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Public Health > EXAM 2 > Flashcards

EXAM 2 Flashcards

1
Q

what is a social determinant of health

A

condition in which people live, learn, work, play, worship that affects a wide range of health risks

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2
Q

what are the 5 domains of SDH

A
  1. economic stability
  2. education
  3. health care
  4. neighborhood
  5. social and comminity context
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3
Q

what can education be a strength of weakness for people

A

think of ward 8

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4
Q

what is important about understanding root cause

A

discover the underlying or systemic cause for something to occur

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5
Q

what are the five parts of the ecological model

A

intrapersonal –> interpersonal processes and primary groups –> instituitional factors –> community factors –> public policy

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6
Q

define racism

A

prejudice, discrimination, or antagonism by an individual, community, or institution against a person or people on the basis of their membership in a particular racial or ethnic group, typically one that is a minority or marginalized.

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7
Q

equity

A

the highest level of health possible for everyone. Healthy equity addresses differences in population health that can be traced to unequal economic and social conditions that are systemic, avoidable and inherently unjust.

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8
Q

equality

A

not taking into account differences people have in their communities

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9
Q

health disparity

A

preventable health differences between groups of people. These differences can affect how frequently a disease affects a group, how many people get sick, or how often disease causes death.

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10
Q

PRAPARE tool

A

help health center collect data needed to better understand and act on their patients SDOH
When having data, healh centers can define and document the increased complexity of their patients, transform care with integrated services and community partnerships to meet the needs of their patients, advocate for change in their communities, and demonstrate the value they bring to patients, communities, and payer.

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11
Q

two types of community diagnosis

A
  1. adverse
  2. assest
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12
Q

what is an adverse diagnosis

A

Risk of contracting tuberculosis among residents of Blake County is related to:a)Immigrants and refugees residing in the county not screening for tuberculosis

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13
Q

what is an asset diagnosis

A

Community cohesion among residents of Blake County Related to: History of racial harmony and Use of mechanisms for peaceful resolution of conflicts

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14
Q

how to we rank our diagnosis’s

A

how important is it to solve
is it a positive change for the community if solved
will it improve quality of life if solved

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15
Q

what is individual impacts

A

patient screning questions about social factors like housing and food access; use dtat to inform care and provide referrals

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16
Q

how do we move individual impacts upstream towards resolving health issues for community

A

implement laws, policies and regulation that create community conditioms supporting health for all people

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17
Q

how can we utilize technology to address social needs

A

NowPow = has a free version and a version health care providers can buy that helps link persons to services

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18
Q

Health care impact that encompasses largr groups

A

tobacco warning labels, heart disease treatment, vaccinations, seatbelt laws, education

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19
Q

health care impacts that have more of an individual effect

A

consoling, medical care, preventative medicine, healthy decisions, money

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20
Q

CDC 5 year plan includes

A

addressing the social determinants of health
changing the context
long lasting protective interventions
clinical interventions
consoling and education

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21
Q

how is the CDC going to change the context

A

school based programming to increase physical activity
school based violence prevention
safe routes to school
motorcycle injury prevention
tobacco control interventions
clean syringes

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22
Q

how is the cdc working to reduce the SDH

A

early childhood education
clean disiel bus fleets
public transportation
water flouridation

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23
Q

3 core functions of public health

A

assess
policy development
assurance

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24
Q

define community

A

the word can really refer to any group sharing something in common

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25
Q

examples of different communitys

A

black community
The arts community
Nursing community

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26
Q

what is the CHNA

A

process that uses quantitative and qualitative methods to systematically collect and analyze data to understand health within a specific community.

