study guide Flashcards
____________ - how to measure health at population level
- tool to quantify health loss form hundreds of diseases, injuries, and risk factors
- health systems can be improved and disparities be eliminated
- incorporates prevalence of given disease/risk factor and relative harm it causes
- allows comparison of effects of different diseases (ex: malaria vs cancer) and then use that information to prioritize prevention, research, and funding
global burden of disease (GBD)
__________ Poisoning
s/s
- h/a
- dizzy
- seizure
- SOA
- Vomit
- Chest pain
Carbon Monoxide
START
S______
T_____
And
R______
T______
- Easy to use
- Focus is on s/s
- Fast
4 focus areas of START
- Ability to follow direction and walk
- Respiratory effort
- Pulse/perfusion
- Mental status
Simple
Triage
And
Rapid
Treatment
Consider interventions to address exposures to identified environmental health hazards.
Hazard control strategies
- At the source (ex: quranatine)
- Along the path (ex: social distancing)
- At the level of the person (ex: PPE)
- Secondary prevention (ex: COVID testing)
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Declaration of alma-ata USSR 1978
The shift entrails transforming primary health care in 3 ways
- Address inequities
- Equity oriented primary health care
- Realign policies to support equity and community
Process
- Begin at house hold level
- Serve 50 square block community radius
- Central hub to coordinate care of that population
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Modifiable environmental risk factors in health include
- air pollution,
- water contamination,
- toxic substances,
- occupational hazards
- unhealthy housing conditions
0
strategies to combat medical mistrust, as it relates to communicable diseases.
- Show authentic representation
- Vaccine messaging should acknowledge systemic racism as a justifiable reason for mistrust before providing vaccine education
- Engage trusted community leaders in public health campaigns
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roles within the NIMS
Level ___ role (1)
Incident commander
- Responsible for creating a unified command between responding agencies
- Evaluates incident
- Creates/oversees plan of action
- Determines needs
Benefits
- Common language and clear communication
- Point of command limits duplication
- Final operational control
1
roles within the NIMS
Level ___ roles (3)
Safety officer
- Responsible for monitoring hazards for daily operations
- Enforcing safety plans for scene operations
- Helps develop emergency response plans if further incidents ensue
Public information officer
- Responsible for communicating info to public
- Facts and viewpoints of responding agency
- Speaks to response efforts/operations
- Death disclosure
Liaison officer
- Relays info between incident commander, general staff, and other agencies
- Group of officers that report to chief officer
- Assist in communication between departments and field response efforts
2
________ = something that can potentially cause harm (no harm unless exposure occurs).
Ex: sharks
______ = hazard + exposure
Ex: sharks + being in the ocean
Hazard
Risk
___________ - Standard approach to incident management and response in the US
- Established by dept of homeland security
- Result of 9/11
Incidents when used include:
- natural disasters
- terrorism
- failing infrastructure
- transportation incidents
Benefits of NIMS
- Standardized and organized process
- National standard for training
- Personnel qualification standards
- Interoperable communication
- Information management systems with commonly accepted architecture
- Supporting technologies and infrastructure
National incident management system (NIMS)
4 phases of disaster management: prevent, prepare, respond, recover
________
- Identify potential hazards
- Vulnerabilities
- Strengthen capacity – resources, organization, resilence
Prevent
Endemic
pandemic
epidemic
Scope:
_______: Localized, consistent presence.
_______: Regional, sudden increase.
_______: Global, widespread.
Rate of Spread:
________: Stable, predictable.
________: Rapid increase.
________: Rapid, global spread.
Scope:
Endemic: Localized, consistent presence.
Epidemic: Regional, sudden increase.
Pandemic: Global, widespread.
Rate of Spread:
Endemic: Stable, predictable.
Epidemic: Rapid increase.
Pandemic: Rapid, global spread.
