GLPH 271 > Module 2 > Flashcards

Module 2 Flashcards

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1
Q

What is epidemiology?

A

The study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems.

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2
Q

T/F: Epidemiological measurements and analysis help health professionals make informed decisions about how to best use resources to prevent disease and promote health

A

TRUE

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3
Q

What role do measurements and assessments have in shaping health interventions?

A

Measurements and assessments in health reveal the need for health interventions. In addition, they provide evidence about whether or not health interventions are effective.

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4
Q

What disease is Bill Gates talking about?

A

Polio

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5
Q

What are examples of epidemiological questions?

A
  • What is the impact of the opioid crisis on mortality in Canada?
  • What interventions are effective in reducing this mortaliity?
  • Should the government spend more money on facilitating access to naloxone kits or on supervised consumption sites to reduce opioid related deaths?
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6
Q

Often epidemiological data collected on __________, such as Indigenous Peoples of Canada, comes from a place of colonization.

A

minority groups

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7
Q

Data registries and databases will often identify Indigenous Peoples through the use of the ________________________

A

Indian Registry

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8
Q

What are two conditions for reaching data sovereignty for Indigenous Peoples of Canada?

A

Decolonization of Data
Indigenous Data Governance

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9
Q

What is Indian Registry? Are all Indigenous Peoples registered under the Indian act?

A

People registered under the Indian Act are recognized by the federal government as having Indian status. That means only Indigenous Peoples living in Canada who are registered with the federal government will have their data recorded and counted to inform new policies.

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10
Q

What is Sovereignty?

A

Full right and power of a governing body over itself, without any interference from outside sources or bodies.

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11
Q

What are the five D’s of colonization of Indigenous data? Maggie Walter noted these:

A

Disparity
Depravation
Disadvantage
Dysfunction
Difference

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12
Q

The five D’s can be used to classify Indigenous populations as… why is this harmful?

A

problematic and in need of help… this is especially harmful as this data can be used to rationalize dispossession and marginalization of specific communities, leading to a false sense of dependency.

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13
Q

What does OCAP stand for?

A

First Nations Principles of OCAP stand for Ownership, Control, Access, and Possession that First Nations control data collection processes in their own communities

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14
Q

TRUE/FALSE: Increased access to Indigenous data is important for communities to determine, under appropriate mandates and protocols, how to make decisions regarding why, how and by whom information is collected, used or shared

A

TRUE

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15
Q

In the cup analogy, what do the seeds going into the cup represent, what about the ones in the cup, and what about the ones leaving?

A

Seeds in - incidence
Ones in already - prevalence
Ones leaving - death/cure

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16
Q

What does prevalence of disease tell us?

A

Number of existing cases of a disease in the given population at some time point.

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17
Q

Calculation for prevalence?

A

of cases/total population

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18
Q

What are the two types of prevalence?

A

Point prevalence - at one specific point in time
Period prevalence - indicative of a period of time

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19
Q

Per how many is prevalence typically reported?

A

per 100 000

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20
Q

What is incidence?

A

Measure of how quickly new cases of a disease arise in a population over defined period of time. Only considers new cases within the “at-risk” population, within the time period.

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21
Q

Incidence is also a measure of…

A

RISK

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22
Q

What is cumulative risk also known as?

A

Incidence Proportion

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23
Q

What is cumulative incidence?

A

a measure of the proportion of the population who develop the disease over a period of time. It is a measure of risk.

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24
Q

What is the formula for cumulative incidence?

