BBH 302 Exam 1 Questions and Answers 100% Verified

Acculturation Process - the longer you have been here you start to adopt practices of US. An increased risk of disease with increasing length of being here. Acculturation you still retain parts of your culture, assimilation you lose your culture. African American women have babies born small at twice rate of white women- why - African Americans collectively have lower SES but even when you correct for that the gap doesn't go away- actually widened as SES improved. Due to unequal treatment of African Americans- racism takes a heavy toll of AA children even before leaving the womb. Weathering Although this is would be an intervention that would be impossible to fund, Dr. Warne mentioned that he would like to prescribe affluence as a treatment for diabetes. In ONE sentence, describe what he meant by that. - Dr. Warne is referring to how in regards to diabetes, affluence could be a treatment because it would decrease the stress of poverty that causes increased stress hormones (which when constantly high triggers the constant release of glucose that leads to diabetes) and also provide healthy food and access to exercise facilities that would decrease diabetes risk. American Indians and Alaskan natives health disparities - sudden infant death syndrome (SIDS), infant mortality, chronic liver diseases/cirrhosis mortality, diabetes mortality (no genetic explanation), unintentional injuries, suicide, smoking during pregnancy, prenatal care. Also fetal alcohol syndrome, domestic violence, alcoholism and substance abuse, homicide (2nd highest), tuberculosis (bronchitis, crowding, poor resources, co-morbid with HIV), obesity, mental health problems American Indians and Alaskan natives leading causes of death - diseases of heart (#1), unintentional injuries, malignant neoplasms (cancer), chronic liver diseases (alcoholism) and cirrhosis. Suicide in top 10. An epidemiologist in the movie stated that __________ increases the risk of cardiovascular disease, infectious diseases, diabetes, strokes and cancer. - social isolation As stated in the movie, after living in the U.S. for _____ or more years, Latino immigrants are 1.5 times more likely to have high blood pressure than when they first arrived. - 5asians barriers to culturally-appropriate care - language barriers, traditional vs. modern medicine, beliefs about causes of illness, limited access in the working poor (very poor health, working conditions, crowding, uninsured and under-insured, fear of public charge). Huge stigma against mental illnesses asians health disparities - one of the healthiest groups in the US. High rates of hepatitis B and TB, lower rates of death for heart disease and cancers overall (but highest rates of all population of cervical cancer in Vietnamese women), higher stomach and liver ca incidence (compared to all racial groups-highest rate of stomach cancer in Korean men) asians leading causes of death - malignant neoplasms, diseases of heart, cerebrovascular disease, unintentional injuries, diabetes, influenza, chronic lower respiratory disease, Alzheimer's, nephritis, suicide asthma - waste treatment plants often built in places where over crowding, residential segregation, bus depots built here so leads to air pollution. Blacks/african americans have very high rates. Blacks/African Americans health disparities - low levels of life expectancy (lowest in black men), highest rates of infant mortality, highest days spent in hospital, high obesity and diabetes (mortality highest in blacks-beta blockers not effective to treat hypertension in blacks), stroke and coronary heart disease (in general biology of arteries are thinner- originally thought blacks doing well so underestimated), highest rates of prostate cancer, highest death rates of HIV/AIDS, high Lupus, TB (US-born not all blacks actually asians, due to poverty/HIV), sickle cell anemia (genetics- west Africa) Blacks/African Americans leading causes of death - disease of heart, malignant neoplasms, cerebrovascular disease, unintentional injuries (these 4 have not changed since 1980), diabetes, chronic lower respiratory diseases (asthma, bronchitis-smoking), nephritis, homicide, Alzheimer's, septicemia Breast cancer - white women highest incidence, black women highest deaths. Later stage diagnoses for black women- less preventative screenings. Tumors larger and more aggressive in blacks (easier to treat may be?) Causes of disparities in blacks - cancer disparities- access to care, later stage diagnoses, centuries of institutional racism, lack of knowledge to care for blacks, genetic fatalism (your parents had it so there's no way you can avoid getting it), urbanization and poverty, distrust or medical system or mistrust (history of dishonesty, etc.)Cervical cancer - Hispanic Latino women have highest incidence rates, highest death rates in black women cliff diagram- explain - we have populations that are high risk, cliff represents disease. There should be tertiary care at bottom of cliff to catch you when you fall. Even better would be primary preventionfence at cliff (seat belts, no