_________ Measure of overall disease burden
- Expressed as the cumulative number of years lost due to ill-health, disability or early death
- 1 DALY = loss of 1 year in good health from either premature death, disease, or disability
- Mortality doesn’t give a complete picture of burden of disease
- takes into account morbidity – suffering that may occur for people living with disease or disability
DALY
practice question:
Years of Life Lost due to premature death = 50,000 per 100,000 population
Years Lost due to Disability= 30,000 per 100,000 population
Years of Life Lost (YLL) = 50,000 per 100,000 population
Years Lost due to Disability (YLD) = 30,000 per 100,000 population
DALY = YLL + YLD = 50,000 + 30,000 = 80,000 per 100,000 population.
modes of transmission: direct vs indirect?
_________ – immediate transfer of agent from one human to another, distance is 3 feet or less
_________ – transfer of agent from one human to another, distance is more than 3 feet
___________
- Vehicle borne
o Animate objects – poor hand washing
o Inanimate objects – shared equipment/toys
o Food/liquid – food borne illness
_________
- Contact transmission – direct transfer with very close contact (STIs, athletes foot)
_________
- Vector borne
o Usually arthropods/invertebrates
o Mosquitos with west nile virus
_________
- Droplet transmission – expelled large droplets from one person and picked up by another (flu, RSV, diptheria)
____________
- Airborne
o Expelled through small droplets – cough, sneeze, singing
o TB, COVID, chicken pox, cold
Direct
Indirect
indirect
direct
indirect
direct
indirect
4 phases of disaster management: prevent, prepare, respond, recover
_______
- Timely warnings
- Protective factors
- Emergency management activities
- Evacuating populations pre-disaster
Prepare
Epidemic
Pandemics
Endemic
___________ - When a disease growth is exponential
- Focus is on how far it reaches (not severity)
- Spreads to international boundaries
- Unpredictable
- Ex: Zika virus cases spreading to multiple continents.
_________ – occurrence of disease in a community/region in excess of normal expectancy
- Ex: Measles outbreak in a small town, Chlamydia outbreak at a university.
__________ – constant presence of a disease with a geographic area/population
- Provides baseline for establishing a public health problem
- Ex: The consistent number of malaria cases in the continent of Africa.
pandemic
epidemic
endemic
5 S of strengthening health systems
- Staff – well trained, qualified, quantity
- Stuff – tools, resources
- Space – safe, appropriate, capacity
- Systems – leadership, government, information, financing
- Social support – provide basic necessities needed to ensure effective care
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Methods of surveillance/assessing exposures
- Toxicology studies - examine the harmful effects of chemical exposures, often using animal models to estimate human health impacts.
- Epidemiologic studies - analyze patterns and causes of diseases in populations to understand links between environmental exposures and health outcomes.
- Environmental monitoring - involves testing air, water, and soil samples to detect levels of pollutants or contaminants. (ex: A public health nurse is distributing radon kits for clients to take home to test radon levels in their homes.)
- Biological monitoring – uses biomarkers like blood or urine tests to measure human exposure to environmental chemicals.
- Product surveillance - tracks chemicals in consumer goods to identify potential toxic exposures before health issues arise.
0
internally displaced persons
Migrants
Refugee
asylum-seekers
______- someone who chooses to move from one place to another, often across an international border.
________ - person who has fled their country and is seeking international protection in another country. They have applied for refugee status, but their claim has not yet been determined.
_______ - a person who must leave their homeland due to persecution of beliefs, race, or ethnicity
_______ - people who have been forced to flee their homes, but unlike refugees, they remain within the borders of their own country.
migrants
asylum-seeker
refugee
IDP
________– number of NEW cases of disease (at a given time period)
_________ – number of ALL/CURRENT cases of disease (at a given time period)
Incidence – number of NEW cases of disease (at a given time period)
Prevalence – number of ALL/CURRENT cases of disease (at a given time period)
Endemic
pandemic
epidemic
An _________ disease is one that is consistently present in a population within a specific geographic area.
- It means the disease’s presence is expected and relatively stable.
- The level of the disease remains at a baseline level.
- Example: Malaria in certain regions of Africa.
