2018 Test Flashcards
Describe a high risk approach to preventing disease
Focus is on interventions for people at the HIGHEST RISK of getting disease.
5 major barriers that disabled people face in accessing services
(1) HEALTH
(2) INFORMATION
(3) TRANSPORT
(4) EDUCATION
(5) EMPLOYMENT
Define ableism
Favouritism of species-typical abilities (i.e. normal is right, not normal is substandard)
The relative risk of dying from breast cancer for women age 40-49 is reduced 15% with routine mammogram. Exaplain why this is bullshit.
This is an example of ECOLOGICAL FALLACY (aka applying population data on an individual level). Remember that the likelihood of dying from breast cancer in THAT AGE RANGE (40-49)is already fucking low so thhe absolute risk reduction on individual level is only 0.05% (from 0.32% to 0.27%). When you factor in the pain from mamagoram malifience is not there.```
____% of the worlds population experiences some form of disability
15% which amounts to about 110-119 million people
Describe the difference between dependence and addiction.
Dependence is the physical withdrawal symptoms accompanying the reduction in dose/drug use after continual use. While this can happen in addiction, addiction is the COMPULSIVE use and LOSS OF CONTROL of use in people despite overt social and physical harm. IT INVOLVES A SOCIAL COMPONENT.
Describe the pattern of diabetes in indigenous populations
It is higher than the rest of Canada (10% vs 5%)
Briefly outline the 7 calls to action regarding health from the truth and r3econcilliation commission
(1) acknowle3dge that current state of Aboriginal health is direct result of previous governmental policies
(2) establish measurable goals to close gaps in health
(3) address jurisdictional disputes & recognize the distinct health needs of Metiis, Inuit, and off-reserve aboriginal people
(4) sustainable funding for new aboriginal healing centres making Nunavut/NWT a priority
(5) recognize value of Aboriginal healing practice and use them in aboriginal pt to in collaboration w healers/elders as requested
(6) increase aboriginal professionals working in health care
(7) all nursing/medial schools take a course on dealing with aboriginal health issues
Define lateral violence.
A range of damaging behaviours expressed by those in a minority oppressed group towards others of that group rather than towards the system of oppression. BEHAVIOUR TOWARDS PEERS.
The aim of the physician is to sometimes heal, often relieve, and always console. Medical advancements including physiatry, OT/PT, social work, disability rights movement, technology/medicine/pharmacy, and accessibility culture falls under which heading.
RELIEVING. There has been a shift as doctors from CONSOLING to RELIEVING the burden of disease of disability.
Disability disproportionately affects _______ populations. These include _____, _______, and _____ households.
Vulnerable, women, elderly, poor
There is a critical window where the dose-dependent relationship of healthy childhood development and its influence on later risks in life including behaviour and mental/physical health is especially important. What is this time frame?
BIRTH-6 YEARS OF AGE
Using drinking and driving as an example. Prevention method A uses ignition locks that require a breathalyzer to unlock your car. (1)which population will this affect (2) why is this not ideal (3) what would this method e classified as?
Prevention B wants to shift alcohol level down in all drivers through an educational program. (1) which population will this affect (2)why is this not ideal (3)what would this method be classified as?
PREVENTION METHOD A would be a classic example of HIGH RISK PRVENTION. You are targeting those with a history of drinking and driving (aka that high risk group that creates the greatest risk). HOWEVER some high risk individuals will always be missed (bc they haven’t been caught) AND you miss out on the entire moderate risk group that actually causes more cases of accidents.
PREVENTION METHOD B would be a classic example of POPULATION PREVENTION wherein you are trying to shift the entire risk left without a huge burden on the individual level. This would effect the entire population but is not ideal because you leave those at extreme risk unaffected [i.e. those extreme drunks/alcohols will not change their behaviour].
The Indian Act was officially legislated in Canada in ______. Canadian Aboriginals received federal voting rights in _____. The federal government pays each First Nations person an annum of $____ according to historical negotiated treaties.
