public health exam 1 Flashcards
what is public health?
about protecting and promoting health, focuses on groups of people and communities, organized and collective efforts
what is health care
focused on the individual, one provided, and focus on treatment
Why is Public Health Important?
Value driven, community-led solutions, and evidence-based decision making, health equity, prevention and wellness
How does Public Health contribute to longer life?
Sanitation, housing, nutrition, and job safety
What are the imbalances between public health and healthcare?
Market system (US targets individual needs), rule rescue(want to be saved only when something is wrong), relative risks(own risks for various things)
Benefits
Abstract, deferred
Cost
Tangible and immediate
First Core Functions of Public Health
Assessment
- data collection, biological analysis, dissemination of finding
Second Core Function of Public Health
Policy Development
- use of scientific knowledge base
- engaging communities,
- appreciation and use of the political process
Third Core Function of Public Health
Assuring needed services are Available
- encouragaing appropraite actions by other entities
- requiring such action through law or regulation
- directly providing Public Health Services
Why is Public Health Contentious?
- may restrict on individual freedom
- questions the role of individual responsibility
- economic and public health intrest can be in conflict
- may take on moral issues
Six sciences of Public Health
Epidemiology, statistics, biomedical sciences, social, behavioral, environmental sciences
Approach to Public Health Problems
- Define Problem
- Identify risk factors
- Prevent cause or develop/ test intervention
- implement intervention
- monitor intervention and assess the effectiveness
Primary Interventions
prevents anything from occurring at all
Secondary prevention
minimize damage once the event has occurred
Tertiary
Minimize disability through rehabilitation
What are some Population Healths measures?
- Death Rates(1/100,000 annually), Infant Mortality(1/1000), Life Expectancy
What influences population health?
Social, economic, and physical environments, personal health practices, individual capacity and coping
Race
group of people similar physical or social characteristics considered by society as forming a distinct group
What is population health?
the health outcomes of a group of individuals including the distribution of such outcomes within the groups
Health
physical well-being, social well-being, and mental well-being
Socioeconomic Status (SES)
the social standing of class of an individual or group.
How is SES measured
Income, education, occupation
Health Difference
a measurable difference in health conditions or deaths compared with the general population- Inequality
How can racism be experience?
Interpersonally (language…), Structurally (society reinforcing stereotypes), Institutionally (racially discriminatory policies)
Health Disparity
Linked to economic, social, or environmental disadvantage. Affect people who have been systematically experience greater obstacles in health- Inequity
Where do disparities arise from?
Inequities in social circumstance: gender, SES, location, ethnicity, religion and race, mental health
Health Disparity are….
avoidable, unnescessaire, and unjust
Life expectancy improves….
when SES increases and are not systematically opressed
Half of all premature deaths are the result of health behaviors factors
smoking, poor diet and physical inactivity, injuries, other preventative
Health Equity
Means social Justice in health- commitment to reduce and eliminate disparities in health
How does economic stability affect health?
housing, medical care, healthful foods
how does education affect health?
income, employment, health knowledge, stress, healthy behaviors, social resources,
how does neighborhood and physical environment influence health
- housing quality and safety
- green space and walkability
- environmental pollution
How does food affect health outcomes?
food security, access to quality foods, availability of healthy options
How does social and community negatively context affect health?
limited economic opportunities, residential segregation, stress
how does health care affect health?
access to care, provider and hospital availability, quality of care
How does Racism Effect Health?
- every seven minutes black people die prematurely
- linked to obesity, breast cancer, to heart disease, and even premature mortality
What powers do the states have?
The power not delegated to the US or prohibited to the states are reserved to them
Parts of the Pbic Health system
federal agencies, state/tribal/local departments, government agencies, clinical care systems, community based organizations, educational institutions, media, private non-profit associations, private industry
What is part of a strong public health infrastructure?
prevent chronic illness, control infectious diseases, monitor food and water safety
What was not made possible without the government?
- immunizations, motor vehicle safety, workplace safety, control of infectious disease, declines in death in heart and stroke, safer and healthier foods, improve maternal/ child outcomes, family planning, fluoridation of water, tabacco warnings
State Governments have Police Power. What is that?
The right to enact laws and regulations to protect public health, welfare, and morals
What two ways are the US Congress involved in Public health?
Commerce power and power to tax and spend(should be spent to promote tax and spend the for the common good of the citizens)
CMS
medicare- health insurance for the elderly
Medicaid- health insurance and nursing home for the poor
Who gives local government authority?
