Exam 1 Flashcards
What does the social model ecological model emphasize
that we are constantly interacting with and influenced by our surrounding
What are the 4 domains associated with social model ecological model
- individual: age, education, income, attitudes, mental health history, trauma
- relationship: family, peer, partner, other social networks
- community: neighborhoods, schools, workplace
- societal: social and cultural norms, policy
What are the 3 concepts of communities
geographic: city, town, neighborhood
common interest: church, professional, people w/ mastectomies
community of solution: group of people who come together to solve a specific issue that affects them all
What are the overarching goals of healthy people 2030
o High quality, longer lives
Free of preventable disease, disabilities, injury, and premature death
o Heath equity, eliminate disparities
Improve the health of all groups
o Social and physical
Environments that promote good health for all
o Quality of life, health development and healthy behaviors
Across of life stages
Primary prevention and examples
Efforts to keep illness of injury from occurring
o Education
Secondary prevention and examples
Efforts to detect and treat existing disease before it is symptomatic
o Cutting nails of diabetics
o Change the medication of a diabetic
Tertiary prevention and examples
Reduce the extent and severity of health problems to its lowest possible level to minimize
disability and restore or preserve function
o Foot ulcers for diabetics
o Rehab to increase quality of life
What are the (3) core foundations of public health
Assessment:
Systemic collection, analysis, and sharing information about health conditions and risks,
and resources in a community
Policy Development:
Use of assessment data to develop policy and direct recourses toward those policies
Assurance:
Availability of necessary services through the community
Define epi
The study of the distribution and determinants of health-related states or events and the
application of this study to the control diseases and other health problems
develops methods for the control of diseases
T/F diseases are random
The spread of disease is NOT random
o Disease patterns can be measured
Endemic
e.g.
Disease that is constantly present on a particular community or region
HIV
Epidemic
e.g.
Occurrence of a great number of cases of disease than ordinarily expected in
in a given population
Swine flu, cholera, AIDS, COVID, H1N1
Outbreak
An increased number of cases in the population that does not approach
epidemic proportions
Pandemic
The simultaneous experience of extensive disease outbreaks or epidemics in
several parts of the world
Mortality rate is
is the ratio of the number of deaths in a virus category (in a specified time
period) to the number of people in a given population (at that time period)
Age specific mortality rate e.g.
SIDS
case fatality rate e.g.
Alzheimer’s, ovarian cancer, ALS
Incidence definition
of new cases of a particular condition identified during a specific time period
divided by the total population at risk during that time period
Prevelance definition
Total number of poeple affected by a particular condition at a specified time new
and old cases divvied by the total population at risk during that time period
Epidemiology triad model includes what 3 categories
Host
Environment
Agent
Web of causation model allows…
the epidemiology to map interrelationships among factors contributing to the
development or prevention of a particular health condition –> Includes direct and indirect causes of disease
o Examples
Tobacco use
Infant mortality
MVA
What is the best evidence from a research trial
random controlled trail
Are cross sectional studies enough
no, data is only collected at one time point
What is a dose reponse relationship
Demonstrates that exposure and disease change together
With increasing levels of exposure there is a corresponding increase or decrease in
occurrence of disease
Case controlled studies begin w/
Begin with disease status
1. Identify those with disease and those without disease
2. Determined the expire statuses of those with and without
State public health agency role
health policy formation
Funding for state public health agencies
federal grants
state funds
fines/fees
Private insurance companies currently pat the majority of
US health care expenditures for those under age 65
Insurance plans: MCO’s
Use a variety of strategies to cut health care coast
Authorization for services:
In network services only and gatekeepers
o PCP Referral to Specialist
Provider restrictions:
In/Out Network choices, no gatekeeper
Insurance plans: HMO’s
Health maintenance organization
Insurance plans: POS
point of service plans
Insurance plans: PPOs
preferred provider organization
Define: premium
the amount you pay monthly to be covered by your health plan
Define: deductible
the amount you owe for health care services you receive during the year
Define: co payment
a flat payment you are responsible for at the time of service, usually a nominal fee paid toward the expense of getting care
Define: co-insurance
the percentage of the amount pained to a health care provider that you are responsible for
Medicare
Medicare (65 and up)
A) Covers hospital related Servies and emergency care
B) covers doctor’s office visits (optional)
