Public Health Flashcards
What changed military hygiene?
gunpowder-many more people died from infections and seriousness of the injury
Elizabethan poor Act
defined what was considered poverty
established indoor and outdoor relief
indoor relief
workhouses, orphanages, hospitals, alms houses
outdoor relief
dole, left in their homes
John Graunt
first demographer, kept records of deaths, diseases, and births
estimate population for the first time
Effects of industrial revolution
pauper children (apprentice slavery)
workhouses for those too poor or old to support themselves
oliver twist
English Sanitary Reform
first sanitary legislation was enacted
Edwin Chadwick
wrote: report on an inquiry into the sanitary conditions of the labouring population of Great Britain
lead to the establishment of general board of health
called for improvements in sanitation and hygiene
following chadwick’s report legislation was passed concerning:
factory management
child welfare
care of the aged
Florence Nightingale
entered nursing profession in response to a pauper’s death in a workhouse in London that became a public scandal
famous contributioon to the crimean war
lady with the lamp
2000patients single handed
established nightingale school of nursing
Jeffery Amherst
british general, smallpox blankets, jerk
what was the cause of the decimation of Jamestown and Roanoke Island?
Smallpox!
Marine Hospital Fund
established by first congress in response to merchant seamen that did not have permanent homes, physicians in each port to care for seamen
Marine Hospital Service
organized as a natinal agency, supervising medical officer later the surgeon general
Port Quarantine Act
due to yellow fever outbreaks immigration restricted to ports allowed physicians to apply bacteriology learned about carriers administered immunizations to immigrates
USPHS
formally marine hospital service
under direction of surgeon general
What/who established the National Leprosarium?
USPHS
When was the establishment for the first agency for veneral diseases?
because of the first world war
Why was narcotics division formed?
response to opium use and recognition of addiction
Who militarized the PHS?
President Wilson in anticipation of entry into WWI with an executive order
hospital services and construction act
after WWII congress gave the USPHS responsibility for a nationwide program of hospital and health center construction
Lillian Wald
established the first public health nursing
Mary Breckinridge
established the Frontier Nursing Service to provide professional health care in the Appalachian Mountains
What was the social security act a response to?
the great depression
what was the social security act for?
to provide funding for health protection and promotion
provided money for poor, elderly, disabled, unemployed
funding for priority diseases
Harry Trumen
asked congress for a national health plan
Lyndon Johnson
signed Medicare and Medicaid into law
What is the public health of any country closely linked to?
population GDP infant mortality average life expectancy number of people living with HIV/AIDS
factors affecting development
isolation poor quality of life due to poverty unsanitary conditions and malnutrition parasitic infections distribution of lands social hierarchy education, literacy racism, religious intolerance population explosion
World health organization
regional centers on every continent
health is a basic human right
pan american health organization
goal is to improve health and living standards in the americas
UNICEF
mission is to protect the rights of children includes: food and supplies disease control family planning child development
USAID-agency for international development
government organization responsible for most non-military foreign aid
DHHS (US department of health and human services)
largest health program in the world
USPHS (US public health service)
commissioned under corps, under leadership of the Surgeon general
US assistant secretary of health oversees all of USPHS
Who oversees all of USPHS
US assistant secretary of health
What are the agencies within the DHHS?
administration for children and families
administration on aging
agency for healthcare research and quality
agency for toxic substances and disease registry
centers for disease control and prevention
centers for medicare medicaid
food and drug administration
health resources and services administration
indian health service
national institutes of health
substance abuse and mental health services administration
What is responsible for federal programs that promote the economic and social well-being of families and children, individuals, and communities
administration for Children and families
what was established as a part of the older americans act
administration on aging
what is charged with improving the quality, safety, efficiency, and effectiveness of health care for all Americans
agency for healthcare research and quality
What serves the public by suing the best science taking responsive public health actions, and providing trusted health information to prevent harmful exposures and diseases related to toxic substances?
agency for toxic substances and disease registry
what is the principal agency in the US government for protecting the health and safety of all americans?
