Population Health Study Guide
2. Specific mortality rate
(age, Sex, gender)**can be crude if not adjusted for age Num: number of deaths in a specified year Denom: Midyear population for age group k=100,000
41. Which group of mothers (race) has the highest infant mortality? (Tying to 9/22 lecture, why might we see this stark difference even after controlling for mother's age, behavior, marital status, education, geography, etc.?)
-Black women have the highest infant mortality (12.4 infant deaths per 1000 people) possibly because of pre-term babies, low birth weight, SES, and access to medical care
64. According to the WHO, what is the difference between impairment and disability?
-Impairment equals the loss or abnormality of function or structure at the organ level -Disability: restriction in participation that results from a lack of fit between the individuals functional limitations and the characteristics of the physical and social environment
40. What is the general trend of infant mortality in the US and how does the US compare to other developed countries in terms of infant mortality?
-The United States is lagging in infant mortality compared to other developed nations, only higher than Slovakia, current IMR is 6.05 infant deaths per 1000 live births we rank 55th
55. Which column of a life table is used to generate a 'survival curve'? What can graphing a survival curve tell us about the health of a population? What is meant by the term "rectangularlization of mortality?"
-The number surviving to each age or lx is used the generate a survival curve. -Rectangularization of mortality also known as the compression of mortality. Flatter and more horizontal at younger ages and more vertical at old ages
53. What are the main components of a life table? What is the key output statistic of a life table? Why is life expectancy considered a "hypothetical" measure and what is a life table radix?
-a life table is a convenient way of summarizing how mortality varies with age -also generates LIFE EXPECTANCY AT BIRTH= key health indicator - it is hypothetical(period) presents the mortality experience of a hypothetical cohort of 100,000 infants if cohort experienced. snapshot of current mortality experience -if you want real mortality then you follow a cohort -complete or abridged if you use intervals the life table radix is the number surviing at the beginning of the first interval, lo, soyou would say 100,000
82. Describe the cultural/behavioral versus structural explanations for observed disparities in health. Which approach is better from a population health standpoint? Would McKeown be considered a "behaviorist" or a "structuralist"?
1) Structuralist view of disease: SES is a "fundamental cause" of disease. Social (distal) factors operate both directly to influence health and indirectly (e.g., by influencing behavior) to affect health. A more distal view of health: the "causes of the causes" -Why are social conditions (SES) "fundamental" causes of disease? Access to resources (money, knowledge, power, prestige, and social connectedness) -- those with the most resources are best able to avoid risks and be less afflicted by disease (2) Cultural/Behavioral (proximal) causes of disease: Easy to focus attention here because behaviors are more proximal to disease in the causal chain. Easier to establish or hypothesize "biological plausibility." Both approaches are plausible. Depending on what stance you take will affect how you develop policy/programs! A population health focus says you need both!
83. What is the difference between equality, equity, and "upstream" interventions?
1. Equality where everyone is treated equally and benefits from the same supports 2. Equity individuals are given different supports to make it possible for them to have equal access. 3. Upstream interventions address cause of inequity and removes systematic barrier
16. What are the 5 leading causes of death in the US in 2014?
1. Heart disease 2. Cancer 3. Stroke 4. Chronic lower respiratory diseases 5. Accidents
5. What three epidemiological or health eras did Susser and Susser (1996) describe and what are their basic features? (Era, paradigm, analytical approach, preventive approach)?
1. Saniitary statistics[miasma]. Clustering of morbiditiy and mortality--->introduce draininage sewage and sanitation 2. Infectious DIseases[germ theory]. Laboratory and expirments---> interrupt transmission through vaccines and quarantines, antibiotics 3. Chronic disease epidemiology[black box]. risk ratios of exposure to outcomes---> control risk factors by modifying lifestyle 4. eco-epidemiology[chinese boxes]=relations within and between localized structures organized in a heirarchy of level. analysis of determinants and outcomes at different levels/contexts.-->apply both information and biomedical technology to find leverage at efficacious levels
7. What are some modern examples of preventive strategies proposed by each era?
1. Sanitation= We still use sewers and flourinated water 2. Infectious disease= we still use vaccines and antibiotics 3. Chronic Disease= Anti smoking campaign and exercise campaigns 4. Eco-epidemiology= Community engagement linked with social health and policy development
77. What are the "social determinants of health" (SDH), specific examples, and how might they directly or indirectly impact health (mechanisms)?
