Exam 1 Flashcards
What are the core functions of our Public Health System?
Equity, Assessment, Policy Development, and Assurance
Assess and monitor population health belongs to which of the core functions of PH?
Assessment
Investigate, diagnose, and address health hazards and root causes belongs to which of the core functions of PH?
Assessment
Communicate effectively to inform and educate belongs to which of the core functions of PH?
Policy Development
Strengthen, support, and mobilize communities and partnerships belongs to which of the core functions of PH?
Policy Development
Create, champion, and implement policies, plans, and laws belongs to which of the core functions of PH?
Policy Development
Utilize equal and regulatory actions belongs to which of the core functions of PH?
Policy Development
Enable equitable access belongs to which of the core functions of PH?
Assurance
Build a diverse and skilled workforce belongs to which of the core functions of PH?
Assurance
Improve and innovate through evaluation, research, and quality improvement belongs to which of the core functions of PH?
Assurance
Build and maintain a strong organizational infrastructure for public health belongs to which of the core functions of PH?
Assurance
Who has primary responsibility of PH under the constitution, federal or state?
State
Does the Federal or State have the responsibility of: ensuring that all levels of government have the capabilities to provide essential PH services with limited authority to require?
Federal
Does the Federal or State have the responsibility of: acting when health threats may span more that one state, a region, or the entire nation?
Federal
Does the Federal or State have the responsibility of: acting where the solutions may be beyond the jurisdiction of individual states?
Federal
Does the Federal or State have the responsibility of: acting to assist states when they lack the expertise or resources to effectively respond in a public health emergency?
Federal
Does the Federal or State have the responsibility of: facilitating the formulation of public health goals?
Federal
What are the 5 sources of Federal Public Health Policy?
Office of the Secretary, Surgeon General, Public Health Service Agencies (PHSA), Non-PHS agencies, Executive Office of the President
What types of funding does the Federal Government provide in regards to PH?
- half of the state funding
- majority of preparedness/emergency funding
How many state health departments are there?
51 (including DC)
How many territorial health departments are there?
8
How many tribal health departments are there?
197
How many local health departments are there?
2533
What are the 4 Governance Classification Systems?
- local/decentralized
- mixed
- state/centralized
- shared
Which Governance Classification System is led by local governments, which make most most fiscal decisions?
local/decentralized
Which Governance Classification System is when some local health departments are led by the state government and some are led by local governments?
mixed (no one arrangement predominates in the state)
Which Governance Classification System is when all local health departments are units of state government, which makes most fiscal decisions?
state/centralized
Which Governance Classification System is when all local health departments are governed by both state and local authorities?
shared
What is the funding for PH like at the state and local government level?
uneven and unstable
What are the 10 Social Determinants of Health?
Social gradient
Social exclusion
Social support
Stress
Early life
Work
Unemployment
Addiction
Food
Transport
How much did the US spend on healthcare in 2017?
$3.5 trillion
How much did the US spend on healthcare per person on 2017?
$10,348
What percent of GDP did the US spend on healthcare in 2017?
17.9%
What are the 4 offices/councils of the Executive Office of the President?
Domestic Policy Council
National Security Council (Homeland Security Council)
Office of Management and Budget
National Prevention Council
What does Public Health 3.0 involve?
- Engaging multiple sectors and community partners to generate collective impact
- Improve social determinants of health
Is life expectancy above or below the OECD average?
below
Is diabetes hospital admissions above or below the OECD average?
above
Is asthma and COPD hospital admissions above or below the OECD average?
above
Is obesity above or below the OECD average?
above
Is breast cancer relative survival above or below the OECD average?
above
Is ischemic stroke case fatalities above or below the OECD average?
below
Is acute myocardial infarction case fatalities above or below the OECD average?
below
Is alcohol consumption in adults above or below the OECD average?
below
Is daily smoking in adults above or below the OECD average?
below
Is colorectal cancer relative survival above or below the OECD average?
above
How much does the US spend per person compared to the OECD average?
2x more
What percentage of our GDP does the US spend compared to the OECD average?
2x more
Does the US spend more or less on social care compared to the OECD average?
less
Does more concentrated areas allow providers to charge a higher or lower price of services?
higher
What is the “safety net” and the population that it serves?
the “safety net” are providers and hospitals that serve disproportionately high numbers of uninsured and publicly insured patients
who are the uninsured?
poor
workers in low paying jobs
certain job sectors
young adults
less educated
minorities
men
people in the South and West
What does EMTALA stand for?
Emergency Medical Treatment and Labor Act
What provides the only true “right to healthcare” in the US?
EMTALA of 1986
Does EMTALA require that care be provided for free or at a low cost?
no
Does EMTALA require that medical treatment be provided beyond being stabilized?
no
Does EMTALA require treatment of inpatients, even with emergency medical condition?
no
What is lacking in the Institute of Medicine (IOM) framework for high quality care?
affordability
Who are common safety net providers?
some public and private hospitals
community health centers and rural health clinics
local public health agencies
some private providers
What does DSH stand for?
Disproportionate Share Hospitals
Under EMTALA, any hospital with an ED that participates in Medicare must do what?
- screen those who present to the ED to if they have an emergency medical condition
- stabilize and/or appropriately transfer the person with an emergency medical condition
What is federalism?
shared sovereignty among levels of government (usually federal and state)
What are the key federal powers? (3)
tax, spend, regulate interstate commerce
How is lead emitted?
Gasoline from cars and paint
What are the human health effects of lead?
Neurotoxin
What are the general corrective actions taken to mitigate lead?
Bean on lead in gasoline, lead in paint, and lead in pipes.
How is NO2/Nox emitted?
Cars, utilities, and fuel combustion.
What are the human health effects of NO2/Nox?
damage to the respiratory tract, respiratory infections, and asthma
How is the ozone emitted?
Not emitted directly, but through Volatile organic compounds VOCs + Nox + sunlight
What are the human health effects of ozone?
Airway reactivity (especially asthmatics) and prematurely ages the lungs
What are the general corrective actions taken to mitigate ozone?
Controlling VOCs and Nox
How are PM emitted?
Burning of materials
Digging
Natural and industrial matters - dust, dirt, soot, smoke
What are the health effects of PM?
Heart attacks and heart disease
Asthma
Increased respiratory symptoms
Chronic bronchitis
Decreased lung function
Premature death from heart and lung disease
How are SO2 emitted?
Coal burning
What are the human health effects of SO2?
Irritation to lungs
What are the general corrective actions taken to mitigate ozone?
Use of low sulfur coals and air scrubbers on coal plants
What is the cause of the thinning Stratospheric Ozone?
Freon or Chlorofluorocarbons (CFCs) getting up into the stratosphere where the sun is strong enough to cleave off the Chlorine atoms creating Chlorine free radicals that then destroy the ozone layer - converting O3 to O2
How many ozone molecules can a singe Cl atom destroy?
100,000
What were freon or CFCs used in?
Foam manufacturing, aerosol, sprays, air conditioners,refrigerators