Exam 1 Flashcards
Epidemic across an extensive geographic region (e.g., multiple countries or continent)
Pandemic
is Community level based on the explicit consideration of multiple levels of influences. Ecology was derived from biological science and refers to the interrelations between organisms and their environments
Can incorporate constructs from models that focus on psychological, social, and organizational levels of influences to provide a comprehensive framework for integrating multiple theories, along with consideration of environments and policy in the broader community
Ecological model
Health status of people who are not organized (or not defined); have no identity as a group. Examples: men younger than 50, adolescents, prisoners, white-collar workers, etc.
Population health
The most inclusive term; Closed to community health, but it includes a broader (e.g., the governmental) actions and conditions to promote, protect, and preserve people’s health
Public health
Proportion of persons who have a particular disease or attribute at a specified point in time in a given population:
Prevalence
Point Prevalence:
Cross-sectional prevalence
Period Prevalence
Presence over longer period
Prevalence Rate Equation
of cases/population X 100
The health status of “a defined group of people” and the actions and conditions to promote, protect, and preserve their health
Community health
number of new cases (or deaths) occurring in a specified population per year
No acknowledgement of differences based on potential confounding variables, such as age, race, sex, income, etc., that impacts the outcome.
Crude Rate
Measures the frequency of a new event (new illness cases) occurring in a population over a period of time
Incidence
Ecology is derived from biological science and refers to the interrelations between organisms and their environments
Ecological Model, as they have evolved in behavioral sciences and public health, focuses on the nature of people’s transactions with their physical and socio-cultural surroundings, which is environments
Ecological perspective-
Time surrounded by - Groups or Populations & Their Characteristics; Environment (Culture, Physiological Factors, Ecological Elements); Causative Factors (Biological, Chemical, Physical)
Epidemiology Triangle - Advanced
Time surrounded by - Host, Environment, Infectious Agent
Epidemiology Triangle - Traditional
Levels of disease
Endemic - Persistent low to moderate disease level
Hyper-endemic - Persistent high disease level
Epidemic - Exceeding expected levels
Pandemic - Epidemic across an extensive geographic region (e.g., multiple countries or continent)
Endemic - Persistent low to moderate disease level
Hyper-endemic - Persistent high disease level
Epidemic - Exceeding expected levels
Pandemic - Epidemic across an extensive geographic region (e.g., multiple countries or continent)
Levels of disease
Compares the risk of an event between two groups;
• “Measure of Association”
• Quantifies the relationship (association) between exposure (or independent variable) and disease
Relative risk
Level of disease: Exceeding expected levels
Epidemic
When new cases occur rapidly over a short period of time in a well-defined population, the incidence rate is referred to as….
Also called as the cumulative incidence rate
In usual, the rate base for attack rate is 100
EX) On June 20, 2017, the cases of diarrhea were reported to the District Health Officer in Stillwater, OK. The illness placed soon after eating contaminated food at a high-school picnic. Attack rates were calculated for each of the foods, with the highest attack rate for cholate cake. Of those who ate the cholate cake, 52 were ill and 8 were not ill, yielding an attack rate of 87%
Attack rate
Study of the occurrence and distribution of disease Summarizes the distribution of a health-related state or event according to: • Who? (Person) • Person characteristics • Where? (Place) • Geographic extent • When? (Time) • Time (temporal) variables • Used when little is known about the disease • Rely on preexisting data • Who, where, when, what • Illustrate potential associations
Descriptive epidemiology
- Further studies to determine why and how diseases or conditions occur
• Used when insight about various aspects of disease is available
• Rely on development of new data
• Why, how
• Evaluates the causality of association
Analytic epidemiology-
is Community level based on the explicit consideration of multiple levels of influences. Ecology was derived from biological science and refers to the interrelations between organisms and their environments
Can incorporate constructs from models that focus on psychological, social, and organizational levels of influences to provide a comprehensive framework for integrating multiple theories, along with consideration of environments and policy in the broader community
Ecological Model, as they have evolved in behavioral sciences and public health, focuses on the nature of people’s transactions with their physical and socio-cultural surroundings, which is environments
Overall summary of ecological model
- There are multiple influences on specific health behaviors (think of the levels)
- Influences on behaviors interact across these different levels
- Ecological model should be behavior-specific, identifying the most relevant potential influences at each level
- Multi-level interventions should be the most effective in changing behavior
What are the core principles of the ecological model?
What are the core principles of the ecological model?
- Multiple influences on specific health behaviors (think of the levels)
- Influences on behaviors interact across these different levels
- Ecological model should be behavior-specific, identifying the most relevant potential influences at each level
- Multi-level interventions should be the most effective in changing behavior
The “close and continuous observation of one or more persons for the purpose of direction, supervision, or control.”
