Brainscape's Knowledge GenomeTM

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


See full index

HSOC 275 > Midterm 2 Second Half > Flashcards

Midterm 2 Second Half Flashcards

1
Q

Did the US age adjusted death rate decrease, increase or stay the same from 2014 to 2015?

A

increase

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

How much did the US age adjusted death rate increase from 2014 to 2015?

A

1.2%

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

What are the leading causes of death in the US?

A
  1. Heart Disease
  2. Cancer
  3. Chronic Respiratory Diseases
  4. Unintentional Injuries
  5. Stroke
  6. Alzheimer’s
  7. Diabetes
  8. Influenza and Pneumonia
  9. Kidney Disease
  10. Suicide

All of the age adjusted death rates for these increased from 2014-2015 except for cancer, which decreased.

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

When did mortality in middle aged white Americans increase?

A

1999-2013

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

What does an increase in mortality in middle aged white Americans indicate?

A

Evidence of growing distress.

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

Why is the US considered an outlier for the GDP/life expectancy trends?

A

It has great wealth and great healthcare spending but shorter life expectancy than peer countries

This is true for all Americans, including the wealthy

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

For what age group is the US ranked for the best (lowest) mortality rate in comparison to peer countries?

A

The elderly

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

In what areas is the US “losing years” in comparison to its peer countries?

A

Unintentional injuries- (Accidents)
Noncommunicable diseases
Cardiovascular disease
Intentional injuries- (Homicide, Suicide)
Perinatal conditions
Drug related causes
Communicable and nutritional conditions- (obesity, BMI)

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

In comparison to its peer countries the US has the _______ infant mortality rate.

A

highest

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

In comparison to its peer countries the US has the _________ number of transportation related deaths.

A

highest

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

In comparison to its peer countries the US has the _________ number of violent deaths.

A

highest

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

In comparison to its peer countries the US has the _________ prevalence of overweight young people.

A

highest

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

Is universal healthcare the setback between US and its peer countries?

A

No because studies utilizing data from before Medicare (1968) and the US had a high mortality rate then even still.

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

What are the three things healthcare decommodification is based on?

A
  1. Private expenditures on health as a % of GDP
  2. Private hospital beds as a % of total beds
  3. % of the population covered by insurance
    * decommodification = the strength of social entitlements, the process of viewing utilities as an entitlement rather than a commodity one must pay for
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Compared to its peer countries the US has ____________ general practitioners as a proportion of total doctors.

A

less

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

Why is it said that the number of general practitioners as a proportion of total doctors is an indicator of population health?

A

They play the largest role in inspiring population health and usually see patients before they have a large issue that requires a specialist

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

Why is evidence regarding quality of healthcare in the US inconclusive?

A

The idea is that quality can be measured by diseases that are hospitalized when they could’ve been cared for by family medicine (example Asthma). In the US we have more hospital admissions for asthma than our peer countries, however it may not be fair to judge the quality of our healthcare with this measure because the US could have a higher asthma burden than its peer countries.

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

Healthcare most likely plays a ________ role in shaping the US mortality rate (especially relative to peer countries)? Why?

A

Minimal.

This is because some key causes of death in the United States are minimally related to healthcare (example: Homicides and Suicides which comprise 23% of extra years of lives lost for US males). Even conditions that are treatable are influenced by behavior such as smoking or obesity

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

US outcomes with respect to myocardial infarction and ischemic stroke are _______ than the OECD average

A

better.

Serves as evidence that healthcare most likely plays a minimal role in shaping the US mortality rate

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

What is the leading contributor to global disease burden?

A

Behavior. This association becomes more prominent in countries with high income.

Behavioral causes comprise 50% of actual causes of death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

The US smokes ___________ relative to peer countries.

A

less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The US calorie intake is ___________ relative to peer countries.

