Test 1 Flashcards
What are the frameworks that exist within public programs?
Health promotion
Health education
Advocacy
Program planning and evaluation
What is a community?
All people within a geographical location or involved in a specific action
What is the definition of health as per the WHO 1946?
A state of complete physical, mental and social well-being and not merely the absence of disease
What branches are included in the wellness holistic model?
Physical
Psychological
Spiritual
Social
What are the sides of the health continuum of a triangle?
Physical
Social
Mental and emotional
What is the definition of health from the WHO 1984?
The extent to which an individual or group is able, on the one hand, to realize aspirations and satisfy needs; And on the other hand to change or cope with the environment.
True or False: Health is the ever changing state that encompassess external and internal physical, emotional, spiritual and social function.
True
True or False: The components including external and internal physical, emotional, spiritual and social function do not overlap but influence the others in a continuum.
False. The components including external and internal physical, emotional, spiritual and social function ALL overlap and influence the others in a continuum.
What is the definition of community health?
The effort that is organized by society to protect, promote and restore the health and quality of life of the people
What is the definition of Public Health?
The science and art of preventing disease, prolonging life, and promoting physical and mental efficiency through organized community effort. The organization and application of public resources to prevent dependency which would otherwise result from disease or injury.
True or False: Public Health is the “Peoples Health”
True
What is the mission of Public Health?
To fullfil society’s interest in assuring the condition in which people can be healthy.
Public Health addresses health concerns of whom?
Group
Community
State
Nation
What is the method of preventing disease and preparing for the unexpected?
The idea of public health
What does Public Health do?
Prevent epidemics
Protect against environmental hazards
Prevent injuries
Promote and encourage health behaviours
Respond to disasters and assist communities in recovery
Assure the quality and accessibility of health services
How does Public Health achieve their goals?
Through health education, research, administration of programs and community efforts
What are Public Health Problems?
A condition or situation that is a widespread or actual or potential cause of morbidity or mortality.
An existing perception that the condition is a public health problem on the part of the public, the government or public health authorities
What are the common criteria to identify a public health problem?
Burden of disease or condition
Prevalance of risk factor for disease or condition
Ability to affect population as a whole
Seriousness of the problem
Economic or social impact
Public health concern
Politics will address the issue
Requirement for group action to solve the problem
Availability of resources
Cultural appropriateness of the problem
Degree to which it negatively affects health equity
What does SES stand for?
Social Economic Status
What are the criteria for public health solutions?
Not hazadous to life or function
Effective in reducing or preventing the targeted disease or condition
Easily and efficiently implemented
Potency maintained for a substantial period of time
Attainable regardless of SES or education
Effective immediately upon application
Inexpensive or within the means of the community
What are some examples of public health solutions?
Vaccine programs
Disease control
Water and envirnmental santitation
Fluoridation in water
Improved motor vehicle safety
What is the World Dental Federation’s definition of oral health?
Oral health is multifaceted and includes the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain, discomfort and disease of the craniofacial complex.
Is there a high burden of oral diseases that remain a widely underestimated public health challenge across the world?
Yes
What is dental public health?
The promotion of oral health and the prevention of dental disease including the control of dental disease through organized community efforts
What is the definition of Dental Public Health according to the Canadian Association of Public Dental Health?
Dental public health is concerned with the diagnosis, prevention and control of dental health disease and the promotion of oral health through organized community efforts. Dental public health serves the community rather than the individual through research, health promotion, education and group dental care programs.
What does Dental Public Health do?
Dental education of the public
Applied dental research
Administration of group dental care programs
How does Dental Public Health compare to overall Public Health?
Dental Public Health is specifically oral health care and education delivered to a target population funded by the government while over Public Health focuses more broadly on health
What are the characteristics of dental disease?
A universal problem which does not go into remission if left untreated
Untreated decay escalates and results in expensive surgical procedures
Can be alleviated and prevented with future public health measures
What is the mandate of specialists in community health?
To provide high quality service to the public while controlling the cost for the taxpayers
Dental pracitioners in public health provide leadership in community issues through
Research
Evidenced based approach to dental treatment
Assessment of the levels of diseases in the community
What are some examples of a public health facility?
Hospital
Clinic
School
Is public health a treatment plan for an individual or a community?
Community
How is payment for public health equated?
With program funding
What has public health contributed to dentistry?
Evidenced base approach to care
Epidemiological studies (Fluroides, caries, prevalence of periodontal disease)
Changes in dental education
What are epidemiological studies?
Studies which assess the factors affecting health and illnesses within a population
Dental hygienists are primary oral health care providers guided by the principles of social justice who specialize in services related to
Clinical therapy
Oral health education
Health promotion
What are the roles for the dental hygienst as a community health practice career?
