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Foundations of Public Health > Midterm Review > Flashcards

Midterm Review Flashcards

1
Q

works to protect and improve the health of communities

A

Public Health

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2
Q

21st century definition of public health

A

The totality of all evidence-based public and private efforts throughout the life cycle that preserve and promote health and prevent disease, disability, and death

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3
Q
  • tries to coordinate public health and healthcare delivery

-Global collaboration

-Tobacco control, Antibiotic resistance, climate change

-Full life cycle approach

-One Health

A

Population Health

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4
Q

what were the years of Population Health

A

(2000s)

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5
Q

about improving community health

A

Population Health

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6
Q

Population Health stresses collaboration among what?

A
  1. Traditional Public
    Health Professions
  2. Healthcare Delivery Professional
  3. Professions that affect health
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7
Q

What Population Health is Measured by

A

-Life Expectancy

-Infant Mortality

-Death Rates

-Quality of Life

-Self- assessed Health

-Happiness and well-being

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8
Q

Determinants of Disease (Big Gems)

A

Behavior
Infections
Genetics
Geography
Environment
Medical care
Socioeconomic- cultural

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9
Q

persons at a higher-than-average risk of disease and/or bad outcomes of disease, either directly or through the healthcare system

A

Vulnerable populations

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10
Q

Implies that as social and economic development occurs.

A

Epidemiological Transition

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11
Q

countries move from poorly balanced diets consisting of nutrients, proteins, and calories to diets of highly processed foods.

A

Nutritional Transition

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12
Q

Focuses on those with the highest probability of developing disease and aims

A

high risk

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13
Q

Focuses on the entire population and aims to reduce the risk for everyone

A

Focusing on the Average

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14
Q

IMPORTANT

Ten Global Public Health Priorities

A
  • Healthcare Systems
  • Mental Health Crisis
  • Reproductive and Sexual Health
  • Malnutrition and Food
    Safety
  • Diabetes
  • Cancer
  • Environmental
  • Pollution
  • Substance Abuse
  • Infectious Diseases
  • Climate Change
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15
Q

what are the core public health functions

A
  1. Assessment
  2. Policy Development
  3. Assurance
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16
Q
A
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17
Q

5 Basic Questions / P.E.R.I.E Process

A
  1. Problem: What is the health problem?
  2. Etiology: What is/are the contributory causes?
  3. Recommendations: What works to reduce the health impacts?
  4. Implementation: How can we get the job done?
  5. Evaluation: How well does/do the intervention(s) work in practice?
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18
Q

frequency of disability/symptoms

A

Morbidity

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19
Q

frequency of deaths

A

Mortality

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20
Q

Chances of dying from the disease

A

Case-Fatality Rate
or
Case-Fatality Risk
or
Case-Fatality Ratio

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21
Q

how to calculate Case-Fatality Rate

A

of cases of disease

of deaths /
# of cases of diseases

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22
Q

what is this an example of

among a total of 200 patients with disease A, 20 of them died from the
disease within 30 days; the 30-day case fatality rate = 20/200 * 100 = 10%.

A

Case-Fatality Rate

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23
Q

How many new cases developed during a specific time period?

A

Incidence

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24
Q

how to calculate incidence

A

𝑜𝑓 𝑝𝑒𝑜𝑝𝑙𝑒 𝑖𝑛 𝑡h𝑒 𝑎𝑡 𝑟𝑖𝑠𝑘 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛

new cases of disease /
# of people in the at risk population

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25
Q

what is this an example of

From 2019 to 2021 there were 114,044 deaths due to COVID-19 with nearly 1 in 4 U.S. adults and older teens who had still not contracted COVID-19 the end 2022

A

Incidence

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26
Q

What percentage of individuals have the disease at a specific time point?

A

Prevalence

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27
Q

what is the calculation for Prevalence

A

of people living with the disease /
total # of people in the population

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28
Q

Three reasons why changes in disease rates may be artifactual rather than real:

A
  1. Differences in the interest in identifying the disease
  2. Differences in the ability to identify the disease
  3. Differences in the definition of the disease
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29
Q

Individuals are selected to be in the study based on disease status

A

Case-Control Study

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30
Q

Individuals are disease-free at the start of the study and identified by their exposure status (exposed or unexposed) and followed over time to determine the probability of developing the disease

A

Cohort Study

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31
Q

Randomization

  • Individuals are randomly assigned to an exposed or nonexposed “cause”
  • Altering or removing the “cause” alters the “effect”

*(intervention works)

  • Ethical issues e.g., cannot assign non-smoking individuals to a smoking group
A

Randomized Controlled Trials (RCTs)

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32
Q

a third variable/factor that distorts the association between exposure and outcome

A

Confounder

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33
Q

is a clinically useful concept of causation

A

Contributory Causes

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34
Q

is a relationship between two events, or variables, in which one event or process causes an effect on the other event or process.

