Population Health and Epidemiology Review

Flashcards covering key vocabulary from lectures on Population Health, the Ecological Model, Prevention & Public Health, Epidemiology, Life-Course Perspective, and Social Justice.

Population Health

A concept encompassing health beyond healthcare, including the influence of social conditions, and requiring collective actions to assure health conditions

Social Conditions (#1 health is more than healthcare)

Factors like distribution of resources, social position, and racism that are equally influential to genes and medical care in determining health outcomes.

Social Position and Health (#2 distribution of resources)

Higher social position generally correlates with a healthier life, while lower social position often leads to earlier disease and a shorter lifespan.

Racism Burden (#3)

Refers to the cumulative negative impact on health due to various forms of racism, including personally mediated, institutionalized, structural, and systemic.

Anticipation of Racism (#3)

The mental and emotional stress response triggered by expecting to encounter racism, which can negatively impact health.

#4 Choices shaped by context

we are shaped by choices we have such ad food deserts where Geographic areas where access to affordable, nutritious food is limited, constraining individuals' choices for a healthy diet.

#5 Toxic Stress

Chronic stress resulting from high demand and low control situations, which can lead to disease and depression.

#6 Health Inequalities are not natural

Disparities in health outcomes that are not natural but arise from societal structures, policies, and are detrimental to overall public health, arise fromd ecisions we made

#7 Social Policy as Health Policy

The understanding that policies related to sanitation, wages, housing, and education are crucial determinants of health and can lead to significant gains in life expectancy.

#8 Societal Cost of Inequality

The collective burden on society due to health inequalities, manifested through increased medical costs and lost productivity, high inequality = poor outcomes

#9 Health is Political

The idea that health outcomes are deeply intertwined with political decisions, power structures, and societal values, we all pay the price 

Ecological Model (Health)

A framework for understanding health determinants across multiple interacting layers: individual, family, community, and systems/policy.

Social Determinants of Health (SDOH)

The conditions in which people are born, grow, live, work, and age that shape health outcomes like morbidity and mortality.

Upstream Change

Addressing the fundamental causes of health issues (e.g., social and economic factors) rather than solely focusing on treating diseases after they manifest.

Morbidity

Refers to health outcomes, specifically the state of being diseased or unhealthy within a population.

Mortality

Refers to the quality and length of life, often measured by death rates within a population.

Primordial Prevention

Actions taken to prevent the development of risk factors themselves by addressing underlying social and economic conditions (e.g., reducing poverty, improving education).

Primary Prevention

Measures taken to prevent disease or injury before it occurs (e.g., vaccinations, wearing seatbelts).

Secondary Prevention

Early detection and intervention to stop or slow the progression of a disease (e.g., screenings, contact tracing).

Tertiary Prevention

Actions taken to reduce the impact of an existing disease or injury, aiming to improve function and prevent complications (e.g., rehabilitation, aspirin after a heart attack).

Prevention Paradox

A phenomenon where an intervention offering small benefits to many individuals can yield a significant benefit for the population as a whole.

Public Health Core Functions

The essential roles of public health, traditionally categorized as Assessment (measuring problems), Policy Development (identifying interventions), and Assurance (implementing and evaluating solutions).

Population (Public Health)

A number of people living in a particular area, often the focus of public health interventions. Health of a population measured by health status indicators

Community ( Health)

A group of people who share common characteristics, often serving as a unit for health interventions. Perspective on public health that assumes community to be an essential determinant of health

Community Health

A perspective within public health that posits the community as an essential determinant of health outcomes.

Public Health

The organized efforts of society to ensure the conditions in which people can be healthy, through collective action.

Epidemiology

The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control health problems.

Epidemiological Triad

A model illustrating the interaction of three components—host, agent, and environment—in disease causation.

Incidence

A measure of the rate at which new cases of a disease or health condition occur in a population at risk over a specified period (can be cumulative or rate based on person-time).

Prevalence

A measure of the total number of existing cases of a disease or health condition in a population at a specific point in time or over a period, representing the disease burden.

