HLPR222 Lecture Notes - Lecture 3: Health Promotion, Disability-Adjusted Life Year, Public Health

56 views4 pages

amethystferret441

3 Mar 2017

School

University of Delaware

Department

Health Promotion

Course

HLPR222

Professor

Kaminski Vera

For unlimited access to Class Notes, a Class+ subscription is required.

Document Summary

Mortality data: derived from information reported on death certificates, used to develop and evaluate national and state initiatives in disease prevention and health promotion. Crude mortality rate (annual mortality rate?: total deaths/total population. Cause-specific mortality rate: number of deaths from specific disease/total population. Age-specific mortality rate: number of deaths in a specific age-group/total population in that age group. Infant mortality rate: number of deaths in infants < 1/total number of live births. Proportionate mortality rate: number of deaths from specific disease/total number of deaths. Case-fatality rate: number of deaths from specific disease/total number with disease, multiply by 100 to obtain a percentage. 1 year / total number of persons in the population at mid-year * Ypll gives more weight to deaths that occur among young people. Disability adjusted life years (dalys: a measure of the overall disease burden, expressed as the number of years lost due to ill-health, disability, or early death.

Related Questions

QUESTION 1 1. The relative importance or burden of a disease within a population will depend on a number of factors including : A. Disease frequency B. Disease severity C. Disease consequences D. All of the above

QUESTION 2 1 . With the epidemiologic transition, there is a reduction in malnutrition and _____ . A. Communicable diseases B. Injuries C. Non-communicable chronic diseases D. Mental health disorders

QUESTION 3 1. A major challenge to developing a burden of disease profile in low and middle-income countries relates to A. Unwillingness to share complete information B. Conflicting disease definitions C. Challenges obtaining information related to cause of death D. All of the above

QUESTION 4 1. The demographic transition describes which of the following changes to society A. Changes in birth and death rates that reflect a modern society B. Declines in mortality followed by a reduction in fertility C. A change in the age structure of the population D. All of the above

QUESTION 5 1. Measures of health status that combine mortality and morbidity data A. Facilitate comparisons both within and across populations B. Help estimate the quantitative health benefits from interventions C. Serve as tools to assist with resource allocation D. All of the above

QUESTION 6 1. The disability-adjusted life year is defined as A. A health gap population summary measure that combines time lost due to disability with that lost due to death B. A measure to compare the gap between the current situation to that of an ideal situation C. A measure that combines the amount of healthy life lost due to morbidity with that lost due to injury. D. Answers B and C

QUESTION 7 1. True or false? A key limitation to mortality-based indicators is that they fail to account for the morbidity caused by disease. True False

QUESTION 8 1. The most widely used composite measure of population health is the DALY, and this epidemiological measure is the sum of morbidity and ________data. A. Years of life lost (YLL) B. Morbidity C. Infant mortality rates (IMR) D. none of the above

QUESTION 9 1. What would be the best source of information on adult and infant mortality (in high income countries)? A. Disease registers B. Vital statistics C. Special survey study D. Hospital clinic statistics

QUESTION 10 1. Which term is best used to describe the proportion of people in a population who have a defined disease at a specific point of time? A. DALY B. Incidence C. Mortality rate D. Prevalence

QUESTION 11 1. Which term is best used to describe new cases of disease occurring in a population? A. DALY B. Incidence C. Mortality rate D. Prevalence

QUESTION 12 1. Which term is used to describe the absence or presence of illness or disease? A. Demography B. Morbidity C. Mortality D. Vitality

QUESTION 13 1. Mortality (death indicators) include: A. Mortality rate B. Infant mortality rate C. Neonatal morality rate D. All of the above

QUESTION 14 1. True or false? The value of life is often implicit in the way resource allocation decisions are made, which suggests that these decisions should be as explicit, open, and transparent as possible. True False

QUESTION 15 1. _________________is projected as the number one leading cause of disease burden in 2030. A. Ischemic heart disease B. Diabetes mellitus C. HIV/AIDS D. Unipolar depression

QUESTION 16 1. Some of the negative aspects of globalization include A. Greater insecurity of employment B. Poorer housing and sanitation due to rapid urbanization C. Greater vulnerability to environmental degradation D. All of the above

QUESTION 17 1. Current concerns about climate change focus on several developments including A. Rising global average land and sea surface temperature B. Increasing frequency of extreme weather conditions C. Both A and B D. None of the above

QUESTION 18 1. True or false? Diseases carried by mosquitoes are especially sensitive to meteorological conditions because they are vulnerable to changes in the ambient temperature. As a result of changing temperatures, infectious diseases such as malaria and dengue have decreased in incidence and geographic range. True False

QUESTION 19 1. True or false? International cooperation of infectious disease control has a long history that includes obligatory reporting of outbreaks of specific diseases. However, compliance with obligatory reporting has been poor due to economic consequences that have often accompanied notification of disease outbreaks. True False

QUESTION 20 1. True or false? Globalization is a relatively new phenomenon that began in the mid-20th century. True False

