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Community Health AF > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Organization of US public health agencies (3)

A

Federal, state, local

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2
Q

What do federal public health agencies focus on (broadly)?

A

Focus on the activity of the DHHS

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3
Q

DHHS administers a variety of agencies and programs; name the main 4.

A
  • Financial assistance to the needy
  • Conducting medical and scientific research
  • Providing health care and advocacy services
  • Enforcing laws and regulations r/t human services
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4
Q

What is the largest health insurance provider in the US, covering 1/4 of the population?

A

Medicare

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5
Q

Who qualifies for Medicare?

A
  • Over 65 and receiving social security
  • Disability benefits for 2 years
  • ALS and on disability
  • Kidney failure and on maintenance dialysis or kidney transplant
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6
Q

How many parts does Medicare have?

A

4: A, B, C, and D

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7
Q

Name the parts of Medicare:

A

Part A : Hospital care, home care, hospice, limited skilled nursing care
Part B : Health care provider services, outpatient care, home health, diagnostic services, PT, DME, ambulance services, MH, preventative services
Part C : (Medicare advantage plan) combines A and B through a private insurance company
Part D : Prescription medication coverage

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8
Q

Part A, B, C, or D Medicare: Health care provider services, outpatient care, home health, diagnostic services, PT, DME, ambulance services, MH, preventative services

A

Part B

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9
Q

Part A, B, C, or D Medicare: Prescription medication coverage

A

Part D

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10
Q

Part A, B, C, or D Medicare: Hospital care, home care, hospice, limited skilled nursing care

A

Part A

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11
Q

Part A, B, C, or D Medicare: Medicare advantage plan. Combines A and B through a private insurance company

A

Part C

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12
Q

Who qualifies for MediCAID?

A
  • Low socioeconomic status - based on household size and income
  • Priority for children, pregnant women and disabled individuals
  • Undocumented pregnant women → covers birth only
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13
Q

What does Medicaid cover?

A
  • Full medicaid covers inpatient and outpatient care, home health, vaccines, preventive care, skilled nursing care (one of the main sources for long term nursing care
  • Sometimes specific for family planning and pregnancy related care
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14
Q

What is Medicaid expansion?

A

You can qualify for medicaid based on income, household size, disability, family status, and other factors → eligibility is different b/t states

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15
Q

How do you qualify for Medicaid expansion?

A

Qualify based on income alone, usually if below 138% of the federal poverty level

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16
Q

What is the primary duty of state public health agencies?

A

Preserving health → health regulations and laws are almost always state based

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17
Q

Many states delegate the primary duty to preserving health to __________?

A

Subordinate gov agencies - health boards that are created by legislative acts

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18
Q

What are the primary responsibilities of the state in preserving health?

A

Primary responsibilities → 6 obligations of public health

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19
Q

Wait, what are the 6 obligations of public health again?

A
  1. Assure an adequate local public health infrastructure
  2. Promote healthy communities and healthy behavior
  3. Prevent the spread of communicable diseases
  4. Protect against environmental health hazards
  5. Prepare and respond to emergencies
  6. Assure health services
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20
Q

What is the primary duty of state public health agencies?

A

Those 6 heckin’ obligations of public health

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21
Q

Re: Local public health. Who appoints the board of health?

A

County commissioners

*A county commission is a group of elected officials collectively charged with administering the county government in some states of the United States; such commissions usually comprising three to five members.

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22
Q

What other roles are there within local public heath (3)?

A
  • Director of public health dept
  • Medical director
  • Division directors
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23
Q

What were the goals of Health Care Reform (Affordable Care Act)?

A
  • Improve quality and lower healthcare cost
  • Access to health care
  • New consumer protections

(Coverage, cost, care)

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24
Q

What is the intervention wheel? Name 6 things it does.

A
  • A conceptual framework based on theory, core functions of PHN
  1. Provides a common language
  2. Population-focused
  3. Priorities identified via assessment
  4. Considers the determinants of health
  5. Contributes to improving population health
  6. Emphasizes prevention
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25
Q

What are the 3 components of the intervention wheel ?

A
  1. Population basis
  2. Levels of practice
  3. Public health interventions
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26
Q

All levels of the intervention wheel are _________-based.

