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Public Health and Epidemiology > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What are the core functions of public health?

A

Assessment
policy development
assurance

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2
Q

What is the purpose of public health?

A

prevent epidemics and spread of disease
protect against environmental hazards
prevent injuries
promote and encourage healthy behaviors
respond to disasters and assist communities in recovery
assure the quality and accessibility of services

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3
Q

What are the 10 essential public health services ?

A

monitor health status
diagnose and investigate
inform, educate, and empower
mobilize community partnerships
develop policies and plans
enforce laws and regulations
link people to needed personal health services
assure a competent workforce
evaluate
research

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4
Q

How are public health and medical care different/ similar?

A

public health - diagnoses, 3% of funding spent on this, prevention

medical care- cure

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5
Q

Disciplines of public health

A

epidemiology
statistics
biomedical sciences
environmental health science
social and behavioral sciences
health policy and mgmt

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6
Q

chronic disease

A

conditions lastin 1/+ years and require ongoing medical attention, limit daily activities or both

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7
Q

health promotion

A

Occurs while individuals are healthy to improve overall health, reduce risks, and increase resistance if exposed

activities often target entire populations (non smoking)

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8
Q

exposures/risk factors

A

factors that increase the risk of a disease developing in a person

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9
Q

disease prevention

A

activities focused on prevention of an illness, target populations consist of at risk individuals

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10
Q

what are the steps to the public health approach?

A

define the health problem
identify risk factors
develop and test community-level interventions to control/prevent the cause of the problem
implement interventions
monitor for effectiveness

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11
Q

What’s the difference between prevention and intervention?

A

prevention- before it happens
intervention- when it happens

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12
Q

Primordial prevention

A

designed for risk factor reduction
targets social and environmental conditions, children
improving access to safe sidewalks to promote physical activity

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13
Q

primary prevention

A

targets susceptible populations or individuals
prevents a disease/injury from occurring
immunizations

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14
Q

secondary prevention

A

early disease detection
targets sub clinical stages of disease
screenings

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15
Q

tertiary prevention

A

targets both the clinical and outcome stages of disease
reduce effects of disease when established in individual
rehab efforts

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16
Q

what is the chain of causation?

A

agent, host, environment
interventions can focus on any of these targets

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17
Q

What are some examples of pharmacist and public health activities

A

Immunizations
health promotion and disease prevention
disease state management
MTM
covid-19 testing
HIV preventions
harm reduction strategies
medication safety
intimate partner violence

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18
Q

Father of Epidemiology

A

John Snow

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19
Q

First epidemiologist

A

Hippocrates

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20
Q

What was the Framingham study and what 3 risk factors did they identify?

A

prospective cardiovascular disease study
1st major epidemiological study of chronic disease

high blood pressure, high cholesterol, and smoking

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21
Q

What happened in Tuskegee?

A

Syphilis investigation
involved 600 african american men
despite discovery of penicillin, men were never offered treatment

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22
Q

Incidence rates

A

number of new cases of a disease in a population within a specified time period

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23
Q

Divisions of department of health and human services

A

AHQR
ATSDR
CDC
FDA
HRSA
IHS
NIH
SAMHSA
CMS
ACF
AoA

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24
Q

US Department of Health and Human Services

A

primary federal agency for public health with 11 divisions
national private organization
sets priorities for health and public health, supports and funds programs and research, monitors nation health, interacts with international partners to promote health

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25
Q

What is police power and an example of it?

A

allows states to pass legislation to take actions to protect the common good

establishment of health and safety standards, seatbelts

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26
Q

Which ethical issues lead to the Belmont Report?

A

Tuskegee and Nuremberg

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27
Q

What was the Belmont report and the 3 principles relevant to the ethics of research?

A

ethical principles and guidelines for the protection of human subjects research
autonomy, beneficence, justice

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28
Q

autonomy

A

people empowered to make their own decisions concerning their actions and wellbeing

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29
Q

beneficence

A

do not harm, maximize possible benefits, minimize possible harms
assessment of benefits and risks

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30
Q

justice

A

equitable distribution of burdens and benefits

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31
Q

What is the IRB?

