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FND I - Summative III > Introduction to Public Health > Flashcards

Introduction to Public Health Flashcards

1
Q

Public Health

A

The science of preventing disease and prolonging life of all people and their communities

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2
Q

Social determinants of health (6)

A

a set of conditions and factors that can significantly impact an individual’s health and well-being.
1. economic stability (employment, expenses, debt)
2. neighborhood and physical environment (housing, transportation, zip code)
3. education (higher education, language, vocational training)
4. food (food security, access to healthy options)
5. community, safety, and social context (social integration, support system, exposure to violence/trauma)
6. healthcare system (health coverage, provider and pharmacy availability, quality of care)

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3
Q

Health Disparities

A

Differences in health that is closely linked to social and economic disadvantage
Some examples include:
- money/socioeconomic status
- water quality
- air quality which leads to high rates of asthma

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4
Q

Health Equity

A
  • a right to the highest possible standard of health, regardless of economic or social status
  • focuses on reducing and eliminating disparities in health
  • no one is denied the possibility to be healthy for belonging to a group that has historically been economically or socially disadvantaged.

You’re in a particular setting and I give you the set of tools.

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5
Q

health inequities

A

unfair health differences between groups of people within countries or between countries

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6
Q

WHO social determinant framework

social determinants that lead to inequalities

A
  1. structural determinants
  2. intermediary determinants
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7
Q

structural determinants

A

socioeconomic and political context in which a person is born into and lives in
- governance
- social and public policies
- social and cultural values that communities place on health

all impact a person’s socioeconomic position

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8
Q

socioeconomic position describes

A

a person’s place in society which can affect their exposure, vulnerability, and outcome to conditions that have an impact in their health

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9
Q

socioeconomic position is determined by a number of factors such as:

A
  • education
  • occupation
  • income
  • gender
  • race or ethnicity
  • social class

Affects the intermediary determinants

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10
Q

intermediary determinants of health

A
  • material circumstances
  • psychosocial factors
  • behaviours
  • biological
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11
Q

Health Promotion

A

process of enabling people to increase control over and to improve their health

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12
Q

Health

A

a state of physical, mental, social wellbeing

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13
Q

5 action areas for health promotion

A
  1. building healthy public policy
  2. creating supportive environments
  3. strengthening community action
  4. developing personal skills
  5. reorienting health services
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14
Q

Strategies for Health Promotion

A
  • advocate
  • mediate
  • enable
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15
Q

Examples of upstream interventions:

A
  • Policy changes: Rules for safer environments (e.g., smoking bans, healthy food policies, implementing laws and regulations in schools, corporations, and businesses)
  • Socioeconomic interventions: Programs to reduce poverty, improve education, and offer affordable housing and healthcare.
  • Health equity initiatives: Efforts to address disparities in health outcomes (e.g., income inequality, racism).
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16
Q

Downstream Interventions:

A
  • individual level
  • how can we help this individual with their disease/injury and prevent mortality?
  • focus on treating and managing immediate health problems and symptoms
  • come into play after health problems have already manifested
  • primarily target the individual or patient level
  • emphasize individual-level care and treatment for disease and injury
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17
Q

Examples of downstream interventions include:

A
  • Clinical treatments: Medical treatments for diseases (e.g., prescribing medication for high blood pressure).
  • Health screenings: Identifying health problems through tests (e.g., mammograms).
  • Health education: Providing info to promote healthier behaviors (e.g., quit smoking programs).
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18
Q

Midstream interventions

A
  • community level
    aim to prevent health issues by addressing both the physical environment and behavior.
  • Preventive (to reduce the risk of health problems before they occur)
  • Physical environment (improving access to safe recreational spaces, reducing pollution, or ensuring clean water sources to promote better health)
  • Promotes healthier behavior (regular exercise, healthy eating, and smoking cessation)

How can we improve working conditions to promote good health?

