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Population Health

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Joss Reimer

on 11 September 2018

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Transcript of Population Health

Population Health
Longitudinal Course
Joss Reimer MD MPH FRCPC
jreimer4@wrha.mb.ca
Adrienne Morrow MSc MD CCFP FRCPC
adrienne.morrow@umanitoba.ca

What are we going to talk about today?
How is the course organized?
What is Population Health?
Health and Its Determinants
Health Promotion
Infectious Diseases and Outbreak Management
Integration
Joss Reimer MD MPH FRCPC
Medical Officer of Health
Family Medicine Obstetrics
Co-director of Undergraduate Medical Education for Dept of Community Health Sciences
Preclerkship
jreimer4@wrha.mb.ca
Adrienne Morrow MD MSc FRCPC
Family Physician & Chief of Staff - Norway House
Public Health Physician
Co-director of UGME for Dept of CHS
Clerkship
adrienne.morrow@umanitoba.ca

Chelsea Jalloh BA B.Ed M.Ed
Community Health Sciences - Undergraduate Medical Education Coordinator
chelsea.jalloh@umanitoba.ca
Summative Evaluation -
What Counts!
Formative Evaluation
What is Population Health
Public Health:
the organized efforts of society to keep people healthy and prevent injury, illness, and premature death. It is the combination of programs, services, and policies that protect and promote the health of all Canadians


Dept of Community Health Sciences
To create, preserve and communicate knowledge with respect to the health of populations and thereby contribute to the physical, psychological, cultural, social and economic well-being of the people of Manitoba, Canada and the world.
Other Resources
Young "Population Health, Concepts & Methods" (Available at library online)

Strauss "How to Practice & Teach EBM"

Public Health Agency of Canada
http://www.phac-aspc.gc.ca/

AFMC Population Health PRIMER
https://afmc.ca/AFMCPrimer.pdf?ver=1.2
Library Resources
http://libguides.lib.umanitoba.ca/medicalstudent?hs=a
Manitoba Specific Resources
Manitoba Government - Public Health
http://www.gov.mb.ca/health/publichealth/

Chief Provincial Public Health Officer - Reports and Position statements
http://www.gov.mb.ca/health/cppho/

Manitoba Centre for Health Policy
http://umanitoba.ca/faculties/medicine/units/community_health_sciences/departmental_units/mchp/
Evaluation
Assessing and Measuring
Administration of Effective
Health Programs
Year 1: 7 Units
Faces
Resources
How will you be evaluated?
Definition
Course Goal
CHS Objectives
Units
Teaching Formats
Faces to know
Integration
Summative - what counts!

Formative - where are you at?
What resources are available?
Course Textbook
Other textbooks
Library Resources
Manitoba Specific
Eliya Ichihashi BSc
Course Administrator for Population Health, Service Learning, Professionalism and Indigenous Health
Scheduling, room booking, OPAL, etc
Eliya.Ichihashi@umanitoba.ca

Course Goals
measuring and improving health
societal and structural factors
balance interventions at the individual level with the population level
integrate with module courses
broaden practice of medicine,
application to clinical practice
scholarship
Format
Lectures
Panels
Community Visits
Whole Group Sessions
Small Group Sessions
Tutorials
Presentations
Debates
Assigned Studies
Required readings
Videos
Online Modules
Almost all reviewed in subsequent small group sessions
All tested on written examination
Around 50 hours in Year 1 and 50 hours in Year 2
Physician Development Sessions in Clerkship
Service Learning Component
Separately organised, delivered and evaluated but marks contribute to total PH mark
Interprofessional Education
Separately organised, delivered and evaluated but marks contribute to total PH mark
Population Health:
framework for thinking about why some people, and some peoples, are healthier than others.
unifying paradigm that links disciplines from the biological to the social, directing attention onto health as an important social goal and proposing policy approaches to promoting health
includes economics, environmental sustainability and social justice
What is Health?
What makes someone healthy?
Why are some groups healthier than others?
Why do people do things that are bad for their health?
"oral contraceptive pills increased the risk of potentially life-threatening blood clots in the legs or lungs by 100 percent"
Old form of the pill: 1 in 7000 women had a clot

New form of pill: 2 in 7000 women had a clot

Risk increased from 0.014% to 0.029%
Measuring Health Status
How big is the health problem?
Is it getting better or worse?
What are the different types of prevention?

