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Policy Midterm
| Term | Definition |
|---|---|
| Blood of the Bite Case | - after WNV spread to North America, the blood supply got compromised due to infected blood being donated -23 people received infected blood |
| West Nile Virus | - vector-borne disease: carried by arthropods (mosquitoes) -80% asymptomatic, 19.23% west nile flu, 0.67% brain and spinal cord swelling |
| Framing of Blood of the Bite Case | - nature of the disease - public health mistakes - precautionary principle |
| Precautionary Principle | - taking advanced action to prevent risk even when there is scientific uncertainty about cause or extent of disease - used when hazards are well established - if not enough evidence cause could overfear |
| Principles of Precautionary Principle | 1. consistency - cases of same nature should be treated to the same extent 2. non-discrimination - all cases of same nature must be treated 3. proportionality - matters taken must match the caliber of the case |
| Risk Management Science | - used in every healthcare facility - identify, monitor, prevent, and prioritize different possible risks to health or safety |
| Risk Assessment | determine risk characteristics |
| Risk Management | explore all possible options - do nothing - implement protective factors - remove hazards |
| Risk | hazard + exposure |
| Hazard | something that can cause adverse health issues |
| Failure Modes and Effect Analysis (FMEA) | failure modes - what failed? failure causes - what cause this to fail? failure effects - what happened because of this failure? |
| FMEA Criticality Matrix | severity + occurrence - high severity + high occurrence = critical - low severity + low occurrence = minor |
| Kever Commissioner (1997) | - public inquiry after the tainted blood supply situation - called for change in the govt. and govt. policies 1. precautionary measures put into place in cause of blood tainting again 2. government that prioritizes safety and health |
| Naylor Report (2003) | - put out after SARS outbreak - highlighted issues in govt. specifically about confusion in allocation of responsibilities between levels |
| Trade-Off | loss associated with choosing one option over another |
| Costs | -direct -indirect - lost wages -intangible - pain, suffering |
| Opportunity Cost | -subset of trade off - the value of the next best option that is lost when picking an alternative option |
| Economic Evaluation | the comparative analysis of costs and effects between different options |
| Cost Analysis | the comparative analysis of COST between 2 options when effect is SAME Costdiff = CostA - CostB |
| Cost Effectiveness Analysis | the comparative analysis of COST and EFFECT between the 2 options cost effectiveness analysis = CostA- CostB / EffectA - EffectB |
| Cost Effectiveness Plane | graph of cost and QALY --> line of willingness to pay |
| Cost Utility Analysis | comparison of different interventions that product QALY cost effectiveness analysis = CostA- CostB / EffectA - EffectB |
| QALY | quality-adjusted life years |
| Walkerton Tragedy | - contamination of water supply due to run-off from farms after heavy rain - E. Coli found in water supply - 7 people died and hundreds sick |
| Framing | - public vs. private - "bad apple theory" - 1/2 person cause something bad - govt. allocation of responsibilities |
| Federal Govt. Responsibilities | matters of law, order, and peace - criminal law power - spending power - power to enforce laws of peace and order |
| Provincial Govt. Responsibilities | matters of healthcare - hospitals and clinics - long-term care - training and regulating of healthcare workers |
| Municipal Govt. Responsibilities | matters of public health - vaccinations - communicable disease tracking and treating |
| Environmental Health | humans and the environment are interconnected - unhealthy environment can lead to adverse health issues |
| Environmental Stewardship Model | to reduce disease, humans have to reduce damage they cause to the environment |
| Scope of Conflict | who is involved and to what extent 1. Visibility - amount of information available 2. Intensity -how strong is their connection 3. Direction- importance of issue |
| Public Goods | - not the same as good for the public Non-rivalrous= if used, doesn't take away from supply for others Non-excludable= if used, provides benefits for everyone |
| Free Rider Problem | when someone doesn't do the incentive in place (ex. pay an admission fee) but still receives the benefits (entering the amusement park) on the basis that its ok bc other people are paying |
| Externalities | how much a product/service affects someone who is not directly impacted |
