Exam 1 Definitions

Question 1

health and public health, WHO definitions

Answer 1

a state of complete physical, mental, and social wellbeing. not merely the absence of disease or infirmity
All organized measures to prevent disease, promote health, and prolong life among the population as a whole

Question 2

goals of public health

Answer 2

promote and prevent illness and disease. ultimately make america a healthier population

Question 3

how do public health and medicine differ

Answer 3

public health is preventative, addressing upstream factors before they cause downstream factors
medicine is acute responses, when it is working it is visible
to have a healthy society, there needs to be both public health and medicine

Question 4

health system definition

Answer 4

all organizations, people, and actions whose primary intent is to promote, restore, or maintain health

Question 5

what are the different elements of a good healthcare system

Answer 5

a robust financing mechanism, a well-trained and adequately paid workforce, reliable information on which to base decisions and policies, well-maintained facilities and logistics to deliver quality medicines and technologies

Question 6

building blocks of healthcare

Answer 6

leadership/governance, healthcare financing, health workforce, medical products/technologies, information and research, service delivery
adequate access and quality of the building blocks leads to improved health (level and equity), responsiveness, financial risk protection, improved efficiency

Question 7

epidemiology definition

Answer 7

the study of the distribution and patterns of disease within a population
not about individuals, but about populations and aggregate numbers

Question 8

social epidemiology

Answer 8

the distribution of disease within a population according to social factors, such as the use of drugs, heterosexual behavior, or social class rather than biological factors
looks at how social conditions effect epidemiology and disease distribution

Question 9

epidemiological transformation

Answer 9

the transition from infectious diseases to chronic conditions as being the major killer of US populations
this shift can be traced to public health efforts, like development of tools to avoid/detect chronic illness, and policies to curb infectious diseases
the only exception to this in last 10 years was covid

Question 10

prevalence definition

Answer 10

total number of cases within a specific population at a specified time, both those newly diagnosed and those diagnosed in a previous year but living with the condition

Question 11

incidence definitions

Answer 11

the number of new occurrences of an event (diseases, births, deaths) within a specific population during a specific period

Question 12

life expectancy rate

Answer 12

life expectancy at birth represents the overall mortality pattern that prevails across all age groups
major correlation between income and life expectency
US life expectancy is going down because of covid pandemic and the drug overdose epidemic

Question 13

mortality definition

Answer 13

the frequency or rate of death in a given population

Question 14

morbidity definition

Answer 14

departure from a state of physical or psychological well-being, resulting from disease, injury, or sickness
could be something as short as a few days or a chronic disability
morbidity is an outcome of the building blocks of the healthcare system

Question 15

infant mortality rate

Answer 15

the frequency/rate of death of infants before their first birthday. the number of infant death for every 1000 live births
a good indicator of population health because hypothetically all babies should be able to survive birth. important marker of overall health of a society
another example of the paradox of US healthcare, US has highest infant mortality rate out of many comparable countries

Question 16

why is child mortality in US rising

Answer 16

premature infants and birth complications, prematurity and SIDS related to social gradient
older teens: motor vehicle deaths and gun violence
doesn’t have anything to do with medicine/health system, more about the child poverty rate, educational attainment, fractions in social safety net, road and gun safety

Question 17

upstream factors

Answer 17

closer to fundamental nature of the cause and often further from observed health outcomes
law, policies, underlying values that shape: income, accumulated wealth, income inequality, educational attainment, employment, household composition, experiences based on race or ethnic group, social mobility, stressful experiences related to any of the above

Question 18

midstream factors

Answer 18

factors that are strongly influenced by upstream factors and that are likely to affect health
neighborhood features, work environments, housing, transportation, conditions in homes/schools/work/community

Question 19

downstream factors

Answer 19

closest to ends of causal chains
unhealthy diet, lack of exercise, smoking, peer influence

Question 20

social class definition

Answer 20

individuals education, income, occupational status, prestige
within each racial group and at each age, those with higher education, income, or occupational status have the lowest rates of mortality and morbidity
education and health strongly interrelated
where people are in the social hierarchy affects the conditions in which they grow, learn, live, work, and age and their vulnerability to ill health and its consequences

Question 21

social gradient

Answer 21

people who are less advantaged in terms of socioeconomic position have worse health than those who are more advantaged
for every income level, there is a difference in life expectancy
this inequality between income groups is part of what is making the US sicker than comparable countries who experience less income inequality
social gradient in health implies that action to improve health has to take place at a societal level, and individuals ability to change is constrained by social circumstances