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27
Q

what is ideally in a CHNA

A

◦Demographics
◦Health issues and outcomes
◦Risk factors
◦Assets and resources
◦Supporting documentation

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28
Q

how do we gather data for CHNA

A

surveys
individual or group inquiry
observations

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29
Q

how can surveys be performs

A

individual interviews
web based surveys
face to face surveys
telephone surveys

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30
Q

what are the pros and cons of surveys

A

Can ask more directed questions
Questions answered
Time consuming
Transcription of notes

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31
Q

how can group inquiry be performed

A

focus groups
community forums
interviews

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32
Q

what can be nice about using group inquiry

A

Can assess body language
Responders lose anonymity
Logistical challenges

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33
Q

how can we gather observational data

A

general field notes
windshield survey
videos on phone

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34
Q

what is the purpose of CHNA

A

identify the target population
establish programs, priorities, goals
Identify organizations that may help meet the needs or provide resources ]identify additional resources and assets
ACA requirements for hospitals
Provide systematic basis for which organizational decisions are made
Create awareness of community concern or problem
Public health department accreditation requirement
Provide baseline for an evaluation
Serve as a public relations tools

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35
Q

list some things that can learn from CHNA

A

Main health concerns in the community
The main reasons for these health concerns
The strengths / assets in the community
Where we might want to intervene to create change

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36
Q

what are the 3 phases of CHNA

A
  1. assessment planning
  2. data collection and analysis
  3. program action planning
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37
Q

what is epidemiology

A

Study of the distribution and determinants of health-related states among specific populations and the application of that study to the control of health problems

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38
Q

what is the purpose of epidemiology

A
  1. discover (agent, host, environmental factor)
  2. determine (importance)
  3. identify (who is at greatest risk)
  4. evaluate (health proramming)
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39
Q

endemic means

A

the constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area.

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40
Q

example of an endemic

A

Malaria is present in Africa at all times because of the presence of infected mosquitoes.

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41
Q

epidemic means

A

refers to an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area.

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42
Q

epidemic can also be called

A

an outbreak

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43
Q

example of epidemic

A

The Ebola virus in parts of Africa is in excess of what is expected for this region.

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44
Q

pandemic means

A

refers to an epidemic that has spread over several countries or continents, usually affecting a large number of people.

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45
Q

example of a pandemic

A

HIV/AIDS is one of the worst global diseases in history.

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46
Q

rate refers to

A

number of cases occurring during a specific period; and is always dependent on the size of the population during that period.

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47
Q

how do you calculate rate

A

number of cases / population at risk

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48
Q

epidemiological investigation

A

identify problem, collect data, formulate and test hypotheses

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49
Q

passive surveillance means

A

Diseases are reported by health care providers
Simple and inexpensive
Limited by incompleteness of reporting and variability of quality

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50
Q

active surveillance means

A

Health agencies contact health providers seeking reports
Ensures more complete reporting of conditions
Used in conjunction with specific epidemiologic investigation

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51
Q

what is an experimental epidemiology study

A

the investigators can control certain factors within the study from the beginning. An example of this type is a vaccine efficacy trial that might be conducted by the National Institutes of Health

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52
Q

what is an observational epidemiology study

A

no control group!

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53
Q

what are the two types of observational epidemeology studies

A
  1. descriptive
  2. analytic
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54
Q

what does a descriptive study

A

the epidemiologist collects information that characterizes and summarizes the health event or problem. (think time, person, place)

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55
Q

what is done in an analytic study

A

the epidemiologist relies on comparisons between different groups to determine the role of different causative conditions or risk factors.

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56
Q

what components are included in descriptive epidemeology

A

time, place, person

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57
Q

time looks at (descriptive epidemiology):

A

date of onset

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58
Q

place looks at (descriptive epidemeology)

A

geographic extent of the problem

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59
Q

person looks at (descriptive epideomology)

A

age, sex, race, medical status

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60
Q

step 1 of outbreak investigation

A

establishing the existence of an outbreak

61
Q

how do establish an outbreak

A

Use data from data sources
meaning that the occurrence of cases of disease are more than expected in a given area or among a specific group of people over a particular period of time
Seeing an increase from the normal amount of cases

62
Q

step 2 of outbreak investigation includes

A

preparing for fieldwork

63
Q

how does one prepare for fieldwork

A

researching the outbreak
gathering necessary supplies and equipment, and
making travel arrangements.

