1. March 20141 Back to Basics, 2014 POPULATION HEALTH Nick Birkett Epidemiology & Community Medicine

2. March 20142 THE PLAN Tues, Mar 18 1300 - 1700 Intro; Epidemiology methods (Dr. N. Birkett) Thurs, Mar 20 0900 – 1200 Health Care System (Dr. D. Coyle) Occupational & Environmental Health (Dr. Marina Afanasyeva) Wed, Mar 26 1300 – 1700 Vital statistics (Dr. N. Birkett) Health determinants, prevention in theory (I. McDowell) Thur, Mar 28 0900 -1200 Health Promotion (Dr. Trevor Arnason) Immunization & Communicable disease control (Dr. N. Birkett)

3. March 20143 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 Toronto Notes

4. March 20144 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).PHELO This has absorbed some earlier CLEO and C 2 LEO topics (Culture, communication, legal, ethics, organization)C 2 LEO

5. March 20145 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 C 2 LEO 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.

6. March 20146 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

7. March 20147 LMCC 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)

8. March 20148 LMCC Objectives (2) We won ’ t be able to cover every objective in detail. Sessions will be based around objectives, with links identified as appropriate. Focus of sessions is on knowledge transfer, not on developing understanding. Start with some overviews.

9. March 20149 LMCC Objectives (3) 78.1: CONCEPTS OF HEALTH AND ITS DETERMINANTS (March 26) 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

10. March 201410 LMCC Objectives (4) 78.1: CONCEPTS OF HEALTH AND ITS DETERMINANTS Determinants of health include: –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. March 201411 LMCC Objectives (5) 78.2: ASSESSING AND MEASURING HEALTH STATUS AT THE POPULATION LEVEL (March 18, March 26) 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..

12. March 201412 LMCC Objectives (6) 78.3: INTERVENTIONS AT THE POPULATION LEVEL (March 26/28) Understand three levels of prevention Concepts of Health Promotion, etc.. Role of physicians at the community level. Impact of public policy

13. March 201413 LMCC Objectives (7) 78.4: ADMINISTRATION OF EFFECTIVE HEALTH PROGRAMS AT THE POPULATION LEVEL (March 20) Structure of the Canadian Health Care System Concepts of economic evaluation Quality of care assessment

14. March 201414 LMCC Objectives (8) 78.5: OUTBREAK MANAGEMENT (March 28) Know defining characteristics of an outbreak Demonstrate essential skills in outbreak control

15. March 201415 LMCC Objectives (20) 78.6: ENVIRONMENT (March 20) 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

16. March 201416 LMCC Objectives (10) 78.7: HEALTH OF SPECIAL POPULATIONS (March 28) Specific target population include: –First Nations, Inuit, Métis Peoples –Global health and immigration –Persons with disabilities –Homeless persons –Challenges at the extremes of the age continuum