Service provider/clinician
Health educator
Consultant
Consumer Advocate/Change agent
Research
Administrator/Manager
What is population health?
A perspective that looks at health in broad terms.
What are the questions the population health looks to answer?
What are the most important factors affecting the health of Canadians?
WHy are some Canadians healthier than others?
What can be done to improve the health of all Canadians?
Define population health
An approach to health that aims to improve the health within a community
Why are some Canadians healthier than others?
Partly because as individuals we are all different in terms of our genetic make-up and the sort of lives we lead.
Partly because some groups of Canadians have fewer opportunites than others.
Who are the key players in public health practice?
Federal Government
Provincial Government
Municiple Government
What are the core functions of Public Health?
Assessment
Policy Development
Assurance
When were the core functions of Public Health developed?
1988
What is the regular and systemic collection analysis and dissemination of information on the health of the community?
Assessment
What is promoting the use of scientific knowledge base in decision making, developing public health policy, and invloves strategizing and using the political process?
Policy Development
What is assuring the communities that services are available to meet the health goals and guaranteed availability of high priority health services?
Assurance
What is fluoride?
A naturally occuring mineral found in soil, water and various foods
Other than naturally found fluoride, how else can fluroide enter the environment?
Through various chemical manufacturing processes
What is community water fluoridation?
The process of adjusting the concentration of fluoride in the community water supply to a level that provides optimal dental benefits.
True or False: the controlled addition of fluoride to a public water supply is typically the largest source of fluoride.
True
Why is water fluordiation successful?
It is not dependent on client cooperation
It is as beneficial as topical flouride over the client’s lifespan as long as water consumption continues
Reduces costs for dental treatment
No dependent on a professional service of a licensed healthcare provider
What is the optimal range for fluoridation?
0.5 - 0.8 mg/L
What is the level Health Canada recommends for fluoridation?
0.7 mg/L
What is the optimal range of fluoridation dependent on?
The mean annual temperature of the region
Why does the optimal fluoride range vary according to temperature?
The hotter the area, the more water people drink. The more water ingested, the more fluoride ingested.
What did Dr. Frederick McKay discover in 1901?
Colorado Brown Stain was caused from excessive fluoridation in the water in Colorado Springs
Who did Dr. Frederick McKay collaborate with?
G.V. Black
What did a new anaylsis techniques identify in the 1930s?
Caries experience reduced by mottled enamel
Who discovered benefits to fluoride of caries experience reduced by mottled enamel?
Dr. Frederick McKay
What was the 21 cities study landmark research?
Identify the lowest level at which fluoride was effective in caries reduction
When was fluoride first added to community drinking water?
1945
In the US when fluoride was added to Grand Rapids Michigan the reduction of DFMT for children ages 12-14 was what percentage?
55%
Where was the first implementation of fluoridation in the water in Canada?
Brantford, Ontario
Prior to fluoridation, what were common dental experiences for young people?
Periapical abscesses
Gaping lesions
Extractions of the first molars
Prior to flurodiation, what were common dental experiences for older adults?
Full mouth extractions
CUD/CLD
What are the current considerations for fluoridation?
Higher education levels
Better technology
Improved standards of living
Accessible to all
Impacted the way people thought about dental health
Many argue it is not safe
Review policy is warranted
Outcomes are smaller now
What are the common concerns of fluoridation?
Health effects
Flourosis
Water flouridation additive
True or False: like any drug, fluoride has the potential to do both good and harm.
True
True or False: in depth research has been shown flouridation is safe and beneficial for the public.
True
True or False: there is a lower caries risk and development of oral diseases with the presence of flouride in the water
True
How many organizations world wide support fluoridation?
90
Who decides whether or not to flouridate the water supply?
Municipalities
True or False: there are not municipalities within Ontario who don’t flouridate the water supply.
False. There are several municipalities within Ontario who don’t fluoridate the water supply due to it being found naturally.
What percentage of water across Canada is fluoridated?
38.7%
What percentage of water across Ontario is fluoridated?
71.1%
Water flouridation of 38.7% across Canada is approximately how many million?
13.9 million
Why is dental fluorosis a low concern in this country?
So few Canadian children have moderate or severe fluorosis that, even combined, the prevalence is too low to permit reporting.
What is the estimated cost of fluoridating water supplies in Canada?
$0.60 to $1 per person per year
For every $1 invested in adding fluoride to the water, how much is saved in dental care?
$38
What did Calgary do in 2011 in regards to water fluoridation?
Stopped their flouridation in the water supply
What happened when Calgary stopped their fluoridation?
