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PUBH 3001 > Exam 1 Review > Flashcards

Exam 1 Review Flashcards

1
Q

What is the definition of public health?

A

the science and art of preventing disease, prolonging life, and promoting health and efficiency through organized community efforts to ensure every individual in the community has a standard of living adequate for the maintenance of health.

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2
Q

How does the WHO define health?

A

A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

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3
Q

Define wellness

A

An active process of becoming aware of and making choices towards a more successful existence

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4
Q

What are the 3 types of prevention and how are they described?

A
  • Primary Prevention - Tries to prevent and injury or illness from occurring at all; targets people without a disease
  • Secondary Prevention - Aims to minimize the severity of the illness or damage due to an injury-causing event once the event has occurred; targets people with early, non-symptomatic disease
  • Tertiary Prevention - Seeks to minimize disability by providing medical care and rehabilitation services; targets people with symptomatic disease
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5
Q

What are the 6 principles of public health and how are they defined?

A
  • Principle of the Aggregate - focuses on the needs of the entire population
  • Principle of Prevention - emphasizes prevention
  • Principle of Epidemiology - relies on epidemiology as its method of inquiry
  • Principle of Community Organization - organizes community resources to meet health needs
  • Principle of Leadership - leads when others cannot or will not
  • Principle of the Greater Good - gives first consideration to interventions that provide greater good for the greatest number of people
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6
Q

What is a determinant of health? What are some examples?

A

Something that affects or determines one’s health.
ex: income, geography, social status, education, literacy level, social/physical environment, personal health practices and coping skills, employment, working conditions, social support networks, biology and genetics, gender, culture, age, child development, current policies (or lack thereof)

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7
Q

What are the top 10 public health achievements of the 20th century?

A
  • Vaccination
  • Motor-vehicle safety
  • Safer workplaces
  • Control of infectious diseases
  • Lowered deaths from heart disease and stroke
  • Safer and healthier foods
  • Healthier mothers and babies
  • Family planning
  • Fluoridation of drinking water
  • Recognition of tobacco as a health hazard
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8
Q

What are the 8 Millenium Development Goals?

A
  1. Eradicate extreme hunger and poverty
  2. Achieve universal primary education
  3. Promote gender equality and empower women
  4. Reduce child mortality
  5. Improve maternal health
  6. Combat HIV/AIDS, malaria, and other diseases
  7. Ensure environmental sustainability
  8. Develop a global partnership for development
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9
Q

What is a primary source of information?

A

original journal article, editorial review board, methods and data given, authors identified
ex: New England Journal of Medicine

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10
Q

What is a secondary source of information?

A

summary of primary, not as complete (methods and data not given)
ex: textbooks, encyclopedias, Medical World News, many “fact sheets”

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11
Q

What is a tertiary source of information?

A

newspaper summary, lay press, very little information given

ex: HuffPost, Time, Reader’s Digest…

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12
Q

What are the 6 steps in the public health approach to prevention?

A
  1. Describe the health issue
  2. Identify causes and risk and protective factors
  3. Breakdown into manageable components
  4. Develop and test intervention
  5. Implement intervention
  6. Evaluate intervention
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13
Q

Top 10 Leading Causes of Death?

A
  1. Diseases of heart (25% of all deaths)
  2. Cancer (22.9% of all deaths)
  3. Chronic lower respiratory diseases (5.7% of all deaths)
  4. Cerebrovascular diseases (5.4% of all deaths)
  5. Unintentional injuries (4.9% of all deaths)
  6. Alzheimer’s (3.3% of all deaths)
  7. Diabetes (2.9% of all deaths)
  8. Influenza and Pneumonia (2.3% of all deaths)
  9. Kidney diseases (2.0% of all deaths)
  10. Suicide (1.5% of all deaths)
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14
Q

Top 9 Leading Actual Causes of Death?

A
  1. Tobacco- 18.1% of all deaths
  2. Poor diet and physical inactivity- 15.2% of all deaths
  3. Alcohol consumption- 3.5% of all deaths
  4. Microbial agents- 3.1% of all deaths
  5. Toxic agents- 2.3% of all deaths
  6. Motor vehicles- 1.8% of all deaths
  7. Firearms- 1.2% of all deaths
  8. Sexual behavior- 0.8% of all deaths
  9. Illicit drug use- 0.7% of all deaths
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15
Q

5 Criterion of Causation

A
  1. Is the association strong?
  2. Is there clear temporality (time sequence)?
  3. Is there a dose-response effect?
  4. If an experiment removes the risk factor, does that reduce the risk of the disease?
  5. Other criteria? (Consistent with existing knowledge? Plausible? Alternative explanations? Different studies in different pop have different conclusions?)
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16
Q

Define the prevention paradox

A

“A prevention measure that brings large benefits to the community affords little to each participating individual.” –Geoffrey Rose

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17
Q

What’s an example of the prevention paradox?