Mental and Physical Health Promotion

Injury Prevention

Healthy Seniors

People with disabilities


Total Health Expenditure, Public and Private Per Capita
OECD Indicators: Health at a Glance 2013
www.dailymail.co.uk
Immunization - science, population level implementation, controversies
Longitudinal Content complements morning course
-relevant material timed together

Examples from morning material
Year 1
Year 2
YEAR 1
YEAR 2 - not finalized
Midterm Exam
Mainly multiple choice, few short answer

Reflection
Food Security and Health - how it relates to your future practice

Substance Use Assignment
Written Assignment

Debate
Structured debate on health care systems topic

LGBTTQ and/or Healthy Sexuality Assignment
Written assignment

Occupational Health
Presentation

Final Exam
Mainly multiple choice, few short answer
Formative Exams (1% each)
Posted on UM Learn - ~1 weeks before exams
Typically offer review in class
Score at least 60% to get the 1%
Unlimited tries
AFMC Primer
Self-test questions following each chapter
OSCE
Opportunity to practice PH skills/knowledge
You must pass PH Year 1 to be eligible for Year 2!
Canadian virtual textbook on Public Health concepts for clinicians
main textbook for this course
integration of Public Health concepts in clinical practice
covers the population health objectives of the MCC
How is the Canadian Healthcare System Organised? Funded?

How is Public Health organised and run in Canada? Manitoba?


Objectives
UK Committee on Safety of Medicines - 1995
Actual study findings
Note: sections on EBM and Population/Public Health
Course Textbook
Broader than Public Health
Challenges to providing preventive and curative services
Vulnerabilities
Unique Health Concerns
Year 2: 6 Units plus Consolidation
abc.net.au
www.trialx.com
Worker in Asbestos Plant in India
Photo Credit: www.cjob.com
Speedway International Fire
Lac Megantic Explosion
www.montrealgazette.com
Environmental Health
Prevention
Health Effects
Clinical Response
Emergency Preparedness and Response
Occupational Health
Clinical
Workplace
Environmental and Occupational Health
UNIT 1
UNIT 2:
Basic Concepts
UNIT 5:
Statistics & Research
Interpreting Test Results
When should I use a test?
What is the difference between screening & diagnosis?
What do these results mean?
Research Design
What are the different types?
When do you use each method?


Statistics
How do you measure study results?
How do you know if a result means something or is a coincidence?
Unit 7:
Evaluating Treatment
Med 2 sessions - linking clinical content with the evidence for treatments

UNIT 3
Unit 4
Unit 6
Assessing and Measuring
UNIT 1
Critical Appraisal
Specific Populations & Topics
Specific Populations & Topics
Specific Populations & Topics
Consolidation
UNIT 2:
Stigmatized Conditions
UNIT 3:
Gender & Sexual Health
UNIT 4:
Global Health
UNIT 5
Infectious Diseases
HIV/TB
Travel Medicine
Administration
Debate - System Types
Resource Management
Specific Topics
Incarceration
Homelessness
Substance Use/Harm Reduction
Broad Topics that bring together everything you've learned so far
Vancouver's supervised injection site saved the health care system $18 million over its 10 years in operation!
Some studies found much higher savings!
Optimal clinical decisions require awareness of the best available evidence
Not all evidence is equal
Evidence alone is never enough
Women's Health
Men's Health
LGBTTQ
Healthy Sexuality
Food Security
Health Systems
Global Conflict & Health
Immigrant/Refugee Health
CLERKSHIP
TTC - applied sessions to prep for clerkship

Combined Family Medicine/Public Health rotation
- experience at MB Health & WRHA
- "on the ground" with Public Health Nurses in rural MB
- Office of Disaster Management - simulation

Physician Development Course
-skills for communication, advocacy
Pre-reading - in class debate & written assignment
In class written assignment
UM Learn Quizzes that all have to be completed prior to the session they are attached to
Reflection - Presentation to your tutorial group
See IPE syllabus
Injury - marks for completing online module
Brief policy with evidence
See service learning syllabus
Exams mostly MCQ with a few short answer. Midterm covers units 1,2 & 3. Final covers everything after unit 3.
Public Health Agency of Canada
AFMC Primer on Population Health
Outbreak Management
Photo Credit: Gary Knight via flickr, CC BY 2.0
Photo Credit: Ian Kelly on Vimeo
IPC & SL are organised separately
Ceilidh Miller
UGME Assistant for Community Health Sciences
ceilidh.miller2@umanitoba.ca
Full transcript