fatality?
    Mortality is a measure for deaths in the whole population, case-fatality is the mortality of the population with a certain disease.
  • What are different types of mortality?
    • Neonatal mortality (<28 days)
    • Infant mortality (<1 year)
    • Child mortality (<5 years)
    • Maternal mortality (maternal deaths due to childbearing)
    • General mortality 
  • What are measures for burden of disease, combining morbidity and mortality?
    HALE (Health-Adjusted Life Expectancy) & DALY (Disability-Adjusted Life Years)
  • What are general trends that influence the global health status?
    • Population growth
    • Ageing of the population
    • Urbanization (water, sanitation, schools)
  • 1555279200 Non-communicable diseases (NCDs)

  • What are the three main causes of death according to the WHO?
    I - Communicable, maternal, perinatal and nutritional conditions
    II - Non-communicable conditions (NCDs)
    III - Injuries
  • What are NCDs?
    NCDs are chronic diseases, usually have a long duration and get worse over time.
  • What are the characteristics of NCDs?
    • Long latency
    • Emerge in middle-age and later life
    • High degree of preventability
    • Long period of treatment and care
    • Comorbidity
    • Strong link to socio-economic development
  • What are the 5 main NCDs?
    • Cancer
    • Cardiovascular diseases
    • Diabetes
    • Chronic respiratory diseases
    • Mental disorders
  • What are risk factors for NCDs?
    • Tobacco
    • Physical inactivity
    • Unhealthy diet
    • Harmful use of alcohol
  • What is a trend linked to obesity?
    In high income countries the people with a middle- and low socio-economic status are more likely to get obese as the fast food restaurants are cheap.
    In low- and middle income countries the 'rich' people get obese.
  • What is a trend in tobacco use and an unhealthy diet?
    Media exposure of tobacco and unhealthy food is paid by the tobacco industry and food industry.
  • What can you say about this idea:
    "Low- and middle income countries should control infectious diseases before chronic diseases."
    Right now LMIC have to deal with both infectious diseases and NCDs. The problem is that it is too expensive to control both.
    At the same time, risk factors for and deaths from NCDs are in a rapid upsurge, especially in urban settings.
  • What can you say about this idea:
    "Chronic diseases mainly affect rich people."
    This is not completely true. Poor people are more likely to develop chronic diseases but they are also more likely to die as a result of these diseases because they have no money for/access to treatment.
  • What can you say about this idea:
    "Chronic diseases mainly affect old people."
    In LMIC, middle-aged adults are especially vulnerable to chronic diseases. People in these countries tend to develop diseases at younger ages, suffer longer (with preventable complications) and die sooner than those in high income countries.
    However, childhood overweight and obesity in children is a rising global problem.
  • What can you say about this idea:
    "Chronic diseases affect primarily men."
    Chronic diseases also affect women, however, women's health is often discussed primarily in relation to reproduction and diseases show different symptoms among men and women.
  • What can you say about this idea:
    "Chronic diseases are the result of unhealthy "lifestyles"."
    Individual responsibility can have its full effect only where individuals have equitable access to a healthy life, and are supported to make a healthy choice.
  • What can you say about this idea:
    "Chronic diseases can't be prevented."
    In reality, the major cause of chronic diseases are known, and if these risk factors were eliminated, at least 80% of all heart diseases, strokes and type 2 diabetes would be prevented.
  • What can you say about this idea:
    "Chronic disease prevention and control is too expensive."
    In reality, a full range of chronic disease interventions are very cost-effective for all regions of the world.
  • What is the distribution of risk factors among HICs and LMICs?
    HICs mostly struggle with tobacco and alcohol use, and obesity/overweight.
    LMICs mostly struggle with tobacco and alcohol use, poor nutrition, and chronic infections.
  • What are social determinants of health?
    • Poverty
    • Economy
    • Education
    • Urbanization
    • Social structures
  • What is the role of urbanization in bringing about chronic diseases?
    Urbanization leads to a change in diet and less physical activity. Furthermore, the number of people increases and more accidents occur. On average, it is easier to get drugs in the cities.
  • What can be a problem with food packages and how can this be solved?
    Food packages often have text on it, saying if it is 'healthy'. In the world, many people are illiterate. A solution for this could be colour coding.
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