Significant increase in caries
Increase in severity occuring at a younger age
What are the factors that interact to create circumstances and produce specific health conditions?
The determinants of health
What are the six key sections of the determinants of health?
Genetic endowment
Environmental
Health services system
Productivity and wealth
Socioeconmic status
Lifestyle
Which of the six key sections of determinants of health has the highest risk factor of disease?
Socioeconomic satus
What do the determinants of health influence?
Health of individuals and populations
Determinants interact and influence each other
How does income and social economic status affect health?
Health status improves with wealth and social status
True or False: the healthiest populations are those in societies which are prosperous and have an equitable distribution of wealth.
True
How does social support networks affect health?
Support from families, friends, and communities is associated with better health
How does education and literacy affect health?
Health status improves with level of education
How does employment and working conditions affect health?
Unemployment and underemployement, stressful or unsafe work are associated with poorer health
How does social environments affect health?
Social stability, recognition of diversity, safety, good working relationships, and cohesive communities provide a supportive society that reduces or avoids many potential risks to health
How does physical environments affect health?
At certain levels of exposure, contaminants in our air, water, food and soil and cause a variety of adverse health effects, including cancer, birth defects, respiratory illness and gastorintestinal ailments
How does health child development affect health?
A young persons development is greatly affected by his or he housing and neighbourhood, family incomes and level of parents education, access to nutrition and physical recreation, genetic makeup and access to dental and medical care
How does biology and genetic endowment affect health?
Genetic endowment provides an inherited predisposition to a wide range of individual responses that affect health status
How does health services affect health?
Health services particularily those designed to maintain and promote health, to prevent disease and to restore haelth and function
How does gender affect health?
One sex may have a higher incidence of a disease
How does culture affect health?
Some persons may face health risks due to a socioeconomic environment which is largely determined by dominant cultural values. There may also be a lack of access to culturally appropriate health care and services
Why is no single determinate of health the most important?
Because multiple factors work in combination
Multiple factors working in combination mean that the determinants must be
Multifactoral
What are groups and communities at a high risk for poor health as a result of the barriers they experience to social, economic, political and environmental resources, as well as limitations due to illness or disability?
Vulnerable populations
What are the vulnerable groups?
Pregnant women
Low-income people
People in rural areas
Geriatrics
Homeless
Recent immigants
Infants and young children
Disabled
Prisoners
Recluses
Migrant and seasonal farmworkers
What is the goal of the population health template?
To identify the determinants of health and work to strengthen them so that people are more likely to be healthy
What is the population health template?
It considers the client’s lifestyle and personal health practices, where the client lives, access to healthcare, and childhood growth and development to strengthen the areas needed so that people can be healthier
How many people are living in Canada?
38.25 million
Where is Canada’s population growth concerned?
Areas with considerable environmental stresses like Toronto and Vancouver
How is the demographic of the Canadian population changing?
Shifting to an older population
How will an older population affect the health care system?
Increased chronic conditions
Increased demand on all areas of health care
Nearly ___% of seniors do not visit the dental office vs ___% of ages 45-64.
44%
27%
___% of individuals aged 65+ years have at least 1 in 10 common chronic diseases.
73%
What is the most common chronic dental disease seen in seniors over 65?
Peridontal disease
What percentage of seniors experience periodontal disease?
52%
What are the largest growing Canadian geographic distributions?
Ontario and BC
What are the most populus Canadian geographic distributions?
Ontario
Quebec
How many low income neighbourhoods are a priority in the Durham region?
Seven
The seven low income priority neighbourhoods make up what percentage of Durham region?
15%
What is the utilization of dental services?
The number of individuals in a given population who receive dental care services during a specific time
What is a dental need?
A need typically exists when a specific oral health disease has been identified in the community.
What is a health demand?
Demand is related to the perception of need and the desire to receive treatment.
What are the factors influencing dental health care delivery?
Need
Demand
Utilization
Legislation
Manpower
Gender
Age
Socioeconomic status
Race and ethnicity
Geographic location
General health
Dental insurance
What is the difference between a need and a demand?
Need is professionally determinded while a demand is client determined
Who is the typical user of dental services?
Female
College educated
Higher income bracket
Suburbanite
Healthy
Has insurance
What percantage of Canadians have had contact with a dental professional in the past 12 months?
74%
How many Canadians avoided going to the dental office last year due to cost?
17%
How many Canadians have avoided the full recommended treatment due to cost in the last year?
16%
How many Canadians have unmet dental needs?
12%
How many Canadians report accessing oral health professionals every five years?
5 out of 6
What does public health practice include?
Assessment
Program planning
Implementation
Evaluation
Difference between public health and private practice?