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19
Q

Stages of Prevention

A
  1. Primary
  2. Secondary
  3. Tertiary
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20
Q

Primary Prevention

A
  • how do we prevent people from getting x disease?
  • prevent development of disease or injury
  • examples: pre-exposure medication, vaccines, masks, package inserts for education purposes
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21
Q

Secondary Prevention

A
  • how can we detect early diseases and start treatment the impact of disease?
  • midstream
  • early detection and treatment reduce impact of disease to prevent long term health effects
  • disease onset
  • examples include screenings, physical exams, lab tests
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22
Q

Tertiary Prevention

A
  • what treatment options are there for x?
  • clinical treatment after the clinical diagnosis
  • minimize the impact of disease
  • examples: administer drugs, therapies that help manage the condition
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23
Q

Individual-Based Strategies for Health Improvement

A
  • targets individual health behaviors and outcomes
  • improves health at the individual level by addressing personal behaviors and healthcare needs
  • examples: health education, medical treatment, behavior change programs (e.g., smoking cessation).
  • personalized care and support tailored to individuals
  • success based on individual health outcomes
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24
Q

Population-Based Strategies for Health Improvement

A
  • targets entire populations or communities
  • improves overall community or population health by addressing common risk factors, social determinants, and environmental factors
  • examples: public health policies, community initiatives, vaccination campaigns, health equity programs
  • systemic changes, policy development, and interventions affecting a broad range of people
  • success based on population-level health outcomes and community well-being
25
Q

Social Justice

A

Fair and equitable division of resources, opportunities and privileges in society

26
Q

5 Categories of social determinants of health

A
  • economic stability
  • education access and quality
  • healthcare access and quality
  • neighborhood and built environment
  • social and community context
27
Q

Herd Immunity

A
  • Protection from Infection: the virus can’t easily spread in the population due to vaccination or prior exposure.
  • protects everyone, even those who can’t get vaccinated (e.g., allergies, weak immune systems, children).
  • The required threshold for herd immunity differs for each infectious disease.
28
Q

R0 (Basic reproduction number)

A

how many people, on average, does this single individual spread the disease to?

29
Q

R0 Assumptions (three)

A
  • Population is homogenous — factors like age, vaccination status, and behaviors that can affect disease transmission are not taken into consideration.
  • Everyone in the population is susceptible (e.g., start of the pandemic)
  • No widespread immunity yet
30
Q

R0 is affected by (3 factors)

A
  • how many people are susceptible to the disease initially
  • how crowded/dense the population is
  • how infectious is the agent
  • how fast does the infectious agent disappear
31
Q

If R0 < 1

A

slow spread, will eventually disappear

32
Q

8 reasons why immunization rates are important

A
  1. Disease Prevention
  2. Reduction of Disease Burden
  3. Protection of Vulnerable Populations
  4. Eradication and Control
  5. Cost Savings
  6. Public Health Preparedness
  7. Global Health
  8. Long-Term Health and Well-Being
33
Q

Re (Effective reproduction number)

A

The number of people in a population that can be infected by an individual at a given time
- Goal: Re < 1

34
Q

Re changes with time due to (3)

A
  • Increasing immunity in the population
  • Rate of death
  • The pathogen itself (e.g., alpha vs. delta vs. omicron)
35
Q

Re is affected by: (2)

A
  • Number of people infected
  • Number of susceptible people in contact with infected people
36
Q

Why is Re important?

A
  • If Re > 1, spread increases exponentially, faster spread, cases go up
  • If Re < 1, spread slows down, cases decline
37
Q

Relationship between R0, Re, and immunity

A

When R0 goes up, in order to keep Re less than or equal to 1, the number of people in the population that need to be immune, will go up.

38
Q

Hybrid immunity

A

also known as mixed immunity, refers to a state in which an individual is protected against a particular infectious disease through a combination of both natural infection and vaccination.

39
Q

The concept of the Chicken Pox Party

A

a practice where individuals intentionally expose themselves or their children to the chickenpox virus in an attempt to build natural immunity, but it is not a recommended or safe method for achieving herd immunity.

40
Q

What does it mean when R0 is high?

A
  • an infectious disease has the potential to spread rapidly and widely within a population
  • this leads to epidemics or outbreaks because they can infect a significant portion of the population before effective control measures are implemented
41
Q

If R0 > 1

A

infection will spread

42
Q

How can we change these determinants?

