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PUBH 302 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Define Public Health

A

The science of preventing disease, prolonging life, and promoting health through organized community efforts and informed choices of society, organizations, public and private communities, and individuals

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2
Q

What are the Ps of public health?

A

Prevention
Protection
Promotion
Prolonging
Product safety
Physical, social, economic environments
Populations
(Big) Picture

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3
Q

What is prevention?

A

Preventing premature death, injury, and illness.
Ex: vaccinations and wearing masks

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4
Q

What is protection?

A

Protecting population by making recommendations to keep people healthy.
Ex: Healthy People goals, MyPlate, 150 - 300 minutes moderate intensity aerobic exercise

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5
Q

What is promotion?

A

Promoting things that are healthy and get people to be more conscious of things they do that are not healthy and how to change those behaviors.
Ex: warning labels on nicotine products, education, and PSA’s

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6
Q

What is prolonging?

A

Prolong life and provide high quality of life.
Ex: increasing life expectancy by improving sanitation and providing vaccines

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7
Q

What is product safety?

A

Food in stores, cars, etc.
Ex: FDA regulations, seatbelts, airbags

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8
Q

What is physical, social, economic environments?

A

Connection between environment and health.
Ex: air we breathe, friends influencing behavior, affording healthy foods

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9
Q

What are populations?

A

What is truly impacting us at a population level in terms of health outcomes.
Ex: examining leading causes of illness, death, injury, and being able to prevent to protect populations who are most at risk.

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10
Q

What is the (big) picture?

A

Everything together.
Ex: PH looks at the complex picture to figure out how to protect people and populations

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11
Q

What are determinants of health?

A

Range of personal, social, economic, and environmental factors that influence health status.
Health and well being.
Risk factors.
Risk conditions.
Lifestyle.

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12
Q

What is health and well being?

A

Genetics.
Healthcare.
Social and Environmental Factors.
Individual Behavior.

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13
Q

What are risk factors?

A

Common causes of death, disability, illness, and injury.
More likely to be under the control of the individuals at risk.
Behavioral: smoking, poor diet, lack of physical activity, alcohol consumption.

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14
Q

What are risk conditions?

A

More distal risk factors.
Less likely to be under the control of individuals.
Biological: age, sex, genetics.
Environmental: safe community/work site, adequate housing.
Enforcement of policies and regulations.

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15
Q

What is lifestyle?

A

Pattern of behavior, more complex, lifetime habits and social circumstances.

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16
Q

What are public health codes?

A

Based on society’s belief system and understanding of health and disease.
Oral tradition –> written law/codes.
Ex: tribal rules, Chinese empire, Bible; Salus populi: suprema lex esta = “Let the welfare of the people of the supreme law.”

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17
Q

What did the Ancient Greeks do?

A

Personal hygiene: important to bathe and wash hands.
Physical fitness: Olympics.
Naturalistic concept: disease caused by the imbalance between man and environment.
- Ex: air, water, places.

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18
Q

What did Hippocrates do?

A

Father of Western medicine.
Casual relationships: disease results from an imbalance of person and environment.
Illness had a physical and rational explanation.
Coined health terms: acute, chronic, epidemic.
- Epis (“on”); demos (“people”).

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19
Q

What did the Roman Empire do?

A

Adopted Greek health values.
Engineers: sewage systems and aqueducts.
Administration: public baths, water supply, markets.

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20
Q

What did the Middle Ages do?

A

Rise in the belief that disease is a punishment for sin or fate.
Rise of christianity (Catholic Church).
Church provides charity and care for sick.
Beginning of PH tools: quarantine of ships and isolation of diseased individuals.

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21
Q

What did the “The Plague” / “Black Death” do?

A

75 - 200 million worldwide died.
About 40% of European population died.

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22
Q

What did the Age of Reason and Enlightenment do?

A

Birth of Modern Medicine.
William Harvey: father of modern medicine.
- Used dissection to create theories and advanced understanding of human anatomy.
- First to suggest humans and other mammals reproduced via fertilization of egg by sperm.
Edward Jenner: 1796 cowpox experiment.
- vaccine.

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23
Q

What did Industrialization and Urbanization do?

A

New and worse PH problems.
- Poverty, slums, disease.

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24
Q

What did Dr. John Snow do?

A

Father of epidemiology.
Broad Street pump.

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25
Q

What did the Great Sanitary Awakening do?

A

Growth in scientific knowledge.
Humanitarian ideals: value of human life.
Connection between poverty and disease.
Water supply and sewage removal.

26
Q

What did the England Sanitary Reform do?

A

Edwin Chadwick report: “Survey into the Sanitary Condition of the Labouring Classes in Great Britain.”
- Landmark research.
- Graphic descriptions of filth and disease in urban areas.
- Reforms in sanitation, healthcare, treatment of poor, children, working classes.
Charles Dickens’ novels: drew attention to these problems.

