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Endocrine System > PCM Health Disparities > Flashcards

PCM Health Disparities Flashcards

1
Q

Our health prospects as being shaped by our experiences in five domains:

A

Genetic and gestational endowments, social circumstances, environmental conditions, behavioral choices, and medical care.

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2
Q

Although only about 2 percent of deaths in the United States may be attributed to purely genetic diseases?

A

Perhaps 60 percent of late onset disorders, such as diabetes, cardiovascular disease, and cancer have some genetic component.

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3
Q

About two-thirds of the risk of obesity may be genetic, but, as with most other predispositions, that risk is expressed only with?

A

Exposure to lifestyle factors that are controllable.

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4
Q

Health is powerfully influenced by?

A

Education, employment, income disparities, poverty, housing, crime, and social cohesion.

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5
Q

Socially isolated persons have a death rate?

A

Two to five times higher than that of those who maintain close ties to friends, family, and community.

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6
Q

For the population as a whole, the most consistent predictor of the likelihood of death in any given year is?

A

Level of education; persons ages 45–64 in the highest levels of education have death rates 2.5 times lower than those of persons in the lowest level.

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7
Q

Poverty, another strong influence, has been estimated to account for?

A

6 percent of U.S. mortality.

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8
Q

The places where we live and work can present hazards in the form of?

A

Toxic agents, microbial agents, and structural hazards.

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9
Q

The sum of the lower boundaries of various estimates of the mortality burden of toxic-agent exposures places their contribution in the range of?

A

60,000 deaths per year.

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10
Q

Structural design and safety shortfalls account for?

A

Approximately 7,000 deaths annually from motor

vehicle crashes, falls, fires, and work-related injuries.

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11
Q

Behavior patterns represent the single most prominent domain of influence over?

A

Health prospects in the United States.

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12
Q

Important determinants of health, the daily choices we make with respect to?

A

Diet, physical activity, and sex; the substance abuse and addictions to which we fall prey; our approach to safety; and our coping strategies in confronting stress.

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13
Q

Diet or to physical activity combined, the range of the estimates for their contributions spans from?

A

300,000 to more than 500,000 deaths annually in the United States.

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14
Q

Substance abuse and addiction inflict?

A

A tremendous toll on the health of Americans.

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15
Q

Tobacco is the leading single contributor to?

A

Mortality

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16
Q

Tobacco and substance abuse as a whole represents?

A

The most prominent contributor to the constellation of preventable illness, health costs, and related social problems facing U.S. families and communities today.

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17
Q

Taken together, behavioral issues represent the greatest?

A

Single domain of influence on the health of the U.S. population.

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18
Q

Improvements in the quality or use of medical

care have a relatively limited?

A

Ability to reduce deaths among Americans.

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19
Q

A long-standing estimate by the Centers for Disease Control and Prevention (CDC) places the contribution of health care system deficiencies to total mortality at?

A

About 10 percent.

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20
Q

On a population basis, using the best available estimates, the impacts of various domains on early deaths in the United States distribute roughly as follows:

A 
Genetic predispositions, about 30 percent; 
Social circumstances, 15 percent; 
Environmental exposures, 5 percent; 
Behavioral patterns, 40 percent; 
Shortfalls in medical care, 10 percent.
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21
Q

95% of healthcare spending in the US goes to? only

A

Medical services

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22
Q

5% goes to healthcare spending?

A

Health improvement

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23
Q

40% of deaths are caused by?

A

Behavioral patterns that could be modified by preventive interventions

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24
Q

Our health prospects are shaped by our experiences in 5 domains:

A

Genetic(2nd) and gestational endowments, social circumstances, environmental conditions, behavioral choices(1st), and medical care

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25
Q

Probably over half of late-onset diseases (diabetes, etc.) have some sort of?

A

Genetic component

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26
Q

Health is influenced by?

A

Education, employment, income disparities, poverty, crime, and social cohesion

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27
Q

Socially isolated people have?

A

A higher death rate

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28
Q

For the population as a whole, the most consistent predictor of the likelihood of death in any given year is?

A

Level of education

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29
Q

Environmentally you have to worry about?

A

Toxin exposure, infectious agents, and structural hazards

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30
Q

Behavior patterns represent the single most prominent domain of influence over?

A

Health prospects in the US (diet, physical activity, sex, substance abuse)

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31
Q

Clinical interventions with solid evidence for health promotion/maintenance:

A

Childhood vaccines, discouraging tobacco use in kids, raising cigarette taxes encouraging physical activity, etc.

32
Q

Prevention can be tough because it targets multiple causes of disease, while medical care often focuses?

A

Only on a single symptom or manifestation.

33
Q

Interest-group dynamics play a big role in health promotion, and many prevention initiatives depend on?

A

Policy changes

34
Q

A lot of people just don’t want to change?

A

Even if they know their behavior is risky (can be due to multiple factors i.e. socioeconomic factors, unwillingness to change)

35
Q

There have been several improvements over the last several years?

A

Discouraging tobacco use and drunk driving, breast cancer screening, cholesterol monitoring, Healthy People Initiative.

36
Q

Healthy People Initiative established measurable targets for?

A

Health improvement (decreased mortality, etc.) and have now broadened their targets to issues of functional status, quality of life, and reducing disparities between social groups.

37
Q

Key elements of public policy for change include?

A

Leadership that informs and motivates, economic incentives that encourage and facilitate change, and science that moves the frontiers

38
Q

It may be better to go ahead and target the most?