smoking laws, brushing teeth, healthy diet, physical activity). There should also be secondary prevention (net right after cliff- safety net programs- screenings, education classes, etc.). Best would be moving them away from cliff= social determinants of health- policies and institutions that keep people low risk Collerectal cancer - American Indians highest rates but not much different than blacks. Scanning between blacks and white not much different differences vs. disparities - disparities are unethical (people who have more money are healthier than those with less). Differences are those such as prostate cancer is higher in men than women due to their biology. Dislocation - moving to unfamiliar area=stress Dr. Iton stated that the relationship between health and wealth is relatively loose for new immigrants. What did he mean by this? - He means that new latino immigrants, even if they are from low SES have better health that wealthy people from US.However the health-wealth relationship becomes tighter as the years pass genetic fatalism - if your family member has a disease you believe no matter what you will get it so you do nothing to prevent. In regards to race- American Indians are prone to have diabetes H pylori and the Asian Enigma - H pylori high in Asia but not equal rates of stomach cancer health disparities in non hispanic whites - highest levels of death from suicide (especially white men, however Hispanics highest rates of ideation), highest incidence of breast cancer in white women, highest uterine cancer, ovarian second highest incidence, prostate and lung cancer 2nd highest incidence in men, highest rates of oral and bladder cancer (chewing tobacco), highest lymphoma and leukemia, high cigarette smoking (25-44 years), highest suicide, alcohol use (highest heavy use in native Americans) and illicit drugs, highest death rates of death from drug poisoningHeckler report 1985 - 60k excess deaths in minority populations. Hispanic/Latino health paradox - most Hispanics in the US have better health than the average population despite higher poverty rates, less education and poorer access to health care compared to non-Hispanic whites. What we see in immigrant health paradox mostly due to Hispanic/Latino paradox. Much lower general mental health problems BUT Hispanic female teens suicide ideation higher. Networks and support that buffer effects of mental health problems. hispanic/latino social determinants of health - language barriers, disconnect between modern medicine and traditional beliefs, urbanization and poverty, represent a large proportion of immigrant pop hispanics/latinos causes of diaprities - underinsured are working and often have multiple part time jobs so don't have reliable health care coverage provided by employer. OR have but copays to high. Immigrants- fear of public charge. Also language barriers, disconnect between modern medicine and traditional beliefs, urbanization and poverty, represent a large proportion of immigrant population hispanics/latinos health disparities - highest teenage child bearing, no or late prenatal care, HIV/AIDS, higher diabetes, higher obesity, higher asthma, higher TB, cancer for all sites (incidence)- cervical cancer highest (but Vietnamese women highest rates of all groups), highest number of health care visits (chronic disease), lower health care coverage hispanics/latinos leading causes of death - cancer leading cause of death (not heart disease), then disease of heart, unintentional injuries, cerebrovascular disease, diabetes, chronic liver disease and cirrhosis, Alzheimer's, Chronic lower respiratory diseases, influenza/pneumonia, nephritis. History of pacific islands: - Japanese took over, then US, then independent. 1946-48 nuclear devices detonated near/around island. 1954- BRAVO- hydrogen bomb, radioactive fallout onto two islandsresettled but broke down community and caused stress/contamination. One island is under US control (army base) and has wealthy resources- indigenous not allowed to live there. People who were once there were resettled. Small island can absorb all of them. Contrast between islands- health of Americans living on army base is similar to middle class neighborhood in America. Lifespan, infant mortality rate, diabetes (30% in islands), and TB disparities. No access to vaccines for hep B how does stress induce labor and cause preterm birth/low birthweight in blacks? - stress may induce labor and cause preterm birth/low birthweight- constricts blood flow to the placenta which decreasesfetal growth (low birth weight baby), increases inflammation in uterus which reduces the amount of room the baby has, cortisol can cause early contractions Immigrants social determinants of health - fear of public charge (scared they will be deported because they will be seen as burden on healthcare system), cultural ignorance (language, customs) In an attempt to combat the hunger that followed after the dam was built, the U.S. Government began to supply commodity foods to the population, which had a direct impact on diabetes rates. This is an example of an act of ______________. - commission