1. economic conditions, social factors, and physical conditions in the environment which people live in and are shaped by the global distribution of money, power and resources 2. prerequisities of health such as peace shelter education food income sustainable resources aka the upstream factors that impact health
7. Case fatality ratio
1. measure of severity of a disease and perceived as a measure of quality of care num: Number of deaths to cause Denom: number of people with disease **proportion so not a measure of risk either
65. What four questions make up the CDC's "Healthy Days" measure of HRQOL?
1.Self rated health 2.Physically unhealthy days 3.Mentally unhealthy days 4. Activity Limitation Days 1. Would you say that in general your health is: 2. Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good? 3. Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good? 4.During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?
1. What percent of the US population has at least one chronic disease? Of the 10 leading causes of death in the US, what percent are preventable?
50% has one chronic conditions 70% of these causes are preventable
70. What are ADLs and IADLs and why are they important?
ADLS= Activities of Daily Living: used to assess basic self acre tasks of everyday life, such as walking, eating, bathing, dressing, toileting, and transferring IADLS: used to assess independent living ability like cooking, driving, using telephone. women have 8, men have 5. you dont need all to live independently
4. infant mortality
An example of age-specific mortality. THERE IS A CHANGE IN DENOMINATOR Numerator: infant deaths Denominator: live births k=1000 You can also do neonatal infant mortality which reflects medical care Days 0-27/live births you can also do postneonatal mortality rate which is a reflection of socioeconomic status Days28>/ live births
66. What is the typical population health indicator derived from the question of self-rated health? What are the pros and cons of this widely-used measure?
An indicator derived from the self rated health question is -Percent of population reporting fair or poor health(prevalence) pro: it is highly predictive of mortality, morbidity biological markers, and behavioral risk factors cons: there are some cultural differences
68. What is the leading cause of disability in the US?
Arthritis and musculoskeletal problems then heart disease
25. What is the difference between incidence and prevalence? What is the mathematical association between incidence, prevalence, and duration?
Both used to measure morbidity Incidence is a measure of risk of a disease based on a count of NEW caases. assumes that all individuals in a specified population at the beginning are disease free Prevalence: measure of how much a disease or condition there is in a population at a given time prevalence= Incidence x Duration
54. Why can life expectancy be compared across populations and time (if the assumptions of when death occurs in an age interval are consistent between years or pops)?
Can compare because it is age standardized and counts for population differences in age structure
life table columns
Column 1 [x, n]: Age interval between the two exact ages indicated (usually 5 years) Column 2 [nqx]: Probability of dying (proportion dying) between age x to x+n Column 3 [lx]: Number surviving to the beginning of each age interval (l0 is radix, assume 100,000 babies) Column 4 [ndx]: Number dying within the indicated age interval out of those surviving to the beginning of the age interval Column 5: Number of person-years lived (nLx) within the indicated age interval by individuals who survive to the beginning of the interval. age interval*number surviving- n/2*deaths ***assume they die halfway Column 6: Total number of person-years lived at and above the age Column 7: life expectancy at age x. ex = Tx/Ix
60. What is meant by the term "compression of morbidity"?
Compressing percent of years lived in bad health resulting in an rectangle shaped mortality curve -shorten time span of bad health
19. Why are counts of health events (e.g., deaths, births, hospital visits) useful but not the ideal metric to use to describe the health of a population? Why is it important to convert a count to a rate or percent? What is the difference between a crude and an age-standardized rate?
Counts are simplest measure of disease frequency pro: useful for describing actual impact of disease in a population or actual utilization of care services con: does not reflect risk of a population. Rates allow for comparisons across groups. Age adjusted accounts for the fact that older people tend to get sick
11. What is the difference between direct and indirect disease transmission? Can you identify/list routes of spread for diseases that are transmitted directly and indirectly?
Direct transmission is person to person. Physicial contact like exchange of bodily fluids, skin contact with body lesions. intercourse Indirect is not person to person. requires common vehicle to transmit.. airborne, waterborne, parenteral, vectors, fomites, vehicles
74. True or False: Education explains most of the difference in black-white infant mortality rates.
False There are more infant deaths for black women with college education than there are for women without HS diplomas
75. True or False: According to Sir Michael Marmot, behaviors explain about half of social gradient in mortality. What are some examples of how social policies drive health (both good and bad)?
False behaviors account for no more than 25%
2. T/F: The US spends more on healthcare than any other nation because the US leads the world on key population health indicators.