A

Seat belt laws, blood alcohol levels, smoking bans, immunizations, recycling

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18
Q

What did John Snow, the father of modern epidemiology, do?

A

traced a severe cholera outbreak to one Broad Street Well, which proved that the infectious disease was not simply a result of “miasmas” or “dirty air”

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19
Q

Incidence

A

the rate of new cases of a disease in a defined population over a defined period of time.
Measures the probability of a healthy person in that population developing that disease during that time.

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20
Q

Prevalence

A

the total number of cases existing in a defined population at a specific time.

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21
Q

What does an epidemic curve show?

A

The number of new cases of disease caused by infection over time. Also shows the incubation period.

22
Q

Why is data essential to public health?

A

• important in making up the surveillance systems that form the basis of effective public health practice
• important in the planning and evaluation efforts that are increasingly being used in public health programming
ex: early notification of communicable disease, recognizing thata community has a problem with unintended pregnancies and low-birth weights, helps recognize that an epidemic is beginning!

23
Q

What are Gostin’s 7 Models of Public Health Intervention?

A
  1. The power to tax and spend
  2. The power to alter the informational environment
  3. The power to alter the built environment
  4. The power to alter the socio-economic environment
  5. Direct regulate of persons, professionals, and businesses
  6. Indirect regulation through the tort system
  7. Deregulation: Law as a barrier to health
24
Q

Describe Gostin’s first model, the “power to tax and spend”

A

supports the public health infrastructure consisting of a well-trained workforce, electronic information and communications systems, rapid disease surveillance, laboratory capacity, and response capability.
ex: Tax relief can be offered for health producing activities such as medical services, childcare, and charitable contribution, and tax burdens can be placed on the sale of hazardous products such as tobacco, alcoholic beverages, and firearms.

25
Q

Describe Gostin’s second model, the “power to alter the informational environment”

A

encouraging people to make more healthful choices about diet, exercise, cigarette smoking, and other behaviors.
ex: health education campaigns, requiring businesses to label their products to include instructions for safe use, disclosure of contents or ingredients, and health warnings, and banning or regulating advertising of potentially harmful products such as cigarettes, firearms, and even high-fat foods

26
Q

Describe Gostin’s third model, the “power to alter the built environment”

A

designing the built environment to reduce injury (e.g., workplace safety, traffic calming, and fire codes), infectious diseases (e.g., sanitation, zoning, and housing codes), and environmentally associated harms (e.g., lead paint and toxic emissions).
Environments can be designed to promote livable cities and facilitate health-affirming behavior by, for example: encouraging more active lifestyles (walking, biking, and playing); improving nutrition (fruits, vegetables, and avoidance of high-fat, high-ealoric foods); decreasing use of harmful products (cigarettes and alcoholic beverages); reducing violence (domestic abuse, street crime, and firearm use); and increasing social interactions (helping neighbors and building social capital).

27
Q

Describe Gostin’s fourth model, the “power to alter socio-economic environment”

A

People of low SES experience material disadvantage (e.g., access to food, shelter, and health care); toxic physical environments (e.g., poor conditions at home, work, and community); psychosocial stressors (e.g., financial or occupational insecurity and lack of control); and social contexts that influence risk behaviors (e.g., smoking, physical inactivity, high-fat diet, and excessive alcohol consumption).
Society can work to try to alleviate each of these determinants of morbidity and premature mortality.

28
Q

Describe Gostin’s fifth model, “direct regulation of persons, professionals, and businesses”

A

set clear, enforceable rules to protect the health and safety of workers, consumers, and the population at large. Regulation of individual behavior (e.g., use of seatbelts and motorcycle helmets) reduces injuries and deaths. Licenses and permits enable government to monitor and control the standards and practices of professionals and institutions (e.g., doctors, hospitals, and nursing homes). Finally, inspection and regulation of businesses helps to assure humane conditions of work, reduction in toxic emissions, and safer consumer products.

29
Q

Describe Gostin’s sixth model, “indirect regulation through the tort system”

A

: Civil litigation can redress many different kinds of public health harms: environmental damage (e.g., air pollution or groundwater contamination); exposure to toxic substances (e.g. pesticides, radiation, or chemicals); hazardous products (e.g., tobacco or firearms); and defective consumer products (e.g., children’s toys, recreational equipment, or household goods).
The tort system aims to hold individuals and businesses accountable for their dangerous activities, compensate persons who are harmed, deter unreasonably hazardous conduct, and encourage innovation in product design. Civil litigation, therefore, can provide potent incentives for people and manufacturers to engage in safer, more socially conscious behavior.

