midterm / final Flashcards
what is public health?
- science of protecting and improving the health of people and communities
- promoting healthy lifestyles, researching disease and injury prevention, detecting, preventing and responding to infectious diseases
- concerned with protecting the health of the entire population
what are the goals of public health?
- prevention and intervention
- primary prevention: prevents an illness or injury from occurring and minimising exposure to risk factors
- secondary prevention: minimise the severity of the illness or damage once the event has occurred
- tertiary prevention: minimise disability by providing medical care and rehab processes
Who were the Sanitarians? Give an example
- public health specialists who identified risks and enforce environmental regulations, health and safety
- eg. Sir Edwin Chadwick?
Who were the bacteriologists - give an example?
- specialised scientist who studies microorganisms and bacteria
Who were the miasmists
- Edwin Chadwick
- Henry Whitehead
- William Farr
assessment
a process to learn about a patients condition
assurance
ensuring the findings gathered through assessment are effectively implemented
economic impact
measuring the burden of disease and illness on financial states
social justice
suggests the minimal levels of income, basic housing, employment, education and health care should be seen as fundamental rights
PERIE
- problem
- identify risks
- design programs
- implementation
- monitor
etiology
how the disease is transmitted
quarantine
a place of isolation in which people that may have been exposed to a disease or illness
immunisation
the action of making a person resistant to a particular infectious disease or pathogen typically through a vaccine
index case
the first person in a group of related cases of a particular communicable or heritable diseases
host
individuals who are exposed to and harbour the disease
reservoir
the habitat in which the agent normally lives, grows and multiplies
susceptibles
a person who is easily affected by a disease
acute infections
- symptoms occur very rapidly after infection occurs
- once recovered, resistance may arise
chronic infections
- responds to agent immunologically but virus doesn’t clear entirely
- chronic infections require fewer susceptibles than acute infections and can be maintained in smaller populations
- eg. HIV/ AIDS
disease transmission
transmission occurs when a person with an infectious disease touches or exchanges bodily fluids with someone else
chain of infection
- susceptible host
- infectious agent
- reservoir
- portal of exit
- mode of transmission
- portal of entry
health disparities and their consequence for disease prevention
- Socioeconomic status, race, religion, access to healthcare, where you live, health literacy
- consequences: increased disease, lack of treatment, low or no vaccinations
market justice
emphasises individual responsibility, minimal obligation to the common good, and the “fundamental freedom to all individuals to be left alone”
individual freedom
freedom of the person in going and coming, equality before the courts, security of private property, freedom of opinion and its expression, and freedom of conscience subject to the rights of others and of the public compare personal liberty
marginal populations
populations which has systematically experienced greater obstacles to health based on their racial or ethnic group, religion, SES etc
tragedy of the commons
the overuse of a shared resource, such as fish or timber stock, or population of a shared resource, such as the air or water, because each individual cares more about his or her own interests than the interests of the population as a whole
chain of evidence
a process and record that shows who obtained the evidence; where and when the evidence was obtained; who secured the evidence; and who has control or possession of the evidence
what is a communicable disease?
- illnesses that are causes by viruses/bacteria that spread through contaminated surfaces/bodily fluids etc
disease
particular abnormal condition that adversely affects the structure or function of all or part of an organism and is not immediately due to any external injury
illness
subjective term relating to an individuals experience of mental or physical sensations or states
what is an epidemic?
spread of an infectious agent reflecting in one place among the people rapidly
pathogen
any organism that causes disease
types of studies required to provide different levels of evidence to support the chain of evidence
- etiology
- causation vs correlation / group association
- cause and effect
- qualitative field research
strategies to reduce the impact of an infectious/ communicable disease?
- quarantine
AIDS characteristics
- virus that attacks cells that help the body fight infection
- weakened immune system
AIDS mode of transmission
spread from bodily fluids of an infected person
AIDS treatment
antiretroviral medicine, which works by stopping the virus replicating in the body, allowing the immune system to repair itself
cholera characteristics
- diarrhea
- nausea and vomiting
- dehydration
cholera mode of transmission
feces, water contamination
cholera treatment
oral rehydration
herd immunity
enough people in a group or area have achieved a virus or other infections agent to make it very difficult for the infection to spread
Epidemiologists: role and job characteristics
- study of the spread of infectious diseases
- investigate pattern and causes of disease and injury
- precise and accurate in moving from observation and interview to conclusions
Other types of research required to support public health
- psychology
- sociology
- anthropology
- political science / policy
- economics
- communication
- demographics
- geography
Critiques of epidemiology
fail to solve many public health problems (tobacco)
Social determinants of health
social factors are central to health outcomes
eg.