27
Q

What did the US Sanitary Reform do?

A

Health records system (births and deaths), vital PH stats as tools to fight disease.
Report of the Sanitary Commission of Massachusetts.
MA State Board of Health.
System of sanitary inspection (water, food, etc).
Vaccination programs.
PH info for citizens.
Lemuel Shattuck.

28
Q

What did the Growth in Scientific Knowledge do?

A

Louis Pasteur: germs cause disease.
- Coined term “vaccine” and created several.
Robert Koch: Koch’s Postulates.
- Identified vibrio that causes cholera.
- Tuberculosis.

29
Q

What did the Sanitation Revolution do?

A

Life expectancy increases due to:
- Clean water and water treatment.
- Food inspection.
- Personal hygiene (bathing).
- PH works departments: garbage collection, landfills, street cleaning.
- PH departments and regulations.

30
Q

Why is PH important?

A

Mortality and morbidity prevented.
Longer life expectancy –> increased from 45 to 75 years in the 20th century, 25 were from PH improvements
- better nutrition, occupational safety, housing, sanitation.
Improved QofL.

31
Q

How do we measure the overall health of a population?

A

Life expectancy from birth, age-adjusted mortality rate.
Condition-specific changes in life expectancy.
Self-reported level of health, functional status, and experiential status.

32
Q

What are condition-specific changes in life expectancy?

A

Condition-specific: cancer mortality rate.
Age-specific mortality rates: infant mortality rate.
- Death of an infant before the 1st birthday.
- Used to compare the health and well-being of populations across and within countries.
- Indicated current health status of population and predicts the health of the next generation.

33
Q

What are self-reported levels of health, functional status, and experiential status?

A

QofL measures.
Includes subject evaluations of positive and negative aspects of life.
- Ex: jobs, school, housing, neighborhoods.
HRQofL is an individual’s or group’s perceived physical and mental health over time.

34
Q

10 Great Achievements in PH, 1990 - 1999.

A

Vaccination.
Motor-vehicle safety.
Safer workplaces.
Control of infectious diseases.
Decline in deaths form coronary heart disease and stroke.
Safer and healthier foods.
Healthier mothers and babies.
Family planning.
Fluoridation of drinking water.
Recognition of tobacco use as a health hazard.

35
Q

What are the 3 levels of prevention and explain each with examples.

A

Primary: action taken to avoid the occurrence of a disease.
- Eating a healthy diet.
- Wearing sunscreen.
Secondary: action taken to identify diseases at their earliest stages and to apply appropriate treatments to limit their consequences and severity.
- Yearly mammogram.
- Cholesterol test.
Tertiary: specific interventions to assist diseased or disabled persons in limiting the effects of their diseases or disabilities; may include activities to prevent recurrence of disease.
- chemotherapy for lung cancer.
- surgery to remove malignant tumor.

36
Q

Purpose of PH law?

A

Protect and promote health; ensure the rights of individuals.

37
Q

What are the major levels of PH law?

A

National: federal health agencies:
- Food and Drug Administration (FDA).
- Centers for Disease Control and Prevention (CDC).
- Administration of Aging (AoA).
Tribal: Indian Health Service and others (IHS).
State: state health agencies and human service agencies:
- South Carolina Department of Health and Environmental Control (SCDHEC).
- Center for Disability Resources (CDR).
Local: local public health agencies/departments.
- Richland Public Health Department.

38
Q

Federal PH responsibilities?

A

Ensure all levels of government have the capabilities to provide essential PH services.
Act where solutions may be beyond jurisdiction of individual states.
Facilitate formulation of PH goals and provide leadership through regulatory powers.
Finance research and higher education.

39
Q

How has PH extended life expectancy?

A

Assessment, Policy Development, Assurance.

40
Q

What are the 10 Essential Public Health Services?

A

How we protect and promote health:
- Assess and monitor population health status, factors that influence health, and community needs and assets.
- Investigate, diagnose, and address health problems and hazards affecting the population.
- Communicate effectively to inform and educate people about health, factors that influence it, and how to improve it.
- Strengthen, support, and mobilize communities and partnerships to improve health.
- Create, champion, and implement policies, plans and laws that impact health.
- Utilize legal and regulatory actions designed to improve and protect the public’s health.
- Assure an effective system that enables equitable access to the individual services and care needed to be health.
- Build and support a diverse and skilled public health workforce.
- Improve and innovate public health functions through ongoing evaluation, research, and continuous quality improvement.
- Build and maintain a strong organizational infrastructure for public health.

41
Q

What is health equity?

A

Everyone has the opportunity to attain their highest level of health.
Create conditions that give everyone the opportunity to reach their best health.
Value all individuals and populations equally.
Address inequities in the places where people are born, grow, live, work, learn, and age.