False. Us spends more on healthcare yet ranks poorly on most measures. Only 1st in in technology
49. Why might avoidable and premature mortality be an indicator of population health or quality of care?
Focuses on potentially unnecessary deaths and weights deaths at younger ages more, can calculate separately for specific causes of death BUT ITS TO DIFFICULT TO UNDERSTAND ARBITRARY SELECTION, UPPER LIMIT CUT OFF. also younger deaths weighted, should each death be equally?
89. What is the "poverty tax?"
Food costs more in poorer communities 1. Smaller supplies--> higher price per ounce 2. Demand---> buy smaller quantities. so money and transportation-->higher price per ounce They also do price fixing where they provide higher prices and lower quality service
63. Why is it important to measure quality of life and well-being (and not just morbidity/mortality)?
Health systems must address needs of rising numbers of individuals with a range of disorders that largely cause disability but not mortality -Reflects how well someone lives rather than how long -Non fatal health outcomes are crucial for promoting individual and population health
58. What is the difference between life expectancy and healthy life expectancy? Why is measuring healthy life expectancy an important population health goal? (i.e., what may be wrong with focusing solely on increasing life expectancy as a public or population health goal?)
Healthy life expectancy takes into account the years spent in good health. -focusing solely on life expectancy doesnt necessarily mean you are living a healthier life. You wont be able to focus on health disparities -also expansion of morbidity= more spending
38. What is the general shape of a mortality curve (plot of age-specific mortality rates) in a developed (developing) country? (i.e., J shaped versus U shaped) What does this shape reflect?
It is J shaped in more developed countries it is U shaped in developing countries with high infant mortality. also lower life expectancy
8. Who is the "Father of Modern Epidemiology" and why? What was the significance of removing the handle off of the Broad Street pump?
John Snow. First suspected waterborne transmission. disproved miasma by using the first natural experiment. Used clusters of cholera death to show that cities from lower thames were associated with more death. WITHIN GROUP ANALYSIS He broke off broad street pump = less deaths
17. What are McKeown's and LaLonde's theses and why were they important to the evolution of population health? Can you tie them to the "behaviorist/strucuralist" and "upstream/downstream" concepts in 9/22 lecture?
Mckeown thesis: improved economic and social conditions reduced mortality from infectious diseases in the 17000s. Lalonde Report said that changes in lifestyle and nevironments can lead to mpre improvements in health IT LAYED DOWN THE FOUNDATIONS OF THE SOCIAL DETERMINANTS OF HEALTH AND CURRENT US POPULATION HEALTH SYSTEM
6. Can we say with certainty we currently live in one specific era? Why or why not?
No, because we utilize strategies from all eras.
3. cause specific mortality rate
Num: Number of deaths from a given cause c in a specified year Denom: Mid year population in that year k=100,000
1. Crude Death Rates
Num:Number of deaths inspecified year Denom:Midyear population in that year k=100,000
81. What is a health disparity?
Observed population-specific differences in morbidity, mortality, well-being, HRQOL, access to care, and healthcare quality -Even after controlling for behavior! ex) race, gender, SES, disability, sexual orientation, age, geography have differences in screening, morbidity, mortality, survivorship, coverage, access, quality HRQoL
21. What are some of the challenges of defining a metric's numerator and denominator? If one or the other were over- or under-counted, what impact would that have on the validity of the metric (e.g., over or underestimated)?
Often we are limited to collecting numerator (e.g, case) data separately from denominator (at risk population) data. -due to potential biases and HIPPA protecting confidentiality= error -for denominators it is hard to know who is truly at risk. -lack if adequate data collection in electronic health record -deala with open populations. cohorts are closed population. denominator is then defaulted at mide-year population The validity of a study would decrease if numerator or denominator was wrong
69. On average, who reports greater morbidity and lower HRQOL, men or women?
On average, women report greater morbidity & lower quality of life- gender bias in reporting (men feel "fine"), women visit the doctor more for pregnancy & menstruation so they look sicker, women more likely to have arthritis (#1 disability) and depression
33. What are common measures of frequency and intensity and when would you most likely use them? Examples?
Prevalence: asks for occurence Frequency: number of episodes Intensity: How much think of binge drinking
61. If given the number of life years lived in a given life table age interval, and the percent of the population healthy (or unhealthy) in that age group, could you calculate healthy life years in that age interval?
