Untitled spreadsheet - Sheet1 (1) Flashcards
What are the five historic racial categories, as defined by the US Census Bureau?
- White 2. Black or African American
- American Indian and Alaska Native
- Asian
- Native Hawaiian and Other Pacific Islander
What are two second division categories, independent of race and based on ethnicity, as defined by the US Census Bureau?
- Hispanic Origin 2. Not of Hispanic Origin
In comparison to white Americans, African Americans have…
Higher infant mortality rates and shorter life expectancy
In 2016, the portion of the United States economy that is spent on providing healthcare rose from ___% to ____%
11% to 17.9%
What are some of the main causes for the increase in healthcare costs (2)?
- The expansion of access to health insurance due to the Affordable Care Act - Investments in new medications, facilities, and technology
In 2017, what five categories did the National Center for Health Statistics divide the population into (based on race and ethnicity) when reporting birth/death rates in the U.S.?
- White (non-Hispanic) 2. Black (non-Hispanic)
- American Indian or Alaskan Native
- Asian or Pacific Islander
- Hispanic
What is life expectancy?
The average a number of years a newborn can expect to live at current mortality levels (commonly broken down between male and female)
What is infant mortality?
How many children, out of 1000, are expected to die before they turn 1.
In 2015, the United States had a higher infant mortality rate than ____ out of ____ of the most developed countries in the world
31 out of 35
What are the top three causes of death?
heart disease, cancer, and unintentional injuries (accidents and poisonings)
What is the main reason for the increase in unintentional injuries in the United States, according to the US Department of Health and Human Services?
The Opioid Epidemic, which has increased deaths from opioid overdoses
Between diastolic and systolic pressure, elevation of which of the two is most often associated with more severe diseases?
diastolic pressure
Babies in the United States in 2015 were expected live about how many years less than babies born in other developed countries?
2-6 years less
Japan Health Index (% of GDP spent on health care, infant mortality rate, male life expectancy at birth, and female life expectancy at birth)
- GDP %: 10.7% - Infant Mortality: 2.0
- Male life expectancy: 81.0
- Female life expectancy: 87.1
Sweden Health Index (% of GDP spent on health care, infant mortality rate, male life expectancy at birth, and female life expectancy at birth)
- GDP %: 10.9% - Infant Mortality: 2.5
- Male life expectancy: 80.6
- Female life expectancy: 84.1
France Health Index (% of GDP spent on health care, infant mortality rate, male life expectancy at birth, and female life expectancy at birth)
- GDP %: 11.5% - Infant Mortality: 3.7
- Male life expectancy: 79.2
- Female life expectancy: 85.5
Germany Health Index (% of GDP spent on health care, infant mortality rate, male life expectancy at birth, and female life expectancy at birth)
- GDP %: 11.3% - Infant Mortality: 3.4
- Male life expectancy: 78.6
- Female life expectancy: 83.5
Switzerland Health Index (% of GDP spent on health care, infant mortality rate, male life expectancy at birth, and female life expectancy at birth)
- GDP: 12.3% - Infant Mortality: 3.6
- Male life expectancy: 81.7
- Female life expectancy: 85.6
Greece Health Index (% of GDP spent on health care, infant mortality rate, male life expectancy at birth, and female life expectancy at birth)
- GDP %: 8.4 - Infant Mortality: 4.2
- Male life expectancy: 78.9
- Female life expectancy: 84.0
Canada Health Index (% of GDP spent on health care, infant mortality rate, male life expectancy at birth, and female life expectancy at birth)
- GDP %: 10.4% - Infant Mortality: 4.7
- Male life expectancy: 79.8
- Female life expectancy: 83.9
United Kingdom Health Index (% of GDP spent on health care, infant mortality rate, male life expectancy at birth, and female life expectancy at birth)
- GDP %: 9.7% - Infant Mortality: 3.8
- Male life expectancy: 79.4
- Female life expectancy: 83.0
United States Health Index (% of GDP spent on health care, infant mortality rate, male life expectancy at birth, and female life expectancy at birth)
- GDP %: 17.1% - Infant Mortality: 5.9
- Male life expectancy: 76.1
- Female life expectancy: 81.1
What two causes of death are the most responsible for the reduced life expectancy for Americans?
Opioid overdoses and suicide rates (“deaths of despair”)
What group most greatly contributes to deaths caused by opioid overdoses and suicides?
non-Hispanic whites who lived outside of large, urban areas
In the 1983 book, “A Tale of Two States”, economist Victor Fuchs discovered that though Utah and Nevada were two similar states, people in Nevada suffered from extremely worse health than those in Utah. Why was this?
The influence of the Mormon church in Utah decreased the smoking and alcohol abuse of the population
What factors, other than healthcare are responsible for altering a person’s health status (3)?
