w7 Flashcards by Garrett Anderson

How to maintain or improve drinking water supply
- Properly dispose pharmaceuticals, household chemicals, oils and paints
- Check for ______ from automobiles and heating fuel tanks – clean up spill using absorbent material like cat liter
- Clean up after ______
- Eliminate/limit use of fertilizers and pesticides
- Participate in watershed activities

How to maintain or improve drinking water supply
- Properly dispose pharmaceuticals, household chemicals, oils and paints
- Check for leaks from automobiles and heating fuel tanks – clean up spill using absorbent material like cat liter
- Clean up after pets
- Eliminate/limit use of fertilizers and pesticides
- Participate in watershed activities

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Climate and health
- Human activities primary driver of climate changes
- Earths average temp has risen – heat waves, melting snow/ice with rising sea levels, changes in precipitation resulting in floods/droughts, more intense hurricanes/storms, wildfires, poorer air quality
- Direct or Indirect impact? – changing weather patterns
- Direct or Indirect impact? - changes in availability of clean water

direct

indirect

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Children and enviro health ________
- Children more effected compared to adults – children eat, drink, and breath more
- Frequently put stuff in mouth, play on ground
- Protective bodily systems not yet fully functional
- Environmental chemicals may disrupt normal biological process, development, and periods of rapid growth

hazards

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____________
- Not a supra-state or government entity
- Doesn’t have an army or impose taxes
- It depends on the political will of its member states to have its decisions put into action
- Relies on the contributions of members to carry out its activities

United nations
- Not a supra-state or government entity
- Doesn’t have an army or impose taxes
- It depends on the political will of its member states to have its decisions put into action
- Relies on the contributions of members to carry out its activities

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Hazard vs risk

_________ = something that can potentially cause harm, no exposure (no harm unless exposure occurs)

_______ = hazard + exposure

Hazard

Risk

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Environmental health _________
Any environmental substance/situation that has the ability to cause an adverse health event
- External to person
- Natural or human made
- Ex: pesticides, chemical in consumer products, radiation, flood waters

hazards

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Environmental health in the home
- Take off shoes at door
- Well ventilated house
- Organic, fresh, local produce
- Grow garden, don’t use pesticides
- Reduce ______ 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

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

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Trauma
_______ to migration
- fleeing violence
_______ migration
- dangerous conditions
- assault
- kidnapping
- trafficking
_______ migration
- uncertainty
- fear of deportation
- chaotic living conditions
- poverty
- lack of social support networks

Trauma
Prior to migration
- fleeing violence
During migration
- dangerous conditions
- assault
- kidnapping
- trafficking
after migration
- uncertainty
- fear of deportation
- chaotic living conditions
- poverty
- lack of social support networks

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Methods of __________/assessing exposures
- Toxicology studies
- Epidemiologic studies
- Environmental monitoring
- Biological monitoring – biomarker
- Product surveillance

surveillance

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Hazard control strategies
- At the ________ (ex: quranatine)
- Along the _______ (ex: social distancing)
- At the level of the person (ex: PPE)
- ________ prevention (ex: COVID testing)

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 entails 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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Examples of impact of climate related events and health
- Maintaining continuity of medications for patients with chronic disease was a barrier post hurricane katrina
- Flooding associated with increase in rate of acute GI illness ED visits
- Wildfire smoke exposure increased CV and cerebrovascular ED visits
- Extreme heat associated with increased preterm birth and adult CV mortality

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Air quality

Air pollution result of emission into air of hazardous substances at a rate that _________ the capacity of natural processes in the atmosphere (rain and wind) to convert, deposit, or _______ them
- Severity changes with season, daylight, industrial activity, changes in traffic, prevailing winds, precipitation

Kentuckys air monitoring network meausres
- Carbon monoxide
- Lead
- Nitrogen dioxide
- Ozone
- Particulate matter
- Sulfur dioxide

exceeds

dilute

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Indoor air quality
Possible contaminants
- Burning ______ for cooking or heat
- Second hand ______ smoke
- Radon
- Formaldehyde
- Asbestos fibers