centers for disease control and prevention
who whorks to assure health care security for beneficiaries of these programs and works to improve quality and efficiency in an evolving health care system
Centers for medicare and medicaid
what is responsible for protecting the public health by assuring the safety, efficacy, and security of humans and veterinary drugs, biological products, medical devices, our nations food supply, cosmetics, and products that emit radiation?
food and drug administration
what is responsible for advancing the public health by helping to speed innovations that make medicines and foods more effective, safer, and more affordable?
food and drug administration
what is the primary federal agency for improving access to health care services for people who are uninsured, isolated, or medically vulnerable?
health resources and services administration
what provides health services for a lot of american indians and alaska natives?
indian health service
what was originally the laboratory of hygiene in the marine hospital service?
national institutes of health
what administers the national suicide prevention hotline?
substance abuse and mental health services administration
What is public health the science and art of?
prevent disease
promote health
prolong life
what does the Oregon department of human services include?
medicaide health codes records for reportable diseases investigation for disease outbreaks regulate insurance administer board of examination for physicians
what does the health services branch of oregon department of human services do?
low income medical programs
mental health/substance abuse
monitors disease outbreaks
restaurant inspection, drinking water quality
vital records
operates Oregon state hospital and eastern Oregon psychiatric center
county level health departments offer what state services?
immunizations
mental health/substance abuse treatment
WIC nutrition program
Essential components of primary care:
- education concerning prevailing health problems and the methods for controlling them
- promotion of food supply and proper nutrition
- and adequate supply of safe water and basic sanitation
- maternal and child health care, including family planning
- immunization against major infectious diseases
- prevention and control of locally endemic diseases
- appropriate treatment of common diseases and injuries
- provision of essential drugs
What is Healthy People 2020 managed by?
the office of Disease Prevention and Health Promotion (DHHS)
What is new for 2020?
a renewed focus on identifying, measuring, tracking, and reducing health disparities through a determinants of health approach
What is the largest organization of public health professionals?
APHA- american public health association
What are the issues confronted by APHA?
federal/state funding for health programs
chronic and infectious diseases
pollution, smoke free society
education in public health
Which section does the chiropractic field belong in?
25th section
What was the rationale for chiropractic to have a section in the APHA?
public health represents the efforts made by a society to protect, promote, and restore health
public health supports prevention and health promotion
to increase the impact on society by adding chiropractic skills and knowledge to those of the rest of the public health community
What are the achievements in Public Health?
deaths from infections diseases declined impact of vaccines motor vehicle safety improvements in workplace safety control of infectious disease decrease in deaths due to coronary heart disease and stroke safer, healthier foods healthier mothers and babies family planning fluoridation of drinking water recognition of hazards of tobacco
Who discovered alternative to boiling oil to cauterize wounds?
Ambroise Pare
Who developed a trial with a series of test groups to determine if lime juice treated scurvy?
James Lind
What are Hills criteria for Causality?
strength of association dose-response relationship temporal relationship consistency plausibility experimental evidence
What is a good study for determining harm?
cohort study
What are the benefits of a cohort study?
look at individuals exposed compared to those not
prospective
good for looking at multiple interactions
more ethically permissible
When is a retrospective case control study useful?
to look at rare conditions or ones that take a long time to develop
What type of a study was the Framingham Heart study?
a cohort study
When do you use relative risk (RR)?
cohort studies
What does an RR=1.0 mean?
risk is equal, no association
What does an RR >1.0 mean?
exposure increases disease risk
What does an RR less than 1 mean?
exposure reduces disease risk
When do you use an odds ratio (OR)?
case control studies
What does an OR=1 mean?
risk is equal
What does an OR >1.0 mean?
exposure increases disease risk
What does an OR less than 1 mean?
exposure reduces disease risk
what is an example of a study without comparison?
case studies
What are case studies useful for?
generating hypotheses and demonstrating need for further studies
What are the three types of epidemiological studies?
descriptive-observational
analytical-attempting to understand associations
experimental-typically clinical or community trials
What is etiology the study of?
causation, study of why things occur
What are the objectives of epidemiological studies?
identify etiology
determine extent of disease in a community to appropriately plan
study natural history of disease and possible prognosis
evaluate new preventive and therapeutic measures
provide the foundation for public policy and regulatory decisions
Who made the observation about cow-pox and small pox?