A

= # of new cases of a disease over a period of time/total population at risk

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25
It is not uncommon to see the numerator (# of new cases over a time period) expressed as an ....
AVERAGE... made when most of the population is susceptible (chronic illness)
26
What does total population at RISK EXCLUDE? How does the equation get modified?
Those who have the disease or who are incapable of developing it. Total population-# of existing cases
27
What does Incidence Density Rate measure? What is it also known as?
Person-Time IR/Incidence Rate length of time people were at risk of the disease of people who develop the disease/# of person-years at risk of the disease
28
Can we assume population is always constant? What are examples of when population increases (2)/decreases(3).
NO Increases - high immigration, birth rate Decreases - high incidence, high death rate from other causes, emigration
29
What is proportion of population developing new cases of disease?
Incidence
30
What is proportion of population with disease?
Prevalence
31
What is this an example of: what percentage of people in Canada had COVID-19 on September 15,2020?
Prevalence
32
What is this an example of: What proportion of people in Canada developed COVID-19 in the first week of September 2020?
Incidence
33
Based on Han Rosling's video, as child mortality rates dropped, women chose to have more/less babies.
less
34
Which African country is the best on the child mortality developing countries graph?
Ethiopia
35
What do incidence and prevalence not measure?
how or why people STOP having the disease if people are cured, die of disease, or die of another cause altogether
36
What does crude mortality rate meaasure?
count of all deaths over a specified time period divided by population at midpoint of the time period being considered
37
What is the typical time period for crude mortality rate? Out of how many people is it reported?
Reported per 100,000 people, usually a year
38
What is the equation for crude mortality rate?
of deaths over a time period x 100 000 / population at midpoint of time period
39
What are the two types of crude mortality rates?
All-Cause --> considers deaths for any reason in the population Cause-Specific --> measures deaths in a population from a specific disease
40
Where were there more opioid related deaths and hospitalization rates?
BC, Alberta, Yukon, Northwest Territories
41
Which age range did the greatest amount of opioid deaths take place?
30-39
42
What percent of the 3823 opioid-related deaths in 2019 were unintentional.
94%
43
How can population subgroups be defined?
Age, sex, race, other demographic factors
44
What is specific mortality rate?
Numerator only encompasses the deaths of individuals who meet the sub-group criteria. Denominator encompasses total number of individuals that meet the criteria. of deaths over a period of time (in certain subgroup) x 100 000/subgroup population at midpoint of time-period
45
What is standardization of mortality rates? When is it used? What is the most common metric to standardize mortality?
Used when comparing mortality in two populations that differ in terms of characteristics that are known to influence mortality. Crude mortality doesn't take into account sex, age, or general composition of population. Most common metric is by age.
46
When looking at mortality rates from Alzheimer's and Dementia in 2010, you see that in Chad it is 4.6 per 100 000, while in Canada it is 36 per 100 000. Why?
Canada has greater proportion of old people
47
What are reasons for changes in Alzheimer's numbers after a few years?
- change in sampling - change in health care quality - changes in diagnostic criteria - possible false data in the magazine/google search
48
Will all-cause mortality always be greater than any single disease specific mortality?
Yes. In calculations only numerator is changed, and must be smaller for any single disease than for all causes of death.
49
Will specific death rates always be greater?
No generalizable statements can be made about the size of the rate since both numerator and denominator changed.
50
In developing countries, it can be difficult to obtain reliable measurements of population morbidity and mortality... WHY?
- people die at home, never been to health facility, makes it difficult for vital event registration
51
What is morbidity?
Condition of having illness/disease
52
What is mortality?
Relates to death
53
A system by which a country's government records and tracks statistics on vital events, including births, deaths, marriages, divorces, and fetal deaths. Includes permanent record for every event and statistics on population dynamics and health indicators on a continuous basis. Helps quantify prevalence, distribution, and causes of mortality while identifying health inequalities.
Vital event registration
54
What is verbal autopsy? Do only medical professionals do this?
- interviewing family members or caregivers of the deceased about the person's symptoms/circumstances the loved one experiences before death - not only doctors, they're looking for special interviewers who don't lead it the wrong way
55
What does relative risk measure?
How many times more likely it is that one group of people will become ill compared to another group
56
This is the cumulative incidence of being exposed to an illness.
Risk
57
T/F: For relative risk, groups can be defined by demographic factors and exposures to a suspected risk