Public is aimed at the community, private is aimed at the individual
What is the private practice model?
Patient:
Exam
Diagnosis
Treatment plan
Treatment
Payment
Evaluation
Education
What is the public health model?
Community:
Survey
Analysis
Program planning
Program operation
Budget/financing
Program evaluation
Education
What are the five steps of community health program planning process?
- Identify the primary health issues
- Develop a measureable process and outcome objectives to assess progress in addressing the health issues
- Select and plan effective health interventions to achieve objectives
- Implement the selected health interventions
- Evalute the selected interventions based on the objectives and use the information to improve the program
What are the six steps of the dental hygiene process of care?
- Assessment
- DH diagnosis
- Planning
- Implementation
- Evaluation
- Documentation
What is the part of the DH process of care that carefully analyzes the program’s target group and resources?
Assessment
Define oral health assessment
The regular and systemic collection, assemblage, and analysis of data and communications regarding the health of the community. Assessment must include stats on health status, community health needs, and epidemiologic and other studies of health programs.
The community oral health assessment allows us to
Identify health problems
Identify resources
Strengthen community and partnerships
What is a needs analysis?
It identifies problems, prioritizes the problems and will provide the information not only about the problem but also about the community itself
During assessment the dental hygienist assesses
The populations needs
Facility needs
resources and funding
How can populations needs be assessed?
Through surverys or dental screening utilizing specific dental index
What information does needs assessment research provide?
What people need
What people want
People’s attitudes
Group service needs
Resources available
Challenges
Relevant alternatives
Changes needed
Possible partners
What are the indications for needs assessment research?
Need to define and solve community oral health problems
To develop long and short range plans for community health initiatives
To prove effectiveness of existing programs
To identify public opinion
To develop community support
Community oral health assessment will answer what questions?
- What community strengths, assets and resources influence oral health in the community
- What capacities, resources, and interventions are available within the community to promote oral health
- What are the oral health problems, concerns and obstacles faced by the community
- What factors contribute to these community gaps and needs
- What are the potential solutions?
- What partnerships in the community can support strategies to ensure future oral health improvements?
What does the purpose of assessment include?
The need to engange and foster the community in a specific community building process, gain insight about specific factors in the community that influence health.
How to describe a community when following the assessment model?
People
Location
Connection
Power relationships
Why should stakeholders be engaged?
Increases the relevance and credibility of the results and likelihood to long term participation
What is the seven step assessment model?
Phase 1: Cultivate partnerships and select and advisory committe
Phase 2: Complete a self-assessment to establish the purpose of the community needs assessment
Phase 3: Design and organize the needs assessment
Phase 4: Collect data
Phase 5: Organize review and analyze the data
Phase 6: Prioritize issues and report findings in preparation for program planning, advocacy, and education
Phase 7: Evaluate the needs assessment
During phase 2, complete a self assessment to establish the purpose of the community needs assessment, what are the potential purposes for conducting oral health assessments?
Target resources
Educate decision makers
Build evidence to oral health concerns
Establish data/update data for targeted populations
Evaluate programs
Prioritize budgets
Generalize findings to the target population
What ways can we assess in the community?
Surveys
Personal interviews
Document analysis
Indices
Community assessments will aid in gathering information about
Demand
Perceived needs
Knowledge level of population
Existing problems and issues
What is CHMS?
Canadian Health Measures Survey
What are the steps in planning survey research?
- Select a topic
- Review the literature
- Select the unit of analysis
- Assemble the survey in instrument
- Select the survey mode
- Design survey sampling
What are the steps to administering a survey?
- Pretest the survey instrument
- Obtain access to respondents
- Administer the survey
- Follow up on non-respondents
What are the steps in analyzing the survey research?
- Process the data
- Analyze the data
What are the most common methods of surveys?
Self-administered questionnaires
Interview survey
Telephone survey
What are the strengths of survey research?
Good for lage populations
Accountability of methods
Suitable for a wide range of topics
Efficient
What are the weaknesses of survey research?
Sampling
Standardization of questions
Some topics not amenable to measurement with surveys
Context of research setting
Limitations of establishing causation
What are the ethical considerations in surveys?
Informed consent
Benefit vs Harm
Rights of anonymity and confidentiality
What are the considerations for your survey?
What do you want to know?
Who are you going to study?
Where are you going to find these people?
How will you gather your information?
When will you confuct this study?
How will you use the data that you collect?
What types of questions should be included in the questionnaire?
Open-ended
Close-ended
Ranking scale
Likert scale
Adjective checklist
What are the characteristics of a good question?
Understandable as the researcher intended
Administered consistently
Communicated consistently
Reliable and valid
