Essay About Public Health Issues And Necessary A Risk Factor

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BMS1042LECTURE 1Learning objectivesUnderstand the public health issues that surround you • Be able to identify the main areas of public health in a current and historical context • Know the difference between cause and association – Introduction to Bradford Hill Criteria Public health issuesAlcoholismObesityAllergies and intoleranceAntibody resistance SmokingIce epidemicMental health The practice of public health aims to:Improve the health of an entire populationReduce health inequalities in a populationStep beyond the individual-level focus of mainstream medicineIMPORTANT TOOLS: EPIDEMIOLOGY & BIOSTATISTICSEpidemiology is the branch of medicine, which deals with the incidence, distribution, and possible control of diseases and other factors relating to health  John Snow & the Broad Street pumpTracking and surveillance to prevent an epidemic  Outbreak investigationCholera, tracking of the original source (the well) to prevent further contamination/ disease outbreakCAUSATIONStatistics can be manipulated to not show causation but correlationThere is usually not one single cause for any disease CAUSATION; SUFFICIENT & NECESSARY A risk factor is sufficient, if the presence of this factor alone is enough to result in the diseaseA risk factor is necessary if the disease is never present when the factor is not present NECESSARY BUT NOT SUFFICIENTTo get tuberculosis it is necessary to be exposed to Mycobacterium tuberculosis but the exposure in itself is not sufficient for the disease state to occurNEITHER NECESSARY NOR SUFFICIENTCigarette smoking is neither necessary nor sufficient for the development of lung cancerNECESSARY AND SUFFICIENTA necessary and sufficient cause of Ebola Fever is the Ebola virus.A necessary and sufficient cause of Huntington’s chorea is the genetic mutation that causes this condition (dominant) SUFFICIENT BUT NOT NECESSARY Decapitation is sufficient for death, but death is not necessarily caused by decapitationFACTORS IN CAUSATION (RISK FACTORS)Few diseases have a single cause hence there are common ‘risk factors’Pre-disposing: age, sexEnabling (disabling): low income, poor nutritionPrecipitating: exposure to a disease agent (organisms, bacteria, viruses)Reinforcing: repeated exposure (radiation, constant re-exposure)Risk factors are used to describe factors associated with the disease (e.g. smoking, lung cancer) CAUSATION-ESTABLISHING EVIDENCETemporal relationship: exposure occurs before disease (cause must precede effect)Plausibility: consistent with other knowledge (but other evidence may just be lacking)Consistency: Several studies giving the same findingStrength of association: What is the relative risk (a weak relationship does not mean a factor is not casual, e.g. smoking) (relative risk/risk ratio and odds ratio – quantitative)Dose-response: Increases exposure = increased outcome Reversibility: remove exposure = no outcomeStrength of study design (advantages and weakness of studies)If there is an association between a possible cause and an effect, it could be due to bias, confounding, casualty of the relationship, and result of chance.

COMMUNICABLE DISEASESAre infectious/ contagious diseasesMeasles, smallpox, Spanish flu, HIV/AIDS, Typhus, Chloera, Black deathNON-COMMUNICABLE DISEASESDiseases that is non-infections and non-transmissible among peopleCardiovascular diseases, cancer, chronic respiratory disease, etc.Leading causes of death and diseases worldwideNCD PREVENTIONTobacco controlPromoting sensible alcohol consumptionImproving nutritionEncouraging physical activity Smoking is the epidemic of the 20th century Injuries are the principal cause of death in almost half of the people under 45 years of ageFactors that may influence road safety or drowning (directly & upstream perspective)EPIDEMIOLOGY IN PROFESSIONAL LIFETIMEEmerging infectious diseasesChanging lifestyles and behaviorsImpact of climate changeDirect (impact on coastal communities)Indirect (food water, social, economic) effectsTemperature change (heat waves, storms, floods)Nutrition and food security (crop yields)Water availability and qualityAir quality (pollutants, aeroallergens)Vector, rodent and bird-borne diseasesExposure to UV radiation LECTURE 2PUBLIC HEALTH BY NUMBERSUnderstand enough biostatistics to be able to make sense of the contents of journal articles – this will be useful for subsequent years of the course. • Be able to do simple statistical analysis. • Be more critical of how public health is reported in the media. Importance of biostatistics in public healthBiostatistics is the science of statistics applied to the analysis of biological or medical dataBiostatisticaians analyse data, give advice to others in research units, sample size calculations, randomization of schedule – topics such as cardiac surgery, antenatal care, breast cancer etc.Biostatistics and Epidemiology go ‘hand in hand’ in public healthGood data analysis involves good dataClassification of data into types of data[pic 1]WHAT TYPE OF GRAPH, SUMMARY STISTICS, ANALYSIS? – Wrong identification of the type of data may result in the wrong analysis being doneTYPES OF DATA• Categorical – Nominal (order of categories doesn’t matter) e.g. Blood group (A, B, O, AB) e.g. Diabetic (Yes / No) Also known as “binary”