HSS1101E Determinants of Health

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HSS1101E Determinants of Health Prof Raywat
Deonandan Jan 15, 2009 Major Diseases/Issues
in Canada classes.deonandan.com/hss1101
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Have I Mentioned How Much I Hate This
Universitys IT System?

• An email was sent to you in error informing you
  of a change in the Jan 19 class
• There is no change in the Jan 19 class.
• It will take place at its regular time
  (230-400) in its regular place (Marion Hall)
• But.

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Fraîcheurs dhiver HSS Chills
Monday January 19th, 1230-200pm, Health
Sciences office, 43 Templeton Le lundi 19
janvier, de 12h30 à 14h00 au local des Sciences
de la santé, 43 Templeton
Au diable le froid ou la grève des transports!
Viens au BBQ te joindre à léquipe HSS souhaiter
la bienvenue au nouveau Recteur, Allan
Rock. Dont let the cold weather or the bus
strike get you down! Come join the HSS GANG at a
BBQ as we welcome the new University President,
Allan Rock.
Farwa Malik Vice President aux affaires sociales
Vice President of Social Affairs Association
des étudiants et étudiantes du Baccalauréat en
Sciences de la Santé Baccalaureate of Health
Sciences Student Association social_at_hssuottawa.ca
Linda Garcia Professeure titulaire et directrice
Full Professor and Director Baccalauréat
spécialisé en sciences de la santé Honours
Bachelor in Health Sciences Faculté des Sciences
de la Santé Faculty of Health
Sciences linda.garcia_at_uottawa.ca
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Review from Monday

• Life expectancy
• Why is it higher as we age?
• Disability Adjusted Life Expectancy
• How is it different?
• Quality Adjusted Life Year
• How and when is it used?
• Disability Adjusted Life Year
• Is it good or bad?

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What Are Some of the Health Crises Facing
Canadians Today?
Obesity
Diabetes
Cancer
? ?Who told you?
Murder
Arthritis
Depression
Car crashes
STIs
Movement disabilities
Cardiovascular Disease
HIV/AIDS
Schizophrenia
Suicide
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What are some of the ways we can measure severity
of a disease in a population?

• Prevalence
• Incidence
• Economic Cost
• DALYs
• Mortality rate
• Years of life lost
• Political priority
• Media coverage

What proportion has it? How many new cases are
there? Cost to whom? How many good years is it
costing? How many are killed? Strong lobby
groups Is Mad Cow really a big deal?
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YLD

• Remember
• DALY years of life lost due to being DEAD
• years of life lost due to being
  DISABLED
• DALY combines death and disability
• But we can tease them apart again
• YLL years of life lost (due to death alone)
• YLD years of life lost (due to disability
  alone)
• DALY YLL YLD

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Burden of Disease

• Burden of disease is a generic term for impact
  of a disease on a populations health it can be
  defined by prevalence, incidence, mortality,
  DALYs, etc.
• Often divided by
• Communicable diseases
• Non-communicable diseases
• injuries

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Leading causes of DALYs, worldwide, 2004
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What if we teased out the low and high income
countries?
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What About Using Cost?
Agncy for Healthcare Rsrch and Qlty, 1996-2002

• Most costly diseases in USA
• Heart conditions (68 billion)
• Trauma (56 billion)
• Cancer (48 billion)
• Mental illness (48 billion)
• Respiratory (45 billion)
• Hypertension (32 billion)
• Arthritis (32 billion)
• Diabetes (28 billion)
• Back problems (23 billion)
• Hemmorhoids (1.2 billion)

This includes prescription drug and hospital stay
expenses. How else could cost have been computed?
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Back to Mortality and YLD
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Canada
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How Do We Get This Data?

• Surveillance
• The monitoring of diseases in order to establish
  patterns of progression
• Two types
• Active
• Going out and looking for diseases
• Passive
• Sitting back and waiting for the diseases to be
  noticed

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Active or Passive?

• Breast cancer screening programme
• Notifiable disease registry

Active Passive
Why do we need surveillance?
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Example crude data from the Canadian Injuries
Surveillance System Leading causes of death due
to injury, 2004 -passive system based on
automatic processing of death certificates and
hospital charts
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Example Canadian Notifiable Disease Surveillance
Report, June 2007
Active system requiring doctors to call the
government when certain illness arise
(Ontario is blank because no data was available
from Ontario in June/2007)
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Next Week

• Human biology Genetics
• Read Biological Basis of Determinants of Health
  pdf
• classes.deonandan.com/hss1101