Public Health Flashcards
Define endemic
Disease that is peculiar or restricted to a locality or region, maintained in the population without external input. Constantly present.
Define epidemic
Outbreak of disease affecting a disproportionately large percentage of population, community, or region at the same time. Higher incidence than expected.
What was the Poor Act of 1601?
Defined “poor” services that people could receive after the collapse of the feudal system
What did John Graunt create in London for the first time?
Bills of Mortality - a record of “vital statistics” -
an attempt to make official record of births and deaths. Used to estimate population
What did Edwin Chadwick work on, and what did it lead to?
Sanitation, hygiene, factory management, child welfare, care of elderly.
Lead to establishment of general board of health.
For what is Florence Nightingale famous?
Establishing a school of nursing.
Nursing work during the Crimean War.
What was the first federal health agency in the united states?
Marine Hospital Fund - physicians in port for merchant seamen.
Eventually became the Marine Hospital Service
Who ran the Marine Hospital Service?
Eventually the surgeon general
What agency transformed into the US Public Health Service?
Marine Hospital Service
What act was passed in 1935 in response to the great depression to try and support the poor, elderly, and disabled?
Social security act
What did the social security act have to do with public health at its conception?
It provided funding for research into priority diseases during the great depression.
What organization declared that health is a human right?
World Health Organization
WHO includes what organization dedicated to improving health and living standards in the Americans?
Pan America Health Organization
What UN organization fights for the rights of children globally?
United Nations Children Fund
What are the categories of children’s rights fought for by UNICEF?
- food and supplies
- disease control
- family planning
- child development
What organization is the largest health program in the world?
Dept. of Health and Human Services
The US Public Health Service is currently under the oversight of what agency?
DHHS
Primary health care is essential care that has what (4) characteristics?
- practical
- scientifically sound
- socially acceptable
- available to all people
What are the (8) components of primary care?
- education
- nutrition & food supply
- safe water & basic sanitation
- family planning, maternal and child health
- immunization
- prevention of endemic disease
- treatment of disease and injury
- essential drugs
What office manages the Healthy People program?
Office of Disease Prevention and Health Promotion
What does the Healthy People program determine and publish?
10 year national objectives for improving American health
What is the main focus of Healthy People 2020?
Identifying, measuring, tracking, and reducing health disparities
What is the largest health care workers organization worldwide?
American Public Health Association
Has section for chiropractic
What are the (4) main areas covered by the American Public Health Association?
- funding for health programs
- chronic and infectious diseases
- pollution & smoke free society
- public health education
Achievements in public health include improvement in what major areas, and recognition of what major health risks?
Improvements in:
- infectious diseases
- vaccinations
- workplace safety
- motor vehicle safety
- safer food
- coronary heart disease
- mother & infant health
- family planning
Recognition of health risks:
- lack of fluoride
- tobacco hazards
Define epidemiology
Controlling health problems through the study of the distribution and determinants of health-related states and events in specific populations
Definite etiology
The study of causation - of why things occur
As relates to epidemiology, the study of what causes a disease
What did Edward Jenner figure out?
That smallpox and cowpox are related and you can prevent smallpox using cowpox as a vaccine
What did John Snow figure out?
That a cholera outbreak was related to a particular water pump - removed the pump handle to prevent people from using it and getting sick
What are the (3) factors necessary for disease transmission?
- Pathogen (usually microbe)
- Susceptible, reactive host (like a human)
- Environmental conditions bringing the pathogen to the host
What are the (3) types of disease transmission?
- direct
- indirect
- vector
What is direct transmission of a disease?
Disease passing from one person to another through physical contact
What does it mean if a person is a carrier of disease?
A carrier is a person who can infect others with a disease without exhibiting symptoms of it
What are the mechanisms of indirect disease transmission?
Contaminated food, water, and inanimate objects
What are the most common vectors of disease transmission?
- insects, especially mosquitos and flies
- arachnids, especially ticks
What are the (3) patterns of host-pathogen relationship?
- mutualistic
- commensal
- parasitic
What is a mutualistic host-pathogen relationship?
Symbiosis in which all involved organisms benefit
What is a commensal host-pathogen relationship?
Symbiosis in which none of the organisms involved obviously benefit from the relationship
What is a parasitic host-pathogen relationship?