42
Q

How to achieve health equity?

A

Address conditions (environmental).

43
Q

What is epidemiology?

A

Study of the distribution and determinants of health-related states or events in specified populations, and application of this study to control health problems (population medicine).
Foundation for PH:
- Relies on systematic and objective approach to the collection, analysis, and interpretation of data.
- Explain why some things happen to some people and not others.

44
Q

How has the focus of epidemiology changed over time?

A

Dr. John Snow: focused on acute infectious diseases.
1930s/40s: shift from traditional epi to wider uses.
1980s: injuries.
1990s: genetics.

45
Q

Why measure health?

A

Track diseases and conditions, monitor health and quality of life.
Identify opportunities for prevention and protection.
Distribution of resources.

46
Q

What is an endemic?

A

Constant presence of disease or infectious agent within geographic area.

47
Q

What is an epidemic?

A

Occurrence of disease in excess of normal expectancy.

48
Q

What is an pandemic?

A

Outbreak of disease over wide geographical area, such as continent.

49
Q

What is a rate?

A

Measure of some event, disease, or condition in relation to an unit of population, along with some specification of time.
- Formula: # of events, cases, or deaths/pop in same area.
- Must have accurate accounts for numerator, denominator, defined population, specified period of time.

50
Q

What are commonly used rates?

A

Death rates: morality/fatality rates; expressed as # of deaths per 100,000.
Adjusted rates: for a total population but is statistically adjusted for certain characteristic.
- ex: age (“age adjusted rate”): allows communities with different age structures to be compared.

51
Q

What is incidence rate?

A

Number of new health-related events or cases of a disease in a population exposed to that risk in a given time period.

52
Q

What is prevalence rate?

A

Proportion of population (ex. total #) that has a particular disease, injury, other health condition, or attribute at a specified point in time or during specified period.

53
Q

What are specific rates?

A

Rate for a particular population subgroup such as a specific disease (disease-specific), age range, or particular race/ethnicity or people (age-specific).
- ex: African American colon cancer rate; 15 - 24 y/o drowning death rate.

54
Q

What is the problem?

A

The what, who, where.
What is the burden of disease in terms of mortality, morbidity, and has it changed over “time.”
Use rates to measure health and compare over time.

55
Q

What is the etiology?

A

The why.
What are the contributory cause(s)?
- Has an association been established at the individual level?
- Does the “cause” precede the “effect?”
- Has altering the “cause” been shown to alter the “effect?”
Not all people with a risk factor will get the disease or condition (ex. cigs are not a sufficient cause for lung cancer); because the risk factor is absent, doesn’t mean the disease or condition can’t happen (ex. cigs are not a necessary cause for lung cancer).

56
Q

What are the recommendations?

A

What works to reduce health impacts?
What is the impact of intervention in terms of benefits and harms?
What do we know based on past experience?

57
Q

What is implement?

A

How can we get the job done and who should be involved?
How should the intervention be implemented?

58
Q

What are behavioral related causes of death?

A

Tobacco use.
Dietary excess and physical inactivity.
Alcohol.
Infections (ex. influenza, pneumonia).
Toxic agents (Ex. environmental pollutants: carbon monoxide, asbestos, etc.).
Firearms.
Sexual behaviors (ex. unprotected intercourse –> hep B, HIV).
Motor vehicle accidents.
Drug related.

59
Q

What are the 4 considerations of the relationship between “causes” and “effects?”

A
  1. Strength: relative risk.
    - RR: probability of Y if X exists / probability of Y if X doesn’t exist.
    - Y = outcome; X = determinant.
    - The RR for people with the factor/condition is greatly increased compared to those without.
  2. Dose-response: amount of exposure x duration (time).
    - ex. the more cigs you smoke over more years increases the chance of lung cancer.
  3. Consistency: studies produce same results over time across different populations.
    - ex. smoking and lung cancer: doesn’t really matter who you are or what you are.
  4. Biological plausibility: known mechanisms that explain relationship.
    - Ex. cig smoke enters lungs.
60
Q

What are micro and macro influences?

A

Increase likelihood of condition of disease.
Ecological perspective: psychological theory about the way people interact with their environment.
Multiple factors involved:
- social and cultural developments.
- impact of social status, poverty, and other broad influences on health.

61
Q

What is the multi causation disease model?

A

Explains onset of disease caused by more than one factor.
ex. CHD is more likely in people who are older, smoke, do not exercise, are overweight, have high blood pressure or cholesterol.

62
Q

What are US actions taken to address PH problems?

A

Seek “best” or “promising” practices.
US Surgeon General’s Reports.
Healthy People 1990, 2000, 2010, 2020, 2030.

PUBH 302 (2 decks)

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