Question 22

racial disparity

Answer 22

disparity: systematic differences accross groups based on socially constructed (not biological) differences
racial disparity: the increased presence of certain diseases, poorer health outcomes, and greater difficulty in obtaining healthcare services for certain races
the differnces can depend on the location, receiving population, and ecisting stereotypes. even though the differences are socially constructed, they still have large consequences in healthcare and the social environment

Question 23

cultural competency

Answer 23

“The ability of individuals to establish effective interpersonal and working relationships that supersede cultural differences” by recognizing the importance of social and cultural influences on patients, considering how these factors interact, and devising interventions that take these issues into account
A culturally competent healthcare system acknowledges and incorporates the importance of culture, and is vigilant towards differences that result from cultural differences

Question 24

cultural humility

Answer 24

An orientation towards caring for one’s patients that is based on: self-reflexivity and assessment, appreciation of patient’s expertise on the social and cultural context of their lives, openness to establishing power-balanced relationships with patients, and a lifelong dedication to learning
Cultural competence attending to the culturally diverse backgrounds of patents, providing person-centered care, and reducing health disparities
The term competence can contribute to the reproduction of social stereotypes and an imbalance of power between patients and providers
Saying competence suggests that there is one core set of beliefs and values that remain unchanged and that are shared by all members of a specific group. Totalizing view
Competence creates us-versus-them, sense of othering

Question 25

primary prevention

Answer 25

the goal is to protect healthy people from developing a disease or experiencing an injury in the first place
this is what public health does

Question 26

secondary prevention

Answer 26

these interventions happen after an illness or serious risk factors have already been diagnosed. The goal is to slow or halt the progression of disease in its earliest stages, and limit long-term disability and prevent future illness
Taking aspirin to prevent first or second heart attack or stroke
Recommending regular exams and screening tests in people with known risk factors for illness

Question 27

tertiary prevention

Answer 27

focusing on helping people manage complicated, long-term health problems such as diabetes, heart disease, cancer, and chronic pain
Goals include preventing further physical deterioration and maximizing quality of life, preventing it from getting worse for the person
Ex. rehab programs, pain management programs, support groups

Question 28

community-rating

Answer 28

A health plan sets the same premium rate for everyone in a given geographical area, the insurer thus ignores any differences in expected costs among insured groups or people
Achieves redistribution of health care more in accordance with human need from healthy to sick and from rich to poor
Erosion of community rating has left higher cost groups and individuals to be charged higher premiums
This is one reason why proposals to reform health insurance often suggest a return to community rating or some other type of premium subsidy from the chronically well to the chronically ill

Question 29

experience-rating

Answer 29

People pay different premiums based on differences in their demographics, past health care utilization, medical status, and other factors. Used to minimize risks associated with policy holders who have high-risk related conditions

Question 30

premium

Answer 30

Payments by the insured on a monthly or annual basis to cover the specific set of losses indicated in the insurance policy

Question 31

redlining

Answer 31

Refusing coverage to certain individuals or groups on the basis of geographical location, belonging to certain business groups that were considered as high risk or on the basis of presumed high risk lifestyles or history of excessive claims

Question 32

deductible

Answer 32

The amount you must cover for medical expenses before your insurance policy gets paid, usually on an annual basis

Question 33

copayment

Answer 33

A contribution made by an insured person toward the cost of medical treatment or other services
Amount is defined by an insurance policy and is paid by the insured person every time a service is received

Question 34

equity

Answer 34

Health inequalities or health disparities refer to differences in health outcomes that might be considered unfair or unjust, these terms are typically related to socio-economic inequalities in most societies
Health equity: everyone has a fair opportunity to live a fair and healthy life
Reducing health inequities is an ethical imperative because of the fact that they can be remedied
Recognizing disparities then acting on it by meeting people where there needs are
Related to fairness, justice, disadvantage
In health, an equitable society is one in which everyone has a fair opportunity to live a long and healthy life
Equality: treating everyone the exact same, regardless of circumstances or specific needs

Question 35

gender

Answer 35

Socially created and learned distinctions that specify the ideal physical, behavioral, mental, and emotional traits characteristic of women, men, and people with non-binary identities

Question 36

asymmetry of information

Answer 36

Healthcare providers know more about health problems than patients, they have the needed education and expertise that makes patients need to rely on the physicians for treatment decisions
Gives providers more power and control
Little room for patient choice or decision making, no control over accumulated spending, patients do not know amount of services that they will need