Public Health: Concept Checklist

Concepts covered across the module lectures, grouped by lecture. Tick each once you can explain it from memory.

L1 Occupational Medicine (27 Feb) L1 Public Health Occupational Medicine

• Define occupational and environmental medicine; WHO objectives of occupational health
• Two-way relationship between work and health, and categories of risk in each direction
• History of occupational medicine: Ramazzini and asking “what is your job?”
• Health and Safety at Work Act 2015: hierarchy of law, duty holders (PCBU, workers, officers, others), regulators
• Definitions of hazard and risk, and the PCBU’s duty
• Health NZ’s seven critical risks, and examples of occupational diseases by source
• Factors in what is reasonably practicable, and the hierarchy of control measures
• Exposure monitoring vs health monitoring, and what does not count as health monitoring
• Burden of work-related harm in New Zealand: deaths and hospitalisations by cause, disease vs accident, cost, OECD comparison, ACC claims by industry
• Recognising work-related presentations in clinical settings, and ACC Schedule 2 occupational diseases
• Notifiable events and when to notify WorkSafe
• Return to work: decline with time off, barriers, and the health benefits of good work

L2 Socioeconomic Environment and Health (12 Mar) L2 Public Health Socioeconomic Environment and Health

• Social determinants of health, the social gradient, and the Barton and Grant health map
• Distinguish inequality from inequity
• Evidence for health inequalities: Whitehall Study, Black Report, Acheson Report recommendations
• Material, behavioural, psychosocial stress and health care pathways from socioeconomic position to disease
• Life-course perspective and accumulation of disadvantage; COVID-19 as an example of the social gradient
• Health inequalities in Aotearoa NZ: child poverty, ethnic inequalities, neighbourhood effects, life expectancy gaps
• WHO 2025 World Report on Social Determinants of Health Equity: structural determinants, scale of inequity, areas for action; income inequality and health outcomes
• Definition of food security, and prevalence of food insecurity and child material hardship (DEP-17) in NZ by group
• Lived-experience barriers to exercise, healthy eating, stress reduction and health care for people in poverty
• What clinicians can do about social determinants of health
• UNCROC principles and health system actions for child health equity
• Cultural competence vs cultural humility

L3 The Built Environment and Health (16 Mar) L3 Public Health The Built Environment and Health

• Global burden of disease from housing: ambient and household air pollution among the top ten risk factors
• Slums and homelessness: NZ definition, four categories, human rights framing, scale
• HAPINZ 3.0: health outcomes and social cost of PM2.5 and NO2 in NZ, and their sources
• Linear (five-tier) and complex systems models of how housing affects health
• Burden of housing-related hospitalisations and deaths in NZ
• Cold, damp and mould: prevalence and evidence linking mould to childhood respiratory admissions
• Household crowding: definition, link to infectious disease, ethnic inequities
• Climate change threats to housing and the air conditioning reinforcing feedback loop
• Housing interventions: retrofitting insulation and heating (health benefits, return on investment), Healthy Homes Standards, state housing
• City design and health: car dependence as a health hazard, the tobacco analogy, transport health gains by group, street design
• Clinician roles: built environment history, individual referrals, and population-level advocacy

L4 Epidemiology of suicide (30 Mar) L4 Public Health Epidemiology of suicide

• Classification of external causes of injury by intent and mechanism; definitions of suicide, suicidal behaviour, ideation and deliberate self-harm
• Global epidemiology of suicide: deaths per year, prior attempt as key risk factor, age groups, low- and middle-income countries, common methods
• Relative prevalence of ideation, attempts and deaths across countries
• NZ suicide data sources (Chief Coroner provisional vs Ministry of Health confirmed) and long-term time trends
• Distribution of suicide in NZ by age, sex, ethnicity and deprivation; suicide as a leading cause of death in young people
• General risk factors for suicide, Ministry of Health risk and protective factors, and factors specific to Māori
• WHO population approaches to suicide prevention vs individual approaches
• Evidence for restricting access to means: Grafton Bridge, Lawyers Head, Sri Lanka pesticide bans, medication pack limits
• Suicide contagion and clusters; effect of celebrity suicide reporting
• Coroners Act 2006 section 71 restrictions and safe media reporting guidance

L5 Global environmental changes _ health (24 Apr) L5 Public Health Global environmental changes _ health

• Environmental and climate action as a professional responsibility for doctors
• Planetary boundaries framework and its trend over time; doughnut economics social foundation and ecological ceiling
• Six truths about climate change as a communication framework
• Climate drivers, exposure pathways and resulting health effects
• Global injustice: disproportionate burden on those who contributed least, heat mortality and per-capita emissions
• Emissions trends, net zero pathways, and political barriers to mitigation
• Sources of greenhouse gas emissions in NZ vs globally
• Mitigation measures with health and equity co-benefits, including active transport and diet
• Principles of health sector adaptation, including partnership with iwi and councils
• Actions available to medical students and clinicians on climate and health

L6 Introduction to health economics (15 Jun) L6 Public Health Introduction to health economics

• Pressures on NZ health funding: ageing, noncommunicable disease, obesity, technology
• Scarcity, efficiency and the fundamental economic problem
• Distinguish health from health care, and health care as one of many determinants of health
• Opportunity cost, and resource allocation at macro, meso and micro levels
• Bases for allocation (need, randomness, cost) and why capacity to benefit is required
• Definition and general approach of economic evaluation, including the comparator
• Four types of economic evaluation: CMA, CEA, CUA, CBA and how consequences are measured in each
• Marginal analysis and calculating an ICER
• QALYs: rationale, HRQoL weights, calculation, and cost per QALY
• Equity and ethical questions economics cannot settle: age, rule of rescue, severity, double jeopardy

L7 Sexually transmitted infections (17 Aug) L7 Public Health Sexually transmitted infections

• The Public Health Model as a framework from problem to response
• STI surveillance sources in NZ, and which STIs are notifiable
• Complications of each major STI
• Descriptive epidemiology of gonorrhoea, chlamydia and syphilis in NZ: time trends, geography and groups affected
• Drivers of STI patterns, and the role of sexual network structure
• Individual-level STI prevention: vaccines, barrier methods, PrEP and PEP
• Population-level STI interventions
• Cervical cancer prevention: HPV vaccination as primary and cervical screening as secondary prevention
• NZ criteria for assessing screening programmes, applied to HPV-based screening
• NZ STI-related action plans