Proportion of life spent healthy = e'x/ex **women have longer life expectancy but more years spent in unhealthy states
90. How does neighborhood design impact health: e.g., the impact of proximity and distance on travel behavior?
Proximity is a function of both density of development and mix of land uses. it determines how many acitivites are within a convenient distance Directness: a function of street network connectivity As proximity and directness increases there are closer amenities so vehicle kilometers traveled. When distance decreases more people are walking and there is air and noise pollution. Also better social connectedness
57. What are the general race and gender trends in life expectancy at birth?
Race- highest for Hispanic female (84)→ white female (81) → Hispanic male (79) → black female (77)→ white male (76) → black male (71) -females have more compression of mortality than males
45. When examining mortality rates over time (or any other health trend), why is it important to be able to distinguish between real versus artifactual difference (examples of each)?
Real changes are changes in age structure of population, changes in survival, changes in incidence Artifactual: Changes in disease recognition, accuracy, or population identification examples: -Artifactual: new screening technologies, or classifications. When they discovered alzheimers or when they started counting hispanics -real: infant mortality rates in the 21st century
86. What is "red lining" and how do red lining practices contribute to segregation?
Red lining were discriminatory practices adopted by FHA and HUD -exclusionary zoning and section 8 steering -discriminatory mortgage funding Fed used interstate highway and urban renewal programs to segregate black in more racially diverse ares -RESULTS IN SEGREGATION, CONCENTRATED POVERTY, AND CYCLE OF DISINVESTMENT
10. What is a reservoir and can you list common reservoirs you may experience in your future work?
Reservoir are the habitats that agents live in.a reservoir could be a lake. In animals hair. Saliva they leave through a protal of exit and enter host through portal of entry
13. What is "risk factor epidemiology" (Susser & Susser) and might a "behaviorist" or a "structuralist" (video discussion) be more inclined to approach disease outcomes and disparities from a risk factor perspective?
Risk factor epidemiology was born to find probable causes and statistical analyses and study designs evolved sampling, four-fold tables and odds and risk ratios. Looks at more of a multi level mode of disease. uses a web of causation and cohort studies to understand it i think a structuralist might be more inclinde
9. In the classic infectious disease transmission model (agent, host, environment), what elements/attributes/characteristics make up each of these points of intervention to "cause" illness?
SINGLE CAUSE SINGLE EFFECT Triad: 1. Host(who) -intrinsic elements or host factors =susceptibility 2. Agent(what) -pathogenicity severity genetically -virulence severity conditionally -dose 3. Where(Environment) -extrinsic entities. environment. or SES standing
32. What is the relationship between incidence and screening?
Screening can increase incidence but can be used a source to reduce future incidence to target at risk populations
88. What is the "Bronx paradox?"
That the south bronx has one of the largest hunger related problems in the nation, yet have one of the highest rates of obesity beause they choose one of the most energy dense foods, which are cheaper solutions -income supports(health bucks) -increasing healthy options, also tax credits to draw in healthy grocers -encouraging nutritious behaviors
14. What is the demographic transition? What is the epidemiological transition? How do these transitions contribute to the burden of illness patterns observed in the US today?
The epidemiologic transition refers to 1. infectious diseases-->chronic diseases 2. Mortality-->morbidity HRQOL 3.Agrarian-->industrial society 1925 was switch of type of diseases The demographic transition refers to: 1. Pre-industrial society: High and low birth rates 2. Developing countries that have improved in sanitation which reduced mortality 3. Developing countries which have access to birth control 4. Population birth rates decline to death rates= population aging -life expectancy THE POPULATION INCREASES AND AGES. INCREASED SUSCEPTIBILITY TO CHRONIC CONDITIONS
3. What is "population health?"
The health outcomes of a group of individuals and the distribution of such outcomes within a grouup
4. What are some key differences between the "medical model" of health versus the "population health" model? Why is understanding the distribution of health outcomes in a population important? Why is understanding the distribution of health outcomes in a population important?
