For Exam 2 Flashcards
Demographic transition =
a shift toward lower birth and death rates that often occurs as pops move from being lower-income economies toward being middle-income and then higher-income economies
Continuous Common Source Epi Curve
persons are exposed to the same source, but exposure is prolonged over a period of days, weeks, or longer. The epi curve rises gradually and might plateau
Non-compliance and non-adherence
Non-compliance: gaps that occur for unintentional reasons or factors beyond the patients control
Non-adherence: gaps that occur because of unilateral and intentional decisions to alter therapy
Gini Index
a measure of the inequality in the distribution of incomes within a particular country
0 indicating complete inequality, 1 indicating complete equality
Obstetric transition =
the shift from a high mmr to a negligible rate that occurs with socioeconomic development
Infertility
the inability to become pregnant when sexually active and not using contraception or the inability to maintain a pregnancy to a live birth
Health disparity
= health inequality = an avoidable difference in health status between population groups
uneven distribution of resources
know diff between equality and equity
Parity =
the total number of live births
Women are at least ___ as likely as men to acquire HIV from an act of heterosexual intercourse
2x
Post-exposure prophylaxis (PEP)
taking ARVs after exposure to HIV in order to reduce the likelihood of contracting in infection
Emergent priorities in sexual and reproductive health
- infertility and access to reproductive health and services
- HIV/AIDS and STIs
- Men’s reproductive health
Health Inequity
unfair and unjust differences that are not inevitable or natural but the product of human behavior
know diff between equality and equity
Attributable Risk Percent (AR%)
proportion of exposed cases averted with the elimination of the exposure
AR% = ((Ie - Io) / Ie) *100
AR% = RR-1 / RR
WHO definition of risk factors
any attribute, characteristics, or exposure of an individual that increases the likelihood of developing a disease or injury
Endometriosis
the tissue that lines the uterus is located on the ovaries or in other parts of the abdominal cavity, and it bleeds with each menstrual cycle, often cuasing pain and resulting in the formation of scar tissue and adhesions
Fertility =
the total number of births, whether the result was a stillbirth or a live birth
Most global health reports use fertility to measure pregnancies in a population
PROGRESS-Plus framework for the SDoH
P. place of residence
R. race, ethnicity, culture, language
O. occupation and employment status
G. gender and sex
R. religion
E. education
S. socioeconomic position
S. social capital
Plus. age, disability, sexual orientation, etc
Gravidity
the total number of times a woman has been pregnant, including miscarriages, abortions, stillbirths, and live births
Odds Ratio
predicts past
tends to overestimate risk
OR = 0 to infinity
OR = 1, exposure is not associated with the disease
OR >1, exposure is positively associated with the disease
OR<1, exposure is negatively associated with the disease
The further OR is from 1, the stronger the association
OR in cohort: Odds of disease in the exposed group (A/B) divided by the odds of disease in the unexposed group (C/D)
OR in case control: odds that cases were exposed to the risk (A/C) divided by the odds that the controls were exposed (B/D)
The odds ratio is similar to RR when the disease does not occur frequently among the exposed (disease is rare)
Extinction
The specific infectious agent no longer exists in nature or in the laboratory (no examples)
Global Burden of Disease Study (GBD)
the most comprehensive worldwide observational epidemiological study to date. It describes mortality and morbidity from major diseases, injuries and risk factors to health at global, national, and regional levels
Examining trends from 1990 to the present and making comparisons across populations enables understanding of the changing health challenges facing people across the world in the 21st century
(For years, those working in global health have attempted to construct a single indicator that could be used to compare how far diff countries are from the ‘state of good health’
Elimination of disease =
reduction to 0 of the incidence of a specified disease in a defined geographical area as a result of deliberate efforts; continued intervention measures are required (ex: neonatal tetanus)
Fibroids
benign tumors in the uterus that can cause heavy bleeding and pelvic pain
SDGs (sustainable development goals) vs MDGs
the MDGs prefaced the SDGs and lumped together hunger and poverty, did not focus on peace-building, did not highlight education, and focused solely on low-income countries
Relative Risk
predicts future outcomes
The probability of an individual becoming diseased is risk
compares the risk of exposed and unexposed
RR = disease risk (incidence) in exposed / disease risk (incidence) in non-exposed
we know incidence because we have temporality
RR = 0 to infinity
1 = null (incidence is the same)
>1 = positive association
<1 = negative association
(further from 1, the stronger the association)
used in cohort studies
VMMC
voluntary male medical circumcision
Income
the amount of take-home pay earned by household members in a time period
Demography =
the study of the size and composition of human populations
In vitro fertilization
a woman’s eggs are extracted from her ovaries, fertilized with sperm in a lab setting, and the resulting embryos are transferred to the uterus
Pre-exposure prophylaxis (PrEP)
taking ARVs prior to a likely exposure to HIV in order to reduce the likelihood of contracting an infection
Attributable risk (AR)
estimates the additional risk (excess) attributed to the exposure
group of interest: exposed, quantifies the risk of disease in the exposed group attributable to the exposure
can use incidence rate (IR) or cumulative incidence (CI)
Policy makers + public health practitioners use this data
= Incidence in exposed group - incidence in the non exposed group
incidence in exposed group = Incidence not due to the exposure (background incidence) + (incidence due to the exposure)
incidence in nonexposed group = incidence not due to to the exposure (background incidence)
in a 2x2 table
= A/A+B - C/C+D
AR = 0 if there is no association (Ie = Io)
if AR>0 then there is causal association
- the value indicates the number of cases of the disease among the exposed, could be attributed to the exposure
Interpreations of the AR is dependent on the assumption that a cause-effect relationship exists between exposure and disease
indicates potential for prevention, if the exposure could be limited (RR, on the other hand, is a measure of strength of the association and the possibility of a causal relationship)
AKA the risk difference (RD)
removes background risk
Social Determinants of Health Graphic
CHENEF
Hill’s Inferential Framework
- Strength: stronger associations are less easily explained away by confounding variables than weak associations
2.Consistency: similar conclusions are drawn even with diverse methods and different populations under variety of circumstances + no other likely causation
3.Specificity: the exposure is linked to a specific effect or mechanism
4.Temporality: the exposure precedes the disease in time (mandatory, but not always easy to prove)
- ex: what is the relationship between lead consumption and neurological impairment/encephalopathy?
5.Biological Gradient: increases in the exposure/dose leads to increased dose/response risk (or an inverse relationship (less probable)) (basically, dosage is impt)
6.Plausibility: appears worthy of belief
7.Experimentation: experimental evidence supports observational evidence
8.Analogy: similarities in things that are otherwise different (similar to consistency)
9.Coherence: the facts stick together to make a coherent whole, or logical, supportive set of conclusions
Propogated Source Epi curve
there is no common source, because the outbreak spreads from person to person. The graph will assume the classic epi curve shape of progressively taller peaks, each being one incubation period apart
Flattening the Curve - what does this look like?
Health Belief Model (HBM)
suggests that a person’s believ in a personal threat of an illness or disease together with a person’s belief in the effectiveness of the recommended health behavior or action will predict the likelihood the person will adopt the behavior
6 components:
1. perceived susceptibility
2. perceived severity
3. perceived benefits
4. perceived barriers
5. cue to action
6. self-efficacy
Point Source Epi Curve
persons are exposed over a brief time to the same source, such as a single meal or an event . The number of cases rises rapidly to a peak and falls gradually. The majority of cases occur within one incubation period of the disease