A

Population

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27
Q

What are the 3 levels of practice on the intervention wheel?

A
  1. Systems level
  2. Community level
  3. Individual level
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28
Q

Re: The intervention wheel. What level changes norms, attitudes, awareness, and behaviors?

A

Community level

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29
Q

Re: The intervention wheel. What level changes organizations, policies, laws, and power structure?

A

Systems level

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30
Q

Re: The intervention wheel. What level changes knowledge, attitudes, beliefs, practices, and behaviors ?

A

Individual level

  • Members of identified population
  • Contributes to improving overall health of population
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31
Q

Re: The intervention wheel. What is red?

A

Case finding: only at individual level.

32
Q

Re: The intervention wheel. What is going on in orange?

A
  • Building does NOT occur at individual level
  • Often carried out at system and community levels
    ex: influenza + vaccine info clinic from case study: health teaching
33
Q

Name 4 data collection methods:

A
  1. Informant interviews
  2. Focus groups
  3. Community forum
  4. Participant observation
34
Q

3 things to do in a community assessment

A
  1. Identify boundaries
  2. Gather data + generate any additional needed information
  3. Follow nursing process
35
Q

What is ADPIE?

A 
Assessment
Diagnosis (analysis)  
Planning
Implementation
Evaluation
36
Q

Name 4 data collection methods

A
  • Key informant interviews
  • Windshield surveys
  • Surveys
  • Secondary analysis
37
Q

What is a windshield survey?

A

Driving around and collecting information

38
Q

What is secondary analysis?

A

Health statistics; previously gathered data (from DHHS); information already developed and we’re using it

39
Q

What are SMART goals?

A

Specific, measurable, attainable, reasonable, time frame

40
Q

What do you need to do to before implementing a project?

A

Assess readiness (organizational + community) to make sure you’re implementing a plan everyone wants to be a part of

41
Q

Why does the PHN need to be aware of environmental health risks?

A

To know what things are affecting the health of the community

42
Q

4 examples of environmental health risks:

A

Tobacco smoke, radon, asbestos, air quality

43
Q

What is radon?

A

Gas in the basement (broken down in rocks → seeps through cracks in lower area of home)

44
Q

Where is mercury coming from?

A

Coal-burning plants + eating fish in close proximity to these plants → risk for pregnant people + fetus

45
Q

What is a VOC?

A

Volatile organic chemicals: odorless chemicals, paint, furniture.

46
Q

S+S of VOC exposure?

A

CNS issues; eye, nose, and throat irritation; kidney + liver damage

47
Q

What are the biggest current threats in environmental health (5)?

A
  • Lead
  • Air pollution
  • Mercury
  • Landfills
  • Climate change
48
Q

What are the main environmental health risks during emergencies (3)?

A
  • Radiation
  • Disease outbreaks
  • Poisoning
49
Q

Name this mineral: Causes poor indoor air quality, cancer causing agent.

50
Q

What is the field of science that studies how the env influences human health and disease?

A

Environmental health

51
Q

How to assess for exposure risk in patients (there is a mnemonic!)?

A 
(I PREPARE)
Investigate
Present work
Residence
Environmental concern
Past work 
Activities referral 
Resources 
Educate
52
Q

Exposure assessment (history) should (3):

A
  • Identify current & past exposure (can occur in any setting; determine if in air, water, food, soil or combination)
  • Short-term goal of reducing or eliminating exposures
  • Long-term goal of reducing adverse effects
53
Q

3 reasons to do an exposure history:

A
  1. Identify current or past exposure
  2. Reduce or eliminate current exposures
  3. Reduce adverse SE
54
Q

Name some social changes we are dealing with as challenges to public health (6).

A
  • Aging of the baby boomers - inc need for home health care
  • Changes in the role of women - more nurses and go beyond this into leadership
  • Health disparities - inc number of poor minorities and uninsured
  • Globalization - spread of disease, migration of nurses and other health care professionals
  • Opioid epidemic
  • Racism
55
Q

Name some political changes we are dealing with as challenges to public health (6).

A
  • PH - core function- policy development
  • Health care reform
  • Affordable care act
  • Immigration and the policy of separating children from their parents
  • Climate change
  • Call for defunding the police
56
Q

Name some economic changes we are dealing with as challenges to public health (4).