the state
CDC
- research, produces health education materials, trains the public health workforce, collects data on the nation’s health
FDA
- food, drug, cosmetics
-safety of manufacture ood, safety of medical deices and safety of vacines
Law Works in PH
- government receives a need
- passess a statue
- can be challenged in court
Epidemiology
the meaure and distribution of health and disease outcomes in the population
Big Figures in Epidemiology
John Snow (water supplies contaminated), Florence Nightingale (reduced death in soliders) Jame Baldwin (race and health side affects)
Objectives of Epidemiology
- identity the cause of disease and risk factors
- determain the extent of disease found in the community
- study the natural history and progression of disease
- evaluate new preventative and therapeutic measures
- provide a foundation for developing public policy
Questions in Epi
Clearly defined, specific time and population
measurement of population in Epi- data collected
clean, objective and measurable, how it it collected: surveys, interview, medical records, lab studies
outcome- occurrence and number of times had
measurements in populations in Epi
age, race, ethnicity, sex
Randomized Control Trials
evaluate new methods, treatment social interventions
Pros- should be free from bias, double blind/ blind, golden standard
Cons- ethical considerations , placebo
Case Control Groups
find groups and then trace their history back to find the exposure
- Pros- good for rare diseases, more efficent
- cons: not efficent for rare exposures, prone to bias from researcher, temporality issues
temporality
whether a cause happens before an effect
Cross-sectional study
exposure and disease status assessed at the same time
- pros:quick and inexpensive, have provides exploratory data
- cons: cannot determine where exposure precedes disease, limited ability to provide inferences
Cohort Study
exposure is measured at onset of study and the disease status is measure at followup
pros: exposure prevedes disease, good for rare exposures
cons: bad for rare disease, expensive and long duration, prone to self-bias
Bias and confounding
bias- systemic error and incorrect estimate of the association
confounding- is a distortion in the association between the exposure and disease presented by third variation
Statistical Analysis
how you build convincing evidence- measured in ratio
incidence
the number of new cases measure in rate
prevalence
the number of preexisting cases measure in percentages in a point of time
endemic
the usual outcome of a disease within a given geographic area and time
epidemic
the occurrence of infectious disease above the normal expectancy in a specific area and time
pandemic
world wide epidemic affecting a large amount of people
Populations
target- want to generalize to
source- specific individuals from which a representative sample is taken
study- the group you get access to
sample- the group in the study
connivence sample
data collection from population member who are conveiently able to participate in study
pro: cheap, easy, good for hypothetical generation
cons: not representative and limits generablizlity
biostatistics
the application of stats in public health; includes clinical trials, genetic variants surveys, brain functions, economic factors, pollulant concentratons
Jerry Cornfield
established relationship between smoking and lung cancer
Misinformation
videos that have been edited, picked statistics, websites that look professional,
Why biostats?
understand and analyze Public Health studies, quantitative resoning skills to evaluate and interpert studies,
Population
entire set of people or things, they have the results applied to them
sample
subset of data, what we collect data on
good sampling
free from bias, efficient, only probability sampling
As n increases the CI…
around the mean gets smaller - more precise estimate
P-value
the probability of an observed result arising by change-
Do biostats use p-values?
no- they are often missused and the increase of sample size decreased the p-value
Bias in Biostats
- people enrolling in a study where they are represented, recalling errors, publication (more positive than negative), algorithmic correlation degree of a relationship between 2 variables or quantities
Infectious diseases
disorders caused by organisms- bacteria, viruses, fungi, or parasites
Koch 4 criteria
- Causative agent is absent from all health organisms but present in diseased
- causing agent must be isolated from the diseased organism
- cultured agent must cause the same disease when inoculated into a health organism
- Same causative agent must be reisolated from the inoculated diseased organism
Pasteur
developed vaccines, and discovered several species of bacteria
Explanations for Diseases
- Miasma (poisonous emanations from filthy water, soil air)
- Contagion and germ theory (puerperal fever; during childbirth led to spsis)
Epiological Transitions - Chronic Diseas
- HIV epidemic
- Covid
Infectious dieseases..
decline during epidemiological transitions
People sill live with HIV
but new cases have decreased
Direct Transmission
person to person contact from one infected person to another person
In the world ….. diseases are the leading cause of death
infectious
pathogens
bateria, viruses, fungi, parasites, prions
what has caused the (re)emergence of infectious diseases
urbanization and crowding, increased mobility, human contact with environment, increased pollutants, potential for bioterror, effects of global warming
Indirect transmission
involves the transfer of pathogen by contact with a contaminated intermediate inanimate object or contaminated vector
Why investigate outbreaks?
identify risk factors, discover new pathogens, new research insight
Types of Exposure
- no infections
- carrier no illness
- subclinical
- clinical infection
3 periods of infectious process
Incubations, latent, infectious
What are someways to break the chain of infection?
hygiene, sanitation, airflow, treating disease
Similarities in Chronic Disease definitions
the length of time (persistent, long duration, longer than a year)
Why is Communication important?
tell the public accurate information, control panic,
Types of Chronic Diseases
heart disease, cancer, chronic lung disease, stroke, Alzheimer, and diabetes
Differences in Chronic disease definitions
comes with time, requires on going medical attention, or limits activity of everyday life
epidemiological transition
change in disease patterns, cause of death, fertility, and life expectancy, shift from infectious diseases to chronic diseases
Individual burden of disease
survival, anxiety, social/economic disease
Public Burden of disease
contagiousness, economic intrest, prevalence, incidence, morbidity, mortality
economic cost of chronic diseases
- cost a lot for medication and loss productivity
- having more than one chronic illness dramatically increases the cost
common causes
poor sleep, nutrition, physical inactivity, tabacco use, physical inactivity, excessive alcohol
Having a infectious can lead to a higher risk for a chronic disease
Having a chronic disease can lead to a higher chance of getting a infectious disease