Health effect
- Acute respiratory infection
- Exacerbation of asthma
- Chronic lung disease
- Lung cancer
- Adverse pregnancy outcomes

fuel

tobacco

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Nurses and environment
- Nurses provide healing and safe environment
- Nurses are trusted source of info
- Nurses are largest healthcare occupation
- Nurses work with variety of cultures
- Nurses effect decisions in their own homes, work, and communities
- Nurses are good sources of info for policy makers
- Nurses translate scientific health literature to make it understandable
- Nurses with advanced degrees are engaged in research
- Health organizations recognize the nurses role in environmental health
- Nursing education requires knowing how to reduce exposures to environmental hazards

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Responding to climate change
- Adaptation or Mitigation? – reducing the flow of green house gases into atmosphere (ex: clean energy like solar and wind)
- Adaptation or Mitigation? – learning to live with and adapt to the climate change that has already been set in motion (ex: plant more trees)
- Drive less
- Reduce beef consumption
- Recycle, reuse
- Use water efficiently
- Turn off lights, computer, TV when not in use
- Plant community gardens
- Advocate - Professional associations, elevate the message, Community engagement

Mitigation

Adaption

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Decolonizing health
- Stresses the commonality of our humanity
- Approach to health which requires a collective action and social justice (ex: partners in health)

__________– specific view of the world based on solidarity principles compels us to expose injustice that leads to poverty and sickness and to fight for the universal human right to health

Social justice

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Bodily reactions to _______ exposure
- Respiratory effects – asbestos, radon, cigarettes
- Neuro effects – mercury, arsenic, lead, vinyl chloride, noise
- Hematologic effects – arsenic, benzene, nitrates, radiation
- Skin effects – dioxin, nickel, arsenic, mercury
- Reproductive effects – lead, ethylene dibromide, PFAs

toxic

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health care systems compared to US

US does ______ compared to peer nations in
- cancer survival
- heart attack and stroke survival
- medicating those with long term chronic conditions (DM)
- research

US does _______ compared to peer nations
- lowest life expectancy while it far outspends its peers on healthcare

well

worse

Particulate matter
- PM _____ – inhalable particles, 10 micrometers or smaller, (dust, pollen mold)
- PM ___ – fine inhalable particles, 2.5 micrometers or smaller, (combustion particles, organic compounds, metals

Particulate matter air pollution effects on body
- Stroke
- Heart disease
- Heart attack
- Lung cancer
- COPD
- Lower respiratory infections
- Pregnancy issues

2.5

____________

Goal – improve health by preventing, detecting, and responding to public health events world wide

Why –
- global health threats can affect people in the US
- focuses on increasing disease monitoring and prevention
- improves global capacity to prevent, detect, and respond to public health threats

objectives
- increase trained individuals globally to prevent/detect/respond to public health threats
- increase globally important PH events that are tracked/reported
- increase lab diagnostic testing capacity, surveillance, and reporting

U.S. healthy people 2030

________ – everything around us (air, water, food). Chemicals, radiation, microbes, and physical forces we come into contact with.
- Interactions with the environment are complex and not always healthy

Requirements for a healthy environment
- Clean air
- Water – safe, sufficient
- Food – safe, adequate
- Settlements – safe, peaceful
- Stable global environment

Environment

Water quality

Consumer _________ report – annual water quality report
- Right to know the quality of drinking water
- Part of the safe drinking water act
- US environmental protection agency requires every community water supplier to provide _______ report
- Monitoring organic and inorganic pollutants with potential health effects

confidence

annual

Nursing roles in enviro health
- Education, prevention, treatment
- Community involvement
- Risk assessments
- Risk communication
- Epidemiological investigation
- Policy advocacy and development

___________ – purposeful exchange of information about risks
- Objective 1 – alert public or decision makers to a significant risk of which they may be unaware
- Objective 2 – calm concerns about a small risk that the public or decision makers perceive as serious

Risk communication

_________ a person who must leave their homeland due to persecution of beliefs, race, or ethnicity - may wait up to 10 years to be resettled - highest level of security vetting to enter US - refugees in US are assigned to an agency to provide basic services for the first 90 days in the US – housing, jobs, English, cash - US government contracts with local organizations to do the refugee resettlement process in the US

refugees

Environmental ____________ Aspect of human health determined by physical, chemical, biological and psychosocial factors in the environment Science and practice of preventing human injury and illness and promoting well being by: - Identifying and evaluating environmental sources and hazardous agents - Limiting exposure to hazardous agents in air, water, food, soil or settings that may adversely affect human health

Environmental health

global comparison of high income countries 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