- lifestyle factors (jobs, family-composition, etc.) - living standard/quality of life (sanitation, housing, public health measures)
- social hierarchy (income, social standing, etc.)
The rising standard of living in the United States from 1900 to 1970, was most associated with a decline in…
death rates from infectious diseases such as measles, tuberculosis, pneumonia, diphtheria, typhoid, and polio
What two important medical discoveries were made in the 20th century?
antibiotics and vaccines
What is allostatic load?
wear and tear on the body associated with chronically elevated levels of stress
A society’s hierarchy of health care is closely associated with ______ status and _______ inequality.
social status and economic inequality
What is the Gini coefficient?
the decimal fraction of a society’s collective income that would need to be redistributed to reach full economic equality (high Gini coefficient = high mortality rate)
On a graph displaying economics within a society, what does the ‘Lorenz curve’ measure?
the actual distribution of income or wealth in a society (the further the curve from the baseline, or ‘line of full equality’, the higher the level of economic inequality)
What does ‘decile ratio’ measure?
the ratio of the income earned by the top 10% of households to the income earned by the bottom 10%
What does ‘income ratio’ measure?
the ratio of the income of the highest-paid executive in a firm to the lowest-paid employee in that firm
What does the ‘Robin Hood index’ represent on a graph?
the maximum vertical distance between the line of full equality and the Lorenz curve
What does ‘poverty income ratio’ measure?
the proportion of collective income in a society earned by the bottom (50%, 70%, etc.) of households
In a 2018 study, researchers concluded that people living in areas classified as ‘less cohesive’ engage in thoughts and behaviors that are related to greater physiological wear and tear, which in turn increases ___________ risk.
cardiovascular risk
Poor quality of a built environment (man-made surroundings) is associated with rapid cognitive decline, especially among what racial demographic?
African Americans
People in disadvantaged positions are more likely to experience what 3 negative forces in their communities in relation to social capital?
- high levels of violence - high levels of social anxiety
- increased perceptions of discrimination
Constant stress due to inadequate living conditions results in chronically elevated levels of stressor hormones. Over time, this leads to what 3 health concerns?
- cellular damage - illness
- premature death
Living in a disadvantaged neighborhood has been linked to higher rates of which 2 diseases?
diabetes and cardiovascular disease
A 2002 study found that elderly people who have regular social engagement tend to have lower _______ rates.
mortality rates
Why do people with stronger social networks have higher levels of antibodies against colds?
the more people we interact with, the more colds we get– thus the more antibodies we develop against future colds
Life expectancy in the U.S. decreased from ____ years in 2014 to ____ years in 2017.
78.9 to 76.6
The CDC reports that suicide rates nationally increased by ___% from 1999 to 2016.
30%
Determine the age group, level of urbanization, and racial groups (2) where suicide rates were highest.
- 35-64 years - rural areas
- White and American Indian/Alaskan Native
The CDC reported that use of what drug was primarily responsible for the recent increase in deaths due to illicit drug use?
fentanyl
Researchers suggest the U.S. currently has 2 opioid epidemics. What are they?
1) prescription drugs (such as painkillers) 2) illegally manufactured drugs (such as heroin)
Between 2000 and 2015, the rate of opioid use increased among all racial groups, the highest being among ____.
Whites
Which state has had the highest opioid overdose death rate in the U.S. since 2010?
West Virginia
The HEAL initiative focuses on improving what 2 means to address the opioid crisis?
1) treatments available for opioid misuse and addiction ) strategies for pain management without the chronic use of opioids
_________ is an opioid derivative that can be can be used to prevent withdrawal symptoms from opioid addiction.
buprenorphine
What are prescription drug monitoring programs (PDMPs) and what is the purpose of them?
require physicians and other professionals who prescribe opioids to register with a state database, allowing staff members to check if a patient has already been prescribed opioids from another provider
What is the Whitehall study?
The Whitehall study was conducted over several decades in England. It followed employees in the British Civil Service, and monitored different aspects of their health status.
What did the results of the Whitehall study show?
that people who have higher paying jobs usually have better health and lower death rates than those with lower paying jobs
What does SES stand for? What does it mean?
Socioeconomic status: a measure of status within the social hierarchy according to measures such as income
What happens to health and mortality rates at lower levels of the socioeconomic hierarchy?
health decreases and mortality increases
People of lower socioeconomic status are at higher risk for what diseases?
arthritis, hypertension, and other chronic diseases
In 2012, two years after the Affordable Care Act (ACA) was signed, how many people had no health insurance and little access to health care?
48 million people (most of them in low-to moderate-income working families)
In 2014, the changes enacted by the ACA reduced the number of uninsured people by _____. However, _____ people were still without health insurance.