A

Causal criteria

35
Q
  • before the onset of disease
  • avoid development of a disease
  • remove risk factor
A

Primary Interventions

36
Q
  • after initial detection of disease but before symptoms
  • early detection treatment
  • prevent progression
A

Secondary Interventions

37
Q
  • after development of disease, but before irreversible disability
  • reduce complications of established disease
A

Tertiary Interventions:

38
Q

How do we evaluate an intervention’s results

A

The RE-AIM framework is increasingly being used to evaluate how well specific interventions work and are accepted in practice

39
Q

10 Essential Public Health Services

A
  1. Monitor health status to identify and solve
    community health problems
  2. Diagnose and investigate health problems and health hazards in the community
  3. Inform, educate, and empower people about health issues
  4. Mobilize community partnerships and action to identify and solve problems
  5. Develop policies and plans that support individual and community health efforts
  6. Enforce laws and regulations that protect health and ensure safety
  7. Link people to needed personal health services and ensure the provision of health care when otherwise available
  8. Ensure the provision of a competent public and personal healthcare workforce
  9. Evaluate the effectiveness, accessibility, and quality of personal and population-based health services
  10. Research new insights and innovative solutions to health problems
40
Q

Health departments throughout the U.S. have provided healthcare to those without other sources of care how?

A

Local Health Department’s Safety Net

41
Q

Federal Public Health
Agencies

A

CDC
ATSDR
NIH
FDA
HRSA
AHRQ
SAMHSA
IHS

42
Q

what are the State Health Departments Responsibilities?

A
  • Collecting vital statistics
  • Running public health laboratories
  • Licensing health professionals
  • Administering nutrition programs
  • Regulating health facilities, such as nursing homes
  • Regulating drinking water
  • Administering statewide Medicaid programs
  • Overseeing state medical examiner offices
43
Q

Global Health Agencies Know

A

World Health Org
unicef
unaids
The world bank
usaid

44
Q

Nongovernmental Organizations (NGOs)

A

American Red Cross
American Cancer Society
March of Dimes
American Heart Association
The Global Fund
American Diabetes Association
The Rockefeller Foundation
Bill & Melinda Gates Foundation
Madd No More Victims
Medecins Sans Frontieres

45
Q

The 7 S’s of Quantitative (Numerical) Sources of Public Health Data

A
  1. Single case / small series of cases
  2. Statistics: vital statistics and reportable diseases
  3. Surveys and sampling
  4. Self-reporting
  5. Sentinel monitoring: prearranged surveillance
  6. Syndromic surveillance: focused on symptom patterns
  7. Social media
46
Q

Life expectancy incorporating quality of life (QoL) measures

  • Mobility
  • Cognition
  • Self-care
  • Pain
  • Mood
  • Sensory organ function
A

Health-Adjusted Life Expectancy (HALE)

47
Q

years of life lost due to DEATH + Years lived with a DISABILITY

A

DALYs

48
Q

Three categories of Disability-Adjusted Life Year (DALY)

A

communicable diseases
noncommunicable diseases
injuries

49
Q

Starts with life expectancy and incorporates measures of the quality of life

A

Health-Adjusted Life Expectancy (HALE)

50
Q

Perception of an increased probability of a feared event

A

Dread Effect

51
Q

Perception of increased probability of an event due to lack of prior experience with the event

A

Unfamiliarity Effect

52
Q

Perception of increased probability of an event due to having a perceived inability to control or prevent the event from occurring

A

Uncontrollability Effect

53
Q

SUCCESs Framework

Perceiving Information in Health Communications

A
  • Simplicity
  • Unexpectedness
  • Concreteness
  • Credibility
  • Emotions
  • Stories
54
Q

Step 6. Decision-Making

A
  • Data can be used for the following purposes:
    • Informing clinicians’ decisions about
      patient care
    • Informing patients’ decisions regarding
      healthcare and research participation *
      Promoting shared decision-making
      between patients and clinicians
55
Q
  • Occurs when clinicians have all the essential information and can make decisions that are in a patient’s best interest
  • Advantage: can be efficient and effective when patients seek clear directions provided by a trusted source
  • Disadvantage: patient may not understand information; patient may not be prepared to participate in the implementation or may not accept responsibility of outcome
A

Informing Clinicians’ Decisions

56
Q

aims to help people in treatment and recovery have informed, meaningful, and collaborative discussions with providers about their health care services.

