Midterm

Question 1

Public Heath

What are the 4 components of public health?

lecture 1 / ch.1

Answer 1

• health issues
• population
• society shared health concerns
• society’s vulnerable groups

Question 2

Population Health Approach

What is the high risk approach to addressing public health problems?

lecture 1 / ch.1

Answer 2

focuses on: those with the highest probability of developing disease

aims to: bring their risk close to the levels experienced by the rest of the population

health of the vulnerable populations

Question 3

Population Health Approach

What is the improving-the-average approach?

lecture 1 / ch.1

Answer 3

focuses on: the entire population

aims to: reduce the risk for everyone

society wide health concerns

Question 4

Health Risks

How far do health risks extend throughout an individual’s life?

lecture 1 / ch.1

Answer 4

from prenatal to postmortem

Question 5

Health Risks

What is the single most important factor influencing the casues of death and disability?

lecture 1 / ch.1

Answer 5

age!

Question 6

Public Health Strategies

What are the strategies used to protect and promote health?

lecture 1 / ch.1

Answer 6

• health care
• traditional public health
• social interventions

Question 7

Public Health Strategies: Health Care

What are the characteristics of health care?

lecture 1 / ch.1

Answer 7

systems for delivering one-on-one individual health services, including those aimed at prevention, cure, palliation, and rehabilitation

Question 8

Public Health Strategies: Traditional Public Health

What are the characteristics of traditional public health?

lecture 1 / ch.1

Answer 8

group and community based interventions directed at health promotion and disease prevention

Question 9

Public Health Strategies: Social Interventions

What are the characteristics of social interventions?

lecture 1 / ch.1

Answer 9

interventions with another non-health-related purpose, which have secondary impacts on health

Question 10

What are contributory causes?

lecture 1 / ch.1

Answer 10

immediate causes of disease

Question 11

What are determinants?

lecture 1 / ch.1

Answer 11

underlying factors that ultimately bring about disease

• causes of causes

Question 12

Determinants

What are the social determinants of health?

lecture 1 / ch.1

Answer 12

behavior
infection
genetics
geography
environment
medical care
socioeconomic-cultural

BIG GEMS

Question 13

Determinants: Behavior

Define behavior

lecture 1 / ch.1

Answer 13

lifestyle choices and/or habits of individuals

Question 14

Determinants: Infection

Define infection

lecture 1 / ch.1

Answer 14

disease, contamination, exposure, etc.

Question 15

Determinants: Genetics

Define genetics

lecture 1 / ch.1

Answer 15

heriditary basis

Question 16

Determinants: Geography

Define geography

lecture 1 / ch.1

Answer 16

area/location
- “the where:

Question 17

Determinants: Environment

Define environment

lecture 1 / ch.1

Answer 17

built environment, toxins, exposure, pollution, etc.

Question 18

Determinants: Medical Care

Define medical

lecture 1 / ch.1

Answer 18

access to & quality of care

Question 19

Determinants: Socioeconomic-cultural

Define socioeconomic-culture

lecture 1 / ch.1

Answer 19

education, occupation, income, culture, and religion

Question 20

Evidence Based Public Health

What is the PERIE process?

lecture 2 / ch.2

Answer 20

• problem: what is the health problem?
• etiology: what is/are the contributory cause(s)?
• reccomendations: what works to reduce the health impacts?
• implementation: how can we get the job done?
• evaluation: how well does/do the intervention(s) work in the practice?

make up the evidence-based public health approach

Question 21

Evidence Based Public Health

How can we describe a health problem?

lecture 2 / ch.2

Answer 21

• burden of disease:
  the occurrence of disability (morbidity) and death (mortality) due to a disease –> look at incidence + prevalence
• course of disease:
  how often the disease occurs, how likely it is to be present currently, and what happens once it occurs
• distribution of disease:
  who? when? where?

Question 22

Distribution of Disease

How can understanding the distribution of disease help us generate ideas or hypotheses about the cause of disease?

lecture 2 / ch.2

Answer 22

• assists epidemiologists in finding group associations or also known as patterns in the frequency of a disease
• to get a greater understanding, examine: person, place, and time

Question 23

Group Association

What do group associations do?

lecture 2 / ch.2

Answer 23

may suggest ideas or hypotheses about the cause, or etiology, of a disease without having information on specific individuals within the group by investigating factors: place and person

Question 24

Group Association

What are some downsides to group association?

