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Terms in this set (64)
What is a health indicator?
a varaible, susceptible to direct measurement, which reflects the state of health of persons in a community
qualities of health indicators
sensitive to change
feasible to measure
What are some sources of health indicators?
- vital stats
- disease registries
- adminsitrative data
- health surveys
What are the 5 vital statistics measured worldwide?
- fetal deaths
T/F: states are legally required to collect vital statistics data
describe the data collection instruments for vital statistics
uniform data collection instruments (used across all the states to ensure you get the same info from KS and MO)
Who are vital measurements reported to
How is mortality data collected?
What does the funeral director supply for the death certificate? The doctor>?
funeral director: demographics
doctor: COD (immediate, underlying, contributing)
What are the 3 main advantages of using mortality data as a measure of health?
- many societies collect this data, so comparisons can be made
- denominator easily defined
- death certificates required by law, so reporting is generally guaranteed
What are the 4 main disadvantages of using mortality data as a measure of health?
- accuracy variable: better with rapidly fatal and easily diagnosed diseases
- stigmatized diseases may not be recorded
- diagnostic techniques change
- disease classification schemes change
for which type of diseases is mortality data most accurate as a measure of health?
better with rapidly fatal and easily diagnosed diseases
how to calculate mortality rate
denominator = population studied
numerator = number of deaths in the population
time period covered (usually a year)
How do you calculate unadjusted (crude) mortality rate?
total # deaths in 1 year/population at year midpoint
generally expressed per 1,000 or 100,000 population
What is a standardized death rate? why do we do this?
the mortality rate of a population adjusted to the rate expected in a standard population
- designed to eliminate differences in pop age distribution as the cause for differences in mortality rates
-it is not hard to imagine that the crude mortality rate in Florida is higher than it would be in most other states of the US (tons of old ppl in Florida)
what types of diseases are reportable diseases (2)
who collects them
where are they reported
most often are communicable or preventable disease
-collected by local health departments
-reported to the CDC
cancer: who collects data (2)
- collected by state health departments
- detailed data collected by NCI on 15% of population
What is the national health interview survey?
what information is gathered (2)
telephone survey of non-institutionalized civilian population: how you are and can you work
1. acute/chronic conditions
2. disability and employment
what is the national health and nutrition examination survey (NHANES)?
what information is gathered (3)
take bus and go across country testing non-institutionalized civilian population
3. lab testing
what is the behavioral risk factor surveillance system?
what information is gathered (1)
telephone survey of non-institutionalized civilian population
data on behavioral risk factors--smoking, diet, safe sex
longitudinal studies that collect a large amount of data on a defined population of people
list 3 examples of cohort studies
1. framingham heart study
2. physician's health study
3. women's health study
Current monitoring for disease risk factors includes what 4 categories?
1. environmental factors (air, water, shelter, food)
2. behavioral factors (tobacco, alcohol, drugs, sex, diet, physical activity)
3. social environment
4. economic circumstances
an act or event or state of nature which initiates or permits, alone or in conjunction with other causes, a sequence of events resulting in an effect
criteria for causation
strength of association
How do you calculate relative risk?
(the incidence of disease in exposed) / (incidence of disease in the unexposed)
What does relative risk mean in terms of epidemiology?
how many times more likely it is that a disease will occur in the exposed compared to unexposed
How do you calculate risk difference?
[a/(a+b)] - [c/(c+d)]
aka (incidence of disease in exposed) - (incidence of disease in the unexposed)
What does risk difference tell you?
gives you an absolute level of risk (typically in # of cases per 100,000 population)
What is population attributable Risk
the amount of disease that is a result of an exposure
(incidence in population) - (incidence in unexposed)
How do you calculate population attributable Risk?
(incidence in population) - (incidence in unexposed)
WHO: a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
quality of life
a global concept including cultural, psychological, interpersonal, financial, and health factors
What is health related quality of life?
the value assigned to the duration of life as modified by the impairments, functional states, perceptions, and social opportunities that are influenced by disease, injury, treatment, or policy
components of health related quality of life
-duration of life
-impairments: symptoms, diagnoses, physiologic measures
-functional status: physical function, psychological function (affective, cognitive), social function (limitations in social role)
-health perception: self reported health, satisfaction with health
-opportunity: ability to withstand illness
Why is measuring health related quality of life important?
- better understanding of the impact of chronic conditions on the individual
- provides a more complete assessment of different disease treatments (med lets you live another year but you're miserable)
How do we measure health related quality of life?
-requires extensive testing and development to establish reliability and validity
quality of life in the health care policy arena: unanswered questions
1. can all states of health be assigned a "QOL" score so that we can quantitatively measure the benefits of an intervention, beyond traditional survival measures?
2. who decides the quality ratings?
3. can all disease states be rated?
the ongoing, systemic collection, analysis, and interpretation of outcome specific data for use in preventing or controlling disease or injury
purpose of immediate surveillance
to detect or prevent epidemics
purpose of annual surveillance
to define the health of a population and allow for appropriate planning of public health policy and intervention
passive surveillance definition
routine reporting of disease to health authorities
active surveillance definition
regular solicitation of information
What two special disease circumstances can be identified by public health surveilleance?
outbreaks and clusters; typically refer to infectious diseases
the amount of disease that is usually present in a population
an increase in the number of disease cases over that typically expected in a population
an epidemic that has spread over several countries/continents
- miss rona
epidemic patterns: common source
everyone is exposed at the same source
ex. group of 10 people had bad potato salad
epidemic patterns: propagated epidemic pattern
transmission occurs from person to person
ex. guy on plane had covid, spread it to people, people spread it to other off the plane,et c
epidemic patterns: mixed epidemic pattern
common source followed by transmission
outbreaks are typically identified through ___ data
outbreaks are typically identified through surveillance data
What are two unique components of outbreak investigation?
1. typically retrospective--relying on people's recall of events
2. require hypothesis generation--often do not know the source of the outbreak at the onset of the investigation
3. time pressure to identify and control source
4. action may be required prior to definitive evidence
steps in outbreak investigation
How do you calculate odds ratio?
T/F: When most epidemics are occurring, by the time the investigation is complete and source is found, the outbreak is almost done
What are disease clusters?
an aggregation of uncommon dzs that in space or time thought to be greater than could be by chance
- usually chronic dz like cancer
what diseases are most often part of disease clusters?
typically refer to chronic diseases, often cancer
What is space-time disease cluster?
defined location over a specified time
What is time-cohort disease cluster?
cluster in a group of people with some common characteristic other than location
Disease clusters almost always come from one of what two places?
work or medical setting
What is the real primary purpose for cluster investigation?
steps in cluster investigation
What is the main challenge in cluster investigation?
what are the other challenges
long term low level exposure is hard to measure
How would you construct a 2x2 table to establish whether exposure to something caused disease?
disease = yes. |. disease = no
exposure = yes. A B
exposure = no c d
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