Class 12

Question 1

Individual vs. Population

Answer 1

Patient vs. Community
Individual vs. Not a conscious decision by individual
Limited Scope vs. Broad Scope

Question 2

Why is prevention less supported and funded than medical care?

Answer 2

Success is invisible, a lack of drama makes prevention less interesting, statistical lives saved have little emotional effect, there is usually a long delay before rewards appear, benefits do not accrue to the payer, persistent behavior change may be required, prevention is expected to produce a net financial return whereas treatment is expected only to treat the individual, commercial interests may conflict with disease prevention, advice might conflict with personal, religious, or cultural beliefs

Question 3

Why did life expectancy in US increase steadily in the 20th century?

Answer 3

Vaccines, Antibiotics, Basic Sanitation

Question 4

US has ________ life expectancy at birth among OECD comparable countries

Answer 4

lowest

Question 5

Leading Causes of Death (2015-2016)

Answer 5

Heart Disease, Cancer, Unintentional injuries, Chronic Lower Respiratory Disease, Stroke

Question 6

Leading Cause of Death Across All Ages

Answer 6

Heart Disease

Question 7

Leading Cause of Death 1-14 years old

Answer 7

Unintentional Injury

Question 8

Leading Cause of Death 15-44 years old

Answer 8

Unintentional injury

Question 9

1st Epidemiology Revolution

Answer 9

Infections

Question 10

Causes of 1st Epidemiology Revolution

Answer 10

Organisms

Question 11

Risk Factors of 1st Epidemiology Revolution

Answer 11

Sanitation, hygiene, nutrition

Question 12

Treatment of 1st Epidemiology Revolution

Answer 12

Antibiotics

Question 13

Prevention of 1st Epidemiology Revolution

Answer 13

infrastructure, pasteurization, vaccines

Question 14

Second epidemiology revolution

Answer 14

risk factors

Question 15

causes of 2nd epi revolution

Answer 15

what people smoke, eat, and drink

Question 16

prevention of 2nd epid revolution

Answer 16

screening, education, warning labels

Question 17

What is Prevention?

Answer 17

interventions aimed at reducing incidence of disease and disability or slowing the progression and exacerbation of illnesses, much more broad than medical care system (includes individual, organizational, and societal actions)

Question 18

Levels or preventions

Answer 18

primary, secondary, tertiary

Question 19

primary level of prevention

Answer 19

prevent onset of disease before it even occurs

Question 20

secondary level of prevention

Answer 20

screening/early detection; reduce impact of disease as it is discovered; try to reverse disease

Question 21

tertiary level of prevention

Answer 21

maintain or improve function; manage long-term health problems and improve quality of life

Question 22

examples of primary level prevention

Answer 22

immunizations, physical activity, healthy diet, better wages, stable housing, seatbelts, fluoridated water, de-leaded gasoline

Question 23

implications of primary level prevention

Answer 23

May reduce population risk of disease, could save $$

Question 24

examples of secondary level prevention

Answer 24

disease screening, smoking cessation, weight management programs

Question 25

implications of secondary level prevention

Answer 25

Rarely cost saving, may be cost effective or good value

Question 26

examples of tertiary level prevention

Answer 26

mode of transportation for trauma patients

Question 27

implications of tertiary level prevention

Answer 27

increase quality of life and improve life expectancy

Question 28

cost saving

Answer 28

cost of prevention is less than cost of treatment

Question 29

cost effective

Answer 29

may not save money in medical treatment costs, but rather significant benefit to population or individual for the cost of prevention

Question 30

health impact pyramid

Answer 30

bottom/population impact: socioeconomic factors, change the context to make individuals’ default decisions healthy, long-lasting protection interventions, clinical interventions, counseling and education top/individual impact

Question 31

ACA mandated coverage for Preventive Services

Answer 31

private health plans must cover a range of a preventive services and may not impose cost-sharing on individuals for the services after passage of ACA

Question 32

Four categories of ACA mandated coverage of preventive services

Answer 32

evidence-based screenings and counseling, routine immunizations, childhood preventive services, preventive services for women

no requirement that these services be cost saving

Question 33

USPSTF

Answer 33

United States Preventative Services Task Force

Question 34

USPSTF Grade A

Answer 34

The USPSTF recommends the service. There is high certainty that the net benefit is substantial.

Question 35

USPSTF Grade B

Answer 35

The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.

Question 36

USPSTF Grade C

Answer 36

The USPSTF recommends selectively offering or providing this service to individual patients based on professional judgment and patient preferences. There is at least moderate certainty that the net benefit is small.

Question 37

USPSTF Grade D

Answer 37

The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.

Question 38

USPSTF I Statement

Answer 38

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.

Question 39

Leading Cause of Death 45-64 years old

Answer 39

Cancer

Question 40

Leading Cause of Death 65+ years old

Answer 40

Heart Disease