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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
What is police power and an example of it?
allows states to pass legislation to take actions to protect the common good establishment of health and safety standards, seatbelts
26
Which ethical issues lead to the Belmont Report?
Tuskegee and Nuremberg
27
What was the Belmont report and the 3 principles relevant to the ethics of research?
ethical principles and guidelines for the protection of human subjects research autonomy, beneficence, justice
28
autonomy
people empowered to make their own decisions concerning their actions and wellbeing
29
beneficence
do not harm, maximize possible benefits, minimize possible harms assessment of benefits and risks
30
justice
equitable distribution of burdens and benefits
31
What is the IRB?
Institutional Review Board approves research studies before they begin
32
Human Subject
any individual who engages in an experiment
33
What are the responsibilities of the IRB?
ensure ethical conduct of research assure protections of human rights and welfare use framework set by the Belmont Report
34
What is informed consent? What reading level should it have?
patient having all the knowledge they need to make their own decisions 8th grade
35
NHANES
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
36
Healthy People 2030
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
37
What are some examples of risk factors
smoking hypertension alcohol consumption sexual practices drug use physical fitness and activity weight dietary intake can be unmodifiable/modifiable
38
USPSTF
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
39
Health literacy risk factors
elderly ethnic/racial minority limited education low socioeconomic status people with chronic disease complex health system reliance on written words for patient instruction
40
health literacy red flags
making excuses perceived resistance has no questions frequently missed appointments/tests non-adherent with meds or treatment
41
What are some ways to work with individuals with low health literacy
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
42
Ask Me 3
What is my main problem? What do I need to do? Why is it important for me to do this?
43
What was inadequate health literacy related to in patients with diabetes
poor glycemic control and higher rates of retinopathy
44
What are the formal assessments of health literacy
The Rapid Estimate of Adult Literacy in Medicine The Test of Functional Health Literacy in Adults The Newest Vital Sign
45
What are the indicators of readability?
The Flesh-Kincaid Readability Test The Fry Readability Formula The Simplified Measure of Gobbledygook
46
Prose literacy
ability to follow written instructions
47
Numeracy
ability to understand numbers or frequency
48
Document Literacy
ability to follow instructions verbally
49
What is the reading level and size of the font that should be used for patient information?
5th grade 12 font or larger
50
What is the first step in cultural competency?
being self-aware
51
What is the LEARN model?
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
What does it take to be a culturally competent clinician?
being aware and accepting of cultural differences understanding the dynamics of difference assessing cultural knowledge be able to adapt to diversity
53
Ethnocentrism
how someone interprets other cultures/co-cultures; view that ones own group or the groups way is superior to others
54
Attitudes
represent our preferences- our likes and dislikes
55
beliefs
what we hold to be true/false
56
values
express judgements between what is desirable/undesirable, right/wrong/ good or evil
57
bias
unjustified negative attitude
58
stereotyping
process by which people use social categories in acquiring, processing, and recalling information about others
59
Pharmacogenomics
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
What’s the difference between pharmacokinetics and pharmacodynamics ?
kinetics- what body does to drug dynamics- what drug does to body
61
What are the 4 types of metabolizers for codeine and what happens to them?
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
What is CLAS?
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
What were the conclusions of the Native American Cancer Study? How could interventions be introduced into this population?
Patients with lower health literacy had more negative attitudes towards cancer and a more progressive form of the disease screenings and education
64
What are the 5 key determinants of health from the CDC
biology & genetics individual behavior social environment physical environment health services
65
Pharmacogenetics
study of variability in metabolism due to heredity
66
What has happened to nutritional guides over the years?
Food guide pyramid -> MyPyramid -> MyPlate adherence to guidelines is suboptimal
67
How much exercise should children get? Adults?
children - 60 min/day adults- 150 min/week moderate activity OR 75 min/week of vigorous activity
68
What is excessive alcohol use?
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
Who would be considered for unsafe use of e-cigs?
youth, young adults, pregnant women, non-tobacco users
70
What are the main components of socioeconomic status?
level of income educational attainment occupational status
71
What are the differences between social and environmental contributors?
social- conditions which people are born, grow, live, work and age environmental- physical, chemical and biological factors
72
What are the steps required to appropriately access healthcare services?
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
What are the CDC’s 10 great public health achievements?
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
National Childhood Vaccine Injury Act (NCVIA) of 1986
ensures an adequate supply of vaccines, stabilizes vaccine costs, and established a forum for injury
75
What is required for documentation during the process of vaccination?
VIS edition date date VIS provided name, address, and title of person administering date the vaccine is administered vaccine manufacturer and lot number
76
Zoster Vaccination Issues
Zostavax confusion with Varivax and Shingrix live vaccine not available anymore vaccine supply issues when approved
77
Various allegations in vaccine controversies
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
What issues have led to the resurgence of preventable disease?
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
Increasing Vaccination Model Components
What people think and feel social processes motivation practical issues vaccination
80
How have tobacco warnings on packages changed over time in the US?
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
What has been the influence of tobacco taxation on tobacco use?
for every 10% increase in prices reduces - youth smoking reduced by 7% - total cigarette consumption reduced by 4%
82
Pennsylvania Clean Indoor Air Act
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
Meningococcal Vaccination issues
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
Pneumococcal vaccination issues
4 licensed vaccines serotype coverage expanding over time immunogenicity of polysaccharide vaccines in infants
85
Influenza vaccination issues
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
HPV vaccination issues
previously available versions parental concerns over sexual behavior safety/adverse effect information on social media first/second cancer vaccine
87
Td/Tdap vaccination issues
12 licensed combination vaccines lawsuits related to DPT adverse effects led to NCVIA vaccination recommended during pregnancy to protect post-birth
88
MMR vaccination issues
passive immunity from mother recent outbreaks in under vaccinated communities concerns over thimerosal and autism
89
National Vaccine Injury Compensation Program (NVICP)
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
Vaccine Adverse Event Reporting System (VAERS)
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
Vaccines for Children
program that provides vaccines at no cost to children who might not otherwise be vaccinated
92
social justice
approach views the equitable distribution of health as a social responsibility
93
market justice
approach emphasizes individual rather than collective responsibility for health
94
CDC
main epidemiological and assessment agency for the nation collects data have centers to address infectious disease, chronic disease, injury preventions, and other issues
95
NIH
greatest biomedical research complex in the world has labs in Bethesda, MD tests experimental therapies enjoys strong congressional support
96
State Health Departments
multiple divisions connection between local and federal groups has police power that it can delegate to local departments
97
State Health boards
provide oversight of state-level departments health officer usually appointed by the governor
98
Tribal Health Department
state level organziation advisory functions may be provided by mechanisms other than a health board
99
Prevalence Rates
number of existing cases of a disease in a population regardless of how long individuals have been ill
100
Reportable/notifiable disease
usually infectious diseases, monitored in a population labs and health care workers can notify the local health department
101
Sentinel Case
first case of a disease in an outbreak
102
Endemic
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
Epidemic
When a disease outbreak spreads to many individuals in one or more populations across two or more geographic areas
104
Pandemic
disease outbreak that involves many people and many countries around the globe.

Public Health and Epidemiology (6 decks)

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