Population and Planetary Health

Population and planetary health covers public health principles, screening programmes, vaccination schedules, and the environmental impact of healthcare. This topic has expanded in recent years with the addition of planetary health to the RCGP curriculum.

Screening programmes are heavily tested. The UK National Screening Committee oversees programmes including cervical screening (ages 25-64), breast screening (ages 50-70, triennial mammography), bowel screening (ages 56-74, FIT test), abdominal aortic aneurysm screening (men aged 65), and diabetic eye screening (annual for all diabetics). You need to know the Wilson and Jungner criteria for evaluating screening programmes.

The UK vaccination schedule changes regularly and AKT questions reflect the current schedule. Key vaccinations include the childhood programme (6-in-1, PCV, MenB, Hib/MenC, MMR, 4-in-1 pre-school booster), the HPV vaccine (years 8-9), the flu vaccine (annual for at-risk groups, all over 65s, and children), the shingles vaccine (ages 70-79), and the pneumococcal vaccine (65+). COVID-19 vaccination is part of the ongoing programme.

Epidemiological concepts tested include incidence, prevalence, mortality rates, life expectancy, and disability-adjusted life years (DALYs). You should understand the difference between incidence (new cases over time) and prevalence (total cases at a point in time).

Health promotion models include the Tannahill model (health education, prevention, health protection), the Ottawa Charter, and behaviour change theory including the stages of change model (Prochaska and DiClemente). AKT questions may ask about appropriate health promotion strategies for specific populations.

Planetary health is a newer curriculum area. Healthcare contributes approximately 4-5% of the UK's carbon emissions. The NHS has committed to reaching net zero by 2040 for direct emissions and 2045 for the broader supply chain. Practical measures include reducing unnecessary prescribing (inhalers are a significant source of emissions), promoting active travel, and reducing waste. You may see questions about the relative carbon footprint of MDI vs DPI inhalers.

Travel health questions cover pre-travel risk assessment, destination-specific vaccinations, malaria prophylaxis, and advice for travellers with chronic conditions.