30
Q

Describe Gostin’s seventh model, “deregulation: law as a barrier to health”

A

Politicians may urge superficially popular policies that have unintended health consequences.
ex: laws that penalize exchanges or pharmacy sales of syringes and needles. Restricting access to sterile drug injection equipment can fuel the transmission of HIV infection. Similarly, the closure of bathhouses can drive the epidemic underground, making it more difficult to reach gay men with condoms and safe sex literature. Finally, laws that criminalize sex unless the person discloses his or her HIV-status make common sexual behavior unlawful.
The criminal law provides a disincentive for seeking testing and medical treatment, ultimately harming the public’s health.

31
Q

3 Criteria for Adequate Health Care Systems

A

● Equitable access to quality care– both prevention and treatment services– for rural and urban populations
● Affordability—even if people have no income or insurance they may receive services
● Sustainability—system has long-term political and financial support

32
Q

3 Functions of Public Health

A
  1. Assessment
  2. Policy Development
  3. Assurance
33
Q

What does the function of assessment entail?

A

● Monitor health status to identify community health problems
● Diagnose and investigate health problems and health hazards in the community

34
Q

What does the function of policy development entail?

A

● Inform, educate, and empower people about health issues
● Mobilize community partnerships to identify and solve health problems
● Develop policies and plans that support individual and community health efforts

35
Q

What does the function of assurance entail?

A

● Enforce laws and regulations that protect health and ensure safety
● Link people to needed personal health services and assure the provision of healthcare when otherwise unavailable
● Assure a competent public health and personal healthcare workforce
● Evaluate effectiveness, accessibility, and quality of personal and population-based health services

36
Q

What does the CDC’s Health Impact Pyramid depict?

A

It shows what factors affect health, with the ones that most affect health at the bottom of the pyramid and the ones that least affect health at the top.
Socioeconomic factors are at the bottom, and counseling and education are at the top.

37
Q

What are the 10 Essential Benefits that private insurance companies must provide under the ACA?

A
  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Maternity and Newborn Care
  5. Mental health and substance use disorder services, including behavioral health treatment
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services, including oral and vision care
38
Q

Medicaid

A
  • covers medical cost of low- to no- income families/individuals
    • children more likely to be covered
  • strict income requirements related to federal poverty level
39
Q

Medicare

A
  • covers adults 65+, disabled individuals who qualify for social security, and those of any age with end-stage renal disease
  • dependent on age, disability, or renal-disease; not related to income
40
Q

What populations are less likely to have health coverage from their employees?

A

Those who work for small businesses that aren’t required to provide coverage to their employees

41
Q

6 Protocol conditions that must be met for clinical research

A 
●	Social Value
●	Scientific Validity
●	Fair Subject Selection
●	Acceptable Risk-Benefit Ratio
●	Informed Consent
●	Respect for Enrolled Subjects/Participants
42
Q

4 Principles for distributing scarce resources

A

● Health Maximization: resources allocated in such a way that the total beneficial impact on health is as large as possible
● Equity: Ensure that everyone has equal chance of receiving a scarce resource or having care
● Priority to worst
● Personal Responsibility: Lower priority should be given to people whose health problems may relate to own health behaviors; people who contribute to society receive greater priority

43
Q

Benefits of teaching comprehensive sexual education in school?

A
  • delayed initiation of sex
  • reduction in the number of partners
  • more likely to use contraception
44
Q

How did the Surgeon General’s 1964 “Smoking and Health” impact smoking?

A

It impacted the prevalence of smoking for the first time as many quit smoking after learning about its effects on health.

45
Q

What are the 5 stages of the Stages of Change model?

A
  1. Pre contemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance
46
Q

4 Factors of the Health Belief Model

A
  1. How vulnerable the person feels to the threat
  2. How severe they think the threat it
  3. Perceived barriers toward reducing the risk
  4. Perceived effectiveness of working to minimize the problem
47
Q

What can be considered the fifth factor in the health belief model?

A

Self-efficacy: people are more likely to adopt healthy behavior if they are confident they have the ability to do so

48
Q

Working Poor

A

Those with an income level below the poverty line despite spending at least 27 weeks in the labor force working or looking for work

49
Q

3 likely health outcomes for high income Minnesotans

A
  1. Live longer (up to 8 yrs longer)
  2. Receive adequate prenatal care
  3. Be insured
50
Q

4 health outcomes for lower income Minnesotans

A
  1. Have fair or poor health
  2. Have an infant die in their first year of life
  3. Have diabetes
  4. Seriously consider suicide
51
Q

Importance of paid leave?

A

People are healthier!

  • less sick time
  • use less healthcare
  • kids do better in school
  • better maternal mental/physical health
  • better prenatal/post-natal care
  • more breastfeeding
  • better parent-infant bonding
  • higher quality of life for elders
52
Q

Levels of the health factor pyramid (top to bottom)

A
  1. Counseling and education
  2. Clinical interventions
  3. Protective interventions
  4. Changing the context (default = healthy)
  5. Socioeconomics

PUBH 3001 (11 decks)

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