HLTC21H3 Study Guide - Midterm Guide: Gulu District, Canadian Food Inspection Agency, Toxin

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Published on 27 Jan 2013
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HLTC07 - Lecture 1: Introduction
Epidemiology: addresses human populations with respect to their health
o Frequency quantified rate of its occurrence
o Prevalence proportion of individuals afflicted by the illness at a particular time health state
o Incidence proportion of individuals that receive the illness at a particular timeevent
o Incidence density number of cases diagnosed in a given population in time
relative to life expectancy of human
population year event
e.g. 10,000 person-years
o Features:
Endemic (one region) versus epidemic(multiple regions) versus pandemic (global)
Knowledge base research and science
Causation etiology/etiogenesis or illness
E.g. causal (attributable) rate ratio such as the study of cigarette smoking in the etiology
of lung cancer
X causes a disease Y if we stop X what does it do for disease Ye.x. cigarette
smoking and lung cancer
Aggregate of differentiated sub disciplines
Many different disciplines can be involved in this field of epidemiology
Demography: the study of populations (size, structure, and potential impact)
o Structureyounger, older, middle aged population
o Most growth occurs in developing countries
o Death rates have fall down faster than the birth ratesresulting in rapid population growth
o 60 years population more than doubled to exceed 7 billion
o Growth rates (difference between birth rate and death rate) 2% in the late 1960s
o Currently about 1.2%/yr 70 million people each year
o Future population projections
Main dragging force is fertility average number of children women has
High projection around 2.6 children per woman
Medium projection 2.1 children per woman
Lowest projection 1.6 children per woman
o Dynamics of population growth
Immigration and emigration doesn’t matter, birth rates and death rates matter
Natural change=birth death
Net migration= who is coming who is leaving
o Purpose
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o Demographic transition:
Transformation of a population
1st stage= Characterized by high birth rates and high death rates, where people live
longer and have smaller familiesinverted cone
o First stage where demographic transition didn’t occur yet
2nd stage= people have a lot of kids, but people also live longer
People are aging triangle
3rd stage= death rates continue to go down, birth rate goes down
4th stage= death rates and birth rates are lowbulging in middle
o Lower proportion of people in 0-4 age bracket
o Youth bulge
o Influences of population growth
Contraceptive prevalence
Mortality from HIV/AIDS and other infectious diseases
Gender equitywoman going into work forcedelaying child bearing, less children impacts
population growth
Migration entering a foreign country key factor in population growth in some places, and
population decline in other places
Emigrationleaving your native country
Government policies India and China have one child policy, other countries promote child
bearing
o Impacts of population growths
Health adverse impact especially on women and children
529,000 women die from child birth/pregnancy for every woman that dies from
pregnancy, others have chronic disabilities
Poverty small families allow for women to apply for work and find workmore investment
and growth
Natural resources as fertility declines government and household have more money per child
We are facing challenged in sustainability. Many people live in conservation lands
Water scarcity causes wars
Conflicts and security all the previous leads to this
Real issue is not having good education, resources, and good life which leads to conflicts
and security
Public Health
o 2nd half of the 2-th century for public health free health care
o ‘Health’ of people at largethe collective level of ill health and disease
the population/community are clients of the health care system which should be available to the
public and society financed
o ‘Health’ - more inclusive than ‘medicine’
o Who are public health professionals people involved in improving health of population and general
conditions that improve the health of certain populations (ex. Nutritionists, nurses, public health
educators)
o What are the actions of public health
Education
Regulations
Service
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Main messages
o World is demographically complex and divers
o Demography Epidemiology
Public Health
HLTC07 Lecture 2: The burden of Disease and Disability
Global burden of disease
o Individual level data are aggregated to generate estimates of quantities
o Limitations
Difficulties in comparing indicators on city, town, country can expect certain categories to
estimate mortality, but not the same for another country
These are all estimates, can be as close as possible to reality. There may have been
numbers that were hard to compare so people had to use projections
Statistics may be partial or fragmented
Some places are capturing data that are not fatal. No clear reporting of these kinds of
conditions
Under or over- estimates
Ties into the partial fragmented data that is available
o People can die and no record of how they dies
o If no reason is sought to why person died then overestimate
o Within a region someone may die and its clear they died of respiratory infection
but not specific how, so it could be over or underestimation
Required detailed and comprehensive assessments
When governments need to set priorities based on detailed and comprehensive
assessments, and lack of it can be a problem in aggregated data and what policies can in
place
o How do they know that this is the most common assessment so that they can
set those priorities
Introduction/ history
o First commissioned by WHO in early 1990s to take place
o First study took place but wasn’t large scale and eventually expanded (revised in 2002)
o Aim is to generate a more comprehensive understanding of mortality and disease
o Done by age, sex, and region. Gives idea of who is dying, getting disease, at what age category and
regions
o Eventually expanded to different regions
o New metric disability-adjusted life year (DALY)
Simultaneously quantifies the burden of disease with mortality
How many years were lost to early death and how many years were lost to premature disability
o First study looked at x number of regions and also looked at bigger categories that were later refined
and separated
o Refines study was based on disease and injuries caused by age, sex, etc.
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