1976; 1960; $5.00
Incidence is influenced by 3 things, and prevalence is influenced by 3 things, what are they?
Incidence: (1)variation in RISK i.e. rate (2) true incidence of disease (3) likelihood of fining/reporting it
Prevalence: (1) incidence i.e. rate being added to existing disease pool (2) death/cure rate (3) likelihood of finding/reporting it
What is effect modification
A third variable positively or negatively effects the observed effect of a risk factor on an outcome.
What directly contradicts the notion that disability is inevitable and acceptable variations of the human form.
Ableism or the idea that normal is right (i.e. favouritism of species-typical ability) and non normal is abnormal/abhorrent.
DESCRIBE 10 HEALTH BURDENS TO HOMELESSNESS
(1) mortality (2) mental health approx 1/3 (3) substance abuse approx 1/2 (4) chronic conditions- because of delays in seeking care, poor adherence, lack of resources
(5) upper respiratory tract infection (6) unintentional injury (7)physical/sexual assault
(8) d3ecreasd access to healthcare (9)poor oral/dental hygiene (10) shelter specific concerns like overcrowding- which favours upper respiratory tract infection
What are the leading causes of mortality in Canada’s Aboriginal Population
Injury/Poisoning
Describe difference between gender and gender identity
Gender= attitudes, feelings, behaviours, expectations a culture characterizes as male, female, or others.
Gender identity= how you in your heart feel about yourself.
What are 5 major ways to improve health outcomes of disabled people?
(1) legislation against discrimination
(2) income support
(3) financial support
(4) education/awareness mainly to remove negative attitudes
(5) see BEYOND disability when treating patients to see if there are other problems
What are 4 major barriers to preventative/curative services to homeless people?
(1) societal barriers (2)racism/discrimination (3)lack of affordable/appropriate housing (4)individual mental/cognitive/behaviour
____ mortality rate is used in large populations to compare health outcomes
____ mortality rate is used to compare neonate healthcare access
____ mortality rate is used to study women’s health
Infant [bc it’s a direct measure of child health and indirect of maternal health], neonatal, maternal
What would be the difference in physician individual-level care vs. Public/population health?
The major difference is the level of treatment. At the physician level you are focused on individualized/personalized care vs. Pop/public health level where you are concerned with patterns of health/illness in GROUPS of people
Which province has the largest # of emergency beds (at 100 000)
Alberta
Use climate control to describe how the human tendency to modify living environments is both a cause and a cure for environmentally mediated disease.
We are attempting to IMPROVE CLIMATE CONTROL by using manmade landscapes and this has led to reduced health risks associated with extreme cold/heat. CONVERSELY we have now introduced problems with poor circulation/indoor pollution. In this sense, the manmade environ is both cause/cure.
What statistic is most commonly used to find cause/risk factors
RELATIVE RISK
Improvement of treatment WITHOUT A CURE OR EARLIER DETECTION will (increase/decrease) prevalence
Nothing more is leaving the barell (because have halted death rate BUT NOT CURED anyone) but you will still have same rate of INCIDENCE (b/c not earlier detection/prevention) therefore your PREVALENCE INCREASES.
Drug A causes mild liver damage.
Drug B causes no liver damage when taken alone.
When Drug A and B are taken simultaneously, there is increased or decreased liver damage as a result.
What is this an example of?
Effect modification- Drug B is the EFFECT MODIFIER because changing the effects of Drug A (exposure) on liver damage (outcome).
This is different than a confounder, because a confounder is INDEPENDENTLY ASSOCIATED WITH EACH.
Finish this sentence. Some have suggested that establishing a comprehensive _____ ______ _____ program in Canada would be the single best way of improving Canadian health outcomes.