A

Institutional Review Board
approves research studies before they begin

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32
Q

Human Subject

A

any individual who engages in an experiment

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33
Q

What are the responsibilities of the IRB?

A

ensure ethical conduct of research
assure protections of human rights and welfare
use framework set by the Belmont Report

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34
Q

What is informed consent? What reading level should it have?

A

patient having all the knowledge they need to make their own decisions
8th grade

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35
Q

NHANES

A

assess health and nutritional status of adults and children in the United States
combines interviews and physical exams
exams a nationally representative sample of about 5000 people per year

determines prevalence of disease and risk factors

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36
Q

Healthy People 2030

A

goals for US population to
- achieve high quality longer lives free of preventable disease
- achieve health equity, eliminate disparities
- create social and physical environments that promote good health
- promote quality of life, healthy development and healthy behaviors

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37
Q

What are some examples of risk factors

A

smoking
hypertension
alcohol consumption
sexual practices
drug use
physical fitness and activity
weight
dietary intake
can be unmodifiable/modifiable

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38
Q

USPSTF

A

The US preventative Service Task Force

16 volunteer experts in prevention and evidence-based medicine that works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services

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39
Q

Health literacy risk factors

A

elderly
ethnic/racial minority
limited education
low socioeconomic status
people with chronic disease
complex health system
reliance on written words for patient instruction

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40
Q

health literacy red flags

A

making excuses
perceived resistance
has no questions
frequently missed appointments/tests
non-adherent with meds or treatment

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41
Q

What are some ways to work with individuals with low health literacy

A

convey an attitude of helpfulness, caring and respect
slow down
use plain, non-medical language
use analogies and pictures
limit to 1-3 concepts
repetition
chunk and check
ask patients to demonstrate understanding
use patient friendly materials and forms

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42
Q

Ask Me 3

A

What is my main problem?
What do I need to do?
Why is it important for me to do this?

43
Q

What was inadequate health literacy related to in patients with diabetes

A

poor glycemic control and higher rates of retinopathy

44
Q

What are the formal assessments of health literacy

A

The Rapid Estimate of Adult Literacy in Medicine
The Test of Functional Health Literacy in Adults
The Newest Vital Sign

45
Q

What are the indicators of readability?

A

The Flesh-Kincaid Readability Test
The Fry Readability Formula
The Simplified Measure of Gobbledygook

46
Q

Prose literacy

A

ability to follow written instructions

47
Q

Numeracy

A

ability to understand numbers or frequency

48
Q

Document Literacy

A

ability to follow instructions verbally

49
Q

What is the reading level and size of the font that should be used for patient information?

A

5th grade
12 font or larger

50
Q

What is the first step in cultural competency?

A

being self-aware

51
Q

What is the LEARN model?

A

Listen and understand patients perception of the problem

Explain your perceptions of the problem and your strategy of treatment

Acknowledge and discuss the differences and similarities between these perceptions

Recommend treatment while remembering the patient’s cultural parameters

Negotiate agreement

52
Q

What does it take to be a culturally competent clinician?

A

being aware and accepting of cultural differences
understanding the dynamics of difference
assessing cultural knowledge
be able to adapt to diversity

53
Q

Ethnocentrism

A

how someone interprets other cultures/co-cultures; view that ones own group or the groups way is superior to others

54
Q

Attitudes

A

represent our preferences- our likes and dislikes

55
Q

beliefs

A

what we hold to be true/false

56
Q

values

A

express judgements between what is desirable/undesirable, right/wrong/ good or evil

57
Q

bias

A

unjustified negative attitude

58
Q

stereotyping

A

process by which people use social categories in acquiring, processing, and recalling information about others

59
Q

Pharmacogenomics

A

broader-based term that encompasses genome wide differences that may determine drug response; study of relationship between variations in a large collection of genes and variability in drug disposition,response, and toxicity

60
Q

What’s the difference between pharmacokinetics and pharmacodynamics ?