An _________ occurs when there is a sudden increase in the number of cases of a disease above what is normally expected in that population in that area.
- It signifies a rapid spread of the disease within a specific region or community.
- Example: A localized outbreak of influenza in a city.
A _________ is an epidemic that has spread internationally, across multiple countries or continents.
- It involves a widespread, global outbreak of a disease.
- Example: COVID-19.
endemic
epidemic
pandemic
stages of infection
Transmissibility
Communicability period
Incubation period
Latent period
___________– period between an infectious agent entering a host and finding conditions favorable, replicating, shedding
____________ – period of time the person is contagious/can infect others
__________ – period between invasion of agent and symptoms appearing
___________ – estimations of the basic reproductive number
Latent period – period between an infectious agent entering a host and finding conditions favorable, replicating, shedding
Communicability period – period of time the person is contagious/can infect others
Incubation period – period between invasion of agent and symptoms appearing
Transmissibility – estimations of the basic reproductive number
best practices for naming new diseases according to the WHO.
- Avoid Geographical Locations:
- Avoid People’s Names:
- Avoid Animal Species:
- Avoid Cultural, Population, Industry, or Occupational References
- Use Descriptive Terms
- Use Acronyms and Alphanumeric Codes
0
UN’s sustainable developmental goals – r/t poverty reduction and measuring and improvising the determinants of health and well being
- No poverty
- Zero hungry
- Good health and well being
- Quality education
- Gender equality
- Clean water and sanitation
- Affordable and clean energy
- Decent work and economic growth
- Industry, innovation, and infrastructure
- Reduced inequalities
- Sustainable cities and communities
- Responsible consumption and production
- Climate action
- Life below water
- Life on land
- Peace and justice strong institutions
- Partnerships for the goals
0
US does well compared to peer nations in
- cancer survival
- heart attack and stroke survival
- medicating those with long term chronic conditions (DM)
- research
US does worse compared to peer nations
- lowest life expectancy while it far outspends its peers on healthcare
0
________ – any event that causes a level of destruction, death, or injury that affects the abilities of the community to respond to the incident using available resources
_____ disaster
- Sudden impact or acute onset
- Slow or chronic impact
_______ disaster
- Unintentional or intentional
- Biologic
- Nuclear
- Incendiary
- Chemical
- Explosive
- Technologic
Disaster
Natural
Human generated
4 phases of disaster management: prevent, prepare, respond, recover
________
- Disaster management team leader
- Clear roles of team
- Triage system
- Life saving actions – START, decontamination
- Surveillance – quarantine, isolation
- Evacuating populations post disaster
Respond
methods used to assess outdoor ozone levels.
Kentuckys air monitoring network meausres
- Carbon monoxide
- Lead
- Nitrogen dioxide
- Ozone
- Particulate matter
- Sulfur dioxide
0
________
- 3-99 patients
- Requires mutual aid and strains resources
- Declare MCI if more resources are needed
______ casualty
- 100+ patients
______ incident
- Unknown causalities
- Search and rescue required
- Long and ongoing
_______ incident
- Number of patients known, not expected to change
- Patients triaged, treated, and removed from scene
Multiple casualty incident
Mass casualty
open
closed
4 phases of disaster management - prevent, prepare, respond, recover
________
- Illness and injury d/t post disaster environment
- Re-establish health services
- Debrief
- Evaluate disaster management response
- Improve
Recovery
Carbon Monoxide Poisoning
Common causes
- in winter – ________
Treatment
- Pulse ox that measures CO
- Pt will read 100% O2 even when they aren’t
- High flow O2 via nonrebreather mask
- Hyperbaric chamber and oxygen washout
poorly vented furnaces
compared 5 domains in 11 countries
- access to care
- care process
- admin efficiency
- equity
- health care outcomes
top performing countries
- Norway
- Netherlands
- Australia
- (USA – 11/11 last place)
4 features of top countries
- Universal coverage and remove cost barriers
- Invest in primary care systems – high value services are equitably available to everyone
- Reduce administrative burdens diverts time, efforts, spending from health improvements
- Invest in social services – especially for children and working age adults
0
____________ – social responsibility to protect the public from exposure to harm when scientific investigation has found a plausible risk
- Precautions can be relaxed once further scientific findings emerge that provide sound evidence that no harm will result
Precautionary principle
issues surrounding the naming of diseases (such as stigma and discrimination).