From the French sur (over) and veiller (to watch)
Systematic ongoing:
• Collection
• Analysis
• Interpretation
• Dissemination
• Of health data
Monitor health events
• Detect sudden changes in disease occurrence and distribution
• Follow long-term trends and patterns of disease
• Identify changes in agent and host factors
• Detect changes in health care
Who Performs
Public health department (local, state, federal)
Medical professionals (doctors, nurses, clinics)
Pharmacies
Epidemiologists
Emergency responders (911 centers, emergency management technicians)
Health insurance providers
Understand the activities of public health surveillance
• What is “Health”? How would you define it?
o The definition of health has changed over time
• Different things to different people
• It is now considered a multidimensional concept that includes:
• -Physical, emotional, social, mental and environmental aspects
• “A state of complete _physical___, __mental___ and social well-being__ and not merely the absence of disease or infirmity” (WHO)
What are the concepts of health?
What are the concepts of health?
• What is “Health”? How would you define it?
o The definition of health has changed over time
• Different things to different people
• It is now considered a multidimensional concept that includes:
• -Physical, emotional, social, mental and environmental aspects
• “A state of complete _physical___, __mental___ and social well-being__ and not merely the absence of disease or infirmity” (WHO)
- Educational Approach:
• The most effective mean for achievement of changes in the health practices and lifestyles of the community
• In general, outcomes are slow but permanent and enduring
• Sufficient time should be allowed for the individual to bring about the desired changes in his/her behavior
• Components
o Communication
o Motivation
o Decision-making - Primary Health Care Approach:
• This is about caring for people, rather than simply treating specific diseases or conditions - community participation
• It provides comprehensive, accessible, community-based care that meets the health needs of individuals throughout their life
• This includes a spectrum of services from prevention (i.e., vaccinations and family planning) to management of chronic health conditions - Administrative/ Service Approach:
• Intend to provide all the health facilities and services to the people as needed
• It becomes a failure if the service is not based on the needs of the people - Legal/Regulatory Approach:
• Government makes laws and regulations to protect the health of the community
o Examples of Common Public Health Laws
o Mandatory vaccinations
o Addressing social welfare through retirement benefits and health insurance
o Required proof of safety
o Promoting improvements and expansions of healthcare infrastructure
o Required environmental impact studies prior to initiating new program
What are the health approaches?
What are the health approaches?
- Educational Approach:
• The most effective mean for achievement of changes in the health practices and lifestyles of the community
• In general, outcomes are slow but permanent and enduring
• Sufficient time should be allowed for the individual to bring about the desired changes in his/her behavior
• Components
o Communication
o Motivation
o Decision-making - Primary Health Care Approach:
• This is about caring for people, rather than simply treating specific diseases or conditions - community participation
• It provides comprehensive, accessible, community-based care that meets the health needs of individuals throughout their life
• This includes a spectrum of services from prevention (i.e., vaccinations and family planning) to management of chronic health conditions - Administrative/ Service Approach:
• Intend to provide all the health facilities and services to the people as needed
• It becomes a failure if the service is not based on the needs of the people - Legal/Regulatory Approach:
• Government makes laws and regulations to protect the health of the community
o Examples of Common Public Health Laws
o Mandatory vaccinations
o Addressing social welfare through retirement benefits and health insurance
o Required proof of safety
o Promoting improvements and expansions of healthcare infrastructure
o Required environmental impact studies prior to initiating new program
Multicausation disease model
Host (e.g., genetic)
Personality, beliefs, and behavioral choices
Complex environment
What are the components of multicausation disease model
What are the components of multicausation disease model
Multicausation disease model
Host (e.g., genetic)
Personality, beliefs, and behavioral choices
Complex environment
Understand dependent variable vs. independent variable -
Dependent Variable Outcome variable (disease or health state) Value depends on the independent variable
Independent Variable
Hypothesized influence on outcome variable
Association
A change in one variable results in a change in another variable
Can be positive or negative
Dependent Variable Outcome variable (disease or health state) Value depends on the independent variable
Independent Variable
Hypothesized influence on outcome variable
Association
A change in one variable results in a change in another variable
Can be positive or negative
Understand dependent variable vs. independent variable -
- Disease does not occur at random
2. Disease has causal and preventive factors that can be identified through systematic investigation
Determine the basic assumptions of epidemiology research-
Determine the basic assumptions of epidemiology research-
- Disease does not occur at random
2. Disease has causal and preventive factors that can be identified through systematic investigation
“Study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the prevention and control of health problems” Determines: What When Where Who Why How
Understand epidemiology
Understand epidemiology
“Study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the prevention and control of health problems” Determines: What When Where Who Why How
To provide the basis for disease prevention by discovering agent, host, and environmental factors that affect health
To identify groups at the greatest risk for a particular disease
To evaluate the importance of causes of illness, death or disability to establish public health priorities
To evaluate the effectiveness and efficiency of targeted services/programs
Understand the purpose of epidemiology
Understand the purpose of epidemiology
To provide the basis for disease prevention by discovering agent, host, and environmental factors that affect health
To identify groups at the greatest risk for a particular disease
To evaluate the importance of causes of illness, death or disability to establish public health priorities
To evaluate the effectiveness and efficiency of targeted services/programs
Monitor health events
• Detect sudden changes in disease occurrence and distribution
• Follow long-term trends and patterns of disease
• Identify changes in agent and host factors
• Detect changes in health care
What are the purpose of public health surveillance?
What are the purpose of public health surveillance?