- the number of uninsured people was reduced by nearly 18 million - 27 million were still without health insurance
When and where was the constitution of the World Health Organization adopted?
At the International Health Conference in New York (1946)
The preamble to the WHO’s constitution defines health as…
a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
Health involves not only the absence of disease, but also_____ (3)?
- The health of the body 2. The health of the mind and emotions
- Health of the social context in which one lives
Andrew Twaddle, a 20th-century sociologist, stated what about health?
…health must be understood first as a biophysical state and that “illness is any state that has been diagnosed by a competent professional”
What are two fundamental dimensions of health, according to the medical model?
- an absence of symptoms (sensations noticed by the patient and interpreted as abnormal) 2. An absence of signs (objective characteristics noted by a health professional, of which a patient may often be unaware)
What is an “area variation”
a phenomena in which the same laboratory tests, are interpreted differently by different individuals
What are the 5 ADLs (Activities of Daily Living)?
- Feeding one’s self 2. Bathing one’s self
- Dressing one’s self
- Being able to use the toilet without assistance
- Being able to transfer one’s self without assistance (EX: from a bed into a chair)
What is MEPS?
- The Medical Expenditure Panel Survey - A survey conducted by the US Agency for Healthcare Research and Quality (AHRQ) since 1996. The purpose of the survey is to measure the health status of the US population
According to MEPS, the number of healthy adults in the US between 2000 and 2014 increased from___ to ____.
From 14 million (42.4%) to 22.4 million (48.2%)
When age and gender was controlled for MEPS, what groups reported lower rates of health (4)?
- African Americans 2. Hispanics
- Those with lower incomes
- Those with lower levels of education
One method of measuring health, as suggested by Wolinsky, is to dichotomize each dimension of health into ____ and ____ and compare the ratio of the two dimensions.
- “well” and “ill” - if someone is well psychologically and socially, but ill physically, they should still be considered well
What does SF-36 stand for? Who created it and what study was it used in?
- A 36-Item Short Form Health Survey created by John Ware for use in the Medical Outcomes Study
The purpose of the SF-36 is to…
compare the health outcomes overtime of patients enrolled in alternative health care delivery systems
How does the SF-36 differ from Wolinksy’s idea of health?
While Wolinsky’s model views health as dichotomous, SF-36 views health as continuous
What are the 4 subscales used to measure overall physical health in the SF-36?
- Physical functioning 2. Role limitations due to physical problems
- Bodily Pain
- General health perceptions
What are the 4 subscales used to measure overall mental health in the SF-36?
- Vitality 2. Social Functioning
- Role Limitations Due to Emotional Problems
- General Mental Health
How does the Wilson and Cleary model suggest that different aspects of health are associated with each other (2)?
- The three dimensions of health are linked, with a change in physical health triggering an emotional and functional change - The three dimensions of health should not be the only thing we focus on/ instead, we should focus on overall quality of life
In the Wilson and Cleary model of health, what are the two fundamental models of poor health? What reduces a person’s quality of life?
- Biological and physical abnormalities are the fundamental causes - A person’s perception of their poor health, reduces their quality of life
A person’s sex can be defined as…
a biologic quality based on chromosomes and sex hormones
A person’s gender can be defined as…
a person’s self-perception and self-representation in a broader social and cultural context
What does ELBW stand for? What are the qualifications to be considered ELBW?
- ELBW: extremely low birth weight - A premature infant weighing less than 1,000 grams
When comparing teenagers born as ELBW with teenagers born at NBW (normal birth weight), what was discovered (2)? What was the difference in the quality of life for the two groups/
The teenagers who were ELBW had lower: - physiological health (cognition and sensation)
- functional health (mobility and self care) However, there was essentially no difference in the two group’s quality of life
What behaviors are commonly seen as causes of illness (7)
- obesity - smoking
- lack of exercise
- high cholesterol
- poor diet
- alcohol abuse
- drug abuse
Rates of asthma, as of 2015, in California, Iowa, Mississippi, and New York
- California: 7.7%- Iowa: 7.6%
- Mississippi: 7.8%
- New York: 9.9%
Rates of diabetes, as of 2015, in California, Iowa, Mississippi, and New York
- California: 9.6% - Iowa: 7.7%
- Mississippi: 13.6%
- New York: 8.9%
Rates of hypertension, as of 2015, in California, Iowa, Mississippi, and New York
- California: 25.7% - Iowa: 30.6%
- Mississippi: 42.4%
- New York: 29.3%
Rates of obesity, as of 2016, in California, Iowa, Mississippi, and New York
- California: 25.0% - Iowa: 32%
- Mississippi: 37.3%
- New York: 25.5%
Rates of breast cancer deaths, as of 2015, in California, Iowa, Mississippi, and New York
- California: 19.6 - Iowa: 18.5
- Mississippi: 21.8
- New York: 19.2
Rates of heart disease deaths, between 2014-2016, in California, Iowa, Mississippi, and New York
- California: 279 - Iowa: 312
- Mississippi: 453
- New York: 348
Infant mortality rate, as of 2016, in California, Iowa, Mississippi, and New York
- California: 4.2 - Iowa: 6.1
- Mississippi: 8.6
- New York: 4.5
Median family income, as of 2015, in California, Iowa, Mississippi, and New York
- California: $64,500 - Iowa: $54,736
- Mississippi: $40,593
- New York: $60,850
According to a study by professor and doctor JK Montez and her colleagues, the highest rates of disability in most states is concentrated in what population?
