Textbook Notes (368,566)
Canada (161,966)
HLSC 2P21 (34)
Chapter 6

HLSC 2P21 Chapter 6: Chapter 6 - Population Health in Canada

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Health Sciences
Terrance Wade

Chapter 6: Moving to a Population Health Perspective • Individual level to population-level: o Makes an implicit assumption that illness, and health status are randomly distributed across the population o Ability to better address health concerns ▪ Health Impact Pyramid – used to describe individual effort required for various public health initiatives and their overall effect on population health ▪ Health interventions target lower down the pyramid will have a greater effect on overall health and require less individual efforts Population Health Measures • Health can be measured at the cellular, individual, and population level o Cellular – cells need a constant supply of oxygen and glucose to be healthy o Individual – focus efforts on prompting exercise and good nutrition, leading to a healthy lifestyle o Population – focus efforts on developing a strategy that will address the needs of the population, not hose of specific individuals • Measures of health at population level fall into three categories: direct, indirect, and proxy • Direct measures of health – generally based on individual-level data that gets aggregated to provide an overall sense of the population o Could be based on reviewing patient medical charts or administrative health care data from provincial/territorial health insurance plans to get an estimate of the number of people with a specific diagnosis o Healthy Utility Index (HUI) – a multidimensional measure of health status, tapping eight domains: vision, hearing, speech, mobility, dexterity, cognition, emotion and pain/discomfort • Indirect measure of health – usually collected at the individual level as well, but focus on markers and lifestyle behaviours that are connected to health outcomes o Health markers – factors linked to health outcomes but not necessarily outcomes (smoking, obesity and nutrition are not measures of a person’s health, but linked to diseases) o Ecological fallacy- direct inference from population-level statistics to specific individuals • Proxy measures of health – population-level indirect measures likely to be associated with overall health status o Often used to compare across countries o Collected as part of the economic profile and vital statistics of countries (life expectancy) • All have limitations o People may not be honest creating bias o Proxy measures can be problematic and contradict one another Epidemiology • The inception of population based epidemiological methods and its demonstrated strength • Two goals of epidemiology: o Understand the rate at which a disease will spread through a population and the overall burden of disease o Identify the exposure that places a person identified with the disease at risk ▪ Host – person made of various characteristics, making them more or less susceptible to disease ▪ Agent – carrier of disease ▪ Environment – context, place, and time in which contact between host and agent occurs John Snow – Cholera Outbreak • 1831 outbreak • Cholera is an intestinal infection caused by a bacterium found in untreated drinking water • Snow mapped identified cases and found they clustered around those who used the pump on Broad street • Ordered the handle to be removed • Importance of his discovery being that he found the cause based on epidemiological investigation o Made possible by the invention of the microscope Statistical Fundamentals n • Rate = (cases / target population) x 10 o Measure of frequency over a specific period of time • Incidence rate – provides number of new cases of a specific disease across a target population over a given period of time o Provides a sense of how fast a disease is spreading • Prevalence rate – provides an estimate of the total number of cases in a given population over a specific period of time, including both new and old cases o Excludes cases where the patient has recovered or died • Prevalence – provides a measure of overall burden of disease over a given period of time o Provides important information for health care systems
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