Health Sci 1002B- Final Exam
Questions with Guaranteed Pass
Solutions.
What did the study done by McClean's magazine (partnered with the CMA) examine? - Answer
Life and death by neighborhood
(where you live may decide how soon you die)
Winter and spring of 2013, the CMA held public town hall meetings in Winnipeg, Hamilton,
Charlottetown, Calgary, Montreal, and St. John's. What were the 4 purposes of these meetings?
- Answer 1. To determine what factors beyond the health care system influence health
2. What initiatives offset the negative impact of these determinants
3. What governments and health care providers should be doing to address these social
determinants
4. How equal access for all to the health care system can be achieved
McClean's magazine partnered up with the CMA to talk about and explore in a town hall format
what 4 main social determinants of health? - Answer income
housing
nutrition/food security
early childhood development
Why did McClean's magazine and the CMA decide to hold these town meetings? - Answer -
Public opinion is very important
- More and more it's coming to light that health is more than just health care
- A study called Code Red prompted this as well
What is Code Red? What did Code Red suggest? - Answer - Study done by a researcher in
collaboration with the Hamilton Spectator (done in Hamilton, ON)
- Health is predetermined by postal code.
What would happen to the baby of a mother who is living in this neighbourhood:
- bottom 20% of the city's income earners
- six times less likely than the wealthiest hamiltonian to seek first-trimester prenatal care
- more than six times as likely to be a teenager or to have dropped out of school - Answer
Her baby's future:
- Born underweight and risk of needing weeks in neonatal intensive care would also be higher
,- Because it's born underweight + environment, the child will likely face a number of difficulties
later in life (ie. heart disease, obesity, diabetes, cognitive delay/impairment)
What was the purpose of the Code Red study? - Answer To describe the disparities in the
determinants of health and health status that exists in the City of Hamilton's neighborhoods in a
way that could be easily comprehended by a lay audience.
How was data collected for the Code Red study? - Answer - Looked at health records;
specifically emergency room visit data and hospital admission records from 2006 - 2008 for
every patient listing Hamilton as a home (~ 400,000 observations)
- They didn't look at these records at the individual level (didn't look at names); it was
anonymous
- Looked at death records along with postal code of residence at the time of death Death
- Both local District School Boards (Catholic and Public) provided data on high school
- Variables relating to various determinants of health were collected from the 2006 Census of
the Canadian population (ie. dwelling value, median income, % of immigrants etc.)
- Data were entered into a GIS for mapping
by renters.
After gathering data and analyzing results from the Code Red study, what did the Hamilton
spectator do between April 10 and April 17, 2010? - Answer Published the Code Red series in
7 instalments (published 7 maps along with associated statistics ie. avg age of death, CV disease,
hospital admission rate etc. so that people could see what was happening by area/postal
code/region)
- One of the maps was an aggregate map which looked at the overall results
What was the key variable in the Code Red study? - Answer Postal code
Describe the statement "Two Streets Two Worlds" as it relates to Hamilton (as determined by
the Code Red study)? - Answer - In neighborhoods like Hamilton's depressed, residents die
an average Third World Death - at 65.5 years of age
- If they lived 5 or 6 km, say, on Rice Avenue in the city's leafy suburbs they would live beyond
86 years
Why can Hamilton Health Sciences not solve the problem (where you live strongly influencing
when you die)? - Answer Health care system's overall objective is helping sick people, not
dealing with the social determinants of health that may have caused them to be sick
Why is "Two Streets Two Words" a reality in Hamilton? - Answer Today's hardest-hit inner-
city neighbourhoods were thriving communities 40 years ago until well paying industrial, steel,
and manufacturing jobs fired a large number of people or left the city entirely. This, combined
, with a pattern of migration (by those who could afford it) from the downtown neighbourhoods
surrounding major industrial plants to the suburbs, produced dramatic inequalities within the
city's boundaries. People who live in the suburbs or outskirts of Hamilton are more affluent/live
longer.
On the aggregate map who does the lowest 20% and the highest 20% represent? - Answer
Lowest 20% = people with the lowest risk (highest socioeconomic status)
Highest 20% = people with the highest risk (lowest socioeconomic status)
Result Highlights of Code Red - Answer In less affluent neighbourhoods: higher acute care
hospital bed use, higher ER room visits (more than 1,000/1,000 people; 13x more), higher high
school dropout rates, much lower property value
What were the conclusions drawn from the Code Red study? Why was it important? - Answer
Code Red documented the disparities in the determinants of health and health status in the City
of Hamilton that has developed as the industrial jobs disappeared from the inner city. The
maps, simple statistics, and stores all woven together provide an effective means of
communicating health information to the public.
- Important because it prompted a number of cities including Sudbury and Saskatoon to do
similar research (found similar results)
- Important because they documented everything (collected data and analyzed/collected it to
confirm what was already thought to be true)
What were the results of the study done in Sudbury (prompted by Code Red) among the most
deprived? - Answer Much higher rates of births to teenage mothers (205%), infant mortality
(139%), and premature death (86%).
What were the results of the study done in Saskatoon (prompted by Code Red) in six low-
income neighbourhoods? - Answer Much higher rates of infant mortality (448%), teen births
(1549%), and suicide attempts (1458%).
What were the outcomes of the Code Red study? - Answer 1. Inspired changes:
implementation of a nurse-family partnership program to guide high-risk mothers.
2. Inspired changes: Incorporation of the implications of social determinants into McMaster
University curriculums for health professionals.
3. McMaster built an $86 million health campus in the inner city (provides primary health care
to an underserved population & gives medical students an understanding of the challenges
residents face)
How did the Code Red study offer support for SODH? - Answer Proved that focusing on non-
medical social problems is a priority.