- social status, social support, food insecurity, housing, education, stress, transportation, work, place, access to health services
public health models of behaviour: health belief model
- specific several factors that determine whether a person is likely to change behaviour when faced with a health threat
- “I am vulnerable to the threat, the threat is serious, by taking action I can protect myself”
public health models of behaviour: self-efficacy
- the sense of having control over ones life
- increase by previous successful performance
- increase by seeing others successfully perform, especially if the model is a peer
- learned helplessness is a pattern of “numbed acceptance of a negative situation”
public health models of behaviour: transtheoetical model
- widely useful in health education
- process involved progress through 5 stages:
1. pre-contemplation
2. contemplation
3. preparation
4. action
5. maintenance
public health models of behaviour: ecological
interaction with their physical and sociocultural environments
levels of health influence
- 5 levels of influence that determine health-related behaviour
1. intrapersonal level –> psychology
2. interpersonal level –> fam, friends, coworkers
3. institutional level –> school, workplace
4. community level –> churches
5. public policy level –> government regulations
Why the environment and health are related
- environmental pollutants can cause health problems (cardiovascular disease etc)
- affects low income individuals more severely due to their location of living
Healthcare system
lowest: population-based public health servives, primary health care, secondary healthcare, tertiary health care (highest)
Outpatient facilities
an individual who visits a hospital, clinic etc for a diagnosis, treatment etc but is free to leave at the end of the day
Quality of health care systems
- should be effective in providing evidence-based healthcare services to those who need them
- safe to avoiding harm to people for whom the care is intended
Health insurance
cover the costs of your medical visits
medicare
- mandatory insurance program for individuals older than 65
- part A = covers hospital insurance, automatically enrolled in part B = pays doctor bills and other outpatient costs.
- Part C = gives beneficiaries more flexibility in which health plans they use
Health policy, aims
decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society
The Affordable Care Act
- requires states to have affordable insurance exchanges
- ensure the expansion of coverage for young adults on their parents plan up to 26
- established a centre for Medicare and Medicaid innovation to begin testing new ways of delivering care aimed at improving quality of care
- reducing the rate of growth in costs for Medicare, Medicaid and the Children’s Health Insurance Program
Steps in a food borne outbreak
- detect a possible multistate outbreak
- define and find cases
- generate hypotheses about outbreak sources
- test hypotheses
- confirm outbreak source
- stop outbreak
Drug safety
- institute of medicine = estimates nearly 100,000 die each year due to adverse drug effects
- drug testing required = on animal models, off-labelling prescribing - prescribing clinician has the authority to use for indications but not specifically approved by FDA
Why is drug safety an important public health strategy
important to identify, as quickly as possible, new risks or changes to the known risks associated with the use of medicines
non-communicable disease examples
- mental health conditions
- strokes
- heart disease
- cancer
- lung disease
- diabetes
Types of strategies that reduce the burden on non-communicable diseases
- reduce harmful diets, physical inactivity, abused tobacco/alcohol use
- implement legal frameworks
- promote insurance and research and development
Deaths of Despair
- Deaths caused by social or economic factors
- The increase in death rates within the US have seen a recent increase in the past years.
- These deaths are seen in middle-age and less-educated individuals who have financial and economical struggles, suggesting a correlation between the 2.
Rent seeking
- engaging in or involving the manipulation of public policy or economic conditions as a strategy for increasing profits
- eg. loans, subsidies, grants, tariffs
Environmental health policies
- governmental action to prevent exposure to environmental hazards
Inpatient facilities
person who lives at the hospital while under treatment
Why medical care is a public health concern
- is there for preventative care
- failures are caused by gaps in the systems (lack of vaccinated individuals)
- medical care is a public health responsibility with communicable diseases
Chronic disease
- no singular source, risk factors less recogniseable
- long onset period
- importance of animal models
- ethical concerns = limited experiments on humans
- possibility of secondary prevention
- not deadly in short run but severely impacts quality of life
- now leading cause of death and disability
US healthcare system comparison
- VERY EXPENSIVE
- absorbs 18% of GDP
- healthcare provided is not very good
- european countries cheaper and better
Medicaid
- Welfare-type program for the poor, with costs shared by the federal government and the states.
- Eligibility determined by incomes and varies across the US
- Medical bills will be paid directly by the state or local government to the provider at a low rate.
Areas where health systems need to be strengthened
- health information, laboratory and immunisation systems, procurement and supply chain management and quality of care etc
Food safety
the conditions and practices that preserve the quality of food to prevent contamination and food-borne illnesses.
programs to prevent food insecurity
- UN world food program = food Assistance for Assets, engages communities in projects like land restoration, providing cash or food in exchange. Through initiatives like the Farm to Market Alliance, smallholders are linked to markets for crop diversification and to increase their business potential.
How does food affect health safety?
- unsafe food contains harmful bacterias, viruses, chemicals etc causing harmful diseases such as cancer and diarrhoea
FDA approval process
- discovery and development
- preclinical research
- clinical research
- FDA review
- FDA post-market safety monitoring = FDA can revoke approval through post-marketing surveillance
How non-communicable diseases poses challenges for public health
- reach the poor more easily
- makes drug more easily available
- infrastructure, economic, demographic etc
- cause diseases (diabetes, cancer etc)
Responsible patients
- patients who take active measures to benefit their health
Causes of deaths of despair - characteristics of individuals who die
- lack of education
- poor economic stability
- social isolation
- geographic distribution
- lack of jobs
- black mortality rate significantly higher
solutions to address deaths of despair
- restoring opportunity by improving several key opportunities and factors
- slowing down drug epidemic
- US should provide universal healthcare
- restorations of services that unions provide
- strengthen safety nets
- wage policies
- education for all
examples of food-borne illnesses
- ecoli in onions in McDonalds
- salmonella in cucumber