C) Covers both part A and B with additional coverage (AKA Medicare advantage)
D) Covers prescription drugs
Medicaid
provides free or low cost medication coverage to children, pregnant women, parents
with dependent children, senior, and people with severe disabilities
What is the CHIP program
The children’s health insurance plan aimed to fill coverage gaps
- Eligibility
o Low income, uninsured children under age 19 and pregnant women caught in
the gap between Medicaid and affordable health care insurance - State administration but funded by federal government and state
Prospective reimbursement
predetermined, fixed payment
Retrospective reimbursement
- Fee for service payment
- Set rates for services are established in advance
- Payment is made after services are provided
- No limits on services allowed = no cost containment
- Redundancy of care = more reimbursement for providers
- Cost $$ on payer
- Sickness is incentivized (pays better than wellness)
Value based care
- Guiding slow restructuring of healthcare system with the overarching goal of value for
patients - Lower cost and better outcomes
- Higher patient satisfaction and better care efficiencies
- Stronger cost controls and reduced risks
- Alignment of prices with patient outcomes
- Reduced healthcare spending and better overall health
Leading cause of death in the US
Heart disease
Leading type of cancer by sex
Females
1. Lungs
Breast
Colon and Rectum
Males
1. Lung
Prostate
Colon and Rectum
Are we required to report chronic illness
no
What is a blue zone
An anthropological concept that describes the characteristics lifestyles and the
environments of the world’s longest-lived people
Blue zone: longevity foods (loma linda)
o Beans
o Nuts
o Oatmeal
o Avocados
o Soy milk
o Weetabix
o Whole wheat bread
o Nut butter
Blue zone: common characteristics
o Down shift (reduce stress)
o Less meat more plants
o Wine at 5
o Family first
o 80% rule (stop when 80% full)
o Move naturally
o Right tribe
o Belonging (faith-based community)
What level am I? Minimizing negative disease-induced outcomes in a patient
tertiary prevention
What level am I? Counseling a healthy patient about reducing risk for STIs
primary prevention
What level am I? A skin survey for precancerous lesions
secondary prevention
What level am I? Checking stool for occult blood
secondary prevention
What level am I? Administering an immunization like the influenza vaccine
primary prevention
What level am I? Adjusting therapy to enhance glycemic control on a women with Type II DM
tertiary prevention
What level am I? Ensuring adequate illumination on a stairway at home
primary prevention
What level am I? Screening for physical, emotional, or financial abuse
secondary prevention
What level am I? Checking for cuts & blisters on the feet of a client with diabetes
tertiary prevention
What level am I? Advocating for a policy requiring older homes to be assessed for lead-based
paint before sale
primary prevention
Removal of asbestos from an older home (to avoid associated health problems).
primary prevention
Advocating for regulations setting safety standards for the disposal of chemical waste.
primary prevention
Stocking the new clinic with anti-venom serum.
secondary prevention
In order to prevent further illness, funding is provided to clean up a contaminated area.
tertiary prevention
Educate community members about first aid practices.
secondary prevention
Providing a pain management referral to deal with long-lasting side effects of Lyme disease.
tertiary
Funding for clinical diagnostic services have been exhausted.
a. biological
b. health system
c. behavioral
d. Environmental
B
A pregnant woman bitten by a Zika-infected mosquito gives birth to a fetus with encephalitis.
a. biological
b. sociocultural
c. behavioral
d. Psychological
A
An Olympic swimmer fell ill after swimming in contaminated water in Rio.
a. biological
b. sociocultural
c. behavioral
d. Psychological
C
To make ends meet, Sam works at a dry cleaning store where he handles the washing chemicals.
a. biological
b. sociocultural
c. behavioral
d. Psychological
B
Medicare beneficiaries include (SELECT ALL THAT APPLY):
a. elderly woman
b. disabled man
c. young parents
d. Children
a
b
“Never events” are discouraged under what reimbursement system?
a. retrospective
b. prospective
c. pay for performance
C
Medicaid funding comes from:
a. federal funds
b. state funds
c. federal and state funds
d. social security contributions
C
Which reimbursement systems (2) could cause HCPs to refuse to care for the chronically ill?
a. retrospective
b. prospective
c. pay for performance
b
c
All of the following are associated with rising health care costs EXCEPT:
a. poverty
b. uncompensated care
c. the aging population
d. more specialty care and services
A
The “donut hole” applies to which part of Medicare?
a. A
b. B
c. C
d. D
D
Which of the following is the largest source of health care funding?
a. medicare
b. medicaid
c. out of pocket payments
d. private insurance
D
Which of the following health issues contributes the greatest global mortality burden?
A. Child mortality
B. Noncommunicable disease
C. Communicable disease
D. Maternal mortality
B
Which primary health care core activities are secondary prevention? Select All
a. control of endemic diseases
b. immunization
c. basic sanitation
d. provision of essential medications
a
d
