VET656: Public Health and Epidemiology - Health Assessment Answer

Health Assessment Task

Public Health Topic 1. Decreasing the burden of stroke.
Will reducing salt intake reduce the risk of stroke? Stroke results from either a blockage in one of the arteries supplying the brain or bleeding from one of these arteries into the brain. Stroke carries a high risk of death and is a major cause of disability worldwide. Hypertension (high blood pressure) is an established risk factor for stroke. Among people with high blood pressure, reducing blood pressure using anti-hypertensive medication substantially reduces the risk of stroke. High salt intake is one factor that contributes to high blood pressure. The extent to which salt intake is a risk factor for stroke remains controversial. The food industry argues that just because high salt
intake is associated with higher blood pressure, it does not mean that higher salt intake causes stroke or that reducing salt will prevent strokes. The association between salt intake and stroke is an important question because salt intake is potentially modifiable both for individuals (for example by following dietary advice) and for populations (for example by reducing the salt added to processed foods). What approach would you take to investigate the association between salt intake and risk of stroke?
Public Health Topic 2

Decreasing hospital admission rates due to acute asthma in children
In children with acute asthma, does dexamethasone given orally reduce the hospital admission rate? Asthma is a chronic inflammatory disorder of the airways. Corticosteroids reduce airway hyper-responsiveness, inhibit inflammatory cell migration and activation, and block late-phase reaction to allergens. Inhaled steroids improve control of asthma and are safe and well tolerated by children, however they do not improve acute exacerbations. Oral corticosteroids may be more effective have known sides effects and convincing a child to take oral steroids can be difficult.
What sort of study could be used to determine whether prescribing oral medication to children with acute asthma is likely to reduce asthma-related hospital admissions?
Public Health Topic 3. Reducing the Global Burden of Respiratory Infections in Infants
What is the impact of indoor air pollution on respiratory infections in infants? There is evidence that indoor air pollution from cooking fires is related to respiratory disease in children and adults in some situations. The health minister has just attended a meeting where this was discussed and is keen to do something about it. In the area where you work, although respiratory infections are an important cause of morbidity and mortality, especially amongst young infants, no one believes that indoor pollution can be important because people spend so much of their time outside. You have persuaded the minister that it would be useful to assess the impact of indoor air pollution on respiratory infections in infants before rushing ahead with any interventions. What approaches could you use?

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