The medical Model -Fee For Service incentivizes volume -Sickcare system focuses on treatment of individual ill patients -Focus on individual risk -Clinical reactive/ (drugs, equipment, dx, maneuvers contribute to health) -Healthcare is central to producing health -Focus on disease -Fragmented, silo'd duplicative The Population Health Model -Value Based Pay rewards quality and incentivizes cost reduction -healthcare system focuses on coordinated holistic care across continuum -Focus on social structures -Comprehensive/proactive/preventitive -Addressing health's determinants and health disparities are central to producing health -Focus on health, wellbeing, Health related quality of life -Integrated and coordinated
44. How is cause of death determined on a death certificate?
They are based on the underlying cause of death. The immediate cause The The underlying cause and OTHER significant causes
43. What are the two main causes of infant mortality in the US (can you define them)?
Two main in US: Congenital disorders(not preventable) low birth weight (less than 2500 grams) and preterm births (less than 37 weeks of gestation)
78. What was the significance of the Whitehall study? Macaque monkey study? Twin study? Cold study?
Whitehall study in England where everyone has difference equal access there was still wealth-health gradient. those in lower classes exhibited poorer health and behaviors Macaque monkey study: monkeys that were less dominant had higher athersclerosis. Monkeys had same diet and mobility. Subordinate monkeys demonstrated higher levels of stress as demonstrated twin study showed that twins who grew up in same environment and genetics had different health outcomes because they had different jobs and different social status
72. What would happen to the prevalence and/or extent of health disparities if we eliminated poverty -- would disparities be completely eliminated?
Would not be completely eliminted but would shrink immensely. there would still be at different levels of wealth, but health differences would be minimal
48. What is premature mortality and its key measure (e.g., YPLL)?
YPLL: Years of potential life lost due to premature death -deaths occurring at younger ages accrue more years of life lost than at older ages
92. Does access to green spaces follow the health-wealth gradient?
Yes, poorer people have less access to greener ares and cleaner. Worse mental and physical health -you also have less access to social connections
47. What is avoidable mortality (not ICD10 codes but overall definition)? What two types of deaths make up avoidable mortality?
avoidable mortality is a type of cause-specific mortality where deaths attributed to "lack of preventive healthcare or lack of timely and effective medical care" -preventable: deaths that could have been prevented due to addressing risk factors -Treatable: Deaths that could have been avoided due to treating the underlying conditions
91. What are "complete streets?" What is "active commuting?"
completed streets are designated and operated to eneable safe access for ALL USERS OF ALL AGES AND ABILITIES -many incomplete roads are dangerous and only accomodate cars. -allows people for physical activity -active commuting -Prevalence of walking or biking to work -share of commuters in a country who walk or bike to work (active commuting) corresponding to that country's prevalence of adult obesity less than 5% of US adults bike or walk to workà 33% of adults are obese -countries with lower rates of obesity tend to have higher rates of commuters who walk or bike to work
20. What are some of the ways we define a 'case' (e.g., numerator) in healthcare (i.e., nosology, case definition, ICD-10)?
difficult to define a case because biases and actually getting the data. classifying who actually is a case Nosology is classification of diseases. You can use diagnostic, clinical, statistical, prognostic, and operation ICD:10 is a disease classsification system cases are categorized into confirmed, probable and suspect cases
24. What is disease? Illness? Morbidity? Comorbidity?
disease may be defined as any departure, subjective or objective, from a state of physiological or psychological well morbidity encompasses disease, illness, injury, and disability. it can be acute or chronic comorbidity: two or more diseases/diagnoeses
42. What is the general difference in cause of death contributing to neonatal mortality versus postneonatal? How might this impact health services and prevention strategies?
eonatal: congenital issues, low quality medical care Postneonatal: SES, environment- more upstream health, preventive, health education
87. What is a food desert?
food dessert is a neighborhood with poor access to HEALTHFUL foods, such as fresh and AFFORDABLE fruits vegetables, low fat milk, and other food that make up the full range of a healthy diet USDA definition: a low income census tract (20% of population in poverty) with 33% or more of population residing at least 1 mile from a supermarket or large grocery store it results from supermarkets following surburban ares and leaving urban areas. Liquor stores stay in these areas -you also need to take in affordability
31. Which is a measure of risk: incidence or prevalence? Why?
incidence is a measure of risk. inciidence rate providdes a measure of the risk of developing a disease or condition within a given population. Prevalence doesnt account for duration or death
6. proportionate mortality ratio
its the proportion of ALL deaths attributed to a particular cause in a given Num: Number of deaths to cause c Denom: Total number of deaths in t. not population k=100 **not a measure of incidence therefore not a measure of risk
