Quiz: True or untrue

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Quiz True or untrue?

• ESP course onPublic health research methods

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INTRODUCTIONTO PUBLIC HEALTH

• The practice of public health is focused on
  primary prevention
• The research methods of public health
  epidemiology are identical to those of clinical
  epidemiology
• When we measure population health, all we get is
  the average and distribution on individuals
  health statuses

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STANDARDIZATION

• If one wants to compare the morbidity or
  mortality rates of two or more populations,
  age-standardization is always necessary
• Direct and indirect standardization always
  produce the same results
• In the case of direct standardization, the
  weighting scheme is derived from the
  age-distribution of the reference population

4
INEQUALITIES IN HEALTH

• In Europe, socioeconomic inequalities in
  mortality, as measured on an absolute scale, have
  narrowed during the past two decades.
• Socioeconomic inequalities in health are mainly
  caused by health-related social mobility
• Socioeconomic inequalities in health can only be
  reduced if the distribution of income and other
  fundamental causes is equalized

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LIFE TABLE ANALYSIS

• If population A has a lower life expectancy than
  population B, it will always also have higher
  age-standardized mortality rates than population
  B
• A period life table will always produce an
  underestimate of the average number of years
  which people born in a particular period will
  live
• The effect of a 10 reduction of the death rate
  for a cause of death which is responsible for 10
  of all deaths, is that life expectancy at birth
  will increase by 1

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PUBLIC HEALTH ASPECTS OF AGING

• The average human life span is likely to be
  somewhere between 80 and 100 years
• Preventing cardiovascular disease by lifestyle
  interventions will increase healthy life
  expectancy and decrease years spent with
  morbidity
• Compression of morbidity will occur if the age
  at death increases faster than the age at first
  infirmity

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MEASURES OF ATTRIBUTION/IMPACT

• The Attributable Fraction is always larger than
  the Population Attributable Fraction
• The Prevented Fraction measures the effect which
  an increase in the prevalence of a
  health-protecting factor will have on the
  morbidity or mortality rate in the population
• The Potential Impact Fraction is always larger
  than the Population Attributable Fraction

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CAUSES OF CANCER

• Changes of cancer incidence on migration suggest
  that, in comparison with life-style or
  environmental factors, genetic factors are
  relatively unimportant as determinants of cancer
• Doll and Petos famous table with the percentage
  of cancer deaths which is attributable to various
  factors shows, that life-style factors are more
  important than environmental factors
• Population Attributable Fractions can only be
  calculated for one risk factor at the time

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ECOLOGICAL STUDY DESIGN

• An ecological study always suffers from the
  ecological fallacy
• Due to the ecological fallacy, individual level
  associations will usually be overestimated in
  ecological studies
• If one has a research question which is phrased
  in terms of an individual-level relationship
  between exposure and health outcome, one should
  never use the ecological study design

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GLOBAL ENVIRONMENTAL CHANGE AND POPULATION HEALTH

• Environmental degradation due to human activities
  currently contribute around 10 to global disease
  burden
• Of all global environmental changes, climate
  change is the most important threat to human
  health
• Epidemiology is not suitable for the
  investigation of the health impacts of global
  environmental change

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COMMUNITY INTERVENTION TRIALS

• Ecological fallacy is never a problem in
  Community Intervention Trials
• Evaluation of the effectiveness of health
  education efforts always requires a Community
  Intervention Trial
• Evaluation of the effectiveness of vaccinations
  always requires a Community Intervention Trial