64
Q

step 3 of outbreak investigation

A

verify the diagnosis

65
Q

how do we verify the diagnosis

A

labs/tests/ patient statements

66
Q

defining and identifying cases

A

step 4 of the outbreak investigation

67
Q

what is a case definetion

A

we define the case, what does it mean for something to be positive or negative

68
Q

example of a case definition

A

COVID example → case definition of what is positive or negative

69
Q

what is considered when making a case definetion

A
  1. clinical information about disease
  2. characteristics about the persons who are affected
  3. info on location and place
  4. specification of time during which the illness onset occurred
70
Q

step 5 of outbreak investigation

A

decriptive epideomology

71
Q

steps 6 through 8 of outbreak investigation involve

A

hypotheses!

72
Q

after creating a hypotheses, what is not step in outbreak investigation

A

implementing control and prevention measure + communicating all findings

73
Q

what is the epidemiological triangle includes

A
  1. Host
  2. Environment
  3. Agent
74
Q

a line list is

A

The line listing is one type of epidemiologic database, and is organized like a spreadsheet with rows and columns
Ex) think spreadsheet

75
Q

surviellence forms

A

think COVID 19 spreadsheet

76
Q

epidemic curves

A

epi curve, shows # of illnesses in an outbreak over time

77
Q

spot maps

A

use dots or other symbols to show where each case lived or was exposed

78
Q

horizontal transmission includes

A

contact
indirect

79
Q

contact transmission includes

A

direct and droplet

80
Q

direct contact example

A

skin to skin (HIV)

81
Q

droplet contact includes

A

coughing, sneezing, sweat

82
Q

indirect contact includes

A

vector, airborne, fecal oral, foodborne

83
Q

vector transmission

A

An indirect transmission process during which the pathogen is indirectly transferred from a reservoir, source or host via an animate intermediary vector to another host
ex) mosquito and malaria

84
Q

airborne transmission

A

Indirect contact infections spread when an infected person sneezes or coughs, sending infectious droplets into the air.

85
Q

fecal oral transmission

A

person touches the stool of an infected person or an object contaminated with the stool of an infected person and ingests the germs.

86
Q

foodborne transmission

A

cross contamination through food

87
Q

what is a type of vertical transmission

A

mother to baby

88
Q

an agent is

A

biologic, chemical, physical, nutritional

89
Q

an environmental factor is

A

temperature, humidity, crowding, housing, water, food, radiation, pollution

90
Q

host is

A

age, sex, race, genetic profile, previous diseases, immune status

91
Q

two examples of agent

A

For Legionnaires-the agent was the legionella bacteria
For COVID-the agent is the coronavirus

92
Q

two examples of host

A

For COVID-we know older adults and ones with co-morbidities are more susceptible. Studies are also showing that low levels of vitamin D impact susceptibility.
For Legionnaires-it was older adults, who smoked

93
Q

two examples of environment

A

For COVID-nursing homes and close quarters were a factor due to ‘host’ and environment. Many of the efforts made, especially in March, were also to address availability of services and not maxing them out (which still happened in some places like NY)
Legionnaire = convention, halfway

94
Q

environment and personal health connections

A

Living in an area were there are toxins or pollutant in the air = various cancer
Living in an area where the water source is not clean = various cancer
Living in an area where there is mold within your apartment = asthma ect
Lack of sidewalks = making the environment not accessible

95
Q

what environmental factors can impact health

A

chemical pollution
air pollution
climate change
disease-causing microbes
lack of access to health care
poor infrastructure
and poor water quality.