A

extremely high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

List behavioral habits that contribute to the US mortality rate relative to other peer countries:

A
  • We smoke less
  • We have a high calorie diet
  • We take on much higher risk taking behavior (ie. wearing a seat belt in a car or a helmet on a motor cycle)
  • Highest rate of road traffic deaths attributable to alcohol
  • Largest percentage of civilian firearm ownership in comparison to peer countries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

List social explanations that contribute to the US mortality rate relative to other peer countries:

A
  • The US has the highest poverty rate

- The US ranks last for reading relative to peer countries, 13/17 in science, and 15/17 in math

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What do US policies and social values reflect?

A
  • Obligation to address inequality
  • Emphasis on individual freedom and personal choice
  • Self-reliance
  • Free enterprise
  • Federalism
  • Religious objections to contraception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Importance of distinctions among features of SES and among specific diseases:

A

Generality often associated with the relationship between SES and health

  • Convenience and dominance of schooling
  • Interactions between features of SES
  • Diseases amenable to care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Associations between social determinants and health are ______.

A

Gradual.

There are gradients to these associations. The same is true of GDP and mortality. Example is age standardized mortality based upon the number of years of schooling someone receives. If you have more years of schooling you tend to live longer, but this is also mediated by confounding factors such as income.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Whitehall Study

A

Sparked the psychosocial revolution.

observation of British Civil Service, select group of people to study (people who have jobs, insurance, high paying jobs). This study negated the idea that SES was the most prominent indicator of life expectancy because job stress is displayed as a factor that increases mortality. People who were higher in the organization in White Hall had higher mortality. Status and sense of control. The psychological impact of employment.

Done by Michael Marmot.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Explain the association of education differentials over time.

A

Between 1960 and 1986, educated men had a much larger decrease in mortality than uneducated men. Leads us to believe that social determinants hinder lower classes from experiencing larger improvements.

Pappas, Queen, Hadden & Fisher (1993)

Newer evidence still holds this relationship.

There are widening differentials when you look at just mortality from heart disease as well. Similar patterns are seen in England and Wales showing its not all insurance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

cumulative advantage

A

growing significance of risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

age-as-leveler

A

declining significance of risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

The disadvantaged are predicted to spend _________ years on disability.

A

More.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Sociologist’s explanation for the relationship between SES and health.

A

Fundamental causes.

According to Link and Phelan, a fundamental social cause of health inequalities has four key components:

The cause influences multiple disease outcomes
The cause affects disease outcomes through multiple risk factors.
The cause involves access to resources that can assist in avoiding health risks or to minimize the sequelae of disease once it occurs.
“The association between a fundamental cause and health is reproduced over time via the replacement of intervening mechanisms”[1]

By these criteria, SES is a fundamental cause for healthcare disparities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Economist’s explanation for the relationship between SES and health.

A

There is less incentive to preserve health.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Psychologist’s explanation for the relationship between SES and health.

A
  • Psychosocial stress/culture

- Hierarchy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Statistician’s explanations for the relationship between SES and health.

A

Selection - childhood health condition impacts adult SES
Contamination- Personal characteristics underlie both health and SES
Reverse Causation- Adult health determines adult SES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Individuals with low SES display __________ risk-taking health behavior.

A

More.

Most likely to be smoking, alcoholic, and overweight, (albeit number of alcoholic drinks is the least prevalent difference between the SES classes).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What percentage of mortality difference is there based on income?

A

9-14%

Risk taking behavior alone does not justify this number, therefore there must be other factors contributing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What disparities do hazard rate ratios point out?

A

Sex- Men 1.0, Women 0.44 (Women are less likely to die than men)
Race- Nonblack 1.0, Black 1.21 (Blacks more likely to die than nonblacks)
Residence- Rural 1.0, Suburban 1.19, Urban 1.63 (The closer you are to a city the higher the risk of mortality)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Explain the idea that health behaviors do not cluster.

A

Health behaviors are not a package deal.

Seen in the Health and Retirement Study where the correlation between health behaviors was noted and most had relatively weak correlations ie. smoking and stopping heavy drinking, or vigorous exercise and losing weight.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What percentage of the variation in health behavior is attributable to education, income, or health beliefs?

