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Foundations of Clinical Practice > Public Health > Flashcards

Public Health Flashcards

1
Q

What are the three Key Roles for public health?

A
  1. Assessment
  2. Assurance
  3. Policy Development
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2
Q

What are the 3 “core” public health services according to Dr. Bob?

A
  1. Environmental Health
  2. Disease control
  3. Health Education/Promotion (best via policy)
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3
Q

What are the 10 essential services of Public Health?

A
  1. Monitor health status to identify problems
  2. Diagnose and investigate problems/hazards
  3. Inform, educate, and empower people
  4. Mobilize partnerships
  5. Develop policies & plans
  6. Enforce laws and regulations
  7. Link to services and assure care
  8. Assure competent public health and healthcare workforce
  9. Evaluate effectiveness
  10. Research
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4
Q

Ways to build walls in regards to disease?

A
  • 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)
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5
Q

Describe the drug resistance of Clostridium difficle since 1980?

A

since the 1980’s the mortality rate per 100,000 people has more than doubled. Growing fastest between 2000 and 2005.

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6
Q

Describe mortality due to vaccine-preventable diseases since 1980?

A

These have all been steadily decreasing. Hep B had a peak in 1995 and has been improving since then

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7
Q

When did mortality due to vector-borne diseases spike in the time since 1980?

A

Around 2001 due mainly to West Nile Virus.

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8
Q

How many reportable diseases are there in AZ?

A

> 80

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9
Q

What are the top ten reportable diseases in AZ?

A
  1. Chlamydia (27,532)
  2. influenza (13.850)
  3. Gonorrhea (8,518)
  4. Valley Fever (4,331)
  5. Syphilis (1,299)
  6. Campylobacter (1,052)
  7. MRSA (1,015)
  8. Hep B (940)
  9. Salmonellosis (635)
  10. Strep pneumoniae (496)
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10
Q

Describe the trajectory of chylamydia, gonorrhea, syphilis, HIV?

A

Since 2012, all have increased with all but HIV above the 4 year average in 2016

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11
Q

How much have cases of chlamydia increases in Maricopa county since 2004?

A

104%

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12
Q

Since when have newly diagnosed cases of gonorrhea increased?

A

Dramatic increase since 2010

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13
Q

What was the trend for gonorrhea rate 1997-2010?

A

steadily declined

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14
Q

How much have gonorrhea cases increased since 2010?

A

139%

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15
Q

Describe number of newly diagnosed cases of syphilis in Maricopa county from 1990 to 2013

A

Steady increase

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16
Q

Describe the number of newly diagnosed cases of syphilis in Maricopa county since 2013?

A

Risen 112%

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17
Q

What was the syphilis rate like in 2016?

A

All time high

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18
Q

What has the change in the syphilis rate been since 2000?

A

No change (despite s94% increase in the past 3 years)

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19
Q

Does syphilis affect men or women more?

A

Men, particularly older men

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20
Q

Describe the difference between AIDS rates and HIV rates since 2010?

A

HIV has increased slightly

AIDS continues to decrease

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21
Q

Since 2000 have HIV rates increased or decreased?

A

stable

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22
Q

Since 2000 have AIDS rates increased or decreased?

A

decreased by 52%

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23
Q

What dual infection is a growing problem in Maricopa County since 2011?

A

Syphilis and HIV

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24
Q

Which congenital disease is nearly double the national rate here in Maricopa county?

A

congenital syphilis is nearly double the rate of congenital syphilis in the US

25
Q

Generally, is the percentage of high school student you have had sex, or are sexually active increased or decreased since 1991?

A

Generally, # of sexually active, those with multiple partners have decreased.

Condom use has increased modestly

26
Q

Is chylamydia symptomatic in women?

A

75% asymptomatic in women

27
Q

What are some of the consequences of chylamidia infection in women?

A
  • Pelvic inflammatory disease
  • Hospitalization
  • Infertility
  • Ectopic pregnancy
  • Chronic pelvic pain
28
Q

What are the resources that have been recommended to address the chlamydia and gonorrhea problem?

A

> 40,000 gonorrhea and chlamydia interviews

Investigators: 60

29
Q

How many investigators are actually employeed by Maricopa county?

A

19 (need 60)

30
Q

About how many infectious disease reports are investigated in Maricopa county?

A

~14%

31
Q

How does Maricopa county per capita funding stack up against US?

A

US average ~$55

MC ~$10

32
Q

How much of MC’s budget is federal versus state?

A

Federal $7 of 11

State/Local: $4 of 11

33
Q

Describe Measles rates between 1950-2001?

A

After the vaccine was licensed in ~1964 rates dropped from about 500,000 to <50,000 by 1968

34
Q

Where are the highest rates of Hepatitis A?

A

Arizona, New Mexico, California, Oregon and Washington

35
Q

What helped decrease the incidence of Hep A in 1998?

A

Day care vaccination requirement

36
Q

How long does it take for immunity against pertussis to wane?

A

5 to 10 years after vaccination

37
Q

How often does pertussis peak?

A

every 2-5 years

38
Q

Who is Tdap especially important for?

A

those in contact with infants

39
Q

When was Tdap vaccine licensed?

A

2005

40
Q

Who is recommended to get a flu shot?

A

Everyone 6 months and older?

41
Q

In what ways is it beneficial to have health care workers be vaccinated against the flu?

A
  • less infection
  • fewer sick days
  • fewer deaths
42
Q

If you can’t get the flu from the flu shot, what side effect can you get?

A

arm soreness

43
Q

Which part of the population has the highest attack rate?

A

children

Kids also shed the virus longer and earlier

44
Q

Who is the main disseminator of the flu?

A

children

45
Q

Which country made the flu vaccine mandatory and saw good results until 1987 when parents were allowed to refuse vaccination?

A

Japan

46
Q

According to mathematical modeling what percent of school kids would need to be vaccinated in order to see >90% decrease in flu for everyone?

A

80%

47
Q

What are the leading causes of death in the US as of 2000?

A
  1. Heart disease
  2. Cancer
  3. Stroke
  4. Chronic lung disease
  5. Unintentional injuries
48
Q

What are 5 important social determinants of death?

A
  1. Tobacco
  2. Poor diet/lack of exercise
  3. Alcohol
  4. Infectious agents
  5. Pollutants/toxins
49
Q

How many children in Maricopa county are obese?

A

1 in 7 MC children are obese

50
Q

How many Maricopa county adults are obese?

A

1 in 4 MC adults are obese

51
Q

What has been determined to cut diabetes risk in half?

A

moderate exercise adn diet changes

52
Q

Describe the overall trend in infectious disease mortality in the US during the 20th century?

A

Declined substantially between 1900 and 1950 (aside from 1918 spanish flu). Fairly steady since the 1950s

53
Q

The use of what improved the mortality rate from infectious disease after 1942?

A

Penicillin (discovered in 1928, used in first patient in 1942)

54
Q

What two factors helped improved death rates for aquatically transmitted diseases?

A
  • Water service

- Sewage service

55
Q

Explain why Policy change is better than Behavior Change?

A

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

56
Q

What is the recommended approach to policy?

A

collaborative: Public health provides background data and education to school officials
- Partners consider and implement decisions

57
Q

What caused 1 in 5 Arizona Smokers to quit between 2007 and 2008?

A
  • Cigarette tax

- Smoking in bars banned

58
Q

What does policy with a small p refer to?

A

Providing education to policy makers and allowing them to implement changes.

*work in partnership

59
Q

Is public health individual health care?

A

NO

Foundations of Clinical Practice (4 decks)

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