A
  • Inc cost of hospital care → lead to capitation (set amount of health care coverage no matter how many visits)
  • Health care has become a major business industry
  • Move towards integrated systems, capitation and more focus on health maintenance
  • Future focus needs to be on community oriented prevention and promotion → primary and secondary care
57
Q

Name some cultural changes we are dealing with as challenges to public health.

A
  • Growing diversity in the american population

* Underrepresentation of minorities as nurses

58
Q

What is a patient-professional partnership that can be used to arrange a continuum of care for rural patients, tailoring and blending formal and informal resources.
Allows patients to participate in their plan of care.

A

Case manager

59
Q

What are some essential skills for case managers (1,000,000)?

A
  • Advocacy
  • Process of advocacy
  • Skill development
  • Systematic problem solving
  • Illuminating values
  • Generating alternatives
  • Impact of advocacy
  • Allocation
  • Conflict management skills
  • Prenegotiation
  • Negotiation
  • Aftermath
  • Collaboration
60
Q

What is a collaborative conversation to strengthen a person’s own motivation for and commitment to change?

A

Motivational interviewing

61
Q

What are the three key elements on which motivational interviewing (MI) is based?

A
  1. Collaboration between the professional and client
  2. Evoking or drawing out the client’s ideas about change
  3. Emphasizing the autonomy of the client
62
Q

What are the 4 principles of MI?

A
  1. Express empathy
  2. Support self efficacy
  3. Roll with resistance
  4. Develop discrepancy
63
Q

What are 3 essential skills in Case Management?

A
  1. Advocacy
  2. Conflict management
  3. Collaboration
64
Q

Steps in the educational process (5):

A
  • Identify educational needs
  • Establish educational goals and objectives
  • Select appropriate educational methods
  • Implement the educational plan
  • Evaluate the educational process
  • ——-> Educator evaluation
  • ——–> Process evaluation
65
Q

What is the Differential Vulnerability Hypothesis?

A

Population groups who are particularly sensitive to risk factors and who possess multiple, cumulative risk factors

ie “Who is fucked the most”

66
Q

What are health disparities?

A

Wide variations in health services and health status between population groups due to:

  • —-> Age
  • —-> Gender
  • —-> Race or ethnicity
  • —-> Income and Education
  • —-> Geographic location
  • —-> Sexual Orientation
67
Q

What are vulnerable populations?

A

Subgroups with greater risk for health problems & poor health outcomes due to:

  • —-> Lower quality care & poorer outcome
  • —-> Patient-level factors
  • —-> Provider-level factors
  • —-> Health systems-level factors
68
Q

Name some issues vulnerable populations are facing?

A
  • Poverty and homelessness
  • Migrant employment, immigrant, and refugee status
  • Substance use disorders
  • Mental health issues/illnesses
  • Violence
  • Disability
  • Veteran status
  • Rural residency
  • Pregnancy in adolescence
  • Incarceration
  • Risk of communicable diseases
69
Q

Name 6 types of poverty.

A
  1. Crisis
  2. Administrative
  3. Persistent/chronic
  4. Absolute
  5. Relative
  6. Neighborhood

Al “CAPARN” will put you into poverty

70
Q

What are the main health risks for farmer/ranchers?

A

Environmental hazards and pesticides

71
Q

What are the main health risks for Native Americans?

A

Diabetes, substance abuse, domestic violence

72
Q

What are the main health risks for African Americans?

A

Diabetes, hypertension, infectious disease

73
Q

What are the main health risks for migrant farmworkers?

A

Pesticides, infectious diseases

74
Q

What are the main health risks for Native Alaskans?

A

Infectious diseases, depression, dental caries

75
Q

What are the main health risks for coal miners?

A

Depression/substance abuse, work-related accidents and trauma

76
Q

Name some common health problems/issues for migrant workers?

A
  • Access to health care—Migrant Health Act of 1962
  • Factors limiting adequate health care services
  • Lack of knowledge
  • Inability to afford care
  • Availability of services
  • Transportation
  • Hours of service
  • Mobility and tracking
  • Discrimination
  • Documentation
  • Language
  • Cultural aspects of health care

Community Health AF (2 decks)

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