A

No more than 14%

This indicates a dominance of situational factors rather than broad relationships.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Relationship between detection of conditions and education:

A

More education increases the likelihood that disease will be detected and subsequently successfully managed.

In the past this was observed in race and SES but the most recent data only education still holds this to be true.

43
Q

What is the relationship between innovation and disparities?

A

As more innovation becomes available disparities widen even as mortality decreases overall.

Example: Income gradients and cholesterol

44
Q

Describe Relative Status and Health

A

Some argue that standing in the social order impacts health directly. Some studies show that position on the social ladder links to self-related health.

45
Q

What are three types of evidence that support the relationship between relative status and health?

A
  1. The Whitehall Study
  2. Income inequality —> Health association
  3. Primate Studies —> Higher status, better health
46
Q

Academy Award winners tend to _________ actors or actresses that never won or lost.

A

Outlive.

47
Q

What are some contingencies to the belief that higher relative status is linked to better health outcomes?

A

Contingencies impact specific individuals, either high ranking or low ranking, by increasing their stress which has a negative impact on their health outcome

  • Dominance style and means of maintaining despotic dominance
  • Style of breeding system
  • Stability
  • Availability of coping outlets for subordinates (primarily low ranking)
  • Ease with which subordinates can avoid dominant individuals
  • Availability of alternative strategies to avoid competition
  • Personality of individuals and their willingness to use resources
48
Q

Selection is ________ for longevity when we look at high status people.

A

Minimal.
The idea that winners typically outlive losers does not always hold.

Example:
Life circumstances have impact and differ from this notion:
♣ Baseball Hall of Fame: elected well after you retire
♣ Presidents: high stress and risk of assassination. Non-trivial risk of assassination allows us to say that losers might do better than winners. Stress would also impact longevity
In all three, Emmy, Baseball Hall of Fame, Presidential and Vice Presidential, the winners should do better if status actually has an impact on longevity.
♣ Hazard ratio < 1 (ex. .77) means that there’s a 23% better chance of longevity in Emmy Award Winners
♣ Hazard ratio > 1 no relation for Baseball Hall of Fame, actually a 12% increase in mortality albeit not significant
♣ Presidential election there is a hazard ratio > 1 and an 66% elevated hazard of mortality for the winner rather than the loser (goes against the assumption that status has impact)

49
Q

What does a Hazard Ratio < 1 mean?

A

That there is a better chance at longevity

50
Q

What does a Hazard Ratio > 1 mean?

A

Increased mortality, lower chance at longevity

51
Q

What are the impact of job characteristics on mental status?

A

A well balanced job acknowledges demand and control as well as effort and reward. Control at work helps to explain some of the gradient among Whitehall workers, but not all.

Control matrix places control in the workspace versus success and failure.

52
Q

Describe the control matrix for workspace stress:

A

High Control, Success- Feeling that you are responsible for your own success and self-confident in the workspace.
High Control, Failure- Feeling that you are responsible for your failure.
Low Control, Success- The really good things that happen to me are due to luck. A feeling that fate controls what is good or bad that happens to you.
Low Control, Failure- Most of my problems are due to bad breaks. I have little control over the bad things that happen to me.

53
Q

SES and psychosocial risk factors:

A

SES shapes exposure to a wide range of psychosocial and environmental risk factors for health. Risks associated with individual factors are small but add up.

Example: Marriages of well educated folks do more to promote health than the marriages of less well educated folks

54
Q

Key elements of fundamental causes:

A

–Cause affects multiple disease outcomes
–Cause operates through multiple risk factors
–Cause involves “resources” that minimize risk for onset or minimize its consequences once disease occurs
–Causal relationship persists over time, as disease conditions and risk factors change

55
Q

Evidence to support reverse causality (health —> ses):

A

Poor health is costly and the initial income losses required to get healthcare persist over time.

Poor health inhibits your ability to work.

56
Q

Evidence to support causation (ses –> health):

A

A study that took place utilized the bull market of the 1990s and compared it to the period of prosperity before it. It concluded that adult income is inconsistently related to health, but education virtually always is and childhood SES often is

57
Q

Over time the correlation between income and health status gets _________.

