Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PUBH 302 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What are social determinants of health?

A

Conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 5 domains of the social determinants of health?

A
  1. Economic stability
  2. Education access and quality
  3. Healthcare access and quality
  4. Neighborhood and built environment
  5. Social and community context
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the unethical research studies of the past?

A

Nazi doctors in the 1940s, Willowbrook State School for Children with Intellectual Disabilities on Staten Island in the 1950s, Puerto Rico Pill Trial in the 1950s, and CIA’s MK-UKTRA program in the 1950s.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What did the Nazi doctors in the 1940s do?

A

Nazi doctors conducted human experiments on prisoners in concentration camps in the 1940s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What did the Willowbrook State School for children with intellectual disabilities on State Island, NY in the 1950s do?

A

Discovery of 2 strains of hepatitis - A and B - and how they spread… developed a prototype hepatitis B vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What happened during the Puerto Rico Pill Trial in the 1950s do?

A

Women were not told that they were involved in a clinical trial or that the pill was experimental and had potentially dangerous side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What happened during the CIA’s MK-ULTRA program in the 1950s?

A

Unwitting subjects endured psychological torture ranging from electroshock to high doses of LSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What was the Tuskegee Study?

A

Involved 600 black men - 399 with syphilis, 201 who did not have the disease.
Researchers told the men they were being treated for “bad blood,” a local term used to describe several ailments, including syphilis, anemia, and fatigue.
The men did not receive proper treatment needed to cure their illness.
In exchange for taking part in the study, men received free medical exams, meals, and burial insurance.
The study lasted for 40 years instead of 6 months and was conducted without the benefit of patients’ informed consent.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What research practices did the Tuskegee Study change?

A

$10 million settlement. US government promised to give lifetime medical benefits and burial services to all living participants. The Tuskegee Health Benefit Program (THBP) was established to provide these services.
The National Research Act was signed into law in 1974.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the National Research Act?

A

Created National Commission for the Protection of Human Subjects in Biomedical and Behavioral Research.
Required researchers to get voluntary informed consent from all persons taking part in studies.
Required establishment of Institutional Review Boards (IRBs - review and decide whether studies meet ethical standards)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are ACEs?

A

Adverse childhood experiences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are types of ACEs?

A

Abuse:
- physical
- emotional
- sexual
Neglect:
- physical
- emotional
Household Dysfunction:
- mental illness
- incarcerated relative
- mother treated violently
- substance abuse
- divorce

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the impact of ACEs?

A

Toxic stress from ACEs has a direct effect on brain development, resulting in changes in:
- decision making
- learning and growth
- forming healthy relationships

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the lasting impacts of early adversity?

A

Injury: traumatic brain injury, fractures, burns.
Mental health: depression, anxiety, suicide, PTSD.
Maternal health: unintended pregnancy, pregnancy complications, fetal death.
Infectious disease: HIV, STDs.
Chronic disease: cancer, diabetes.
Risky behaviors: alcohol and drug abuse, unsafe sex.
Opportunities: education, occupation, income.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the stress response system?

A

Prolonged release of stress hormones activates SNS resulting in the release of stress hormones, such as cortisol.
When stress hormones are released in excess of normal, it has a negative impact on different areas of the brain… other organs:
- HPA axis.
- Amygdala.
- Prefrontal cortex.
- Hippocampus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What affect do ACEs have on life expectancy?

A

Life expectancy with 6+ ACEs: 60 years.
Life expectancy without ACEs: 80 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Preventing ACE strategy: strengthen economic supports to families

A

Approach:
- strengthening household financial security
- family-friendly work policies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Preventing ACE strategy: promote social norms that protect against violence and adversity.

A

Approach:
- public education campaigns; legislative approaches to reduce corporal punishment
- bystander approaches
- men and boys as allies in prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Preventing ACE strategy: ensure a strong start for children.

A

Approach:
- early childhood home visitation
- high-quality childcare
- preschool enrichment with family engagement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Preventing ACE strategy: teach skills

A

Approach:
- social-emotional learning
- safe and healthy relationship skill programs
- parenting skills and family relationship approaches

21
Q

Preventing ACE strategy: connect youth to caring adults and activities

A

Approach:
- mentoring programs
- after-school programs

22
Q

Preventing ACE strategy: intervene to lessen immediate and long-term harms

A

Approach:
- enhances primary care
- victim-centered services
- treatment to lessen the harms of ACEs
- treatment to prevent problem behavior and future involvement in violence
- family-centered treatment for substance use disorders

23
Q

Why is the health system a public health concern?

A

Poorly understood.
Complex; multiple systems.
Continuity of care issues.
Costly:
- $4.1 trillion.
- higher than any other industrialized nation
- includes the organization, financing, admin. program and services provision
- projected to reach $6.2 trillion by 2028
Geared toward treatment and lesser so prevention.

24
Q

What is the Gap?

A

Rise in chronic disease.
Uninsured/under-insured.
Misuse of ER.
Reward doing more, rather efficiency/outcomes.
Inappropriate care/tests.
Defensive medicine.
Malpractice costs.
Greater use of high cost technology, procedures.
Brand name prescription drugs.
High US costs for R&D.
Price variations/lack of transparency.
High administrative costs.
“Middlemen.”
Higher wages for providers.
Limited competition.
Profit.

25
Q

What are the economic issues?

A

We spend more money on healthcare than any other industrialized country.
Powerful part of US economy, BUT…
- we are not healthier
- many healthcare services are not affordable
- 8 - 10% non elderly population are uninsured and do not have access

26
Q

What are the characteristics of the non elderly uninsured?

