Exam 1 Flashcards
When did the transition from infectious to chronic disease happen?
1940
Taking a historic look at developed countries allows us a view of three distinct ______
epochs
The first epoch is called the age of ______
pestilence
What did the age of pestilence mainly consist of?
High death rates, endemic diseases, malnutrition, infectious diseases, and famine.
The age of declining pandemics was the _____ epoch
second
The age of declining pandemics was mainly consisted of what?
decline in epidemics
What were the four leading causes of death in the United States during 1900?
pneumonia/influenza/bronchitis, tuberculosis, diarrhea/enteritis. heart disease
What were the four leading causes of death in the United States during 1990?
heart disease, cancer, stroke, injuries
The age of degenerative and manmade disease is the _______ epoch
third
What did the third epoch (the age of degenerative and manmade disease) consist of?
great effects on life expectancy, fertility, and population aging.
What was the life expectancy during the age of pestilence?
20 years
Why is 20 years the life expectancy of the age of pestilence?
high infant and maternal mortality rates
What was the age of declining pandemics life expectancy?
40 years
What declined during the age of degenerative and manmade disease?
infant and maternal mortality rates, fertility, overall mortality rates
What is the life expectancy during the current epoch?
75 years
What was the average life expectancy in the US during 1900?
47.3 years
What was the average life expectancy in the US by 1987?
75 years
Why did life expectancy increase so much?
declines in infant mortality
Which population benefited less from the decline in deaths from infectious disease?
elderly
The decline in mortality from 1900-1977 was greatest among what population?
infants (gradually increasing until the elderly)
When mortality rates decline, what also declines?
birthrate
How much have fertility rates in the US declined since the last century?
one-third
A decline in birthrates will increase the average ____ of the population
age
What percentage of people in the US lived to the age of 65 during 1900?
25%
What percentage of people in the US lived to the age of 65 during 1985?
70%
The proportion of those over 75 grew more rapidly than those who were what age range?
65-74 years
Why does the size of the elderly population have a dramatic effect on healthcare?
increase of chronic conditions like arthritis, injuries, heart disease, and hypertension
Healthcare costs have increased because of which population?
the elderly
Increased healthcare costs has shifted individual out of pocket expenses to _______
third-party payers
Governments paid for 9 percent of personal health expenses in what year?
1929
In 1987, governments paid for what percentage of personal healthcare costs?
41%
Why did federal healthcare expenditures increase so much after 1965?
programs like Medicare and Medicaid
Much of the epidemiologic transitions is fueled by improvements of what?
housing and nutrition, public health measures, water, sanitation, and living conditions.
Medical care accounted for what percentage of the decline in mortality?
20%
Government and health-related professions responded to public health needs by establishing what?
Public Health Service, American Public Health Association, and health education at Harvard
Increases in chronic disease required changes in what?
research, practice and policies
What act created in 1974 was the result of a growing national focus on disease prevention and health promotion?
Health Information and Health Promotion Act of 1974
The Research in Aging Act created what?
National Institute on Aging
The National Institute on Aging focused on what?
Conducting biomedical, social, and behavioral research and training related to the aging process and diseases and other needs of the elderly
What standardized nutritional info on food packaging starting in 1973?
The Food and Drug Administration
What is the federal government’s primary agency coordinating efforts to prevent chronic disease?
Public Health Service
What does the Office of Minority Health do?
Operating a resource center that provides info on minority health issues, risk factors, and resources
What does the National Clearing house for Alcohol and Drug Information do?
disseminate scientific findings, program and product descriptions, publications, and audiovisual resources to state alcohol authorities and to professional organizations
Changes in individuals’ _______ can reduce their risk of ______
behaviors, disease
The strongest evidence that changing behavior can reduce risk of disease is in what area?
tobacco use
The result of concerted societal effort has seen dramatic declines in what?
heart disease and stroke mortality
People who quit smoking reduce coronary heart disease risk by how much?
More than half within one year of quitting
How much is stroke risk reduced by when quitting smoking?
More than 50 percent within two years
The National Cholesterol Heart Education Program was launched in what year?
1987
What is the purpose of the NCHEP?
develop policy recommendations to reduce risk of heart disease by lowering cholesterol levels
The National High Blood Pressure Education Program’s purpose is?
reduce prevalence of hypertension through educating health professionals in control of hypertension and educating population in importance of hypertension
As a result of the NHBPEP, what happened?
more people aware of their high blood pressure and stroke-related deaths reduced
High risk approaches have not demonstrated what?
a significant reduction in coronary heart disease mortality
what consists of community interventions?
educational, community organization, service development, policy change strategies
following up ten years after community interventions revealed what?
significant reductions in negative health-related behaviors and improvements in blood pressure and cholesterol levels. declines in heart disease mortality
what is missing from health promotion?
recognition of addressing social conditions such as poverty and discrimination
What is usually regarded as the best view of health promotion?
the art and science of helping people change their lifestyle for optimal health
Why is it that changing one’s health became an important view?
control medical costs, create a social climate emphasizing self-help and individual control over health, and skewed views of medicine
Which two documents went over environmental factors in health and not just individual behaviors?
Lalonde Report and the Surgeon General’s Report Healthy People.