Older adults (45+) who did not complete high school
What states had the highest rates of disability?
Mississippi, Kentucky, and West Virginia
According to the federal government, a baby born in the United states in 2016 could expect to live, on average, for how many years? How long could a male expect to live? A female?
- On average: 78.6 years - Male: 76.1 years
- Female: 81.1 years
What is a principal contributor to reduced life expectancy?
the rate of infant mortality
In 2016, which state had the highest infant mortality rate? Which state had the second highest? The fifth lowest? The absolute lowest?
- Alabama had the highest - Mississippi had the second highest
- California had the fifth lowest - Vermont had the lowest
Which state has the lowest rate of death from heart disease, and what is the rate? Which state has the highest rate?
- Minnesota has the lowest (225 deaths/100,000 for those over age 35) - Mississippi has the highest
In 2015, which state had the lowest median income for a family of four?
Mississippi
According to the WHO, what are the 4 standard indicators to compare health among countries globally?
- Male life expectancy at birth 2. Female life expectancy at birth
- Infant mortality rate: # of babies, out of one thousand, who will die before their first birthday
- Maternal mortality rate: of one hundred thousand women giving birth,the number who will die as the result of complications during birth
Argentina (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 74 - Female expectancy: 80
- IMR: 10
- MMR: 52
- Per capita: $20,270
Bangladesh (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 71 - Female expectancy: 74
- IMR: 28
- MMR: 176
- Per capita: $4,040
Brazil (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 71 - Female expectancy: 79
- IMR: 14
- MMR: 44
- Per capita: $15,160
Canada (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 81 - Female expectancy: 85
- IMR: 4
- MMR: 7
- Per capita: $45,750
Colombia (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 71 - Female expectancy: 78
- IMR: 13
- MMR: 64
- Per capita: $14,170
Democratic Republic of Congo (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 59 - Female expectancy: 62
- IMR: 72
- MMR: 693
- Per capita: $870
Greece (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 79 - Female expectancy: 84
- IMR: 3
- MMR: 3
- Per capita: $27,820
Haiti (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 61 - Female expectancy: 66
- IMR: 51
- MMR: 359
- Per capita: $1830
India (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 67 - Female expectancy: 70
- IMR: 35
- MMR: 174
- Per capita: $7,060
Mexico (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 74 - Female expectancy: 79
- IMR: 13
- MMR: 38
- Per capita: $17,740
Nigeria (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 55 - Female expectancy: 56
- IMR: 67
- MMR: 814
- Per capita: $5,680
Norway (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 81 - Female expectancy: 84
- IMR: 2
- MMR: 5
- Per capita: $63,530
Russian Federation (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 66 - Female expectancy: 77
- IMR: 7
- MMR: 25
- Per capita: $24,893
Singapore (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 81 - Female expectancy: 85
- IMR: 2
- MMR: 10
- Per capita: $90,570
United States (Male and female life expectancy at birth, IMR, MMR, and Per Capita Income)
- Male expectancy: 76 - Female expectancy: 81
- IMR: 6
- MMR: 14
- Per capita: $60,200
In Western countries, when determining IMR, an infant born alive is defined as an infant who has….
a spontaneous heartbeat and other signs of vital organ functioning
In a country that does not have resources to provide intensive care to a premature infant, an infant that is born alive is defined as an infant who has…
survived the first 24 hours of life
According to an analysis published Dimitris Kontis and his colleagues, which predicts the life expectancies across 35 industrialized countries through the year 2030, what is the probability of a change in life expectancy for men and women?
- 85% chance of an increase for men - 65% chance of an increase for women
Projected life expectancy (through the year 2023) is lower in countries that have…(4)
- higher young adult mortality - higher major chronic disease risk factors
- higher social inequalities
- less effective health systems
By 2030, according to Dimitris Kontis and his analysis, how will the life expectancy in the United States compare to other industrialized countries?
The life expectancy will be even lower
What does DALY stand for? What is it?
- DALY: disability-adjusted life year - a measurement instrument used to estimate the magnitude of the burden created by a disease or condition