Monitor health events
• Detect sudden changes in disease occurrence and distribution
• Follow long-term trends and patterns of disease
• Identify changes in agent and host factors
• Detect changes in health care
- Credibility:
• The degree to which the message is perceived as trustworthy by the receiver
• It should be scientifically proven, based on facts
• It should be compatible with local culture and goals - Interest:
• If the health education topic is of interest to the people, they will listen to it
• Health educator should identify the “felt needs” of the people and then prepare a program based on the needs (e.g., needs assessment) - Participation:
• Health educator should encourage people to participate in the program
• Once the people are given a chance to take part in the program, it leads to their acceptance of the program
• Methods like a lecture, symposium, conference, group discussion, panel discussion, etc. provide opportunity for people’s participation - Motivation:
• “The fundamental desire for learning/doing something of an individual”
• Motivation should be relevant to individual’s needs and desire
o Ex) for a teenager, appearance might be a motive to take care of his body weight whereas for an adult, it can be the healthy life - Comprehension:
• Level of understanding of the people who receive the health education
• Should first determine the level of literacy and understanding of the audience
• Words that are strange or new to the people should not be used
o Ex) Instead of saying “Exercise at least 30 minutes of moderate to vigorous intensity aerobic activity”, a better way of explaining would be “Walk 7,500 steps/day for health benefits - Reinforcement:
• This is the principle that refers to the repetition needed in health education
• It is not possible for the people to learn new things in a short period of time
• So repetition is a good idea
• This can be done at regular intervals and it helps people to understand new ideas or practice better - Learning by Doing:
• If the learning process is accompanied by doing new things, it is better instilled in the minds of people
“If I hear, I forget
If I see, I remember
If I do, I know” - Known to Unknown:
• Before the start of any health education program, the health educator should find out how much the people already know and then give them the new knowledge
• The existing knowledge of the people can be used as the basic step up on which new knowledge can be placed
9. Setting an Example:
• The health educator should follow what (s)he preaches
• (S)He should set an example to others to follow
10. Good Human Relations:
• The health educator should have good personality and should be able to maintain friendly relations with the people
• The health educator should have a kind and sympathetic attitude toward the people and should always be helpful to them in clarifying doubts or repeating what is not understood
11. Feedback:
• For any program to be successful, it is necessary to collect feedback to find out if any modifications are needed to make the program more effective
12. Community Leaders:
• Community leaders can be used to reach the people of the community and to convince them about the need for health education
• Leaders can also be used to educate the people as they already have a good relationship with the people of their community
• The leaders may have an understanding of the needs of the community
13. Soil, Seed, Sower:
• Soil is “the community”
• Seed is “information”
• Sower is “the person giving the information – Health Educator”
Understand the principles of health education?
What are the definition of community?
Traditional - Four possibilities:
• Functional spatial units meeting basic needs for sustenance
• Units of patterned social interaction
• Symbolic units of collective identity
• Political action unit to make change
Community Definition: Health Research/ Community Health
1.)A geographic area with specific boundaries (e.g. a neighborhood, city, county, state)
2. A group of people who have common characteristics (e.g., location, race, ethnicity, age, occupation, interest in particular problems or outcomes, or common issues)
Traditional - Four possibilities:
• Functional spatial units meeting basic needs for sustenance
• Units of patterned social interaction
• Symbolic units of collective identity
• Political action unit to make change
Community Definition: Health Research/ Community Health
1.)A geographic area with specific boundaries (e.g. a neighborhood, city, county, state)
2. A group of people who have common characteristics (e.g., location, race, ethnicity, age, occupation, interest in particular problems or outcomes, or common issues)
What are the definition of community?
Incidence and prevalence measure different aspects of disease occurrence
Prevalence Incidence
Numerator: All cases, no matter how long diseased Only NEW cases
Denominator: In general, all persons in population Only persons at risk of disease
Measures: Presence of disease Risk of disease
Most useful: Resource allocation; the burden of chronic disease Risk, etiology; study of causation
Compare incidence vs. prevalence
- ) General/Physical Environment: Socio-economic, Political, Cultural, Environmental Conditions
- ) Living & Working Conditions: Housing, Healthcare Service, Work/Unemployment, Education, Water Sanitation, Agricultural & Food
- ) Social & Community Network: Family Support, Participation w/ governmental processes
- ) Individual & Lifestyle Factors: Diet, Physical activity, Alcohol, cigarette, drug use, Hand washing
- ) Biology & Genetics: Age, sex, HIV status, Family History of Heart Disease/Health
What are the concepts of determinants of health?
1.) Informing people
• Increase individual’s awareness
o People are informed about the different diseases, their etiology and how to prevent them
2.) Motivating people
• Concerned with clarifying/ changing attitudes, beliefs, values and/or opinions
• After health information is given, it is necessary to motivate them change their lifestyles so that becomes favorable to promoting health and preventing disease
• Motivation is defined as “a combination of forces that initiate, direct, and sustain behavior”
3.) Guiding into action
• Concerned with development of skills and action
• A person who has obtained health information might be motivated to change his/her behavior and lifestyle
• He/she might need professional help and guidance so as to bring about these changes and to sustain these altered lifestyles
What are the objectives of health education
