Module 1 lecture Flashcards
How has the definition of health evolved?
From absence of dz to a state of complete physical, mental, and social well-being
Revised in 1978 calling for a level of health that permits ppl to lead socially and economically productive lives
Health and dz are not necessarily opposites
How has there been a shift in measuring health?
Shift from mortality-based measures to indicators of functionality and healthy lifespan
-Both quality and quantity are important
-Perceptions are influenced by social and cultural factors
Why is mortality data used in measuring health?
Because it is most readily available
What are two common measures of health?
Mortality and life expectancy
What is an overall indicator of pop health?
Life expectancy
How is health status improving in the US?
Life expectancy at birth
Birth outcomes better
Years of healthy life
How are dz trends changing?
Shift from infectious to chronic dz
Where are disparities increasing?
Ethnic and racial groups
Socioeconomic groups
What is the ecological model of health?
There are a range of personal, social, economic, and environmental factors that influence health status
Definition of risk factors
The factors linked with health problems
What do risk factors include?
Biological
Environmental
Lifestyle
Psychosocial
Use and access to health services
What are major global threats to health in the 21st century
Overpopulation
Production of greenhouse gases
Poverty
What do social conditions include?
Economic inequality
Urbanization
Mobility
Cultural values, attitudes
Policies related to discrimination and intolerance on the basis of race, gender, and other differences
What do conditions in the national level include?
Major sociopolitical shifts, such as:
Recession
War
Governmental collapse
What does the built environment include?
Transportation
Water and sanitation
Housing
Urban planning
What are the three levels of risk factors?
Determinants
Direct contributing factors
Indirect contributing factors
Determinants in terms of risk factors
Most proximal
Proven to directly influence the level of a health problem
What is a direct contributing factor?
Scientifically established to affect the level of a determinant
What are indirect factors?
Community specific
Affect the level of a direct contributing factor
More likely to be controllable and the basis of community interventions
Steps of health problem analysis
Begins with the identification of a health problem
Establishes determinants
Identifies direct contributing factors for the determinants
Identifies indirect contributing factors
What are common economic analysis approaches?
Cost-benefit
Cost-effectiveness
Cost utility
What do cost benefit analyses involve?
Assess the ratio of costs to benefits
Determine whether the result of an intervention justifies its expense
Most comprehensive
Gold standard of economic evaluations
Results are expressed in terms of net costs, net benefits, and time required to recoup an inital investment
Health outcome benefits are expressed in years of life gained or quality-adjusted life years
What do cost effectiveness analyses involve?
Cost to achieve a specific outcome
Focus on one outcome when several options are available
Compare cost-effectiveness when several options are available
Results expressed as cost per life saved or cost per case prevented.
The outcomes could be years of life saved, cases prevented, cases diagnosed
More appropriate for health promotion programs or interventions
Cost utility analyses- what do they involve?
Cost to achieve a quality-adjusted outcome
Useful when an intervention affects both morbidity and mortality
Useful when there are a variety of outcomes
Results are characterized as cost per quality adjusted life years
What is Healthy People?
A nation’s 10-year goals and objectives for health promotion and dz prevention
Produces a framework for public health priorities and interventions
What were the two overarching goals of Healthy People 2010?
Increase quality and years of healthy life
Eliminate health disparities
What are the special emphases for Healthy People 2020?
An ecological and determinants approach
The role of health information tech and health communication
“All hazards” preparedness as a public health issue
What are the 4 overarching goals of Healthy People 2020?
Attain high quality, longer lives free of preventable dz, disability, injury and premature death.
Achieve health equity, eliminate disparities, and improve the health of all groups
Create social and physical environments that promote good health for all
Promote quality of life, healthy development and healthy behaviors across all life stages
What was the main defining feature of public health prior to 1850?
Battling epidemics
What was the main defining feature of public health from 1850-1949?
Building state and local public health infrastructure
The sanitary movement era
What was the main defining feature of public health from 1950-1999?
Filling gaps in medical care delivery
What was the main defining feature of public health after 1999?
Preparing for and responding to community health threats
In what different ways does the public view public health?
The system and social enterprise
The profession
The methods: knowledge and techniques
Governmental services (especially medical care for the poor)
The health of the public
What was the definition of public health in 1988?
Fulfilling society’s interest in assuring conditions in which people can be healthy
What is implied in this 1988 definition?
Improving conditions and health conditions for others is acting in our own self-interest
Improving the health of others provides benefits to all
Assuring conditions in which people can be healthy means promoting everyone’s well-being
What are key frameworks that explain public health?
Ecological perspective of health
Systems perspective of health
What does the Public Health in America document of 1994 contain?
Broad vision and articulation of the mission of public health
Core functions of public health
Essential PH services.
What is the view of the systems perspective of PH?
Broad view of PH as a social enterprise
Brings together the mission and functions of PH in relation to the inputs, processes, outputs, and outcomes of the system.
What are the unique features of PH?
Social justice perspective
Inherently political
Ever-expanding agenda
Link with gov’t
Grounding in science
Focus on prevention
Uncommon culture and bond
What does the social justice perspective argue?
Significant factors within society impede fair distribution of benefits and burdens
Such impediments include social class distinctions, heredity, racism, and ethnicism
To solve these problems, collective actions are required where those less affected take on greater burdens
Why is PH political in nature?
Because it serves society with different values and perspectives, it is frequently caught in the middle of tensions and conflicts
How is PH ever-expanding?
Moved from just infectious dz to other issues, such as substance abuse, teen pregnancy, long-term care, and bioterrorism preparedness.
Under what medical ethics principal is government involvement related to?
Beneficence
What are the two strategies in which governments can influence PH?
Modifying public policies
Providing programs and services
Under what sciences is PH covered?
Medical sciences
Physical sciences
Social sciences
What is the reason for the public’s undervaluation of PH?
Since many targets of PH prevention are effects to be avoided, the results of success is unseen
What contributes to the uncommon culture of public health?
Many different sciences, strategies, and methods are used to achieve intended outcomes.
Multidisciplinary and interdisciplinary approach.
What are the terms used to describe the value of PH?
Public opinion
Morbidity and mortality prevented
Economic benefits
Quality of life