A

kinetics- what body does to drug
dynamics- what drug does to body

61
Q

What are the 4 types of metabolizers for codeine and what happens to them?

A

ultra rapid- possible toxicity
extensive metabolizer- normal morphine formation
lntermediate metabolizer- reduced morphine formation
poor metabolizer - avoid codeine use due to lack of efficacy

62
Q

What is CLAS?

A

Culturally and Linguistically Appropriate Services
guidelines for providing culturally competent care, language access services, organizational supports for cultural competence
if you receive federal funds you have to provide language services

63
Q

What were the conclusions of the Native American Cancer Study? How could interventions be introduced into this population?

A

Patients with lower health literacy had more negative attitudes towards cancer and a more progressive form of the disease

screenings and education

64
Q

What are the 5 key determinants of health from the CDC

A

biology & genetics
individual behavior
social environment
physical environment
health services

65
Q

Pharmacogenetics

A

study of variability in metabolism due to heredity

66
Q

What has happened to nutritional guides over the years?

A

Food guide pyramid -> MyPyramid -> MyPlate

adherence to guidelines is suboptimal

67
Q

How much exercise should children get? Adults?

A

children - 60 min/day

adults- 150 min/week moderate activity OR 75 min/week of vigorous activity

68
Q

What is excessive alcohol use?

A

For women- 4/+ drinks consumed on one occasion or 8/+ drinks a week

For men- 5/+ drinks consumed on one occasion or 15/+ drinks per week

69
Q

Who would be considered for unsafe use of e-cigs?

A

youth, young adults, pregnant women, non-tobacco users

70
Q

What are the main components of socioeconomic status?

A

level of income
educational attainment
occupational status

71
Q

What are the differences between social and environmental contributors?

A

social- conditions which people are born, grow, live, work and age

environmental- physical, chemical and biological factors

72
Q

What are the steps required to appropriately access healthcare services?

A

gain entry into the health care system
access a health care location where needed services are provided
finding a provider with whom the patient can communicate and trust

73
Q

What are the CDC’s 10 great public health achievements?

A

vaccine-preventable disease
tobacco control
prevention and control of infectious diseases
maternal and infant health
motor vehicle safety
cardiovascular disease prevention
occupational safety
cancer prevention
childhood lead poisoning prevention
public health preparedness and response

74
Q

National Childhood Vaccine Injury Act (NCVIA) of 1986

A

ensures an adequate supply of vaccines, stabilizes vaccine costs, and established a forum for injury

75
Q

What is required for documentation during the process of vaccination?

A

VIS edition date
date VIS provided
name, address, and title of person administering
date the vaccine is administered
vaccine manufacturer and lot number

76
Q

Zoster Vaccination Issues

A

Zostavax confusion with Varivax and Shingrix
live vaccine not available anymore
vaccine supply issues when approved

77
Q

Various allegations in vaccine controversies

A

MMR vaccine causes autism- FALSE

mercury based preservative in thimerosal causes autism/neuro-developmental disabilities - FALSE

influenza causes GBS - RISK INCREASES

vaccines can cause chronic diseases of autoimmune etiology - FALSE

HPV vaccines may increase risk of autoimmune and other disorders - FALSE

Aluminum can cause autoimmune/other disorders like MMF - FALSE

Too many vaccines may overwhelm the immune system - FALSE

78
Q

What issues have led to the resurgence of preventable disease?

A

social media
promotion of natural lifestyles and clean living
online communities
generations removed from pre-vaccine era
inconsistent use of mandates and exemptions
some vaccines wane in effectiveness over time
new cultural norms evolving from COVID-19 pandemic
loss of trust in institutions to provide guidance

79
Q

Increasing Vaccination Model Components

A

What people think and feel
social processes
motivation
practical issues
vaccination

80
Q

How have tobacco warnings on packages changed over time in the US?