A

Stronger.

For children the older they get, the more their family’s SES impacts their lifelong health. There is association between childhood health status, adult SES, and adult health.

58
Q

Consequences of poverty for health in children:

A

Increased risk of asthma, diabetes, and epilepsy
Increased exposure to severe conditions

Insurance is only part of the issue. New studies are looking into maternal health literacy

59
Q

Preston Curve

A

Life expectancy versus country’s GDP. It recapitulates the patterns we’ve discussed on the individual level.

Hard to quantify the effect of macroeconomic conditions and society level factors on individual health.

60
Q

Describe the impact of discrimination on the mortality rate of a society:

A

The higher the rate of discrimination, the higher the mortality rate and the lower the life expectancy, regardless of an individual’s race.

In the US this is observed across states

61
Q

Describe the relationship between the status of women and the mortality rate of a society?

A

The higher the status of women, measured by political participation, decreases the all cause mortality of the entire society regardless of gender.

62
Q

Relationship disappears between the share of income going to the least well off 70% and life expectancy in a society when _________

A

different years are used or more countries are added to the study. Weaker evidence is seen at low levels of aggregation

63
Q

The relationship between race and health outcomes is most robust in the US, but the association often disappears when controls are taken into account. What are the controls?

A

–Education levels, % black
–Regional fixed-effects
Multilevel studies still find evidence, especially for homicide

64
Q

Caveats to the epidemiological transition

A

Deviations in pace:

  • Japan went through the stages more rapidly
  • Some developing countries are still going through the phases

Deviations from linear and unidirectional change:

  • Counter-transitions: when age specific mortality rate rises rather than falls
  • Age-specific transitions: the epidemiological transition happens along all ages, but can be more prominent among the young

Reverse transitions

65
Q

Standard of living as the causal engine

A
  • Incomes improved leading to improved diet
  • Specific medical intervention mattered little
  • The market is beneficent
66
Q

Purposeful action as the causal engine

A
  • The market is not beneficent
  • Health-focused interventions matter a great deal
  • Technology and knowledge are important
67
Q

Two causes for life expectancy to be on the rise:

A

Cause 1: Standard of living on the rise
Incomes are increasing
Market is thrivin
Medical interventions didnt matter so much because people are livin
Cause 2: Purposeful action is having impact
The market aint thrivin dont attribute shit to that it aint shit
Health focused interventions MATTER
Technology and knowledge are important
So cause 1 is like you’re rich so life is good and cause 2 is like a golden age of discovery and we’re evening out

68
Q

McKeown Thesis

A

argued that the population growth since the late eighteenth century was due to improving economic conditions, i.e. better nutrition, rather than to better hygiene, public health measures and improved medicine

Eliminating potential explanations

  1. Decline in organism virulence
  2. Immunization
  3. Urban hygiene improvements
  4. Nutritional improvements

1 and 3 definitely not. 4 there but hard to prove

69
Q

What was the decline in mortality rate in England in the late 19th century attributable to?

A

getting rid of infectious disease

70
Q

Why is CDR in Sweden greater than the CDR in Kazakhstan?

A

Sweden has an older population

71
Q

What disease supports the McKeown Thesis?

A

Tuberculosis, because no specific medical intervention triggered an improvement and improvement started well before hygiene and public health were involved.

72
Q

What disease objects the McKeown Thesis?

A

Smallpox, because medical intervention mattered a great deal in preventing its spread.

73
Q

What is one critique of the McKeown Thesis?

A

That height has a strong correlation with diet, but a weak correlation with life expectancy, so how can diet be an indicator of life expectancy?

74
Q

The Preston Curve states that an increase in life expectancy can be due to one of two components:

A

1) that arising from a movement along what economists call an aggregate ‘health production function’, relating life expectancy to real GDP
(2) that due to an upward shift in the function caused by ‘technological change’, the ability to use given resources more productively to control disease and lengthen life

75
Q

Critiques of the Preston Curve theory:

A

It’s not all due to GDP sometimes there are improvements in life expectancy that do not coincide with economic prosperity

76
Q

Urban-rural differences in life expectancy can be up to _______.