Early childhood development
Approximately how many people in Canada are homeless. (A) 150000-300000 (B) 1 mil- 1.5mil (C) 50000-100000 (D)500000-750000
A, approximately 150 000 to 300 000 people are currently homeless in Canada
Formula for standard morbidity ratio
Total # observed death/ total # expected death. If expected SMR is 100 but you calculate a 110 SMR the death rate is 10% higher than expected.
Complete this chain of events in the neomaterial model of social determinants: economic process/political decisions —> ___________ —> neomaterial matrix of life —> health
Resources available to people + public infrastructure
Which feature most clearly differentiates opiod ADDICTION from opiod DEPENDENCE
(A)increasing frequency of use/daily dosage over time
(B) loss of control of use despite overt harm
(C) intolerable withdrawal symptoms
(D) intolerable physical side effects
(E) inability to stop using opiod at will
Opiod dependence is a physiologic process (can get drug sick/jonesing) where you use drugs solely to prevent withdrawal symptoms vs. Opiod addiction defined as the COMPULSIVE USE/LOSS OF CONTROL OF USE DESITE OVERT SOCIAL/PHYSICAL HARM (it adds a social component).
A would be be related to TOLERANCE [characterized by a decline in the response to specified dosed of drug over time bc of continued use] therefore have to up dose
C/D would fit into physical dependence
The societal collapse of the Soviet Union was predicted by an increase in mortality and outbreak of diphtheria before the collapse. What SDOH would this fall under?
Social environment (the policies/economy of Soviet Union influenced the breakout of disease and thus health outcomes).
Tolerance for error, low physical effort, proper size/space, equitable, perceptive, simple/intuitive, flexible are all principles of:
Universal design [or reducing barriers to disabled persons]
Define Sickness
Social/cultural conception of health conditions —> influences how a patient reacts
______ _____ are central to the definitional elements of complex trauma and affect a traumatized individuals’ relationship to her or his self and to others.
DISRUPTED ATTACHMENT
Define dependence
The physiological phenomenom related to adaptation to long-term drug use such that reduction in dose/drug results in withdrawal symptoms
Formula for Quality-Life Adjusted Years
Used to evaluate therapy = (average # of additional years gained from intervention) * (QOL in those years)
Ranging from 0-1 where 1 is healthy and 0 is not good QOL
WHAT HAPPENS WHEN OU SUPERIMPOSE risk curve with distribution of risk (2 things)
(1) see that MANY PEOPLE EXPOSED TO A SMALL RISK results in MORE CASES than few people exposed to a HIGH RISK
(2) PREVENTION PARADO: prevention measure that brings large benefit to community might offer little to each individual [shift curve approach instead to not cause burden to individaul]
Define capacity and performance
CAPACITY= what a person can do in a standardized environment (optimal conditions/often clinical setting) without barriers or facilitators of their usual environment PERFORMANCE= what a person can do in their current/usual environment with all barriers/facilitators in place [aka their usual environment)
What are the 3 major ethical considerations in health prevention?
(1) beneficence and non-malificence
(2) patient autonomy
(3) equity
What is the difference between addiction and iatrogenic addiction.
While addiction is the loss of control & compulsive use of drugs despite social/physical harm, iatrogenic addiction is a SUBSET that is driven solely by the physician prescribing behaviour.
What is Simpson’s paradox
A type of ecological fallacy (where something learned @ population level does not apply to individual level). Basically, aggregate results from population data complete obscure data at the individual level (and the association observed in aggregate data is OPPOSITE of subgroups that comprise it).
Personal habits/coping skills are strongly influenced by 4 other SDOH. Which factors might this include.
Social, Environmental, Income, Culture would be the major ones influencing personal habits.
Define Wellness
Subjective experience of physical, mental, social, spiritual well-being allowing a person to achieve full potential
____ ______ is behaviour/gender expression that doesn’t match cultures masculine or feminine norms. __________ ______ is a term used by some who identify with unrestricted gender norms.