Edward Jenner
Who made the observation that the outbreak of cholera was from the water pump?
John Snow
What are the factors needed for disease transmission?
pathogenic organism
reactive host
environmental conditions
What er the methods of transmission?
direct
indirect vector
What is direct transmission?
person to person contact (touching, kissing, etc)
What is a carrier?
individual that does not exhibit symptoms but harbors organisms causing disease
What is indirect transmission?
contaminated food or water
contact with inanimate objects (fomites)
What is vector transmission?
insects and arachnids
notably mosquito, flies, and ticks
What pattern of host/pathogen relationship is characterized by symbiosis in which both or all organisms benefit?
mutualistic
What type of symbiosis has no obvious benefit for organisms involved?
commensal
What type of symbiosis has one partner benefiting at the expense of the other?
parasitic
What are the effects of urbanization on the immunity of a community?
sewage
water pollution
international travel
changing disease patterns
What is a reservoir?
long term host of pathogen of an infectious disease, usually without harm to itself and serves as a source from which others can be infected
Which type of reservoir has the microbes viable and multiplying?
primary reservoir
Which type of reservoir has the microbes viable but not multiplying?
secondary reservoir
What is zoonosis?
any infectious disease that can be transmitted from animals, both wild and domestic, to humans
What kind of an infection is maintained in the population without the need for external inputs?
endemic infection
What is it called when a disease appears as new cases in the population at higher than normally expected rates (of incidence), substantially exceeds what is “expected?
epidemic
What is a small and localized epidemic called?
outbreak (difficult to discern from epidemic)
What is a global epidemic of an infectious disease that affects people and/or animals over a large geographical area?
pandemic
What is herd immunity?
when a critical portion of a population is immune to a disease either naturally or through immunization
What is the principle of herd immunity?
the inability of an infectious disease to spread due to the lack of a critical concentrations of susceptible hosts
What is the incubation period?
the time elapsed between an exposure to a pathogenic organism and when symptoms and signs are first apparent
What is morbidity?
measurement of an incidence of a disease
What does calculating morbidity take into account to make it a measure of risk?
new events
what do you calculate to determine how fast the disease develops in a population?
morbidity
What is prevalence?
number of individuals affected at a specific time
What is the attack rate?
the proportion of people exposed to the disease during the outbreak who do become sick
What is mortality?
the death rate due to a given disease
What calculation gives information about the severity of a disease?
mortality
What is the BOD? and why is it important?
biochemical oxygen demand, it is used to assess the quantity of oxygen needed by microbes in water
What is eutrophication?
high BOD results in the aging of a body of water
What is MacConkey testing?
Lactose + =dark purple colonies
lactose - = colorless colonies
What is EMB agar testing?
lactose + = colonies with dark center
lactose - =colorless colonies
What is the primary process in sewage treatment?
physical process
removal of about 50% of solids in sedimentation tanks
remaining is called the effluent with reduced BOD by 25%
What is the secondary process in sewage treatment?
biological process, two options:
trickling filter or activated sludge process
What is the trickling filter system in sewage treatment?
effluent is sprayed over rocks, used in smaller treatment plants
What is activated sludge method for sewage treatment?
slime forming bacteria added to effluent and stirred, the bacteria digest remaining organic material, then treated with UV or chemicals
What is tertiary treatment in sewage plants?
add lime or alum to remove phosphates and nitrates, then dechlorinated by aeration as flows down steps
expensive and not always used
What are other sources of water pollution?
agricultural runoff
phosphorous fertilizers
toxic waste
industrial waste
How are milk grades determined?
used to be by USPHS, now by USDA
What is the test for effective milk pasteurization?
phosphatase test (it should be removed at the end of the process)
What is the process of pasteurization?
originally 30 min at 62 degrees, now 15 seconds at 72 degrees
What are the storage guidelines to prevent contamination of meat and meat products?
fresh 3-10 days
0C for 30 days
-20C for several months
In what food is bacterial contamination common?
poultry
In what food are microbes present?
seafood
What prevents botulism?
commercial canning at high temps