Crude Rate

An unadjusted measure of a health event in an entire population, not accounting for confounding factors like age or sex.

Adjusted Rate

A rate that has been standardized statistically to account for differences in population characteristics (e.g., age or sex) when comparing health events across populations.

Standardized Mortality Ratio (SMR)

A measure used to compare the observed number of deaths in a population to the expected number of deaths if the population had the same age-specific mortality rates as a standard population.

Relative Risk (RR)

A measure of association that compares the risk of an outcome in an exposed group to the risk in an unexposed group.

Odds Ratio (OR)

A measure of association that compares the odds of an outcome in an exposed group to the odds of an outcome in an unexposed group, often used in case-control studies.

Interpretation of Risk Measures (>1)

For Relative Risk or Odds Ratio, a value greater than 1 indicates an increased risk of the outcome among the exposed group.

Interpretation of Risk Measures (<1)

For Relative Risk or Odds Ratio, a value less than 1 indicates a protective effect of the exposure against the outcome.

Causation vs. Correlation

The distinction between two variables being simply associated (correlation) versus one variable directly causing another (causation), which requires considering factors like confounding, temporality, and ecological fallacy.

Critical Periods (Life-Course)

Specific developmental windows (e.g., fetal, childhood) during which exposures can have profound and lasting effects on an individual's health.

Accumulation of Risk

The concept that health is influenced by the total burden of exposure to detrimental factors over time, including dose-response effects, clustering of risks, and chains of risk.

Allostatic Load

The 'wear and tear' on the body caused by chronic or repeated exposure to stress, leading to physiological dysregulation.

Health Equity

Providing resources and opportunities based on individual needs to achieve fair health outcomes, in contrast to equality which provides the same inputs to everyone.

Health Disparities

Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health experienced by socially disadvantaged populations (e.g., gaps by race, SES, gender).

Poverty

A state of resource insecurity that leads to detrimental health outcomes such as poor nutrition, unsafe housing, and chronic stress.

Income Inequality

The unequal distribution of income within a population, often measured by the Gini Index, with higher inequality correlating to worse health outcomes.

Forms of Racism

Various ways racism manifests, including personally mediated (individual prejudice), institutionalized (discriminatory policies/practices), structural (societal systems), and systemic (entrenched across institutions).

Redlining

A discriminatory practice that historically denied services or increased costs for residents in certain areas based on race/ethnicity, leading to segregation, poverty, violence, and exposure to environmental toxins.

White Supremacy Culture Traits

Characteristics often embedded in institutions that reinforce racial hierarchy, such as perfectionism, power hoarding, and prioritizing objectivity over emotion.

Social Justice Principles (Health)

Foundational beliefs that ensure rights are not denied due to perceived inferiority, requiring collective societal action and the involvement of affected communities to achieve health equity.

Cultural Humility

A lifelong commitment to self-reflection and critique, openness to learning from others, addressing power imbalances, and developing mutually respectful partnerships with communities to improve health.

Intersectionality

The interconnected nature of social categorizations such as race, class, and gender, creating overlapping and interdependent systems of discrimination or disadvantage for individuals or groups, leading to compounded disadvantage.

Practice Implications for Health Equity

Actions such as recognizing cultural lenses and biases, building diverse relationships, elevating community knowledge, and advocating for systemic change to promote health equity and social justice.

high risk strategy

screen individuals and target high risk

population strategy

target population determinants of health, lower risk factors, shift population mean left

steps of problem intervention

1. measurment, what is the scope of the problem

2. identify risk and protective factors, what are the causes

3. develop and evaluate intervention, what works and for whom

4. implementation, scale up effective intervention

inequity

continuing and oersistent gaps, can be traced to unequal economic and societal conditions, systemic and unavoidable.

moving toward social justice

• identify our own cultural lenses to recognize potential powert differences and power imbalance

• recall differences arent innately bad but values can be complex and nuanced

• how and shy sociocultural explinations ead to equitable solutions

best known solutions are already known by: 

affected community

3 steps to equity

assesment, policy development, assurance