- Diseases names after location causes stigmas towards the country and people from there
- COVID-19, “Chinese virus” increased anti-asian sentiments and lead to violence
- Monkey pox = mpox
Public health implications
- Language
0
roles within the NIMS
Level ___ roles (4)
Operations section
- Manage and plan day to day response
- Oversee all field operations
- Chain of command – field operations back to command
Planning section
- Problem solving issues as they come up during response
- Predicting and planning next phase of incident response
- Develop demobilization plan and emergency action plan
Logistics section – service branch and support branch
- Facilities
- Medical response
- Food and water
- equipment
- movement of equipment – may be contracted by FEMA before disaster, trucking and utility companies, generator and heavy equipment rentals, medical evacuation
Finance/admin. Section
- Responsible for documenting all expenses that need reimbursed (federal and state dollars)
- Tracks hours worked, cost of supplies, cost of compensation
3
patterns of transmission.
_________ – nonhuman to human (ex: cat can spread toxoplasmosis to a human, but that humans do not spread it to others.)
__________ – nonhuman to human, human to nonhuman
________ – parent to child during fetal development, birth, breast feeding (ex: HIV)
_________ – person to person
______genous – internal source (present and asymptomatic in the body, ex: E coli. Can exist in gut with no symptoms but if it gets into urinary tract it causes problems)
_______genous – external source (ex: eating contaminated food and getting botulism)
patterns of transmission.
Unidirectional – nonhuman to human (ex: cat can spread toxoplasmosis to a human, but that humans do not spread it to others.)
Bidirectional – nonhuman to human, human to nonhuman
Vertical – parent to child during fetal development, birth, breast feeding (ex: HIV)
Horizontal – person to person
Endogenous – internal source (present and asymptomatic in the body, ex: E coli. Can exist in gut with no symptoms but if it gets into urinary tract it causes problems)
Exogenous – external source (ex: eating contaminated food and getting botulism)
mitigation vs adaptation
_________ – reducing the flow of green house gases into atmosphere
- clean energy like solar and wind
- improving energy efficiency
- sustainable transportation
- protecting carbon sinks like forests.
__________– learning to live with and adapt to the climate change that has already been set in motion
- plant more trees
- developing drought-resistant crops
- fortifying infrastructure against extreme weather events
- implementing early warning systems
- enhancing disaster preparedness
Mitigation
Adaptation
environmental factors in the home:
Major concerns
- Crowding
- Temp
- Injury hazard
- Water quality
- Air quality
- Noise
- Safety
Environmental health in the home
- Take off shoes at door
- Well ventilated house
- Organic, fresh, local produce
- Grow garden, don’t use pesticides
- Reduce red meat consumption
- Clean with baking soda and vinegar
- Low VOC paints
- Eat smaller fish to decrease mercury consumption
- Reconsider personal care products
- Avoid tobacco smoke and reduce radon
- Avoid sources of BPA (plastic) and PFAs
Possible contaminants
- Burning fuel for cooking or heat
- Second hand tobacco smoke
- Radon
- Formaldehyde
- Asbestos fibers
Environmental health hazards include
- Radon
- Toxic Waste
- Pesticides
- Extreme weather events
Focus of public health
Control
Elimination
Prevention
Eradication
________ – reduce/eliminate exposure or susceptibility to a disease
________ – reduce incidence/prevalence of a disease
_________ – control of a disease within a specific geographical area
_________– reduce incidence worldwide to 0
Prevention – reduce/eliminate exposure or susceptibility to a disease
Control – reduce incidence/prevalence of a disease
Elimination – control of a disease within a specific geographical area
Eradication – reduce incidence worldwide to 0