1. The risk of acquiring disease is measured by the a. Incidence rate b. Incidence rate times the average duration of the disease c. Incidence rate divided by the prevalence rate d. Prevalence rate e. Prevalence rate times the average duration of the disease

2. The strength of an association between a factor and a disease is best measure by a. Incubation rate b. Incidence of the disease in the total population c. Prevalence of the factor d. Attributable risk e. Relative risk

3. Case fatality rate for a given disease refers to a. The crude mortality rate per 100,000 population b. Cause-specific mortality rate due to the disease c. A fatal outcome of any disease d. The percentage of deaths among cases of the disease e. The proportion of deaths due to the disease among all deaths from all causes

4. An investigator is interested in etiology of neonatal jaundice. To study this condition, he selected 100 children who were diagnosed with this condition and 100 children born in the same period and in the same hospital who did not have a diagnosis of neonatal jaundice. He then reviewed the obstetrical and delivery records of their mothers to determine various prenatal and perinatal exposures. This is an example of a(n): a. Cross-sectional study b. Case-control study c. Cohort study d. Clinical trial e. Experiment

5. Which of the following statements describes the major advantages of a randomized clinical trial? a. It avoids observer bias b. It lends itself to ethical justification c. It yields results replicable in other patients d. It rules out self-selection of participants to the different treatment groups d. It enrolls representative patients

6. A survey conducted in England revealed that of 224 families in which there had been a known case of poliomyelitis, 56 maintained parakeets as a family pet. In another British survey, 30 out of 99 poliomyelitis patients questioned kept parakeets. The inference that there is some relationship between the presence of a parakeet in a household and the occurrence of poliomyelitis among household members is a. Correct b. Incorrect because of failure to distinguish between incidence and prevalence c. Incorrect because a proportionate ratio is used when a rate is required to support the inference d. Incorrect because a failure to recognize a possible cohort phenomenon e. Incorrect because there is no control or comparison group.

7. An investigator determines the correlation coefficient between triglyceride levels and degree of atherosclerosis in sampled blood vessels to be +1.67. On the basis of this you would conclude that: a. Triglyceride level is a good predictor of atherosclerosis b. Triglyceride level is not a good predictor of atherosclerosis c. High triglyceride levels cause atherosclerosis d. Atherosclerosis cause high triglyceride levels e. The investigator has incorrectly determined the correlation coefficient

8. A screening test of known sensitivity and specificity is applied to two populations. The prevalence of the disease being screened for is 10% in population A and is 1% in population B. Which of the following is true? a. The percent of all negative tests that have false-negative results is lower in population A than in population B. b. Specificity is lower in population A than in population B. c. Reliability is higher in population A than in population B. d. The percent of all positive tests that have false-positive results is lower in population A than in population B. e. Specificity is higher in population A than in population B.

9. Serum cholesterol levels are obtained for four healthy men. The probability that all will fall below the 10th percentile of the distribution of cholesterol for healthy males is: a. 0.4 b. 1 â (0.1)4 c. (0.1)4 d. (0.9)4 e. Cannot be determined from these data

10. In a diabetes screening program, the screening level for a positive blood sugar level in test 1 is set at 160 mg/dl, and in test 2 at 130 mg/dl. The sensitivity is: a. Greater in test 1 b. Greater in test 2 c. Equal in test 1 and 2 d. Dependent on the size of the population being evaluated

Part II 1.The California Occupational Mortality study data set was employed to assess mortality data for the years 1979-1981. A 2% sample of employed persons from the 1980 census of California was used. It contains the occupation of each person who had died. This study, like any occupation-based study, is restricted to the work life span as far as age of subjects is concerned. This study used ages 16-64 years. Certain persons, because of their source of work, were excluded as subjects: homemakers, retired persons, students, disabled, military personnel, etc. Only main-stream-type employment was used in this study to establish occupations at risk for heavy alcohol drinking. Using the Table below, answer the following:

1.What occupations are most vulnerable to acquiring cirrhosis of the liver from heavy drinking?

2.List several of the occupations identified by the research studies that are more vulnerable to alcohol-induced, cirrhosis related deaths and that have the highest mortality rates.

3. What are possible confounding variables for the research in occupations and heavy drinking that lead to fatal diseases?

4. Based on available research data, develop and construct a web of causation along with the appropriate decision trees for occupational group-related alcohol deaths. Table. Alcohol Related Deaths in California, 1979-1981 Cirrhosis 5.5% Digestive organ cancers 5.7% Injuries 13.7% Suicide and homicide 5.% All other causes 64.9%

Zika and microcephaly Since May 2015, Brazil has experienced a significant outbreak of Zika virus. In recent years, Brazilian officials reported an increase in the number of babies born with microcephaly.

1. Briefly describe what we know and what we do not know about Zika virus.

2. What has been done and what should be done to prevent Zika virus epidemic in US and world-wide?

This includes showing all calculations and explaining why you selected a specific answer for each multiple choice question (i.e. donât just circle the correct answer). I am looking to see how you got the answer, not just that you have the correct answer.