Environmental health resources toxFAQs – agency for toxic substances and disease registry summaries of hazardous substances national environmental public health tracking network alliance of nurses for healthy environments - Working groups – education, research, practice, policy/advocacy

Impact of climate change on human health - More extreme weather - Air pollution – asthma, CV disease - Changes in vector ecology – malaria, lyme disease, etc. Rising sea levels - Increasing allergens – respiratory allergies, asthma - Water quality impacts – cholera, harmful algal blooms Increasing CO2 levels - Water and food supply impacts – malnutrition, diarrheal disease - Environmental degradation – forced migration, civil conflict, mental health impact Rising temps - Severe weather – injuries, fatalities, mental health impact - Extreme heat – heat related illness and death, CV failure

Agency for _____ substances and disease registry Protects communities from harmful health effects related to exposure to natural and man made hazardous substances

toxic

leading cause of death – global - ischemic heart disease - stroke - COPD _____ income countries - Neonatal conditions - Lower respiratory infections - ischemic heart disease ______ income countries - ischemic heart disease - Alzheimer’s - stroke

low high

Global healthcare delivery Partners in health – 5 S’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

_________ Totality of exposure individuals experience from conception until death and its impact on chronic disease

Exposome

Global Health Philosophy, Practices and Approach has Evolved Colonial remnant in global health - Practices that further strengthen the unequal power hierarchy - Organization and regulations that put more power in the rich and powerful - The unwritten norm that the developing world is incapable of solving its own health problems Decolonizing global health - Build global consensus to remove practices of colonial remanent - Move towards a multipolar global health governance structure centered with WHO - Push for a paradigm shift to believe that with continuous economic and social development the world can solve its health problems

_____________ Buildings and spaces created by humans that influence health behaviors or outcomes - General conditions – street and sidewalk condition, street lights, parks, playgrounds, transportation - Exposures in buildings/spaces – SHS, radon, noise level, overcrowding, proximity to hazardous facilities - Land use – pollution, destruction, Misuse or maintenance of land ________ – temperatures vary with land use - Hotter in downtown and industrial environments compared to rural areas and parks - Stays warmer even at night

Built environment Heat islands

Home environment Major concerns - Crowding - Temp - Injury hazard - Water quality - Air quality - Noise - Safety

U.S. and global health - protects US residents from threats to their health - humanitarian obligation – enable healthy people everywhere - broader mission of US foreign policy – reduce poverty, stronger economy, peace, national security, strengthen image of US to the world - promotes peace

____________ Understanding and promoting of health in an inter-cultural and interdisciplinary context - Goal – improve health for people in all nations by promoting wellness and eliminating avoidable disease, disability, and death - Includes study, research and health care practice that focuses on improving health and equity worldwide - Includes epidemiology, sociology, economic disparities, public policy, environmental factors, cultural studies, anthropology, engineering

Global health

____________ - Establish by the UN - Responsible for international public health - Advocates for universal health care, monitoring public risk, coordinating responses to health emergencies, promoting health and well being - Funded by voluntary member states and private donors

World health organization - Establish by the UN - Responsible for international public health - Advocates for universal health care, monitoring public risk, coordinating responses to health emergencies, promoting health and well being - Funded by voluntary member states and private donors

__________ effect - Earth gets heat from the sun - Green house gases (carbon dioxide) trap the heat and keep it from escaping back to outer space - Trapping some of this heat is good bc it warms the planet enough for us to live - Adding extra carbon dioxide (burning fossil fuels) traps more heat making the earth warmer

Green house gas

Environmental ________ Fair treatment and meaningful involvement of all people with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies Populations of special concern - Pregnant - Children - Elderly - Individuals with disabilities - Vulnerable populations - Workers

justice

refugees: major challenges - lack of access to health care – not available to migrants without legal immigration status, language and cultural barriers, lack of information, only given health insurance for 3 months - risk of communicable disease – poor living conditions, lack of health care and vaccinations - chronic health problems – interruption of care - food insecurity and nutritional problems - limited access to sexual and reproductive health services – prenatal care, poor pregnancy outcomes

____________ Measure of overall disease burden - Expressed as the cumulative number of years lost due to ill-health, disability or early death - years lived with disability – years of life lost = DALY - 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 - DALY takes into account morbidity – suffering that may occur for people living with disease or disability

Disability adjusted life year (DALY)

Environmental health and theory ____________ – 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

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

___________ 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)