A

Ten years

77
Q

As income improves why are mortality improvements offset?

A

More people move to urban areas.

78
Q

Controlling disease requires ______________.

A

New institutions.

–Public health infrastructure
–Knowledgeable public who engage in consistent practices
–Shifting focus from external causes (e.g., God) to internal ones (e.g., how I prepare food)

79
Q

Epidemiological Transition

A

In progressing from high to low mortality, all populations experience a shift in the major causes of illness. These changes are associated with socioeconomic improvements—as total mortality declines and income rises, communicable disease mortality declines

80
Q

Pre Epidemiological Transition

A

High death rate coupled with high birth rate. Lots of infectious disease. Nutrition and reproductive health struggling.

81
Q

Post Epidemiological Transition

A

Low death rate and low birth rate. Chronic illness arises as infectious diseases subside. Degenerative and “Man-made” diseases

82
Q

What are the four transitions?

A

External injuries to infectious disease
–Larger populations, higher density, longer periods in the same location

Infectious to degenerative disease
–Reductions in crisis mortality (e.g., 1918 pandemic)
–Gradual decline in infectious disease
–Population ages

Cardiovascular to cancer
–Accelerated in the 1970s
–Factors: better preservation and less salt, anti-hypertensives, better detection

Cancer to ??
–In the 1990s some countries witnessed a decline in total cancer mortality

83
Q

Female mortality

A

Females’ risk of dying is less than that for males in the post-reproductive period at all life expectancy levels, but females have a higher probability of death during the adolescent and reproductive age intervals at low life expectancy levels.

84
Q

Are we getting healthier? What are the two theories that respond to this question?

A

Compression of morbidity (Fries)

Failure of success (Gruenberg)

85
Q

Compression of morbidity (Fries)

A

The lifespan is finite
The compression of morbidity occurs if the age at first appearance of chronic disease increases more rapidly than life expectancy.

86
Q

Model of Chronic Disease

A

Over time, conditions are prevented or postponed, even though everyone is subject to risk for disease
Some of the most important illnesses are, thus, universal

87
Q

Failure of Success (Gruenberg)

A

Medicine puts emphasis on causes of death rather than on causes of non-fatal chronic diseases.
We are living longer only to live for longer periods of time with disease and disability

88
Q

The process of population health change

A

risk factors –> disease, conditions, impairments

—-> functioning loss —> disability —> death

89
Q

When does the slowing of mortality decline?

A

The 1980s

90
Q

Why did men’s mortality improve faster than women’s mortality?

A

Smoking

91
Q

ADL

A

Activities of Daily Living

92
Q

Over time disability has _________.

A

Declined

93
Q

Relation between cardiovascular disease incidence and mortality:

A

There has been a greater decline in cardiovascular mortality than in the incidence of cardiovascular disease, which results in more persons with heart disease

94
Q

Risk factor on the rise:

A

Obesity

95
Q

Risk factors on the decline:

A

Smoking, diastolic BP, cholesterol

96
Q

Self reported health over time:

A

Self-reported health has improved, especially as fewer report poor health

97
Q

The 1970s

A

–Longer life and worsening health

–Disease and disability are linked

98
Q

The 1990s

A

–Higher disease prevalence overall, but better health

–Disease is no longer closely linked with disability

99
Q

The 2000s

A

–Growing morbidity and mortality among middle-aged (non-Hispanic) white men and women

100
Q

Juvenile mortality

A

mortality under 25

101
Q

Background mortality

A

risks of mortality that do not change with age

102
Q

Senescent mortality

A

level of mortality that increases with age, due to deterioration. Assume that a new born survives to 25 and is not subject to background mortality

103
Q

Mortality trends from 1850 to 2000

A

Over time we’ve caught up with senescent life expectancy

Life expectancy was propelled by improvements in juvenile mortality especially

104
Q

Current trends depend more on improvements in ____________.

A

senescent mortality

this is really improvement in chronic disease

HSOC 275 (2 decks)

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