79. How do power, control, and stress interplay to impact health?
less power-->less control-->more stress -->worse health
52. What is the difference between life expectancy and life span?
life expectancy is how long someone on average if death rates do not change at a certain age can expect to live. -pros: age adjusted; widely acepted; 2 easy data inputs (#deaths + population counts, by age group) -Cons: challenging to calculate -it is age adjusted widely accepted 2 easy data inputs life span is the oldest possible age someone can live
Fun facts to know for the oldest age groups
nqx for the oldest age group must equal 1.0 lx for the oldest age group equals ndx for the oldest age group nLx for the oldest age group equals Tx for the oldest group
5. maternal mortality ratio
num: number of maternal deaths in t denom: Number of live births in t k=100,000 cause-specific type of mortality
26. If incidence increases, must prevalence necessarily increase?
old cases may drop more than there are new cases. if the duration is short the prevalence may decrease. prevalnce ignores risk because it idnores duration of disease
46. Why is age adjusting so important when comparing the mortality of two populations or examining the mortality of a population over time?
old people get sick and die more easily.
80. What are distal (upstream) versus proximal (downstream) causes of health and health disparities? Which is a more distal health factor, smoking or neighborhood poverty?
proximal causes of death are behaviors like smoking, nutrition and health outcomes like morbidity HRQoL distal determinants are like structural determinants like policies and programs and social/cultural institutions as well social determinants like employment status
37. Why are crude rates "crude?" How do you calculate crude death rates?
quick and easy, but crude because not age-adjusted. Number or deaths in a specific year/ Midyear population k=100,000
85. What is the difference between the social and the built environment? Why would your zip code determine your health (e.g., direct and indirect mechanisms)?
social environment and built and environments are linked -social environment: refers to behaviors, connections, norms, social capital, and demographic characteristics -built environment: How design, construction, and placement of buildings within a community, as well as the design of the surrounding building
73. What is the "social gradient in health" or "health-wealth gradient"? What are the two main hypotheses that explain the observed statistical correlation between social status and health?
the health-wealth gradient is the inverse association between poor health outcomes like(morbidity, mortality, disability, poor mental health, poor/fair self-rated, low HRQOL, chronic illness, etc. and Socioeconomic correlation more present in adulthood 1) Social causation hypothesis Lower SES-->worse health. lower SES associated with less access to health care, higher stress, lower abiliry to process health information, unhealthy behaviors, less access to health producing environments allostatic load builds up from chronic wear and tear from adverse childhood-->impairment-->risky behaviors-->disease, disability-->premature 2) Health selection hypothesis •Health affects SES (Health à SES) •"Social drift" hypothesis: Unhealthy persons "drift down" to poverty •Mechanistic process: Childhood health affects adult SES indirectly via its affect on the individual's ability to achieve higher SES status (e.g., via educational attainment) or to rise out of low SES status
56. If given two survival curves, could you identify which represents a healthier or older population?
the more rectangle the healthier and older the population
67. What is the general association between age and prevalence of disability?
the prevalence of disability. 65+
22. If given population count data over time, could you calculate percent change? If given prevalence data for two groups, could you calculate/identify measures of percent change (relative difference) and percentage point difference (absolute difference)?
time based difference: New-Old/Old Interest- reference/ reference Caution: Don't confuse percentage point difference (absolute difference) with percent difference (relative difference)
71. According to the video, In Sickness and in Wealth, how does social class "get under your skin" (biological mechanism)? What key stress hormone is involved?
when you are working 2 jobs, live with uncertainty, no control of destiny-->higher levels of CORTISOL---> increases heart rate, blood pressure, and memory. should go back down but chronic stress leads to decreased memory, immune function, and leads to diabetes, hypertension, and heart risk. the brain also shrinks -it accumulates when one cannot take breaks
28. If given examples of health statistics or survey questions, could you determine whether the statistic/question was asking about incidence, point prevalence, or period prevalence?
yes
50. If given a table of age-specific mortality rates and the number of deaths per age group, could you calculate YPLL?
yes
15. If shown a set of population pyramids, could you infer which population is older? Younger?
yes i can
27. If given population and health data, can you calculate incidence, period prevalence, and point prevalence?
yes i can
84. Is all policy health policy?
yes, it affects structural and social determinants of health. Access, sense of control, stress etc. -should move focus from fixing healthcare to look more upstream
30. What is the effect on your incidence rate (e.g., overstated or understated) if your population denominator failed to be specific to those people at risk of the event in the numerator or if your numerator included repeated (or duplicated) cases?
you decrease the said risk if you overestimate who is at risk if you underestimate than you increase the said risk of a population