A

shared decision-making

57
Q
  • Family income
  • Educational level and parents’ educational
    level
  • Professional status and parents’
    professional status
A

Socioeconomic Status

58
Q

phenomenon describing the hierarchical differences in health outcomes among populations based on the values society places on certain characteristics (education, jobs)

A

Socioeconomic gradient:

59
Q

calculates economic inequity across populations

A

Gini Index

60
Q

*** 10 Key Categories of Social Determinants of Health

A
  1. Social Status
  2. Social Support or Alienation
  3. Food
  4. Housing
  5. Education
  6. Work
  7. Stress
  8. Transportation
  9. Place
  10. Access to Health Services
61
Q

An individual goes through a series of incremental stages to change their
behavior rather than making significant changes all at once

A

Stages of Change Model

62
Q

Intention is an individual’s main predictor of behavior change; it is influenced by their attitude, beliefs, and control

A

Theory of Planned Behavior

63
Q

Health Belief Model (HBM)

A

Demographic Variables
Psychological Characteristics

64
Q

Focuses on interactions between an individual and their social system

A

Social Cognitive Theory

65
Q

Focuses on how a new idea, product, or social practice e.g., behavior (an innovation) is disseminated and adopted in a population

A

Diffusion of Innovations Theory (DOI)

66
Q

Electronic Monitoring

A

Sentinel Monitoring

67
Q

Social Marketing Approach

A

Product
Price
Place
Promotion

68
Q
  • Includes words and symbols that help the target audience identify with the service However, it goes deeper than just words and symbols.
  • Method of implementing the fourth “P” or promotion - builds upon the first three “Ps*:
  • Requires a clear understanding of the product or the behavior to be changed (product)
    Puts forth strategies for reducing the financial
    and psychological costs (price),
  • Identifies the audience and segments of the audience and asks how each segment can be reached (place)
A

Branding

69
Q

Planning framework provides a structure to design and evaluate health education and health promotion programs through a diagnostic planning process followed by an implementation and evaluation process

A

Precede-Proceed

70
Q

Power of state governments to pass legislation and implement actions to protect the common good

A

Police Power

71
Q

** The U.S. Constitution allows, but does not require, the government to act to protect public health or to provide healthcare services

A

Negative Constitution

72
Q

A collaborative approach that integrates and articulates health considerations into policymaking across sectors to improve the health of all communities and people

A

Health in All Policies Approach

73
Q

*** The standard of U.S. law that healthcare providers, either individuals or institutions, do not have an obligation to provide health services

A

No-Duty Principle

74
Q

** risk to an individual created through one’s own actions

A

Self-imposed risk

75
Q

*** risk to individuals and populations that is out of their direct control

A

Imposed risk

76
Q

Nuremberg Code

A
  1. The voluntary consent of the human subject is absolutely essential.
  2. The experiment should be such as to yield fruitful results for the good of society, unprocurable by other methods or means of study, and not random and unnecessary in nature.
  3. The experiment should be so designed and based on the results of animal experimentation and knowledge of the natural history of the disease or other problem under study that the anticipated results will justify the performance of the experiment.
  4. The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.
  5. No experiment should be conducted where there is an a priori reason to believe that death or disabling injury will occur, except, perhaps, in those experiments where the experimental physicians also serve as subjects.
  6. The degree of risk to be taken should never exceed that determined by the humanitarian importance of the problem to be solved by the experiment.
  7. Proper preparations should be made and adequate facilities provided to protect the experimental subject against even remote possibilities of injury, disability, or death.
  8. The experiment should be conducted only by scientifically qualified persons. The highest degree of skill and care should be required through all stages of the experiment of those who conduct or engage in the experiment.
  9. During the course of the experiment, the human subject should be at liberty to bring the experiment to an end if he has reached the physical or mental state where continuation of the experiment seems to him to be impossible.
  10. During the course of the experiment, the scientist in charge must be prepared to terminate the experiment at any stage, if he has probable cause to believe, in the exercise of the good faith, superior skill, and careful judgment required of him, that a continuation of the experiment is likely to result in injury.
77
Q

The Belmont Report

A

Respect for Persons
Beneficence
Justice

78
Q

*** Focuses on key issues of defining informed consent and selecting participants for research

A

The Belmont Report

79
Q

Led to the development of the institutional review boards (IRBs); must approve most human research

A

The Belmont Report

80
Q

An extraordinary public health event which constitutes a public health risk to multiple countries through international spread of disease and potentially requires a coordinated response

A

Public Health Emergency of International Concern

81
Q

Is there a right to healthcare

A

*** In 1948, a right to health care was incorporated into the Universal Declaration of Human Rights and the World Health Organization’s Constitution

“Everyone has the right to a standard of living adequate for the health and well- being of himself and his family, including…medical care…and the right to security in the event of…sickness….”

82
Q
  • Imitative organized by the U.S. Department of Health and Human Services
  • Collaborative effort of a multitude or private and public organizations
  • Sets evidence-based objectives aimed at improved the nation’s health
A

Healthy People 2030

83
Q

The study initially involved 600 Black men – 399 with syphilis, 201 who did not have the disease. Participants’ informed consent was not collected. Researchers told the men they were being treated for “bad blood,” a local term used to describe several ailments, including syphilis, anemia, and fatigue.

A

problems associated with the Tuskegee Study

84
Q

Framingham study and its results or findings

A

Here are a few of the major findings from the FHS: 1960s: Cigarette smoking was found to increase the risk of heart disease, and cholesterol level, blood pressure, and electrocardiogram abnormalities were found to increase the risk of heart disease.

Foundations of Public Health (9 decks)

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