Lecture 6 highlights Flashcards
List the 5 domains of the social determinants of health
1) Economic stability
2) Neighborhood and built environment
3) Education access and quality
4) Social and community context
5) Healthcare access and quality
5 domains of social determents of health: What is the goal for economic stability?
Steady employment to reduce # who live in poverty
5 domains of social determents of health: What is the goal for neighborhood and built envt?
Create neighborhoods and environments that promote health and safety
5 domains of social determents of health: What is the goal for education access and quality?
Increase educational opportunities and help children and adolescents do well in school
5 domains of social determents of health: What is the goal for social and community?
Increase social and community support
5 domains of social determents of health: What is the goal for increasing health care access and quality?
Increase access to comprehensive, high-quality health care services
Differentiate between primary, secondary, and tertiary interventions
1) Primary: before onset of the disease
2) Secondary: after development of the disease, but before symptoms
3) Tertiary: after initial symptoms, but before irreversible disability
List 3 things at the intersection of bioethics and public health ethics
1) Critical rights
2) Human rights
3) Societal goals involving individual input
What aims to measure the potential impact of known hazards (inherent danger of an exposure) through the quantity, route, and timing of the exposure?
Risk assessment
Public Health Assessment includes data ______________ in a community.
on actual exposure
Public health assessment addresses not just the risks in a specific location, but also the risks to large numbers of individuals and often ____________________
to the population as a whole.
Ecological risk assessment examines the impacts of contaminants on ________________ ranging from chemicals, to radiation, to genetically altered crops
ecological systems
____________ from industry contaminated the _____________ in the 1800s and 1900s. It has been filtered by fish who absorbed it in their fat.
Mercury; Great Lakes
Recommendations for limiting fish consumption during pregnancy are a mainstay; why?
Low levels pose risks to fetuses (neurological damage)
1) What fish should pregnant pts avoid?
2) What should they limit?
1) Avoid shark, swordfish, marlin, king mackerel, and tilefish
2) Limit salmon, pollock, catfish, and canned light tuna
There are often interactions between exposures that lead to an impact much greater than the estimate. This is called what?
Multiplicative interaction
A __________ is an interacting group of items forming a unified whole that maintains its existence and functions as whole based on the interaction of its parts
system
What is basically the investigation of systems?
Systems analysis
What is systems thinking?
An approach that examines multiple influences on the development of an outcome or outcomes and attempts to bring them together in a coherent whole.
According to reductionist thinking, we are searching for the single etiology (_________) and the one-and-only answer (_________) to what should be done to improve the outcome.
cause; effect
Systems thinking utilizes data derived from ____________thinking but goes beyond that to look at _____________ that cause disease and disease outcomes
reductionist ; multiple factors
Systems diagrams begin with identifying the ___________ that will be included in the systems.
key factors
What are the 2 things each factor of a systems diagram requires?
1) Indicate the direction in which it operates
2) Indicate whether the factor operates to reinforce/increase another factor or dampen/decrease (+ or -)
What can a negative feedback loop help identify?
Bottlenecks
List the initial 2 steps of systems analysis (hint: both are from reductionist thinking)
1) Identify the most important influences
2) Indicate the relative strength of the impact [of each influence] (linear relationship = reductionist)
Instead of looking at one factor or intervention at a time (reductionist), systems thinking asks about what?
The best combination of interactions + how they can be used together
Step 4 of systems analysis: Identify the _________________ that may occur in a system by identifying the _____________ that occur in the system.
dynamic changes ;feedback loops
Give examples of positive and negative feedback loops
1) Positive: Do the higher taxes on cigarettes that have reduced the number of people smoking lead to changes over time in social attitudes, which themselves may set the stage for greater enforcement of public smoking regulations?
2) Negative/ decreasing: Raising cigarette taxes might reduce the money available to low-income individuals to pay for smoking cessation programs if these services are not paid for by health insurance
____________ feedback loops reinforce or accentuate the process; ____________ feedback loops slow down the process
Positive; negative
Step 5 of systems analysis: By studying the dynamic nature of systems over time, we can identify____________ that limit the effectiveness of systems and in step 6, leverage points that provide opportunities to greatly improve outcomes
bottlenecks
Step 6 of systems analysis: _______________ provide opportunities to greatly improve outcomes
Leverage points
(ex: addiction, IDing pregnant woman who smoke & are ready to quit)
List the 6 initial steps of systems analysis
1) Influences
2) Relative strength of impact
3) How influences or interventions interact
4) Identify dynamic changes by identifying feedback loops
5) Bottlenecks
6) Leverage points [can be bottlenecks]
Human health is dependent on animal health and the health of the ecosystem is what idea?
One Health
One Health focuses on developing a ________ thinking approach regarding the connections between human, animal, and __________ health
systems; ecosystem