Gender nonconformity, gender queer
Define tolerance of a drug.
A decline in response to specified dose/drug over a period of continued use.
Although there is a huge variety of medications that can be abused, they all have ONE THING IN COMMON. What is it?
Abuse is the continued misuse of a drug despite overt negative health consequences. All medications the abuser must have made a RISK-BENEFIT analysis to justify continued misues. THE USER HAS TO GET SOMETHING OUT OF IT TO MAKE IT WORTHWHILE.
What is the leading cause of mortality in Canada’s indigenous population A) external causes B) cancer3 C) circulatory disease d) respiratory disease E)endocrine/immune
A) EXTERNAL CAUSES like self harm (5-6X higher in aboriginal youth), violence/trauma, accidents
Complete the sentence. Testing will ___ prevalence and ____ incidence as previously unknown cases are discovered. Prevention will ___ incidence. Effective treatment (that does not cure) will _____ prevalence in the case of fatal disease as disease duration is lengthened.
INCREASE, INCREASE. DECREASE. INCREASE.
Describe some individual level factors that may apply to homelessness
Could be anything but should be along this list: adverse childhood experiences, low educational attainment, lack of employment skills, family breakdown, mental illness, substance abuse, poverty
Define Illness
Subjective sense of feeling unwell (a persons experience of disease - can be experienced by cultural/social)
Define Disease
PATHOLOGICAL process (threshold) that may or may not produce symptoms resulting in pt illness (i.e. can HAVE DISEASE but not be ill)
in 2008 a 4 year $110 million national randomized control trial in Canada was conducted for what health initiative?
HOUSING FIRST- providing subsidized/secure housing to homeless populations because housing insecurity is one of the major causes of health inequity in Canada [barriers to healthcare etc]
Formula for Disability Adjusted Life Years
PYLL + PYLD = years lost + (weight)*(avg duration of disease)
(A) incidence and (b) prevalence will (increase/remain stable/decrease) with INCREASED TESTING ONLY
(A) increased (b) increased
Previously unknown cases are discovered increasing incidence BUT bc no death/cure rate are mentioned the “water tank” will also increase, increasing prevalence.
Formula for potential years of life disabled (PYLD)
=(average duration) * (weight) where weight reflects severity of disease ranging from 0 (perfect health) to death (1)
Can also be (average duration) * (weight) * (# of incident cases) when PREDICTING PYLD
What is the major problem with the medial model of disability?
If we think of disability solely as a health condition we UNDERESTIMATE our ability to correct factors that could be contributing to disability
What measurement uses person-years, person-days etc?
INCIDENCE DENSITY= number of new cases in @ risk pop over interval / PERSON-YEARS OF OBSERVATION*
Social environment incorporates 4 factors that are not under the control of a single individual. What are they.
(1) political (2) economic (3) familial (4) cultural
If a year following stroke is equivalent to 0.8 normal years and Bob/Bill are twins. Bot gets a stroke at 55 and dies 10 years later. Bill is healthy but is hit by a bus at 65 [therefore both twins have the same lifespa]. How many years did Bob actually lose in lifespan compared to Bill due to stroke?
(10years from intervention) * (0.8) = 8 YEARS compared to Bill’s 10 years. Therefore He lost an equivalent of 2 years from his stroke and his QALY was 2 years shorter than bills
The __ treaty areas of Alberta encompass ____ reserve and ____ First Nations
3; 140; 45
What would be the opposite of ableism?
To see disability as diversity, akin to gender, sexual orientation, or ethnicity . I.e. the idea that some disabilities are not species-typical or representative of normative function but they are INEVITABLE, AND ACCEPTABLE VARIATIONS OF THE HUMAN FORM.
Barriers exist in the physical and social environment and can be (1) (2) (3)
Structural, attitudinal, or financial
What would 1 DALY MEAN
1 lost year of healthy life (i.e. 1 year * 1 weight) = 1 death.
