Public Health Module 5 and 6 Flashcards
What is Bioethics
Elements of both healthcare and public health. Applies morals and values to areas of potential conflict and integral part of health law and policy.
What is police power
Allows state to pass legislation and take actions to protect the common good
What are the topics addressed in the scope of health law, policy and ethics
Tools to encourage and discourgage behaviors by individuals and groups: Public health, bioethics, health care
Expand on health care
Concern about access, quality, and cost of care, emphasis on services for entire population, especially vulnerable groups
Importance of the 3 topics
Address right to healthcare and how health care balances rights
What is Interstate Commerce clause
Major source of federal authority in public healthy and health care
Health policy
Decisions, plans and actions that are taken to achieve specific health goals for a population
Health policies can be made by who
made by private groups, commercial trade associations, government organizations.
Health in all policies approach
Private and public entities work towards common goals to achieve improved health for all white reducing health inequalities.
Healthy People
Prioritizes the issues that affect the health of the U.S. population
What happened in 1948
Right to health care incorporated into the Universal declaration of human rights and the constitution of the world health organization
Self-imposed risk vs. imposed risk
Self: individuals who knowingly take risk
Imposed: Risk to individuals or population that is not in your control/beyond direct
What is the Belmont Report
Defines the rights of research subjects and outlines three basic ethical principles:
Aspects of Belmont Report
- Respect for persons: Autonomy, protect those with diminished autonomy
- Beneficence: Do no harm, maximize possible benefits and minimize possible harms
- Justice: Fairness in distribution
- Institutional review boards (IRBs): Must approve most human research before it can begin
What is burden of disease and what are the factors
The impact of the disease on the population, burden of disease is measured by number of factors (WHO).
1. Mortality = Death rate caused by disease
2. Morbidity = The rate or degree of disease in individuals/populations
3. The financial impact of disease
Define Risk Factor
Factor that makes individual or population more susceptible to disease
What are the non communicable disease risk factors:
A. Tobacco
B. Unhealthy diet
C. Sedentary behavior and inactivity
D. Harmful use of alcohol
E. Obesity
4 main non-communicable disease
- Cardiovascular
- Cancer
- Chronic respiratory disease
- Diabetes
Name other common diseases
- Alzheimer
- Arthritis
- About 50 more common ones
Define non-communicable disease
Main cause of death and disability, more common in developed countries.
What can disease morbidity also be defined as or equal
Chronic Disabilities
Other non-communicable factors include
Increases in cots of healthcare and poor quality of life
What is mental health leading cause of in U.S.
Disability
What are the preventative, curative and rehabilitative approaches to non-communicable diseases:
A. Screening for early detection
B. Multiple risk factor intervention
C. Identification of cost-effective treatments
D. Genetic counseling and intervention
E. Research
Screening for early detection of NCDs and examples
Detection at early stage
Treatment
Better outcomes = Reduce or prevent disability —— Reduce or prevent death
Examples: Colon Cancer, Vision disorders, Hearing disorders
Criteria for NCD Screening Program
- Disease produces substantial death and or disability
- Early detection is possible and improves outcome
- There is a feasible testing strategy for screening
- Screening is acceptable in terms of harms, costs and patent acceptance
What approach is used to address burden of NCD and what are the steps
Multiple risk factor approach
Identify possible risk factors Target them by an intervention approach (Ex: treatment)-Intervention is called Multiple Risk Factor Reduction
When are these steps/approach effective
Most effective when there are constellations or groups of risk factors that cluster in definable groups of people
When are these steps/approach useful
Useful when two or more risk factors increases the risk more than would be expected by adding together the impact of each risk factor
Define cost-effective interventions approach
- Cost-effectiveness combines issues of benefits and harms with issues of financial costs
- Compares a new intervention to the current or standard intervention
a. Is the additional net-effectiveness of an intervention worth the additional cost
b. Is a small loss of net-effectiveness worth the considerable savings in cost
Which part of quadrant do you want to be on
Right lower side
Define genetic counseling approach
- Targeted diseases that are caused by gene abnormalities
a. Tay-Sachs disease in Ashkenazi Jews
b. Sickle-cell anemia among African Americans
(Both caused from presence of certain genes)
c. Down syndrome = chromosomal abnormalities
Define genetic counseling approach continued (actual steps of procedure)
Predict the risk of a disease:
Presence of breast cancer gene variant (BRCA1)
Degree of association varies (incomplete penetrance)
Not easy to predict the outcome
Define pharmacogenetics testing
Shows information how people respond to drug
Helps identify the best drug and best does
A. Some people are allergic to abacavir
a. HIH antiviral agent
b. 10 percent Caucasians carry a gene that give 50 percent chance of developing fetal hypersensitivity
c. Alternative drugs exist
d. Example of how this approach can intervene
Define ethical, legal and social implications of genetic counseling approach
Should we identify disease when little can be done
Sharing of genetic risk information
Discrimination based on genetic information
Providing equal access to tests = health equity
How to prevent long-term mortality and morbidity during NCD intervention
- Weigh short-term benefits verses long-term problems
a. Example: drugs that suppress immune system (Rheumatoid arthritis) - Death from drug overdoes in U.S increased 500 percent since 1990
After introduction of prescription opioid drugs look at long-term harm potential long-term
Alzheimer’s: One of the most rapidly increased NCD (Non-Communicable Disease)
2 moral impulses that animate public health
- Advance human well-being by improving health
- Focusing on the needs of the most disadvantaged.
Define 4 components of healthful eating and being physically active:
- Intrapersonal
- Interpersonal
- Community/Institution
- Macro/Public Policy
Provide examples of Intrapersonal healthy eating and physical activity
Control of individual, examples: taste preferences or lack of nutrition knowledge and skills, inadequate cooking skills
Physical limitations, joints, shortness of breath, lack of interest, lack of self-confidence and motivation
Provide examples of Interpersonal healthy eating and physical activity
Primary social relationships surrounding individual, Food intake related to parents’ nutrition knowledge and food intake, expectation that it’s negative to eat healthy when others around you don’t
Physical: Socioeconomic factors: lower frequency of weekly families’ meals, lower exercise rates
Provide examples of community/instituion healthy eating and physical activity
Neighborhoods, work sites, schools: Characteristics of environment influence eating behaviors, limited food availability, fewer stores, more fast-food places, difficulty traveling places.
Provide examples of macro/public policy healthy eating and physical activity
Local, state, and federal policies: Food Stamp Program, limited English or literacy levels, cyclic eating pattern, food pricing
Describe the benefits of screening
More effective treatment, better future health, Reassurance, informed decisions, worthwhile use of resources, reproductive choice
Describe the downsides of screening
Incorrect results, treatment risks, difficult decisions, anxiety or false reassurance, over treatment, harms from screening tests