A
  • identifying the structural and intermediary determinants of health and taking appropriate actions to improve them
  • needs actions in all sectors and levels including local, national, and international
43
Q

Factors that bridge the structural and intermediary determinants

A
  1. social cohesion
  2. social capital
44
Q

Racial Inequity

A

The unfair and unequal distribution of resources along racial lines

45
Q

Equality

A

Giving the same assistance to all

46
Q

Upstream Interventions

A
  • societal level
  • what policies and programs can we implement to improve public health?
  • what’s going on in society, how can we create specific policies?
  • focus on addressing root causes
  • aim to prevent health issues before they occur or at an early stage
  • often involve changes at the societal, community, or policy level
  • focuses systemic and structural changes to improve overall population health
47
Q

Population-based approach

A

Focuses on societes as a whole rather than individuals

Informs educators, policymakers, community leaders who play a crucial role in improving the health of the community

48
Q

Re assumptions

A

population has mixed susceptibility and immunity

49
Q

For a disease to stop/disappear

R0, Re?

A

R0 < 0
Re < 1

50
Q

How do vaccinations decrease R0 and Re?

A

immunity

50
Q

With a larger R0, more of the population needs

A

immunity via vaccines or exposure in order to reach herd immunity and for cases to decline (Re < 1)

51
Q

What is the significance of the Re for Omicron compared to Delta? What does this mean with respect to the herd immunity threshold and the number of people getting infected?

A

The Re for Omicron is almost three times higher for Omicron compared to Delta. An Increased Re implies the virus is much more transmissible and the immune population has dropped below the vaccine threshold. Because of this, the number of people getting infected will go up (e.g., a surge).

52
Q

Suggest two upstream strategies to lower the Re for Omicron

A

In order to lower the Re for Omicron, you want to stop the chain of transmission. In order to do so, upstream strategies could include mandatory vaccinations, masking campaigns, and lockdowns, basically any policy-driven prevention strategy.

53
Q

List two social determinants of health that could potentially lead to increased childhood obesity compared to an affluent neighborhood in Palo Alto

A

Lack of playgrounds, lack of grocery stores selling fresh food, lack of transportation to stores that sell fresh food, crowding, SES, etc.

54
Q

Describe two specific interventions to decrease this health disparity and increase health equity

A

Providing access to those who need it, in a way that fits their specific needs. Examples include health promotion materials in different languages, bringing farmer’s markets to the neighborhood, community outreach programs to those who are isolated, increasing safe transportation to those who need it, etc.

55
Q

A San Francisco City Supervisor proposes a plan to give each family in San Francisco a $50 voucher to buy fresh fruits and vegetables as a mechanism to promote healthy eating. The $50 vouchers will be equally distributed to all districts in San Francisco. Do you think this will be effective in eliminating health inequities and promote health disparities? Why or why not? Provide two reasons to support your answer.

A

This is not likely to eliminate health inequities, but it may have some minimal benefit. Providing everyone with the same benefit (e.g., giving everyone $50) treats everyone equally without regards to individual needs (equity). Families have different needs (different number of kids, income, etc). This approach also does not factor in social determinants of health such as the neighborhoods they live in. Some neighborhoods do not have grocery stores that sell fresh vegetables and residents may not have resources to travel to another neighborhood.

56
Q

You are the pharmacist at the California Poison Control Center. A concerned mother calls to ask for advice. Her two-year-old son bit through a glow stick on Halloween and ate the fluorescent liquid. You advise the parent on treatment.

Is this an upstream, midstream, or downstream intervention, and why?

A

Downstream intervention because it is clinical treatment for the ingestion of the glow stick (which is actually harmless).

57
Q

You accompany your 74-year old grandfather to his checkup. As part of his routine health maintenance, his doctor recommends a bone density test to see if he has osteoporosis and is at an increased risk of breaking a bone. This is an example of what type of prevention:

A. Primary
B. Secondary
C. Tertiary

A

a) Primary prevention is incorrect since primary prevention is used to prevent the onset of osteoporosis/osteopenia.

b) Secondary prevention is correct since the bone density test is for early detection and treatment of his osteoporosis in the hopes of preventing bone fractures.

c) Tertiary prevention is incorrect since that would be treatment of low bone density (osteopenia or osteoporosis).

FND I - Summative III (5 decks)

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