Describe the paradigm shift in disability
From a medical understanding towards social in the sense that disability arises from an interaction between people with a HEALTH CONDITION/IMPAIRMENT and their ENVIRONMENT. Basically disability is the experience of an impaired individual with their environment
The 2012 removal of OxyContin resulted in a balloon effect and the seismic shift in early 2000s to heroin/injectables. Fentanyl has increased recently and is (number-number)X more powerful than OxyContin, while cafentanil is (number)X more powerful.
Fentanyl is 50-80X more powerful than OxyContin.
Cafentanil is 10000X more powerful than OxyContin.
What are the 2 approaches to preventing disease?
High risk and population
What is a crucial first step when trying to implement a prevention program?
Know the natural history/progression of disease
How is harm reduction an extension of tertirary care?
The goal of tertirary care isn’t to CURE but rather to PREVENT PHYSICAL DETERIORATION/MAXIMIZE QOL therefore harm reduction doesn’t focus on preventing use per se, but on minimizing harm.
Define environmental determinant of health
Modifiable factors in the PHYSICAL ENVIRONMENT that influence health and aren’t under voluntary control. Basically everything outside the body [EXTERNAL AGENT] that influences health/causes disease
Explain the effort reward imbalance model
High efforts [overcommitment which is a crucial aspect of this model] —> strain —> poor health & low rewards
An improvement in health outcomes with an increase in social status regardless of material wealth describes WHAT FAMOUS STUDY?
Whitehall study showing mortality/morbidity improvements are not equal across classes
What is the difference between the world health survey and the global burden of disease project? what is the similarity
Both strive to estimate the global burden of disease BUT WHS is just surveys (64% of the population) vs. GBD project which uses DALYS and categorizes them
What are the 3 main theoretical directions by current SOCIAL epidemiologists?
(1) PSYCHOSOCIAL: ppls perception/experience of personal status being unequal in society leads to poor health/stress
(2) NEOMATERIALIST: it’s perception of disease (like social production) AND STRUCTURAL CAUSES (policy/economy in health)
(3) ECOSOCIAL: sociology/biology inseparable- no aspect of biology can be understood divorced from knowledge of history of individuals’ societal way of living
Describe some health issues facing LGBTQ community
SO MANY. Could include things like violence/trauma, mental health issues, suicide, substance abuse, risk taking behaviour, lack of self care, higher tranmission of STI, less access to health services (due to discrimination and lower income status), missing gender specific needs [a trans man still needs to be screened for cervical cancer, an a trans woman still needs a prostate exam] etc.
A _________ is independently associated with an exposure and outcome
Confounded
Trauma and noise would fall under what type of environmental exposure
PHYSICAL
Fill in the blanks. An individuals _____ orientation does not determine their behaviour. Choice of sexual rather or identification of _____ orientation says nothing about an individuals sexual ______.
Sexual, sexual, behaviour
How does iatrogenic addiction occur?
Doc puts pt on long term opiod use —> tolerance leads to increasing dose —> pt becomes dependent —> doc skittish about amount prescribing and stops pt cold turkey —> pt is left w withdrawal symptoms —> has to relieve symptoms by turning to shady sources.
What are the 6 major historical determinants of health for Aboriginals?
(1) COLONIALISM
(2) ASSIMILATION (including residential schools)
(3) ECONOMIC CHANGE (shift then eventually poverty)
(4) ALCOHOL INTRODUCTION
(5) EPIDEMICS
(6) RACISM
Children with _____ impariements generally fare better than those with _____ or _____ impairments.
Physical, sensory, intellectual
Internal phobias, or the internationalization of society’s negative perceptions can turn into 4 major health consequences:
(1) substance abuse (2) poor mental health/suicide (3) lack of self care (4) risk taking behaviour
Infectious disease carried through food/water/insect/animal would fall under what TYPE of environmental exposure?