A

Vulnerable groups first

39
Q

More innovative science, better targeting of social efforts to improve health, new models for policy implementation, and stronger leadership all can assist with?

A

Nonmedical health improvement

40
Q

When the Patient is Racist

The jist:

A

An Asian “doctor-in-training” goes in to take care of a “mean drunk” who has a swastika tattoo on the inside of his biceps. She tells one of her peers. He tells her to educate the patient on racism. She remembers….
–Dr. Jain wrote an essay on the medical profession’s attitude toward patients who discriminate against doctors.

41
Q

Dr. Jain wrote an essay about?

A
  • -He had a patient that got mad at him about the pharmacy and told him to go back to India.
  • -He walked out angry and handed out the care of the patient to another doctor.
  • -Other physicians told him that was dumb, and he should go back and apologize.
42
Q

In 2000, the American Medical Association codified its opinion on the issue, issuing in its code of ethics?

A

Amandate that doctors could not refuse to care for patients based on any “invidious” discriminatory criteria like race or ethnicity.

43
Q

One study: up to almost a third of doctors would, without question?

A

Concede to a patient’s demand for physicians of a certain race, ethnicity, gender or religion.

44
Q

“The medical profession knows this happens but?

A

Doesn’t want to talk about it.”

45
Q

Unlike physicians who might experience such discrimination on occasion, nonphysician providers and hospital or nursing home workers?

A

Are in a particularly vulnerable position because they are in constant contact with patients and have less control over policies regarding patient requests.

46
Q

Recent law suit:

A

Involved a hospital that barred a black nurse from caring for or even touching a white patient’s baby, revealing the extent to which patient requests are accommodated

47
Q

Moreover, several recent studies indicate that a provider’s?

A

Race, ethnicity, gender and even social class do make a difference. Patients tend to receive better care from providers who are most like them

48
Q

“There’s something wrong,” Dr. Jain said, “when a person can go to work, be subject to intolerance or abuse and

A

Have it be ignored and accepted by colleagues as part of the job.”

49
Q

In the United States, life expectancy and other health status measures vary dramatically depending on factors?

A

Such as race, gender, educational attainment, and ZIP code, that should not make a difference

50
Q

Biggest differences in health are on the?

A

County-level. Life expectancy can vary county-to-county by 10 years or more.

51
Q

There’s been a widening inequality in mortality when comparing?

A

Counties over a 4-decade period ending in 1999 (increasing in some).

52
Q

Health varies base on?

A

Race, gender. Black population has 3.8 year less life expectancy than white. Historically, women have lived longer. Gap has narrowed b/c female mortality rose 42% from 1992-2006.

53
Q

With race and gender combined, inequalities are?

A

Larger. One study: black males have life expectancy 20 years shorter than Asian females.

54
Q

Disparities also linked to?

A

Ethnicity, language, sexual orientation. Closely related to education, income, social class.

55
Q

Low income: increased risk of dying from?

A

Non communicable disease (diabetes, cancer, heart disease, etc)

56
Q

Disparities not consequence of?

A

One single factor.

57
Q

3 causes of disparities?

A

A. modifiable behavior: diet, exercise: good. smoking: bad. manage health probs: asthma, diabetes.
B. social, cultural, physical environments: low education, poor, less grocery stores: unhealthier
C. health care

58
Q

Nationally, black patients live closer to?

A

High-quality hospitals than whites, but 25-58% more likely than whites to have surgery at low-quality hospital.

59
Q

Primary care is important to people being?

A

Healthy and living longer.

60
Q

Having health insurance, getting regular health care →

A

Being healthier

61
Q

Policy makers are trying to translate?

A

These findings into effective solutions. Ha.

62
Q

CDC: during 1900s: Americans gained 30 yr life expectancy from birth. Why?

A

25 due to vaccination, safer workplaces, healthy mothers and babies.

63
Q

Smoking, sedentary lifestyles, and bad eating habits are?

A

Bad for you.

64
Q

There is a Commission to Build a Healthier America?

A

Their job is to build a healthier America.

65
Q

Primary care reduces inequality by?

A

Preventing diseases, especially noncommunicable ones through screening, support, and vaccines.

66
Q

We need to teach people how to?

A

Exercise (I recommend prancerizing) and stop smoking.

67
Q

Closing the gaps in health care is?

A

Difficult

68
Q

The Task Force on Community Preventive Services was created to?

A

Summarize what’s known about the effectiveness of community-based interventions to improve population health outcomes.

69
Q

Task Force (TF) worked from an?

A

Ecologic perspective, connecting health with human, cultural, economic, and social activities.

70
Q

Social determinants of health are?

A

Societal conditions that affect health and can
potentially be altered by social and health policies and
programs.. duh.

71
Q

3 categories of social determinants are?

A

Social instituations, surroundings, and social relationships.

72
Q

Fundamental premise of the Community Guide:

A

Access to societal resources determines community health outcomes (i.e. standard of living, culture and history, social institutions, built environments, political structures, econ systems, and technology)

73
Q

Impoverished social environment is?

A

A potential source of both stressors and resources

74
Q

Conditions in the social environment associated with health outcomes:

A
  1. neighborhood living conditions
  2. opportunities for learning and developing capacity
  3. community development and employment opportunities
  4. prevailing community norms, customs, and processes
  5. social cohesion, civic engagement, and collective efficacy
  6. health promotion, healthcare opportunities, and disease/injury prevention
75
Q

Solutions require cross-institutional collaboration with?

A

Communities to tailor relevant programs

Endocrine System (6 decks)

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