| Public-Private | different ownerships of services applies to financing and delivery of the service |
| Privatization | the act of moving something from public to private - transfer of public assets to private ownership - termination of public programs and disengagement of government - public funding of private services |
| Street Level Bureaucracy | - policy makers who personally interact with citizens - deemed the 'ultimate policy makers' - ex. police, teachers, social workers - difficult bc training is very different than actual situations they endure |
| O'Connor Report | -report written after Walkerton - gave recommendations to the govt. on 2 topics: 1. tips on managing another water in-contamination crisis 2. tips to public health (training, protocols, tracking/managing/treating disease) |
| Swiss Cheese Model | - when there are gaps in policies/ factors, increases chance of accident/injury - holes line up = accident occurs ex. insufficient training, funding cuts, lack of resources |
| Trimming the Fat Case | - due to rising levels of obesity in Canada, policymakers have been getting increasingly concerned |
| Obesity | - both a disease and a risk factor BMI= ratio of weight to height - normal= 18.5-24.9 - overweight= 25-29.9 - obese= 30+ |
| Why Treat Obesity? | - because of the adverse health issues that can result from obesity, healthcare expenditure and dependence has increased - 27.6 B dollars have been spent to combat obesity |
| Redistributive Policies | impose costs or provide incentives that encourage individuals and systems behaviours - ex. taxations |
| Regulation Policies | impose rules that encourage individuals and systems behaviours ex. laws |
| 'Allocational' Policies | providing funding to activities and strategies to produce long-term health benefits for the population |
| Trade-Offs in Obesity Policy | balance between protecting the health of populations, respecting individual decisions, and healthcare expenditure |
| Stakeholders in Obesity Policy | - different ministries of government (health, environment, agriculture) - food industry - physicians - schools |
| Policy Instruments | 1. exhortation- the govt. encourages people/systems behaviour 2. expenditure- the govt. allocates money to specific things 3. regulation- the govt. uses rules to encourage peoples behaviour 4. public ownership- the govt. directly runs an activity |
| The Black Box Problem | - the unexpected chain of reactions between a policy and the effect it has on the health issue - contents of the black box= logic model |
| Logic Models | inputs - activities - outputs - outcomes |___________________________________| feedback loop |
| Inputs | resources needed to put into activities to ensure they can run |
| Activities | activities done after the policy implementation that contributes to effect on health issue |
| Outputs | direct result of activity |
| Outcomes | - short-term: easiest to measure - intermediate - long-term what actually occurred when the policy was put in place |
| Feedback Loop | using the outcomes to adjust inputs to ensure more success in future policies |
| Forward Logic | starting with what policy we want to implement and working forward from there |
| Backward Logic | starting from what desires we want to achieve and working backwards from there |
| Dimensions for Analyzing Policy | 1. Effect 2. Implementation |
| Effect- Effectiveness | how effective was this policy? |
| Effect- Unintended Effects | did this policy create any unintended effects? |
| Effect- Equity | did this policy affect certain groups more than others? |
| Implementation | - cost - feasibility - acceptability |
| TB Toronto Case | - 5 Tibetian refugees entered Toronto infected with Tuberculosis - heavy media coverage |
| Communicable Disease Transmission | -direct: person-to-person -indirect: vehicle or vector -airborne: through air particles |
| Canada Health Act (1983) | -implemented publicly insured healthcare for Canadian citizens -accessibility -universality -publicly funded -comprehensiveness |
| Constitution Act (1982) | charter of rights and freedoms -included indigenous rights -plays a role in allocation of resources between federal and provincial in terms of health care -7 parts |
| The Interim Federal Health Program | gave refugees temporary, limited health coverage -was taken away for a period of time -fully reinstated in 2016 |
| Federal Policy Changes because of TB Case | changes to immigration and disease-detection at the border |
| Provincial Policy Changes because of TB Case | enabled uninsured Canadians to receive TB treatment |
| Lalonde Report | health is more than healthcare -biology, environment, lifestyle |