BIOLOGICAL
Dif between point and period prevalence
POINT= (all existing cases)/ (population size NOW) aka at a specific time PERIOD= (all existing cases over an interval) / (pop @ mIDPOINT of interval) aka during specific interval
The six major effects of complex post-traumatic stress are
(1) disregulation of emotion/impulses
(2) changes in attention/consciousness
(3) altered self-perception
(4) altered relationships with others
(5) somatization (physical pain)
(6) alterations in systems of meaning (hopelessness)
There are 3 types of adverse childhood experiences that tend to cluster, what are they?
(1) Abuse (2) Neglect (3) Household dysfunction
Describe some community or society level factors contributing to homelessness.
Could be anything including LACK OF AFFORABLE HOUSING, labor market conditions, income inequity, and racism/discrimination
The compulsive use and loss of control of a drug despite overt SOCIAL or PHYSICAL harm is known as _____
Addiction
What is the social prejudice that views normal as right and not normal as “abnormal, abhorrent, or wrong”
Ableism
Formula for (a) infant mortality rate (b) neonatal mortality rate (c) maternal mortality rate
(A) deaths in children <1 / live births in same year
(B) deaths in children <28 d / live births in same year
(C) death during pregancy or childbirth / live births in same year
What was housing first based off of? I.e. how is it “evidence based”
Pathways to Housing in NYC that worked
Define disability
Not part of the health condition, or an impairment itself, but the interaction bw individual WITH impairment + his/her environment
The distribution of risk is usually
Bell curved
Describe difference between endemic, epidemic, pandemic
ENDEMIC= disease that exists permanent in particular region EPIDEMIC= outbreak of disease attacking many ppl @ same time through dif communities PANDEMIC= epidemic spreads globally
If life expectancy is 75 years and someone dies from myocardial infarction at age 55 what is there PYLL?
20 PYLL
What is Klein triad
When treating a risk factor in a pt
(1) overestimate the actual risk to the pt
(2) overestimate the absolute risk REDUCTION that intervention will have
(3) underestimate risk that INTERVENTION carries itself
________ is the proper way of consuming a pharmacologic agent. ____ is using a drug for purposes other than what it was prescribed for. _____ is continued misuse of medication despite overt negative health consequences. The user has to be _____ _____ out of it in order to make it worthwhile.
Use, Misuse, Abuse, Getting something
What fraction of the homeless population has a mental illness or substance abuse?
1/3 of the population have a mental illness, 1/2 experience substance abuse
Describe the difference between health inequity/health inequality
HEALTH INEQUALITY= difference in health status/distribution of health determinants between population groups
HEALTH INEQUITY: health differences that are AVOIDABLE, UNECESSARY, AND UNJUST and can be fixed
A strategy focused on not removing the underlying cause but on LESSING ITS IMPACT/COMPLICATIONS for patients.
Harm Reduction
LGBTQ stands for
Lesbian, Gay, Bisexual, Trans, Queer/Questioning
The aim of the physician is to sometimes heal, often relieve, and always console. Where does prenatal screening, selective abortion, institutionalization of children in group homes, and disabled adults in care centres fall.
CONSOLE
____% of registered First Nations live on-reserve and crown land. There are _____ reserves as of 2018.
61%; 140 reserves
Use the worst case of mass poisoning (in Bangladesh) to describe how the human tendency to modify living environments is both a cause and a cure for environmentally mediated disease.
Put arsenic in ground water to SUCCESSFUL reduced diarrheal disease in children, however this conversely exposure millions of Bangladeshis to carcinogenic levels of arsenic.
____ is an inequality that is unjust. It is due to modifiable correctable causes
INEQUITY
Define health protection, promotion, and prevention
HEALTH PROTECTION: aims to protect population from hazards
HEALTH PROMOTION: aims for population to live AS HEALTHY AS POSSIBLE
HEALTH PREVENTION: aims to prevent progression of specific disease [via DALYS]
5 mortality formulas, what are they?
