Back to Basics, 2012
POPULATION HEALTH
Nick Birkett
Epidemiology & Community Medicine
March 2012
1
THE PLAN
Thur, Mar 22
0900-1200
Intro; Epidemiology methods (Dr. N. Birkett)
Fri, Mar 23
0900-1200
Health Care System (Dr. D. Coyle)
Health determinants, prevention in theory (I. McDowell)
Thur, Mar 29
0900-1200
Prevention in practice: Periodic Health Exam
(Dr. G. Dunkley)
Occupational & Environmental Health (Dr. B. Pinard)
Tues, April 10
Vital statistics (Dr. N. Birkett)
1300-1700
Immunization & Communicable disease control
(Dr. N. Birkett)
March 2012
2
Structure
• Lectures with discussion & some trial
MCQs.
• Built around the MCC Objectives for
Qualifying Examination
• Emphasis is on core ‘need to know’ rather
than on depth and justification
• Focus is on topics not well covered in the
Toronto Notes
March 2012
3
MCC QE, Part I
• Revised objectives arose from many discussions over
Public (or Population) Health competencies for physicians
(much of what UOttawa covers in SIM)
• MCC content now named Population Health, Ethics, Legal
& Organizational topics (PHELO).
• This has absorbed some earlier CLEO and C2LEO topics
(Culture, communication, legal, ethics, organization)
March 2012
4
MCC QE, Part I
• Aim is to merge population health & some
CLEO objectives into main pool of questions,
showing clinical relevance of prevention, etc,
rather than keeping separate.
• Many C2LEO topics are included in Part II of
the exam.
• MCC now mapping all its objectives onto
CanMeds roles. Population health content links
to roles such as scholar, advocate, manager:
these may be the themes underlying some
questions.
March 2012
5
MCC MCQ format
• Questions generally include a clinical scenario
– Topics should be clinically relevant to a CanMeds
role
• One correct answer & 4 plausible distractors
–
–
–
–
No “except” questions. No “all of the above”
Sometimes correct = the better answer
Management: often “What is your best next step?”
Avoid “factoids” (‘which is the second most
important cause of death in Canada?’)
• Key features – each question tests one concept
March 2012
6
LMCC New Objectives (1)
Population Health
• Concepts of Health and Its Determinants (78-1)
• Assessing and Measuring Health Status at the Population
Level (78-2)
• Interventions at the Population Level (78-3)
• Administration of Effective Health Programs at the
Population Level (78-4)
• Outbreak Management (78-5)
• Environment (78-6)
• Health of Special Populations (78-7)
March 2012
7
LMCC New Objectives (2)
C2LEO (URL to LMCC objective page)
• Considerations for
– Cultural-Communication, Legal, Ethical and
Organizational Aspects of the Practice of
Medicine
March 2012
8
LMCC New Objectives (3)
• We won’t be able to cover every objective
in detail.
• Sessions will be based around objectives,
with links identified as appropriate.
• Start with some overviews.
March 2012
9
LMCC New Objectives (4)
78.1: CONCEPTS OF HEALTH AND ITS
DETERMINANTS (March 23)
• Define and discuss the concepts of health, wellness,
illness, disease and sickness.
• Describe the determinants of health and how they
affect the health of a population and the individuals it
comprises.
• Lifecourse/natural history
• Illness behaviour
• Culture and spirituality
March 2012
10
LMCC New Objectives (5)
78.1: CONCEPTS OF HEALTH AND ITS DETERMINANTS
•
Determinants of health include:
–
–
–
–
–
–
–
–
–
–
–
–
March 2012
Income/social status
Social support networks
Education/literacy
Employment/working conditions
Social environments
Physical environments
Personal health practices/coping skills
Healthy child development
Biology/genetic endowment
Health services
Gender
Culture
11
LMCC New Objectives (6)
78.2: ASSESSING AND MEASURING HEALTH
STATUS AT THE POPULATION LEVEL
(March 22, April 10)
• Describe the health status of a defined population.
• Measure and record the factors that affect the
health status of a population with respect to the
principles of causation
– Principles of Epidemiology, critical appraisal,
causation, etc.
March 2012
12
LMCC New Objectives (7)
78.3: INTERVENTIONS AT THE
POPULATION LEVEL (March 23)
• Understand three levels of prevention
• Concepts of Health Promotion, etc.
• Role of physicians at the community level.
• Impact of public policy
March 2012
13
LMCC New Objectives (8)
78.4: ADMINISTRATION OF EFFECTIVE
HEALTH PROGRAMS AT THE
POPULATION LEVEL (March 23)
• Structure of the Canadian Health Care
System
• Concepts of economic evaluation
• Quality of care assessment
March 2012
14
LMCC New Objectives (9)
78.5: OUTBREAK MANAGEMENT (April
10)
•
Know defining characteristics of an
outbreak
•
Demonstrate essential skills in outbreak
control
March 2012
15
LMCC New Objectives (10)
78.6: ENVIRONMENT (March 29)
•
Recognize implications of environmental
health at the individual and community levels
•
Know methods of information gathering
•
Work collaboratively with other groups
•
Recommend to patients and groups how they
can minimize risk and maximize overall
function
March 2012
16
LMCC New Objectives (11)
78.7: HEALTH OF SPECIAL POPULATIONS
(March 29)
•
Specific target population include:
–
–
–
–
–
March 2012
First Nations, Inuit, Métis Peoples
Global health and immigration
Persons with disabilities
Homeless persons
Challenges at the extremes of the age continuum
17