Public Health Flashcards
What are the three Key Roles for public health?
- Assessment
- Assurance
- Policy Development
What are the 3 “core” public health services according to Dr. Bob?
- Environmental Health
- Disease control
- Health Education/Promotion (best via policy)
What are the 10 essential services of Public Health?
- Monitor health status to identify problems
- Diagnose and investigate problems/hazards
- Inform, educate, and empower people
- Mobilize partnerships
- Develop policies & plans
- Enforce laws and regulations
- Link to services and assure care
- Assure competent public health and healthcare workforce
- Evaluate effectiveness
- Research
Ways to build walls in regards to disease?
- Literally build wall (isolate)
- Treat to render noninfectious
- Treat patient’s contacts to cut off incubating disease
- Immunization
- Behavior change
- Keep sanitary conditions (to prevent spread)
- Policy decisions that help prevent transmission (ex. access to health care)
Describe the drug resistance of Clostridium difficle since 1980?
since the 1980’s the mortality rate per 100,000 people has more than doubled. Growing fastest between 2000 and 2005.
Describe mortality due to vaccine-preventable diseases since 1980?
These have all been steadily decreasing. Hep B had a peak in 1995 and has been improving since then
When did mortality due to vector-borne diseases spike in the time since 1980?
Around 2001 due mainly to West Nile Virus.
How many reportable diseases are there in AZ?
> 80
What are the top ten reportable diseases in AZ?
- Chlamydia (27,532)
- influenza (13.850)
- Gonorrhea (8,518)
- Valley Fever (4,331)
- Syphilis (1,299)
- Campylobacter (1,052)
- MRSA (1,015)
- Hep B (940)
- Salmonellosis (635)
- Strep pneumoniae (496)
Describe the trajectory of chylamydia, gonorrhea, syphilis, HIV?
Since 2012, all have increased with all but HIV above the 4 year average in 2016
How much have cases of chlamydia increases in Maricopa county since 2004?
104%
Since when have newly diagnosed cases of gonorrhea increased?
Dramatic increase since 2010
What was the trend for gonorrhea rate 1997-2010?
steadily declined
How much have gonorrhea cases increased since 2010?
139%
Describe number of newly diagnosed cases of syphilis in Maricopa county from 1990 to 2013
Steady increase
Describe the number of newly diagnosed cases of syphilis in Maricopa county since 2013?
Risen 112%
What was the syphilis rate like in 2016?
All time high
What has the change in the syphilis rate been since 2000?
No change (despite s94% increase in the past 3 years)
Does syphilis affect men or women more?
Men, particularly older men
Describe the difference between AIDS rates and HIV rates since 2010?
HIV has increased slightly
AIDS continues to decrease
Since 2000 have HIV rates increased or decreased?
stable
Since 2000 have AIDS rates increased or decreased?
decreased by 52%
What dual infection is a growing problem in Maricopa County since 2011?
Syphilis and HIV
Which congenital disease is nearly double the national rate here in Maricopa county?
congenital syphilis is nearly double the rate of congenital syphilis in the US
Generally, is the percentage of high school student you have had sex, or are sexually active increased or decreased since 1991?
Generally, # of sexually active, those with multiple partners have decreased.
Condom use has increased modestly
Is chylamydia symptomatic in women?
75% asymptomatic in women
What are some of the consequences of chylamidia infection in women?
- Pelvic inflammatory disease
- Hospitalization
- Infertility
- Ectopic pregnancy
- Chronic pelvic pain
What are the resources that have been recommended to address the chlamydia and gonorrhea problem?
> 40,000 gonorrhea and chlamydia interviews
Investigators: 60
How many investigators are actually employeed by Maricopa county?
19 (need 60)
About how many infectious disease reports are investigated in Maricopa county?
~14%
How does Maricopa county per capita funding stack up against US?
US average ~$55
MC ~$10
How much of MC’s budget is federal versus state?
Federal $7 of 11
State/Local: $4 of 11
Describe Measles rates between 1950-2001?
After the vaccine was licensed in ~1964 rates dropped from about 500,000 to <50,000 by 1968
Where are the highest rates of Hepatitis A?
Arizona, New Mexico, California, Oregon and Washington
What helped decrease the incidence of Hep A in 1998?
Day care vaccination requirement
How long does it take for immunity against pertussis to wane?
5 to 10 years after vaccination
How often does pertussis peak?
every 2-5 years
Who is Tdap especially important for?
those in contact with infants
When was Tdap vaccine licensed?
2005
Who is recommended to get a flu shot?
Everyone 6 months and older?
In what ways is it beneficial to have health care workers be vaccinated against the flu?
- less infection
- fewer sick days
- fewer deaths
If you can’t get the flu from the flu shot, what side effect can you get?
arm soreness
Which part of the population has the highest attack rate?
children
Kids also shed the virus longer and earlier
Who is the main disseminator of the flu?
children
Which country made the flu vaccine mandatory and saw good results until 1987 when parents were allowed to refuse vaccination?
Japan
According to mathematical modeling what percent of school kids would need to be vaccinated in order to see >90% decrease in flu for everyone?
80%
What are the leading causes of death in the US as of 2000?
- Heart disease
- Cancer
- Stroke
- Chronic lung disease
- Unintentional injuries
What are 5 important social determinants of death?
- Tobacco
- Poor diet/lack of exercise
- Alcohol
- Infectious agents
- Pollutants/toxins
How many children in Maricopa county are obese?
1 in 7 MC children are obese
How many Maricopa county adults are obese?
1 in 4 MC adults are obese
What has been determined to cut diabetes risk in half?
moderate exercise adn diet changes
Describe the overall trend in infectious disease mortality in the US during the 20th century?
Declined substantially between 1900 and 1950 (aside from 1918 spanish flu). Fairly steady since the 1950s
The use of what improved the mortality rate from infectious disease after 1942?
Penicillin (discovered in 1928, used in first patient in 1942)
What two factors helped improved death rates for aquatically transmitted diseases?
- Water service
- Sewage service
Explain why Policy change is better than Behavior Change?
Policy forces behavior change where as behavior changes are more like recommendations.
Ex. BC- warn against 2nd hand smoke vs. PC - creates smoke-free workplaces
What is the recommended approach to policy?
collaborative: Public health provides background data and education to school officials
- Partners consider and implement decisions
What caused 1 in 5 Arizona Smokers to quit between 2007 and 2008?
- Cigarette tax
- Smoking in bars banned
What does policy with a small p refer to?
Providing education to policy makers and allowing them to implement changes.
*work in partnership
Is public health individual health care?
NO