The Lalonde Report popularized the concept of health field through which four parts?
human biology, environment, lifestyle, and health care organization
The Surgeon General’s Report looked at the ______ as a contributor to deteriorating health.
environment
Why was the Lalonde Report’s focus on self-imposed risk so criticized?
it seemed to have a victim-blaming tone
This report emphasized policy and institutional change as well as personal behavior change:
The U.S. Surgeon General’s Report
health promotion is what?
behavior and lifestyle issues
health protection is what?
the physical environment
What is revealed about communities in studies like the Stanford Three Community and the Minnesota Health Disease Study?
community efforts can reduce risk factors
What is considered THE risk factor for disease?
social class
People higher in the socioeconomic ladder have lower mortality rates: True or False
True
What did sociologists like Aaron Antonovsky note about American health promotion efforts?
The obsession with personal control is prevalent throughout American culture; this intertwines with American health promotion efforts mainly focusing on the individuals’ behaviors
U.S. health promotion efforts is well grounded into the concept of what?
marketplace democracy; health is seen as something to be bought and sold
American health promotion is seen as what?
vehicles for profit increases and cost containments
How does WHO define health promotion?
a mediating strategy between people and their environments, combining personal choice and social responsibility in health
WHO highlights what types of things for health promotion?
organizational change, community development, and legislation
Educating people about health knowledge was only talked about until after these three concerns were addressed:
health access, development of an environment conducive to health, strengthening social networks
What is the Epp Report?
a framework for health promotion with its foundation rooted in the WHO’s health promotion principles
If Canada was to achieve health for all, what three challenges must be overcome?
reducing inequities, increasing prevention, enhancing coping abilities
How will Canada’s three universal health challenges be overcome?
self-care, mutual aid, healthy environments, public participation, community health services, healthy public policy.
How many cities from around the world have joined the Healthy Cities Project?
85
What is Oxford’s key goal to offset health inequalities?
Strategies that include working through the housing, recreation, planning, and environmental health sectors
What was involved in Oxford’s goal to offset health inequalities?
structural changes on the municipal level such as merging of an environmental health committee with a new health liaison committee.
Why is the City Health Working Group of significant importance?
it was a group combined of representatives of housing, urban engineering, treasury, and recreation.
What did the City Health Working Group do?
formulated a health strategy that was adopted as policy and set health targets such as smoke free places, safe routes to school for children, and health screening improvements in the workplace
What did Oxford do to get a careful evaluation of offsetting health inequalities?
comprehensive health data base for city, an action research project that works with neighborhoods on health measures like home safety, welfare benefits, testing for physical fitness. quarterly newsletter for key projects such as AIDS prevention, nutrition, home safety, and improving ethnic minority health
Explain the importance of the Healthy Cities Project and the World Health Organization
highlights the importance of developing health promotion efforts that reflect a truly balanced concern for personal behavior change within context of broader structural changes
Who is the founder of cellular pathology and why is he brought up?
Rudolf Virchow; he suggested land reform and redistribution of wealth instead of immediately thinking of medical reform when confronted with a typhus epidemic
How did Virchow view medicine and politics?
medicine is a social science and politics nothing more than medicine on a large scale
What are the four functions of medicine according to Henry Sigerist?
Promoting health, preventing illness, restoring the sick, and and rehabilitation.
How is health promoted according to Henry Sigerist?
promoted by providing decent standard of living, good labor conditions, education, physical culture, means of rest and recreation. large coordinated groups are needed for this. he begins with statesperson and ends with physician, seeing that public health is prioritized over medical care
Ronald Labonte quote is about what?
how can health educators assist people of different backgrounds and socioeconomic status
In Oakland, California, new programs in education, transportation, and economic development will result in what?
enhance the health of the city and its people
Define the concept of a healthy city.
a city that responds to its developmental needs, its organizations and its people, stressing education, community, and reciprocity between the individual and the broader unit
What percentage of US population in 1900 reached age of 65?
25 percent
What percentage of US population in 1985 reached age of 65?
70 percent
What accompanied the epidemiologic transition?
Development of institutions that address problems of chronic disease
What did the 1979 Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention include about controlling mortality caused by chronic diseases?
Major improvements in health status would be achieved through health promotion and disease prevention efforts rather than through increases in medical care services.
What percentage of mortality is related to lifestyle behaviors?
50 percent.
What is the purpose of the National Cholesterol Heart Education Program?
develop policy recommendations designed to reduce risk of coronary heart disease by lowering cholesterol levels
define health promotion as a personal behavior change
the art and science of helping people change their lifestyle to move toward a state of optimal health
define WHO’s definition of health promotion
a process of enabling people to increase control over and to improve their health
what principles are set forth by WHO that underlie their health promotion vision?
acting on the causes of health and using approaches that go beyond lifestyle education and intervention
what are some examples that align with WHO’S health promotion vision?
community development, organizational change, and legislation
True or false: the healthy cities project shows an example of developing health promotion efforts that reflect a concern for personal behavior change within the context of broader structural changes
true
True or false: The quote of “medicine is a social science and politics nothing more than medicine on a large scale” belongs to Rudolf Virchow
true
Describe Henry Sigerist’s four functions of medicine
promotion of health, prevention of sickness, restoration of the sick, and rehabilitation
What is the ultimate challenge for health educators according to Ronald Labonte?
creating social and health conditions premised on health promotion and which allow all the world’s citizens to achieve a state of health