(1) CRUDE= (deaths in year)/(mid point population) OR (deaths during specified period) / (population specified)
(2) neonate= (deaths < 28d) / (live births in same year)
(3) infant= (deaths <1 yr) / (live births in same year)
(4) maternal = (deaths during pregnancy/childbirth) / (live births in same year)
(5) case= (deaths due to specific DISEASE) / (cases of that disease)
Define the general term queer
It is an identity label in DEFIANCE of gender/sexual restrictions and is a general term for people whose sexual orientation doesn’t correspond to societal norms.
Using childhood obesity give an example of public vs. Population health initiatives.
Could be anything. Basically the distinction that needs to be made is the public health is an organized effort of society to keep people healthy/prevent injury, illness and premature death VS. Population health which is addressing underlying determinants (broader) and linking disciplines from biological —> social to foster health.
Ex. Public health: subsidize healthy lunch programs, ban soft drinks from schools, promote physical activity. Population health: URBAN FOOD DESERTs- do sig parts of population lack access to a grocery store? Or tackling the food system itself [agricultural system].
The dread of cancer or stigma of mental illness would fall under: (A) sickness (B) illness (C) disease (D) health
Sickness- the social/cultural conceptions of health conditions which influence how a patient will react
Describe the difference between the social selection and causation perspectives.
Social selection: health influences social mobility/SES position
Social causation: social position determines health through intermediate factors
Housing should cost < ___% of your total income before tax
30
______ ____ is defined as a recovery-oriented approach to ______ that involves moving people into independent and permanent housing as quickly as possible, with no preconditions, and then providing them with additional services/supports as needed.
Housing First; homelessness
Define the term abuse
Ongoing MISUES of a medication DESPITE OVER NEGATIVE HEALTH COSNEQUENCES.
The following would be examples of what type of ethic consideration:
(A) the fact that prevention programs like cardiac rehab often don’t target the population most affected (like homeless/heart disease)
(B) Disease Screening may make healthy patients worse
(C) doctors can coerce patients into getting unnecessary screening/testing
(A) EQUITY - vulnerable populations most at risk of disease often worse served by preventative programs
(B) MALIFIENCE
(C) AUTONOMY - coercive power of doctors can make healthy people believe they are sick
Of the 6 historical determinants in aboriginal culture (colonialism, epidemic, alcohol, racism, assimilation, economic change) this can lead to a historical trauma response (psychological, social, or physical). Give an example of each.
This could be many things (examples shown below):
(1) PSYCHOLOGICAL: PTSD, depression, anxiety/stress
(2) pHYSICAL: nutritional stress and compromised immune system
(3) SOCIAL: domestic violence, childhood abuse/maltreatment, substance abuse, suicide, unemployment poverty
A patient becoming physically dependent due to physician prescribing pattern describes:
Iatrogenic addiction
There are 2 major theories as to why opiods fit so perfectly into human opiod receptors, what are they/
THEORY 1: We developed a symbiotic coevolution with opiods OR
THEORY 2: opiod poppies actually SHAPED the development of human conciousness/evolution
What is the most important measurement of burden of disease and why?
DALY. Daly’s (PYLL + PYLD) allow you to envision how disability negatively impacts health [as compared to crude mortality rates]. Something like depression could be low on mortality lists BUT VERY HIGH on DALY’s [bc of the disability attributed to the disease].
Describe 6 disease outcomes that differ bw men/women.
Could be anything. Some examples include women are more at risk of (1) domestic violence (2) maternal mortality (3) social status (4) chronic pain (5) breast/ovarian cancer
Vs.
Men more at risk of (1) interpersonal violence (2) aggression (3) smoking/alcohol (4) occupational hazards
Ongoing misuse of a medication despite overt negative health consequences is
ABUSE
What are the THREE STANDARDS that acceptable housing must meet
(1)adequate- no major repairs (2) affordable (<30% of income before tax) (3)suitable (bedrooms/size)
There are many spectrums of gender, identity, sex etc.