96
Q

how is income related to health disparities

A

poor housing
lack of food
unable to afford child care
medical cost
living in unsafe or unhealthy conditions
poorer health

97
Q

how is education related to health disparities

A

Dropping out of school leads to social and health problems
Health Risks: obesity, substance abuse, intentional and unintentional injury
Shorter life = those with education are linked to having better self advocate skills and understanding healthy living habits
Health literacy

98
Q

how is employment related to health disparities

A

income + insurence

99
Q

how is language related to health disparities

A

health literacy
Access to healthcare
poor health outcomes
experience lower quality care

100
Q

who is most effected by health disparities

A

Racial and ethnic minorities
Immigrants
Children
Elderly
Poor
Less educated
No health insurance
Rural
People who live in developing countries
LGBTQ

101
Q

health disparities in the local community references …

A

school assessment

102
Q

school assessment works by

A

tally up the questions answered true and from there have an idea of score

103
Q

medical dessert

A

Areas without access to hospitals, primary care physicians, pharmacies and other healthcare providers
Requires more than 60 minutes of travel to reach an acute care facility

104
Q

what leads to a medical dessert

A

finances
hospital closures
lack of healthcare providers

105
Q

environmental health

A

“Freedom from illness or injury related to exposure to toxic agents and other environmental conditions that are potentially detrimental to human health”

106
Q

environment and health relationship

A

→ The World Health Organization estimates that as much as 24% of global disease is caused by avoidable environmental exposures
→ The environment significantly affects more than 80% of major diseases
→ More than 33% of disease in children under the age of 5 is caused by environmental exposures (WHO, 2006)

107
Q

example of environment and health impact

A

asthma
lead poisoning
cancers

108
Q

nurse’s role in the environmental health

A

Alliance of Nurses for Healthy Environments (ANHE) and American Nurses’ Association (ANA) partnership:
Development and inclusion of an Environmental Health standard in the ANA’s Scope and Standards of Practice for nurses (2010)

109
Q

how can one get mercury

A

tuna

110
Q

pesticides

A

grass and crops

111
Q

air pollutants

A

ventillation and big cities

112
Q

lead

A

old paint, old homes

113
Q

blood lead level in children

A

no more then 5mcg

114
Q

how can we prevent certain environmental exposure

A

✨Home improvement practices that create hazards can be avoided to reduce lead exposure
✨Pesticides can be avoided – Integrated Pest Management (IPM)
✨Less toxic cleaning products can be chosen
✨Diet can be altered to reduce mercury and pesticide exposure
✨Water can be tested for solvents and treated or replaced

115
Q

what is lead

A

Lead is a highly toxic metal that poses a serious threat to health.

116
Q

what can be the effects of lead

A

Damage to brain and nervous system
slowed growth and development
learning and behavior problems
hearing and speech problems
Which can then cause …
lower IQ
decrease ability to pay attention
underperformance in school

117
Q

where is lead coming from

A

air
water
soil
lead pain
toxic treats

118
Q

nursing actions for lead toxicity

A

education!!!!
lead screening
health assessment

119
Q

what can help reduce the risk of lead poisoning

A

water filtration
nutritional interventions
person behavior
housing

120
Q

tertiary prevention of lead poisoning

A

Early education interventions ⇒ Individuals with Disabilities, Education Act (IDEA)

121
Q

what is mercury

A

Highly toxic
Bioaccumulation: Accumulates in fish

122
Q

what can happen with mercury exposure

A

🤰Prenatal exposure in low doses can be associated with: deaf, blind, language issues, retardation, memory

123
Q

nitrates

A

CAFO - concentrated animal feeding operations -> main culprit
Toxic level: over 10mg/L

124
Q

what can happen with exposure to nitrates

A

Consequences: cancer, birthd defects (blue baby syndrome), thyroid disease
Assess risk, prevent exposures through education and advocacy

125
Q

how do we reduce the risk of nitrates

A

Action steps: Seal off wells, keep wells away from runoff
** boiling well water Concentrates the nitrates = BAD

126
Q

what are the effects of pesticides

A

Effects nervous system
irritates face/eyes
Carcinogens
effects endocrine system

127
Q

what is the public health action for dealing with pesticides

A

Public health actions: Integrated Pest Managemen t(IPM)- (alternatives to pesticide use - keep pests out, dry pests out, eliminate toxins, dry them out)