A

caution-> warning-> SURGEON GENERAL’S WARNING

Family Smoking Prevention and Tobacco control act of 2009 created graphic labels - these got challenged

proposed new labels that occupy 50% of front/rear panel on cigarette packages, 20% of area in advertisement

81
Q

What has been the influence of tobacco taxation on tobacco use?

A

for every 10% increase in prices reduces
- youth smoking reduced by 7%
- total cigarette consumption reduced by 4%

82
Q

Pennsylvania Clean Indoor Air Act

A

regulates smoking in public places/workplaces

exemptions:
- full service truck stops
- tobacco shops, manufacturers, wholesalers and importers
- private clubs and cigar bars
- 25% of casino gaming floors
- drinking establishments/restaurants where food is less than or equal to 20% of the revenue

83
Q

Meningococcal Vaccination issues

A

2 serocoverage types with different recommendations
difficult to measure effectiveness given decline in outbreaks
no effect on herd immunity, protection aimed at high-risk period

84
Q

Pneumococcal vaccination issues

A

4 licensed vaccines
serotype coverage expanding over time
immunogenicity of polysaccharide vaccines in infants

85
Q

Influenza vaccination issues

A

changes in formulation and effectiveness each year
need for revaccination every year
getting the flu from the flu vaccine
prevention of complications vs disease
concerns over egg allergies

86
Q

HPV vaccination issues

A

previously available versions
parental concerns over sexual behavior
safety/adverse effect information on social media
first/second cancer vaccine

87
Q

Td/Tdap vaccination issues

A

12 licensed combination vaccines
lawsuits related to DPT adverse effects led to NCVIA
vaccination recommended during pregnancy to protect post-birth

88
Q

MMR vaccination issues

A

passive immunity from mother
recent outbreaks in under vaccinated communities
concerns over thimerosal and autism

89
Q

National Vaccine Injury Compensation Program (NVICP)

A

no-fault alternative to for resolving vaccine injury claims
funded by a tax on each dose of vaccine
use of vaccine injury table and FAQs

90
Q

Vaccine Adverse Event Reporting System (VAERS)

A

joint program of the CDC and FDA
post-marketing safety surveillance program for adverse events that occur after administration of vaccines
healthcare professionals are required to report

91
Q

Vaccines for Children

A

program that provides vaccines at no cost to children who might not otherwise be vaccinated

92
Q

social justice

A

approach views the equitable distribution of health as a social responsibility

93
Q

market justice

A

approach emphasizes individual rather than collective responsibility for health

94
Q

CDC

A

main epidemiological and assessment agency for the nation
collects data
have centers to address infectious disease, chronic disease, injury preventions, and other issues

95
Q

NIH

A

greatest biomedical research complex in the world
has labs in Bethesda, MD
tests experimental therapies
enjoys strong congressional support

96
Q

State Health Departments

A

multiple divisions
connection between local and federal groups
has police power that it can delegate to local departments

97
Q

State Health boards

A

provide oversight of state-level departments
health officer usually appointed by the governor

98
Q

Tribal Health Department

A

state level organziation
advisory functions may be provided by mechanisms other than a health board

99
Q

Prevalence Rates

A

number of existing cases of a disease in a population regardless of how long individuals have been ill

100
Q

Reportable/notifiable disease

A

usually infectious diseases, monitored in a population
labs and health care workers can notify the local health department

101
Q

Sentinel Case

A

first case of a disease in an outbreak

102
Q

Endemic

A

disease that occurs in a population at a low but consistent and persistent levels so that a limited number of cases occur each year

103
Q

Epidemic

A

When a disease outbreak spreads to many individuals in
one or more populations across two or more geographic areas

104
Q

Pandemic

A

disease outbreak that involves many people and many
countries around the globe.

Public Health and Epidemiology (6 decks)

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