Below is data from the United States Cancer Statistics about the number of news cases of lung cancer in males in the U.S. for 2011 for ages 30 and older.

Table 1: U.S. Population Size and Incidence Cases of Lung Cancer in Males for 2011

Age (Years)	U.S. Male Population	White Population	White Incidence Cases	Black Population	Black Incidence Cases
30-34	10,181,564	7,950,924	88	1,383,650	22
35-39	9,666,162	7,557,263	212	1,271,897	23
40-44	10,363,126	8,259,215	643	1,324,847	132
45-49	10,856,131	8,766,225	2,032	1,373,346	444
50-54	10,976,172	9,004,383	5,128	1,329,551	1,148
55-59	9,733,849	8,101,629	8,607	1,091,030	1,687
60-64	8,466,308	7,183,960	12,340	845,362	2,067
65-69	6,014,777	5,178,255	15,792	539,796	2,077
70-74	4,360,942	3,769,569	16,011	376,129	1,864
75-79	3,204,196	2,807,216	14,319	255,221	1,426
80-84	2,319,839	2,078,071	11,284	154,155	883
85+	1,873,942	1,688,433	7,616	117,267	545
Total	88,017,008	72,345,143	94,072	10,062,251	12,318

3. What is the age-specific incidence rate for lung cancer in white men age 75-79 for 2011?(1 pt)

0.005 per 1000

1.3 per 1000

1.2 per 1000

5.1 per 1000

5.6 per 1000

F. Cannot be calculated from the given information

4. What is the age-specific incidence rate for lung cancer in black men age 75-79 for 2011? (1 pt)

0.005 per 1000

1.3 per 1000

1.2 per 1000

5.1 per 1000

5.6 per 1000

F. Cannot be calculated from the given information

Questions 5 through 7 are based on the information below:

Using the information in Table 1, researchers calculated the crude incidence rates and age-adjusted incidence rates (via the direct method) for both groups.

Table 2: Crude incidence rates and age-adjusted incidence rates for white and black males

White Males		Black Males
Crude Incidence Rate	Age-adjusted Incidence Rate	Crude Incidence Rate	Age-adjusted Incidence Rate
1.3 per 1000	1.2 per 1000	1.2 per 1000	1.5 per 1000

5. True or False, there is likely a difference in the age composition between the white and black males. Explain your answer

6. Based on the information in Table 2, it was reported that there was an increased risk of lung cancer in black males in 2011. (1 pt)

The conclusion is:

Correct, the age-adjusted rate is higher in black males compared to white males

Correct, because both the crude and age-adjusted rates are higher in black males compared to white males

Incorrect, because the incidence rate for white males is actually higher than the incidence rate for black males

7. What type of age-adjusted rate was calculated in table 2? How does it differ from the age-adjusted rate in question 5 in the in-class exercise for age-adjustments? Hint: See slide title: Adjustments for Other Measures of Disease Frequency in the lecture title Adjusted Rates (1 pt)

Question 8 is based on the information given below:

Cause-specific mortality rates for men in 2010 in the U.S. from various types of cancers are shown in the table below:

Cause-Specific Mortality Rates

(per 100,000 Men)

Location of the Cancer

in the Body White Asian

Pancreas 13.2 5.7

Prostate 19.1 2.5

Lung 62.3 18.5

Skin 4.9 0.3

8. The inference that White men in the U.S. are at higher risk of death due to cancer of the pancreas, prostate, lung, and skin compared to Asian men in the U.S. is

A. correct

B. incorrect because of failure to determine cause-specific mortality rates

incorrect because proportionate mortality alone does not give an estimate of risk

D. incorrect because of failure to adjust for differences in the age composition of the two populations

E. incorrect because counts were used when cause-specific mortality rates were needed

9. In January 1996, a team of epidemiologists identified a sample of 4,500 men, 65-74 years of age, for a study of prostate cancer. Tests indicated that 315 of the men already had prostate cancer and, therefore, were not at risk. The rest of the men were followed prospectively for five years to determine the incidence rate of prostate cancer in the sample. By the end of the five years of follow-up 156 of the men had developed prostate cancer. What is the incidence rate of prostate cancer in this group?

10. An epidemiologic investigation that started on January 1, 2011, identified a population of 1,000 individuals. At the start of the study 4 were found to have the disease. During the year of study, 6 new cases were found; thus a total of 10 cases were identified. Among those 10 cases, 6 deaths occurred during the year. What was the prevalence of the disease during the 1-year study?

pinkhornet564

HLPR222 Lecture Notes - Lecture 3: Health Promotion, Disability-Adjusted Life Year, Public Health

Document Summary

Get access

Related Documents

HLPR222 Lecture Notes - Lecture 4: Bladder Cancer, Unimodality, Blood Sugar

HSCI 130 Study Guide - Final Guide: Cohort Study, Prevalence

HSS 4303 Study Guide - Midterm Guide: Total Variation, Attributable Risk, Relative Risk Reduction

Related Questions