| Utilitarianism | the ethical thing to do is the one that provides the most good for the most amount of people |
| Philosophical Considerations in Policy | -how knowledge is generated -our understanding of phenomena -basis for choosing and undertaking interventions -reflect community values -reflect policy maker's values -acceptable policy levers |
| Martsolf and Thomas | positions on key public issues are driven by implicit and unarticulated philosophical presuppositions that guide the individuals' notions of the nature of government, individual moral obligation, and what it means to be a community |
| Why Study Policy? | -instruments of organizing and managing society -key in advocacy work -influences allocation of resources -can be an 'intent' but also an 'understanding' and 'process' -essential programs that work to change society |
| Policy-Making and Analysis Orientation | -different people with different goals/aims/beliefs -changing nature of knowledge -different perspectives on what health is and how to achieve it -equity and equality considerations |
| Consensus Policy Theory | - deciding as a whole on a policy - could be based off significant evidence, etc. - everyone agrees on decision "nuts and bolts" lens |
| Conflict/Critical Policy Theory | - considerations of social/class polotics and inequalities in influence and power - includes gender, race, class, disability, etc. "socio-cultural-economic" lens |
| Other Considerations in Policy-Making | -ideology -worldviews |
| Decision Theory | ideology + worldviews - on any given occasion, a person is guided by their beliefs and values - "preference attitudes" - what criteria someone's preference attitudes should satisfy in any generic circumstance |
| Normative Ethics | what is right and what is wrong? what is a good decision and what is a bad decision? -based on justice and ethical choices |
| Prescriptive Ethical Principles | -offer recommendations for moral action -not values |
| Virtue Ethics- Aristotle | -virtuous habits: person-based rather than action-based -good people create good societies and good decisions -in health care services: compassion, honesty, morally correct actions |
| Deontology/Duty-Based | -every person has an inherent dignity and value - what is right or wrong is universal and applicable in all circumstances, even if it produces bad results |
| Principilism | -autonomy -justice -beneficence -non-malificience |
| Casuistry | previous cases are a social construct in terms of being reflective of ideology, popular culture, or societal bias -path dependency -use what we did in previous situations to know what to do in this situation |
| Personalism and Ethics of Care | -emphasis on human dignity and subjectivity cannot be reduce to material objects and natural instincts -compassion, sympathy, empathy, kindness, information |
| 2021 TB Updates | low risk -small % of immigrants infected -infected people were identified and treated |
| Mass Screening | screen EVERYONE |
| Selective Screening | screen only vulnerable people |
| Multiphasic Screening | -done over periods of time -to track disease progression |
| Surviellance | monitoring disease status of the population |
| Case Finding | tracking down potential cases due to their history -ex. finding everyone who was on same flight as infected person |
| Population Survey | surveying entire population -ex. CCHS |
| Institutional Arrangements | the policies, systems, and processes that organizations use to legislate, plan, and manage their activities efficiently and effectively coordinate with others in order to fulfill their mandate |
| PYLL | potential years of life lost - # of years someone of your age and gender would typically lose -identifies risk to life -helps prevent most common risks |
| HALE | health-adjusted life expectancy -# of years you would live without specific disease |
| CIHI | collection of ALL health records |
| Demography and Population Geography | -branch of social science -concerned with human population, its structure, change, and relationship with environment -includes size, rate of growth, fertility, life expectancy, and mortality |
| 'Built' Environment | -neighbourhoods -homes -workplaces -schools -shops and services -sidewalks and bike paths -streets and transit systems -food systems -building and other infrastructures |
| Opportunity Structures | socially constructed and socially paterned features of the physical and social environment which may promote or damage health either directly, or indirectly through the possibilities they provide for people to live healthy lives |
| Opportunity Costs | the true cost of something is what you give up to get it |
Created by:
aubreygoosen