Conditions
- Cancers
- Cardiovascular disease
- Chronic kidney disease
- Chronic liver disease
- Chronic lung disease, such as:
- chronic obstructive pulmonary disease
- lung fibrosis
- Chronic pain
- Injury, such as:
- intentional
- unintentional
- Mental illness
- Metabolic diseases, such as:
- Neurodegenerative diseases, such as dementia
- Adverse reproductive outcomes, such as:
- fertility variations
- preterm or small for gestational age
- developmental issues (environmental injury)
- perinatal mortality and key infant outcomes, such as birthweight and infant mortality rates
- maternal morbidity / mortality
- Relevant other non-communicable diseases, including those with inequitable distribution
Risk factors
- Absence of social and emotional wellbeing
- Alcohol
- Drug abuse
- Denial and abuse of human rights
- Deprivation
- Domestic violence
- Inactivity and sedentary behaviour
- Overweight / Obesity
- Poor nutrition
- Problematic gambling
- Tobacco smoke and e-cigarette exposure
- Other disease-specific risk factors
Prevention
- Health promotion programs addressing risk factors, focusing on:
- building healthy public policy and legislation
- creating environments supporting health
- healthcare services and systems
- individuals and health literacy
- strengthening community action
- Primordial, primary, secondary, and tertiary prevention
- Relevant legislative frameworks
- Relevant governmental / non-governmental organisations
- Harm minimisation of tobacco, vaping and e-cigarettes, drugs, and alcohol, including:
- demand reduction
- harm reduction
- supply reduction
- Priority populations:
- Aboriginal and Torres Strait Islander peoples
- Māori (tangata whenua)
- Pacific peoples
- homeless
- LGBTQIA+ people
- lower socioeconomic status
- people in custodial settings
- people experiencing unstable housing
- people who inject drugs
- people of refugee and/or asylum seeker background
- rural and remote
- youth
Public health management
- Harm minimisation
- Health promotion program development, implementation, operation, and evaluation
- Mapping and collaboration with relevant stakeholders
- Policy, advocacy, legislation, and regulatory change
- Population health surveillance and screening
- Transition to sustainable future
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- consider the impact of the situation on individuals, workplaces, family, and the wider community
- dentify relevant epidemiology, disease sequelae, and public health prevention and control pathways
Manage
- advise on evidence-based public health management
- consider and advocate for intersectoral and multisectoral approaches to management
- recognise potential complications of disease and their management, and initiate preventative strategies
Consider other factors
- identify individual, social, cultural, environmental, and other health determinants, and legal responsibilities, in public health management of risk factors and conditions
Procedures
- Establish known details to date
- Decide whether to investigate further
- Consult relevant documentation:
- cluster investigation protocol
- Understand team functions
- Engage with relevant stakeholders
- Ensure effective management of cases is underway
- Investigations, such as epidemiological investigation and exposure assessment:
- recognise limitations of study power, and the role of chance
- use appropriate analyses, such as Poisson and small area analyses
- Recognise when to escalate or expand investigation
- Ensure control of sources of risk, such as environmental pollution
- Communicate to gather relevant public health information and disseminate findings and recommendations to a variety of audiences, including stakeholders, public, and the media, including effective oral and written communication
Monitor access and use of health technologies and interventions
- Diagnostic services
- Ethical, regulatory, and resource implications
- Health care systems – private / public
- Health insurance-based systems / Out-of-pocket costs
- Pharmaceuticals
- Public health implications of genetic factors and technologies, including their roles in:
- determining causality
- epidemiological research
- health care
- screening
- Treatment services
Screening
- Screening as a secondary prevention strategy
- Features of organised population screening programs
- Potential benefits and harms of population screening programs
- Current and forthcoming programs in Australia / Aotearoa New Zealand
- Criteria for introducing a new program in Australia / Aotearoa New Zealand
- Implementation and delivery of programs
- Evaluation, quality assurance, and improvement of programs:
- potential sources of bias in evaluation – volunteer, lead-time, length
- design of studies to evaluate programs
Surveillance
- Descriptive epidemiology of health problems
- Uses:
- detection of patterns of chronic disease, such as geographic and time trends
- future projections
- health advocacy
- identifying at-risk populations
- links to services, such as notifiable diseases
- monitoring and evaluation of interventions / public health programs
- research, such as generating research questions
- resource allocations
- health technologies and health care usage
- Elements of a surveillance system:
- case definition
- confidentiality
- cycle of surveillance
- incentives to participation, such as for clinicians
- population under surveillance
- Approaches to surveillance:
- active versus passive
- information systems
- laboratory-based surveillance
- notifiable disease reporting
- record linkage
- registries
- sentinel events
- surveys
- Analysis of surveillance data:
- advanced techniques to adjust for sampling designs
- descriptive statistics
- Attributes of surveillance systems:
- fit-for-purpose
- simplicity
- flexibility
- data quality
- acceptability
- sensitivity
- predictive value
- accuracy and completeness of descriptive information
- representativeness
- timeliness
- stability
- Awareness and analysis of systems particularly as they relate to inequities:
- quality and safety, such as high morbidity and mortality around women’s health in regional, rural, or remote hospitals
- Using an equity lens to understand and analyse public health issues and systems so everyone can attain their full potential for health and wellbeing