Questions with Guaranteed Pass
Solutions.
What did the study done by McClean's magazine (partnered with the CMA) examine? - Answer
Life and death by neighborhood
(where you live may decide how soon you die)
Winter and spring of 2013, the CMA held public town hall meetings in Winnipeg, Hamilton,
Charlottetown, Calgary, Montreal, and St. John's. What were the 4 purposes of these meetings?
- Answer 1. To determine what factors beyond the health care system influence health
2. What initiatives offset the negative impact of these determinants
3. What governments and health care providers should be doing to address these social
determinants
4. How equal access for all to the health care system can be achieved
McClean's magazine partnered up with the CMA to talk about and explore in a town hall format
what 4 main social determinants of health? - Answer income
housing
nutrition/food security
early childhood development
Why did McClean's magazine and the CMA decide to hold these town meetings? - Answer -
Public opinion is very important
- More and more it's coming to light that health is more than just health care
- A study called Code Red prompted this as well
What is Code Red? What did Code Red suggest? - Answer - Study done by a researcher in
collaboration with the Hamilton Spectator (done in Hamilton, ON)
- Health is predetermined by postal code.
What would happen to the baby of a mother who is living in this neighbourhood:
- bottom 20% of the city's income earners
- six times less likely than the wealthiest hamiltonian to seek first-trimester prenatal care
- more than six times as likely to be a teenager or to have dropped out of school - Answer
Her baby's future:
- Born underweight and risk of needing weeks in neonatal intensive care would also be higher
,- Because it's born underweight + environment, the child will likely face a number of difficulties
later in life (ie. heart disease, obesity, diabetes, cognitive delay/impairment)
What was the purpose of the Code Red study? - Answer To describe the disparities in the
determinants of health and health status that exists in the City of Hamilton's neighborhoods in a
way that could be easily comprehended by a lay audience.
How was data collected for the Code Red study? - Answer - Looked at health records;
specifically emergency room visit data and hospital admission records from 2006 - 2008 for
every patient listing Hamilton as a home (~ 400,000 observations)
- They didn't look at these records at the individual level (didn't look at names); it was
anonymous
- Looked at death records along with postal code of residence at the time of death Death
- Both local District School Boards (Catholic and Public) provided data on high school
- Variables relating to various determinants of health were collected from the 2006 Census of
the Canadian population (ie. dwelling value, median income, % of immigrants etc.)
- Data were entered into a GIS for mapping
by renters.
After gathering data and analyzing results from the Code Red study, what did the Hamilton
spectator do between April 10 and April 17, 2010? - Answer Published the Code Red series in
7 instalments (published 7 maps along with associated statistics ie. avg age of death, CV disease,
hospital admission rate etc. so that people could see what was happening by area/postal
code/region)
- One of the maps was an aggregate map which looked at the overall results
What was the key variable in the Code Red study? - Answer Postal code
Describe the statement "Two Streets Two Worlds" as it relates to Hamilton (as determined by
the Code Red study)? - Answer - In neighborhoods like Hamilton's depressed, residents die
an average Third World Death - at 65.5 years of age
- If they lived 5 or 6 km, say, on Rice Avenue in the city's leafy suburbs they would live beyond
86 years
Why can Hamilton Health Sciences not solve the problem (where you live strongly influencing
when you die)? - Answer Health care system's overall objective is helping sick people, not
dealing with the social determinants of health that may have caused them to be sick
Why is "Two Streets Two Words" a reality in Hamilton? - Answer Today's hardest-hit inner-
city neighbourhoods were thriving communities 40 years ago until well paying industrial, steel,
and manufacturing jobs fired a large number of people or left the city entirely. This, combined
, with a pattern of migration (by those who could afford it) from the downtown neighbourhoods
surrounding major industrial plants to the suburbs, produced dramatic inequalities within the
city's boundaries. People who live in the suburbs or outskirts of Hamilton are more affluent/live
longer.
On the aggregate map who does the lowest 20% and the highest 20% represent? - Answer
Lowest 20% = people with the lowest risk (highest socioeconomic status)
Highest 20% = people with the highest risk (lowest socioeconomic status)
Result Highlights of Code Red - Answer In less affluent neighbourhoods: higher acute care
hospital bed use, higher ER room visits (more than 1,000/1,000 people; 13x more), higher high
school dropout rates, much lower property value
What were the conclusions drawn from the Code Red study? Why was it important? - Answer
Code Red documented the disparities in the determinants of health and health status in the City
of Hamilton that has developed as the industrial jobs disappeared from the inner city. The
maps, simple statistics, and stores all woven together provide an effective means of
communicating health information to the public.
- Important because it prompted a number of cities including Sudbury and Saskatoon to do
similar research (found similar results)
- Important because they documented everything (collected data and analyzed/collected it to
confirm what was already thought to be true)
What were the results of the study done in Sudbury (prompted by Code Red) among the most
deprived? - Answer Much higher rates of births to teenage mothers (205%), infant mortality
(139%), and premature death (86%).
What were the results of the study done in Saskatoon (prompted by Code Red) in six low-
income neighbourhoods? - Answer Much higher rates of infant mortality (448%), teen births
(1549%), and suicide attempts (1458%).
What were the outcomes of the Code Red study? - Answer 1. Inspired changes:
implementation of a nurse-family partnership program to guide high-risk mothers.
2. Inspired changes: Incorporation of the implications of social determinants into McMaster
University curriculums for health professionals.
3. McMaster built an $86 million health campus in the inner city (provides primary health care
to an underserved population & gives medical students an understanding of the challenges
residents face)
How did the Code Red study offer support for SODH? - Answer Proved that focusing on non-
medical social problems is a priority.