TRUE
58
What is the relative risk equation?
a/(a+b) / c/(c+d)
59
What do a b c d stand for
a = primary group (E+) with the disease (D+) b = primary group (E+) without disease (D-) c = comparative group (E-) with disease (D+) d = comparative group (E-) without disease (D-)
60
What if RR<1, What if RR=1, What if RR>1?
RR<1 --> primary interest group has a lower risk of disease RR=1 --> primary interest group has equal risk of disease RR>1 --> primary interest group has higher risk of disease
61
Before RR values can be interpreted, they need to be subjected to statistical tests of significance. What do these test?
If discrepancy between risks is by chance or not.
62
If you can't calculate ________, you can't calculate RR, therefore you must use......
incidence, odds ratio
63
What cases will you have to use odds ratio to approximate relative risk?
- when outcome is rare - when you cannot quantify the at risk population such as in retrospective case-control studies
64
What is the odds ratio?
(axd)/(bxc)
65
What is the most accepted metric for global burden of disease (GBD) is the ....
Disability Adjusted Life Year (DALY)
66
What is DALY a measure of?
Overall disease burden, expressed as cumulative number of years lost due to ill-health, disability, or early death
67
What is the equation for DALY
= Years Lived with Disability (YLD) + Years of Lost Life (YLL)
68
How to calculate YLD?
Prevalence (years lived with disability) x disability weighting factor Disability weighing factor is 0 to 1 with 0 being perfect health and 1 being death; represents the degree to which a disease negatively impacts an individual's life
69
What are YLL - years life lost?
of deaths x (life expectancy - death)
70
Is higher or lower DALY better?
Lower is better! measure of burden and disease we want less burden!
71
What are two criticisms of daily?
- evaluates health through ableist lens - weighting disability, able-bodied people valued more highly than those with disability - doesn't account for age of people which relates to their ability to contribute to society
72
Support for DALY?
- prioritize interventions based on people's potential to contribute to society
73
How do Indigenous communities keep track of and pass on knowledge of the burdens of a specific disease?
Through storytelling, oral history, and oral record keeping in addition to written record keeping
74
T/F: Oral histories and storytelling both convey events from the past and offer lessons or cautionary tales to the listener.
TRUE
75
Difference between oral histories and storytelling.
Oral histories - specific to time period or special event that happened; historically accurate Storytelling - gives storyteller more creative and imaginative liberty to better emphasize the teaching or lesson (can be cautionary or based on community and traditional values)
76
Specific individuals in Indigenous communities are selected to be ... what do they have permission to do?
orators - permission to tell stories even if they were not their stories initially. can add own experience, increasing protective knowledge held within stories. If the community loses the people that have the protective stories, the communities lose that protective effect
77
Who are orators? What is an example?
public speakers of community, selected for position based on the community's clan system. For example, Mohawks of the Bay of Quinte, the Turtle clan is generally regarded as storytellers
78
Do stories shared within Indigenous communities have quantitative records? What do they reference though?
No Make reference to healing
79
How many years has Louise Profeit-LeBlanc from the Na-cho Nyak Dun First Nation been storytelling for?
Over 30 years
80
Why did the star girls return to Earth?
To take care of their parents who take care of them; had power to heal; one of them couldn't leave her husband and wanted to have baby --> north star, left her baby and went to earth with her sister. Northern lights came when she passed away. Honour parents, beware of people sick and suffering
80
T/F: Oral record keeping is less accurate.
False; not always the case, Indigenous oral record keeping is completed through complex and sophisticated ways
81
What is one performative practice for Indigenous oral record keeping?
Dancing and drumming - Many Indigenous communities used songs and dancing to recount legends, stories and traditions. Dancers use motions that act out the words of the songs, usually reenactments of previous generations
82
Renee Hulan and Renate Eigenbrod studied what?
effectiveness and accuracy of oral traditions.
83
Oral tradition definition Renee Hulan and Renate Eigebrod
The means by which knowledge is reproduced, preserved and conveyed from generation to generation. Oral traditions form the foundation of Aboriginal societies, connecting speaker and listener in communal experience and uniting past and present in memory
84
Many societies that use oral record keeping have now begun to utilize ___________ to document events; however, many communities continue to use oral traditions as their main form of knowledge transmission, and consider it an intrinsic component of their culture and society.
written word
85
What is an example of blending of oral and written record keeping?
SARS outbreak and smallpox - Western communities leveraged knowledge and previous experience, and as Meaghie Champion writes, some Indigenous communities used previous knowledge to fight SARS
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