HLTH200 Lecture Notes - Lecture 3: Social Epidemiology, Urinary Incontinence, Safe Sex
28 May 2018
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HLTH200: Week 3
Measuring Health
Global health, inequity and inequality → at a global level – widening gap
• Globalisation = major contributing factor to health inequality
Why do we measure health?
• Benefits of measuring health
o Better understanding of causes of disease and how it impacts
o cost
o allocation of resources
o we can start to set goals as to what we want to achieve with health
o assess whether we are making progress with those goals
• To look for:
o Change over time
o Differences between groups/regions/cultures/countries
• To evaluate an intervention
• To make decisions about the allocation of resources
o E.g. prevalence rates of disease in population – has this changed over
time?/For different groups? Do we follow the same individuals?
o Engagement in behaviours? Do we as a population smoke more or
less? How have policies/programs been associated with engagement?
o Does more funding need to be provided for a particular disease,
population group, health service or behaviour?
Clinical medicine (biomedical)
• Individual disease
• Diagnosis and treatment
VS.
Public health
• Population health
• Prevention and health promotion
Example: obesity (trends and population groups)
• USA = highest rates of obesity
• Rates of obesity are increasing from 1970 to 2010
• 2010 – lines are not solid, data shows projections (not guaranteed factual
data), just based on current trends
• Austria – greater increases not as fast (more flat) as Australia
• Australian data
o Men and women in major cities, inner regional, regional and remote
areas → men have higher rates of obesity overall
o SES status → the more money you have, less likely to be obese
• Patterns of physical activity; men and women in Australia
o Highest amongst 18-24, but big drop to 25-34 group
find more resources at oneclass.com
find more resources at oneclass.com
▪ Potentially due to parenthood/transition to work, transition
from uni to life
Decision-making
• Developing (and funding) programs
• Evaluating programs – ideally:
o Following same group of people over time to see improvement in
program (e.g. Measure Up Campaign)
o Observing effect of an intervention (e.g. trials of a Munch and Move
program)
• Other allocation of funds e.g. hospitals, treatments
Measuring health status:
Health conditions → prevalence of disease, disorder, injury or trauma or other health-
related states e.g. proportion of population diagnosed with cancer
Human function → alterations to body structure/function (impairment), activity
limitations and restrictions in participation e.g. associated disability from having
cancer. Healthy years of life lost, morbidity.
Wellbeing → measures of physical, mental and social wellbeing of individuals
Deaths → mortality rates and measures of life expectancy
Increased life expectancy:
• The control of many infectious diseases
• Improvements in hygiene and sanitation
• Advances in medical care
• Rising living standards and better working conditions
• Better nutrition and health education
• Reductions in smoking
Self-assessed health:
• So the majority of Australian people can expect to live for a long time, but are
we healthy and happy when we are alive?
• Often used in population health surveys
• Provides information on how healthy people think they are
• Good predictor of:
o Subsequent illness
o Future health-care use
o Premature mortality
• Self-rated health of Australians
o 1 = very good/excellent → 15 year old and over Australians rated 55%
o 2 = good → 29%
o 3 = fair/poor → 15%
• Among people who speak a language other than English in the home
o People saying English is very good tend to rate higher as
excellent/very good
o Proficiency is poor in English, saying health is poor is much higher
o May be due to SES, community connections, community isolation etc.
find more resources at oneclass.com
find more resources at oneclass.com
Other measures of health –
• Determinants of health
o Environmental factors
o Health behaviours – attitudes etc.
o Education
o Community and socioeconomic
• Health system performance
o Continuity of care → ability to provide uninterrupted, coordinated care
or service across programs, practitioners etc.
o Responsiveness → service is client oriented
Qualitative research –
• Fundamentally about meaning
• Analysis of words (and actions, pictures etc.) and not numbers (quantitative)
• Seeks to describe experiences, perspectives, assumptions, worldviews
• Contrary to popular belief, it does have a methodological rigour
Some more important differences –
• Quantitative research
o Use large samples
o Views research as something you do on participants
o Personal characteristics of experimenter irrelevant
o Results and conclusions based on statistics
• Qualitative research
o Uses case studies and individuals
o Views research as something you do with participants
o Personal characteristics of experimenter important
o Results and conclusions based on shared understanding between
researcher and reader
• ‘Mixed method’ research uses both and seeks to identify differences and
similarities in order to develop a fuller understanding of a phenomenon
Qualitative methods and public health –
• To explore a context to health and health behaviours
• To explore motivations for health. Why people engage in behaviours
• E.g. drinking cultures, drink driving, negotiation of safe sex
• To give marginalized or disempowered groups a voice: immigrants; those
living in poverty
• Often qualitative research leads to a systematic collection of quantitative data
(on a much larger scale)
Conclusion –
• Multiple ways of measuring health
• Current measures perhaps more weighted towards prevalence and mortality-
related data
• Qualitative research does have utility for public health
o Marginalised groups, reasons for behaviour and understanding
experiences of the system
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Global health, inequity and inequality at a global level widening gap: globalisation = major contributing factor to health inequality. Public health: population health, prevention and health promotion. Health conditions prevalence of disease, disorder, injury or trauma or other health- related states e. g. proportion of population diagnosed with cancer. Human function alterations to body structure/function (impairment), activity limitations and restrictions in participation e. g. associated disability from having cancer. Wellbeing measures of physical, mental and social wellbeing of individuals. Deaths mortality rates and measures of life expectancy. Increased life expectancy: the control of many infectious diseases. Improvements in hygiene and sanitation: advances in medical care, rising living standards and better working conditions, better nutrition and health education, reductions in smoking. Qualitative research : fundamentally about meaning, analysis of words (and actions, pictures etc. ) and not numbers (quantitative, seeks to describe experiences, perspectives, assumptions, worldviews, contrary to popular belief, it does have a methodological rigour.