128
Q

Perfluoroalkyl Substances (PFAS)

A

this chemical is found in non-stick pans, and other products
Bioaccumulates in humans, long ½ life (3-7 years), accumulatesin blood, effects fetuses, excreted in pee & breastmilk,
Educate on toxicity
widespread human exposure
efefcts organ systems

129
Q

how can we reduce th exposure to PFAS

A

Public Health Actions: REDUCE EXPOSURES->Filter water, dust control, test soil, check fish advisories
BEST STRATEGY: reduce and prevent exposure
🩸Test blood for humans who are highly exposed

130
Q

how can we improve the environment

A

two pronged approach = mitigation, adaption

131
Q

mitigation means

A

Reducing emissions of and stabilizing the levels of heat-trapping greenhouse gases in the atmosphere

132
Q

what does adaption mean

A

Adapting to the climate change already and in the future

133
Q

international collaboration and solutions that are science-based to resolve the current global environmental issues.

A

“Health and sustainability should be central to the economic response following the pandemic, which should also be designed to improve the resilience of societies to cope
Rely on EBP, collaborate, advocate
Prevention of Hazardous Exposures is Key for Healthy People

134
Q

different types of public health assessments

A

Levels (or concentrations) of hazardous substances
Whether people might be exposed to contamination and how they may come in contact with it (that is, through “exposure pathways” such as breathing, eating, or skin contact with contaminated air or soils)
What levels of a toxic substance might cause harm to people
Whether working or living near a hazardous waste site might affect people’s health
Other dangers to people, such as unsafe buildings, abandoned mine shafts, or other physical hazards.

135
Q

federally funded nonprofit health centers

A

Federally funded nonprofit health centers or clinics that serve medically underserved areas and populations.
FQHCs include community health centers, tribal health clinics, migrant health services, and health centers for the homeless. Medicaid provides higher payment rates for outpatient facilities designated as FQHCs compared to facilities not so designated.

136
Q

the nursing process includes

A

assessment
diagnosis
outcomes
plan
implement
evaluate

137
Q

why do you prioritize nursing diagnosis

A

to determine what should be done first –> usually have to long of a list of needs to do all at once

138
Q

how do you determine a goal for a community

A

overarching, think they can be long term

139
Q

how is an objective different from a goal

A

more specific then a goal, specific to what you want to get out of the goal, clear and concise, need to be determined as a yes or no (quantifiable)

140
Q

Which of the following is an example of a correctly written objective for a community
health program designed to address underage drinking among school-aged children?

A. Participants will have increased knowledge about the effect of alcohol use on adolescent brain development

B. The prevalence of underage drinking among school-aged children will decrease by 10% within five years as noted on the district’s YRBS

C. Following 3 one hour classes, 90% of 5th graders will be able to identify 3 ways in which alcohol affects the body

D. The number of adolescents verbalizing approval of social drinking among
their peers will decrease by 50%

A

C

141
Q

what should not be your only intervention

A

education (it actually has the smallest impact!), just telling someone what they should do is not going to make a good change overall

142
Q

what types of evaluation

A

outcome evaluation
impact evaluation
process evaluation

143
Q

process evaluation

A

ongoing throughout the study, can make changes throughout

144
Q

outcome evalaution

A

what occurred in the end? was it what you wanted?

145
Q

impact evaluation

A

cause and effect, positive and negative, broader then the outcomes (what were the unintended consequences)

146
Q

An outside evaluator is hired to conduct interviews
with participants of a program. Which type of
evaluation would this most address?

Outcome
Process
Impact

A

impact (outside evaluator is key)

147
Q

ecological model

A

thinking systemically –> how one thing impacts another

148
Q

upstream thinking

A

thinking about prevention and having a community impact and how we want to improve community conditions

laws policies and regualtions

149
Q

midstream

A

the indivual impact

Public Health (1 decks)

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