Symbiosis in which only one partner benefits, at the expense of the other
What is a reservoir of infection?
A long term host of a pathogen, usually without injury to itself.
Can be inanimate or living
What is a primary reservoir of infection?
What are 2 examples?
An infection source with microbes that are viable and multiply
- food
- soil
What is a secondary reservoir of infection?
What are 2 examples?
An infection source with viable microbes that do not multiply
- air
- soil
What are living reservoirs of infection?
- humans
- non human animals
What is zoonosis?
Any infectious disease that can pass from non human animals to humans
- tape worm
- mad cow disease
Risk of disease can vary with what characteristics or circumstances?
- age
- gender
- ethnicity
- occupation
- previous disease
- nutrition
- sources of food and water
What is the difference between endemic and epidemic?
Endemic diseases are constantly present in a population.
Epidemics are a higher than expected incidence of a disease
What is a pandemic?
A global epidemic of an infectious disease that affects people or animals
What is an outbreak?
A localized epidemic —> no clear distinction between epidemic and outbreak
What is herd immunity?
When a critical portion of a population is immune to a disease (immune by any method)
How does herd immunity protect the herd?
It results in the inability of an infectious disease to spread, due to lack of susceptible hosts
What is BOD as relates to water quality?
Biochemical Oxygen Demand
What is eutrophication?
The aging of a body of water, as a result of high BOD
What are coliforms?
Microbes present in water that are:
- Gram negative
- lactose fermenting
- gas producing
- facultative
How many coliforms can be present in drinking water?
Zero
MacConkey and EMB agar are testing for the presence of what kind of colonies by looking for what product?
Coliforms, by looking for the presence of lactose
Lactose (+) = dark purple colonies, or colonies with dark centers, depending on the test
What is the primary goal of sewage treatment?
Reducing biochemical oxygen demand
What happens during the primary treatment of sewage?
Physical process: removal of solid material in sedimentation tanks
What is the product of primary sewage treatment?
Effluent
What happens during the secondary treatment of sewage?
Biological process, either:
- trickling filter: effluent sprayed over rocks, allowing microbes to digest organic material
- activated sludge process: slime-forming bacteria added to effluent, which digest organic material and form flotsam. Water then treated with UV light
When does the most BOD reduction happen in sewage treatment?
Secondary treatment (95% reduction)
What happens in the tertiary treatment of sewage?
Addition of lime or alum to remove nitrates and phosphates.
Dechlorination follows.
Expensive.
How is milk pasteurized?
15 seconds at 72 degrees
Used to be 30 mins at 62 degrees
What enzyme should be destroyed in pasteurization?
Phosphatase
What is the goal of a harm study?
Assessing the causal relationship between an exposure and a disease
What is a confounder?
Anything that independently affects the relationship between an exposure and an outcome (disease)
What are the (6) conditions Hill outlined for determining causality?
- Temporal relationship
- Dose-response relationship
- Experimental evidence
- Strength of relationship (statistical significance)
- Consistency
- Plausibility
What kind of study is best for looking at multiple, interactive causes of harm?
Cohort study
What kind of study allows us to calculate a relative risk?
Cohort study
What is a relative risk?
The likelihood that exposure to a particular factor results in an specific outcome, compared to not being exposed.
Ex: line workers are 5.7 times more likely to get carpal tunnel than those who do not do line work.
Exposure = line work
Relative risk = 5.7 times increased risk
What kind of study allows us to calculate an odds ratio?
A case control study
What is an odds ratio?
The likelihood that a group with a particular outcome was exposed to a certain factor (retrospective)
What does it mean if the relative risk or odds ratio = 1?
That exposure to the factor does not affect risk of disease
What does it mean if the relative risk or odds ratio is less than 1?
That exposure to the factor decreases likelihood of disease
What does it mean if the relative risk or odds ratio exceeds 1?
That exposure to the factor increases risk of disease
What are 2 “pros” of a case control study?
- speed: it’s retrospective so you can gather your data quickly
- rare conditions: you can study rare conditions that may never develop if you were to do a prospective study
What did Ambroise Pare discover in the 1500’s?
Figured out how to cauterize wounds without boiling oil
What did James Lind study in the 1740’s?
Scurvy, and whether it could be treated with lime juice.
