Prev Med Flashcards
natural h/o dz: pre dz vs latent dz vs symptomatic dz
susceptibility stage vs subclinical stage, pathologic changes vs onset of sxs, clinical stage, time of dx
primary vs secondary vs tert prevention
before onset of dz; prevent dz from occurring or inc resistance of dz vs in subclinical stage; screening & early detection to interrupt dz before becoming sx vs clinical stage; limit physical & social conseq of sxs
2 main ways to eval preventive med programs: cost effectiveness vs cost/benefit. cost benefit analysis?
expenditures required to achieve effect vs ratio b/ expenditures to make program & beneficial results. compare costs of intervention to health benefits –> helps govt determine budget
challenges of preventative programs: demonstrating benefits vs delay benefits vs accrual of benefits vs discounting vs priorities
need scientific proof but unethical to do RCT –> animal/observational studies, also $$$; varying risks & exposures across diff pop; t/dx = sponsored by pharm companies vs no instant gratification; worse for dzs w/ long latent periods; affects political support vs ins, health maintenance companies, govt & individuals get benefits but if only individuals -> less politically attractive vs present value of benefits = discounted -> hard to show cost/effective or post cost/benefit vs current & urgent probs = more attractive
def of social determinant of health vs health disparities
conditions in which ppl are born, grow, work, live, age & the systems in place to address illness vs health diff linked w/ soc/econ/environ disadvantage; obstacles of health based on race, religion, SES, gender, age
trends w/ education & health outcomes
higher ed –> healthier, live longer, more autonomy. low income, disability, social discrimination -> struggle w/ math & reading -> less likely to graduate; low income -> less money for food/exer/med, stress -> chronic dz
health professional shortage area vs medically underserved areas
shortage of primary medical/dental/mental health providers determined by provider ratio; geographic & pop HPsA vs area designated dby HPsA as having too few pcp, high infant mortality/poverty/elderly
econ vs health vs soc conseq of healthcare shortage?
nonins pt, cost of medicare, missed workdays/employment vs supply/demand of meds & staff, delayed/declined high quality care vs inc morbid/tality, extra stress, med bills
fed qualified health centers aka community health centers
fed supported safety-net programs giving services to special pop -> improve access to primary healthcare to ppl regardless of location, age, sex, race, dz status
FQHC eligibility requirements
in medically underserved area; mandated to give med/dental/behavioral health services; governed by board of directors; accessible, sliding scale to adjust fees, culturally competent, accept medicaid&care
equality vs equity vs justice
everyone benefits from same supports -> equal tx vs everyone gets support they need vs causes of inequity was addressed -> systematic barrier removed
3 steps to approach equity
value all ppl equally, rectify injustices, provide resources according to need
implicit vs explicit bias. systemic racism?
unconscious & unintentional asmptns we make d/t unconscious assoc about diff social groups vs intentionally not liking ppl. collection of policies perpetuating status quo of racial inequities
pathways to health equity: intraperson vs interperson vs institutional vs community vs systemic lvl
internal racism, stereotype threat, embodying inequities vs overt discrim, implicit bias vs hiring/promotion practice, under/over eval of contributions vs diff resrc allocation, racially/class segregated schools vs immigration, incarceration, predatory banking
areas to address sDOH at community vs pop vs clinical lvl
health & crisis intervention, strengthening fam/children, self sufficiency vs screen for social needs, pop-based & individual-targeted preventive strats = complementary (not exclusive) vs screening to ID sDOH, know your community-based partners & resrcs
steps to do outbreak investigation
- prepare field work
- est outbreak
- verify dx
- case def
- find cases systematically
- descriptive epidemiology
- hypothesis
- eval hypothesis
- reeval hypothesis
- lab & environ studies
- ctrl & prevention measures
- surveillance
- communicate results
ctrlling an infxn requires knowing…? 6 universal strats to prevent & ctrl infxn
how it’s spread/transmission. wash hands, decontaminate/disinfect, infxn ctrl precautions like masking, quarantine exposed, prophylaxis of exposed, ctrl vectors/carriers
abx = inappropriately/unnecessarily rxed, leading to…? abx stewardship?
adverse drug reactions (Amoxicillin for mono), C.difficile, antibiotic resistance, and increase mortality. effort to measure and improve how abx = prescribed by clinicians & used by pts
explain process of vax safety
development -> safeguards; lab tests for safety; clin trials -> safe? effective? rxn?; manufacture w/ FDA; batch test -> purity? potency? sterile?; cont monitor w/ FDA & CDC
vax indic vs vax CI vs missed opportunities
target/at-risk pop vs no live atten for immunocompromised, allergy, current infxn vs pt = eligible for vax but didn’t finish it completely (likely d/t misperception that pt didn’t need it at the time)
what is pop-based/herd immunity? standards of immunization practice for peds vs adults
large portion of pop = immune to virus/bacteria –> resistant –> bug has nowhere to go. avail of vax, assess immunization status, effective communication to parents, storage & admin, vax coverage vs recommend vax, assess immunization status, admin or refer to vax provider
why are vax hard to talk about? how to communicate it better?
changing, conflicting, time = limited, diff groups -> diff interests/needs (rural pts = hard to trust drs). Corroborate: acknowledge pt’s concern; About me: build knowledge/expertise, “I did research”; Sci: give documented accurate info; Explain/advise: advise pt/parent based on science.
Healthy People 2030 goals
Improve health by preventing, detecting, and responding to public health events by inc # trained ppl, # of events, lab/diag test & surveillance and dec dz & death
Disability-Adjusted Life Year vs Years of Potential Life Lost vs Mortality Rates Among Children Under Five
length of health lost d/t dz and time spent w/ dz vs measures premature mortality in diff age groups; more wt on death v probability a newborn baby will die before reaching 5yo; #/1,000 live births