Woman, Genderqueer, Men are examples of ____
Feline, androgynous, masculine are examples of _____
Female, intersex, male are examples of _____
Heterosexual, bisexual, homosexual are examples of ____
GENDER IDENTITY
GENDER EXPRESSION
BIOLOGICAL SEX
SEXUAL ORIENTATION
What are the 5 major values of harm reduction?
(1) universality/interdependence of human rights [ppl using drugs don’t forfeit human rights]
(2) evidence [in public health]
(3) focus on harms
(4) pragmatism [knowing some use of mind-altering substances is inevitable and some level of drug use is normal]
(5) dignity/autonomy [community integration OVER social isolation]
An increased death rate will (increase/decrease) prevalence
DECREASE (water leaving barrel @ faster rate than is entering it)
Describe how the legislation of Purdue Pharma/ OxyContin was a balloon effect.
The balloon effect is a phenomenom when trying to intervene in one part of a market (in this case drugs) makes things worse. Basically, the legislation against OxyContin/Purdue Pharma saw an EXPLOSION/SEISMIC SHIFT of heroine/injectables in working class white people on the market [had to get pain killers somewhere].
_____ insecurity is one of the major causes of health inequity in Canada
Housing
The rates of suicide in Aboriginal youth are HIGHLY REDUED BY
THE ESTABLISHMENT OF SELF-GOVERNMENT
In Aboriginal populations what is the MAJOR FACTOR contributing to early death?
ADVERSE CHILDHOOD EXPERIENCE [ABUSE, NEGLECT, HOUSEHOLD DYSFUNCTION]
The medical officers of health oversee health _______ via infrastructure and regulation with the goal to _____________________.
The Health Education/Ottawa Charter oversees health _______ via individual and community level interventions with the goal to________.
___________ aims to prevent progression of a specific disease.
PROTECTION, PROTECT POPULATION FROM HAZARDS
PROMOTION, HAVE POP LIVE AS HEALTHY AS POSSIBLE
HEALTH PRVENTION.
Why is work/income so important in a disabled population?
While they don’t necessarily drive poverty/disability, having an income allows disabled people to modify their environment and overcome societal/environmental barriers
Why does tolerance happen?
Thought to be RECEPTOR DESENSITIZTATION/DOWNREGULATION
Fill in the blanks for mortality:
In a large stable population, the mid to end year mortality rate will be _______.
In a small population with a lot of flux in deaths the _____ of the crude mortality rate will be affected.
In a small population with few deaths the ____ of the crude mortality rate will be affected.
Stable, denominator [aka the population specified/mid year population will be affected bc the pop might change drastically], numerator [if you have a small pop with few deaths ANY DEATH WILL CHANGE THE NUMERATOR DRASTICALLY but have limited effect on denominator].
Remember crude mortality rate= (Deaths in year)/ (mid year population) OR (deaths during specified period)/ (population specified)*10n
The physician historically _______ disabled patients, but now with the advent of rehabilitation, pharmacy, disability rights this shift is now to _____.
CONSOLED, RELIEF
The goal of ______ therapy is to provide opiods to meet a patients DEPENDENCY but in a controlled/affordable manner without significant highs or withdrawal symptoms.
Methadone
Which statistic is used to estimate frequency with which disease is occurring or avg time delays between cases
INCIDENCE DENSITY/RATE. Ex. Ebola the mortality rate was fairly role (1000 deaths/ 2 mill = deaths/ pop specified) BUT …. those deaths occurred in 1800 cases of Ebola for a CASE FATALITY RATE (1000/1800) > 50%
______ ____ are structural/individual conditions that may lead to loss of current stable housing, _____ ____ are those who maintain housing but at a significant burden to other basic needs
Imminent risk; precariously housed