Answer 24

• existence of group association does not ensure that a cause-and-efect relationship exists
• can be misleading if they suggest relationships that do not exist at the individual level

Question 25

# Group Associations What happens when the factors, person and place, occur more frequently? ## Footnote lecture 2 / ch.2

Answer 25

when the factors occur more frequently among groups with disease **than** among groups *without* the disease we call them: ***risk indicators / risk markers***

Question 26

# Etiology How is etiology established? ## Footnote lecture 2 / ch.2

Answer 26

going beyond group association and focusing on associations at the individual level

Question 27

# Etiology What are the 3 requirements for establishing etiology? ## Footnote lecture 2 / ch.2

Answer 27

1. **Individual Association:** The cause and effect occur together more often than by chance. *(Example: Smokers are more likely to develop lung cancer than non-smokers.)* 2. **"Cause" Precedes "Effect":** The cause happens before the effect in time. *(Example: Smoking occurs before lung cancer develops.)* 3. **Altering the "Cause" Alters the "Effect":** Reducing or removing the cause leads to a change in the effect. *(Example: Decreasing smoking reduces lung cancer rates.)*

Question 28

# Etiology What studies are used for each requirement? ## Footnote lecture 2 / ch.2

Answer 28

individual association = case-control cause precedes effect = cohort altering the cause alters the effect = randomized controlled trials

Question 29

# Etiology What does contributory cause imply? ## Footnote lecture 2 / ch.2

Answer 29

- "cause" increase the chances that the "effect" will develop - its **presence** *does not guarantee* that the **disease will develop** (does not establish sufficient cause) - its **absence** *does not guarantee* that the **disease will not develop** (does not establish necessary cause)

Question 30

# Recommendations Define recommendations ## Footnote lecture 2 / ch.2

Answer 30

summaries of the evidence about which interventions work to improve health outcomes ***they indicate whether action should be taken*** - benefits - harms - costs

Question 31

# Implementation Define implementation ## Footnote lecture 2 / ch.2

Answer 31

interventions; acting on the strong recommendations **- use the "When-Who-How" approach:** deciding when, who, and how to intervene depends in large part upon the available options, the evidence that they work, and our attitudes toward different types of interventions

Question 32

# Implementation - Intervention What are the levels of intervention? ## Footnote lecture 2 / ch.2

Answer 32

- **primary**: take place before the onset of the disease - **secondary**: occur after the development of a disease or risk factory but *before symptoms appear* - **tertiary**: occur after the initial occurrence of symptoms but *before irreversible disability*

Question 33

# Evaluation Define evaluation ## Footnote lecture 2 /ch.2

Answer 33

evaluating whether an intervention or combination of intterventions has been successful in reducing the problem - how much of the problem has been eliminated - how much of the problem remain

Question 34

# Evaluation What framework can you use to evaluate factors? ## Footnote lecture 2 / ch.2

Answer 34

**RE-AIM** *how well does the intervention work in practice?* - Reach - Effectiveness *how well is the intervention accepted in practice?* - adoption - implementation - maintenance

Question 35

# Sources of Public Health Surveillance What are vital statistics? ## Footnote lecture 3 / ch.3

Answer 35

birth, death, fetal death after 20 weeks, marriage, and divorce

Question 36

# Vital Statistics What are the uses of vital statistics? ## Footnote lecture 3 / ch.3

Answer 36

births and deaths are key to defining leading causes of disease

Question 37

# Public Health Measurements What is HALE? ## Footnote lecture 3 / ch.3

Answer 37

**health adjusted life expectancy** - summarizes the health of populations; quality of health

Question 38

# Public Health Measurements What is DALY? ## Footnote lecture 3 / ch.3

Answer 38

**disability adjusted life year** - used for and allows for comparisons and changes based on categories of diseases and conditions

Question 39

# Health of Population What public health information is widely used to determine how healthy we are as a country / population? ## Footnote lecture 3 / ch.3

Answer 39

- infant mortality rate - life expectancy

Question 40

# Public Health Information How do we determine the quality of health information on the internet? ## Footnote lecture 3 / ch.3

Answer 40

by considering the following: - authors - information - relevance - timeliness - links (internal links) - privacy

Question 41

# Healthcare Decisions What are the 3 approaches to make healthcare decisions? ## Footnote lecture 3 / ch.3

Answer 41

- **inform of decision** - **informed consent** - **shared decision making**

Question 42

# Healthcare Decisions Inform of decision | define ## Footnote lecture 3 / ch.3

Answer 42

clinician has all the essential information and can make decisions that are in the patient's best interest

Question 43

# Healthcare Decisions Informed consent | define ## Footnote lecture 3 / ch.3

Answer 43

clinician provides a recommendation and patient needs to be given adequate information and give their permission before intervention

Question 44

# Healthcare Decisions Shared decision making | define ## Footnote lecture 3 / ch.3

Answer 44

clinician provides information or resources to the patient, with which he or she can make a decision