A

1 or more full-time workers, family income 200 - 390%, and hispanic ethnicity.

27
Q

Reasons for being uninsured among uninsured non elderly adults?

A

Coverage not affordable, not eligible for coverage, do not need or want, signing up was too difficult or confusing, cannot find a plan that meets needs, and lost job.

28
Q

What does the nation’s health dollar go towards?

A

Investment.
Government.
Out of pocket.
Other third party payers and programs.
Health insurance.

29
Q

How are healthcare services paid for?

A

Health insurance (government insurance programs and private insurance).
Out-of-pocket.
Other (investments, third party payers).

30
Q

What is Medicaid?

A

Health insurance coverage for 1 in 5 Americans.
Assistance to 10 million Medicare beneficiaries.
> 50% long-term care financing.
Support for healthcare system and safety-net.
State capacity to address health challenges.
Benefits reflect the needs of the population it serves.

31
Q

Who does Medicaid benefit?

A

Low-income families:
- pregnant women: pre-natal care and delivery costs
- children: routine and specialized care for childhood development (immunizations, dental, vision, speech therapy)
- families: affordable coverage to prepare for the unexpected
Individuals with disabilities:
- child with autism: in-home therapy, speech/occupational therapy
- cerebral palsy: assistance to gain independence (personal care, case management and assistive technology)
- HIV/AIDS: physician services, prescription drugs
- mental illness: prescription drugs, physicians services
Elderly individuals:
- Medicare beneficiary: help paying for Medicare premiums and cost sharing
- community waiver participant: community-based care and personal care
- nursing home resident: care paid by Medicaid since Medicare does not cover institutional care

32
Q

Who does Medicare cover?

A

People who are 65+.
People under 65 with certain disabilities.
People with end-stage renal disease.

33
Q

What are the different parts of Medicare?

A

Medicare Part A (hospital insurance):
- covers inpatient hospital stays, care in a skilled nursing home facility, hospice care, and some home healthcare.
Medicare Part B (medical insurance):
- certain doctors’ services, outpatient care, medical supplies, and preventive services.
Medicare Part D (prescription drug coverage):
- pay a monthly premium for coverage.

34
Q

What is the PPACA?

A

Patient Protection and Affordable Care Act.
- benefits for women: providing insurance options, covering preventive services, and lowering costs.
- young adult coverage: coverage available to children up to age 26.
- strengthening Medicare: yearly wellness visit and many free preventive services for some seniors with Medicare.
- holding insurance companies accountable: insurers must justify any premium increase of 10% or more before the rate takes effect.

35
Q

What has happened because of ACA?

A

Medicaid eligibility used to be limited to specific low-income groups: elderly and persons with disabilities, children, and pregnant women.
- not eligible: adults and parents.
ACA Medicaid expansion would cover adults up to 138% FPL in all states.
- now eligible: parents and adults.

36
Q

What is a premium?

A

Payment an insured person makes on an insurance policy

37
Q

What is a deductible?

A

Amount the insured pays before the policy (insurance company) starts to pay

38
Q

What is a co-pay?

A

Specific amount insured pays (out-of-pocket) for healthcare services at the time the costs are incurred with the insurer paying the remaining costs; typically a fixed amount.

39
Q

What is co-insurance?

A

Same as co-pay except the amount is a %. (80/20; 60/40).

40
Q

US Healthcare System Trends: growth of high deductible health plans/HSAs

A

Among adults ages 18 - 64 with employer-based health coverage from 2007 through 2017, enrollment in HDHPs coupled with HSA grew from 4.2% to 18.9% without HSA, the percentage of adults grew from 10.6% to 24.5%

41
Q

US Healthcare System Trends: Issues

A

Cost of , access to, and quality of care.
- shifts from fee-for-service –> value/quality.
- hold providers accountable for the ultimate costs, quality, and outcomes of their services

42
Q

US Healthcare System Trends: shortage of physicians

A

aging, sick pop., and aging providers

43
Q

US Healthcare System Trends: paying to keep people out of hospitals

A

Decrease in community hospitals, length of stay, admissions.
Push to deliver home-based care, telemedicine.

44
Q

What are the opportunities for innovation?

A

Types of insurance plans - traditional, MCOs, high deductible health plan + HSAs.
- engaging employers in lowering costs.
Empower patients/consumers.
- call for increase transparency.
- shopping for care.
More than half expressed a willingness to receive care in a non-traditional setting if the care was less costly and more convenient.
Drug pricing.
More focus on social determinants of health.

45
Q

What are vertical integrators?

A

What: companies looking to control the costs of their supply chain by owning more of it.
Examples: CVS health/Aetna; Cigna.
Capabilities: ability to control more of the supply chain and reduce unit costs of goods through increased negotiating power, elimination of middlemen, more data on patients, greater ability to steer patients to lower-cost care.

46
Q

What are employer activists?

A

What: employers seeking to limit the growth of their healthcare costs.
Examples: Amazon.
Capabilities: huge pools of employees, vested interest lowering costs, technological and business prowess, and pooled negotiating power.

47
Q

What are technology invaders?

A

What: technology companies seeking to grab a greater foothold in healthcare.
Examples: Google, Apple.
Capabilities: strong knowledge of consumer behavior, knowledgeable employees and innovative culture, general trust of consumers, strong analytics and technological capabilities.

48
Q

What are health retailers?

A

What: retailers looking to gain market share by better understanding desires and behavior, and providing some types of healthcare directly.
Examples: Walmart, CVS health.
Capabilities: retail locations with existing consumer traffic and financial systems, knowledge of consumer behavior, supply chains.

PUBH 302 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions