PUBH 302 final- Galloway QUESTION AND CORRECT ANSWER

PUBH 302 final- Galloway QUESTION AND CORRECT ANSWER Define public health - CORRECT ANSWER-actions that society takes collectively to ensure that the conditions in which people can be healthy can occur Define the "Ps" of public health - CORRECT ANSWER-Prevention Protection Promotion Prolonging Product safety Physical, social, economical environments (Big) Picture Populations define prevention - CORRECT ANSWER-practicing health and safety habits to remain free of disease and injury define protection - CORRECT ANSWER-protecting the population, making reccomendations to keep people healthy define promoting - CORRECT ANSWER-promoting healthy habits, promoting ways to think about healthy behavior define prolonging - CORRECT ANSWER-prolonging life and quality of life product safety - CORRECT ANSWER-ensuring safety of food product, vehicles define physical, social, economic environments - CORRECT ANSWER-healthy air in the environment, social influences, affording healthy habits define populations - CORRECT ANSWER-what is truly effecting us at the population level, what are the leading causes of death? who is vulnerable or "at risk"? define (big) Picture - CORRECT ANSWER-looking at the complex world we live in and public health's role is to dig into the big picture and figure out how to protect populations define health issues - CORRECT ANSWER-identify shared health concerns within a society by looking at surveillance data define determinants of health - CORRECT ANSWER-the range of personal, social, economic, and environmental factors that influence health status define health - CORRECT ANSWER-a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity define quality of life - CORRECT ANSWER-involving social, emotional, mental, spiritual and biological fitness on the part of the individual, which results from adaptations to the environment define physical health - CORRECT ANSWER-absence of disease and disability; functioning adequately; physical condition of the body define emotional health - CORRECT ANSWER-ability to feel and express full range of human emotions; express/ control appropriately define social health - CORRECT ANSWER-ability to interact/communicate effectively; connect with others; demonstrate respect/tolerance; sense of belonging define mental (intellectual) health - CORRECT ANSWER-ability to make sound decisions and think critically; strive for continued personal growth/learn new information define spiritual health - CORRECT ANSWER-unifying force within individuals; meaning in life; common bond between individuals; individual perceptions of faith define environmental health - CORRECT ANSWER-awareness of the environment's importance to health, as well as human influence on environment define risk factors - CORRECT ANSWER-set of common causes of death, disability, illness and injury (behavioral- smoking, poor diet, lack of physical activity, alcohol consumption) more likely to be under the control of individuals at risk define risk conditions - CORRECT ANSWER-more distal risk factors: biological (age, sex, genetics); environmental (safe community/work site; adequate housing); enforcement of policies and regulations; less likely to be under the control of individuals define lifestyle - CORRECT ANSWER-pattern of behavior; more complex, lifetime habits and social circumstances C. Everett Koop - CORRECT ANSWER-(Surgeon General) stated that tobacco is bad for you and your health In 1984, he wrote that nicotine has an addictiveness similar to that of heroin or cocaine. He took on big tobacco He instituted the practice of requiring rotated health warning labels on cigarette packs and required advertising to include labels He issued a challenge to Americans in 1984 to "create a smoke-free society in the United States by the year 2000" He released 8 reports on the health consequences of tobacco use including the first report on health consequences of involuntary tobacco smoke exposure He started to inform the public on the AIDS epidemic DUI's in South Carolina Article 1. Define the public health issue. Why is this a PH problem? 2. What are the factors/determinants involved in this problem? 3. What controversial and/or ethical concerns may be involved? - CORRECT ANSWER1. a) motor vehicle accidents related to alcohol b) not enough law enforcement dealing with DUIs c) SC is number 2 in the nation of most deaths out of 100,000 people from drunk driving 2. a) the person makes the choice to drink and drive b) the more you drive under the influence without getting caught, the more comfortable you get doing it c) people will DUI 80 times before getting caught d) the dash camera and officer not getting set up properly leading to not being able to convict the drunk driver e) males are more likely to drink and drive than women3. a) the role of the breathalyzer and how it can be refused b) distrust in law enforcement because of the copious amount of evidence required c) pulling someone over for possibility of DUI is subjective Define Health codes - CORRECT ANSWER-powerful codes and regulations that are based on the society's belief system and the society's understanding of health/disease Public Health in Ancient Greece - CORRECT ANSWER--personal hygience -physical fitness (olympics) -naturalistic concepts (disease caused by imbalance between man and environment) -The Greeks understood the importance of washing hands, bathing, exercising, and eating good food Hippocrates - CORRECT ANSWER-father of western med -believed that illness had a physical and rational explanantion -looked for and described casual relationships between disease and other factors (climate, soil, water, lifestyle) Public Health During the Roman Empire - CORRECT ANSWER--adopted Greek health values -built aqueducts to bring water into the city -advanced plumbing technology - collected taxes to support public services Public Health During the Middle Ages - CORRECT ANSWER-- shifted away from Greek and Roman values - decline of hygiene and sanitation - faith and prayer were accepted treatments for illness - plague - developed the concept of quarantine Public Health during the Age of Reason and Enlightenment - CORRECT ANSWER-- renewed interest in reason and enlightenment laid foundation for more specific explorations William Harvey - CORRECT ANSWER--demonstrated the function of the heart and circulatory system - first to suggest that humans and other mammals reproduce via fertilization of an egg by sperm - birth of modern med -used dissection Edward Jenner - CORRECT ANSWER-- proved that swinepox or cowpox provided immunity against smallpox - coined the term vaccine -laid foundation of modern immunology as a science Problems caused by Industrialization Urbanization - CORRECT ANSWER-- slums -poverty -disease Great Sanitary Awakening - CORRECT ANSWER--the birth of modern public health -Great strides in scientific knowledge to help understand the origin and treatment of disease. -Interest in humanitarian ideals -Acknowledgement of the connection between poverty and disease. -Even today, poverty is the single best predictor of poor health. -Returning to what the Romans had figured out, new infrastructure for clean water and sewage removal -Birth of a system to monitor the health status of communities Bubonic Plague - CORRECT ANSWER-plague brought by fleas pneumonic plague - CORRECT ANSWER-plague spread by sneezing, fever was more contagious bc it was spread airborne Renaissance Global Exploration effects on PH - CORRECT ANSWER-disease was spread by traders and explorers between countries - killed 90% of the indigenous people in the New World Four Phases of the Development of modern-day public health described by Ashton - CORRECT ANSWER-1) an initial environmentally-focused phase which addresses infectious diseases related to "urbanization, poverty, and squalor" 2) second phase of personal preventive medical services related to immunization, family hygiene, health education, and family planning which began with the development of vaccines 3) third, therapeutic era that began with the development of insulin and antibiotics. 4) A recognition that the 'environment' is also social, economic and psychological and that 'healthy public policy' (Hancock, 1982) is an appropriate part of this new public health. Dr. John Snow - CORRECT ANSWER-- became concerned of the cholera outbreaks in London - made careful observations about the disease and who caught it - used a "ghost map" to trace all the deaths and was able to detect the pump that was causing the illness - removed the handle off the broad street pump and the illness subsided -using epidemiological practices, he identified and stopped the outbreak and source of cholera England Sanitary Reform - CORRECT ANSWER-- Chadwick Report "Survey into the Sanitary Condition of the Labouring Classes in Great Britain - graphic descriptions of filth and disease spread in urban areas - reforms in sanitation, health care and treatment of poor working classes - first modern sanitation legislation was enacted in 1837 Lemuel Shattuck - CORRECT ANSWER--Developed the original plan that led to the establishment in 1869 of the nation's first Board of Health in Massachusetts Louis Pastuer - CORRECT ANSWER-proposed the germ theory of disease, which which was crucial to the development of modern scientific medical practices Robert Koch - CORRECT ANSWER-Developed the culture plate method to identify pathogens Sanitation Revolution - CORRECT ANSWER-Clean water; water treatment Food inspection Soaps, disinfectants, and pharmaceuticals Personal hygiene (bathing) Public works departments; garbage collection, landfills, and street cleaning Public health departments and regulation STD and 3 guiding questions: 1. Define the public health issue. What makes this a public health issue? 2. What are the factors/ determinants involved in this problem? 3. What controversial/ethical concerns may be involved? - CORRECT ANSWER-1. rise in cases of gonorrhea, chlamydia, and syphilis 2. a) unprotected sex b) moms pass it on to their children c) some people are symptomatic d) some are resistant to antibiotics e) contraceptives do not prevent STDs 3. a) getting tested, knowing if you have something b) right to privacy v. right to be protected c) personal/ religious beliefs d) sex ed being taught Infant Mortality - CORRECT ANSWER-Death of an infant from time of birth - 1 year old - overall infant mortality= neonatal deaths + postneonatal deaths Infant Mortality Relevance to PH - CORRECT ANSWER-- used to compare the health and well-being of populations across and within countries - looks at health of the mother, population growth, conditions where babies thrive, and neighborhood impact - indicates current health status of the population *Has decreased since 1990 What are risk factors for infant mortality? - CORRECT ANSWER-Low birth weight premature birth male infant maternal age <15 or >40 not married US born mother Poverty Primary Prevention - CORRECT ANSWER-action taken to avert occurrence of disease, preventing exposure to risk factors ex: smoking cessation programs, healthy diet, wearing sunscreen, not texting and driving - CORRECT ANSWER-examples of primary prevention Secondary Prevention - CORRECT ANSWER-action taken to identify diseases at their earliest stages and to apply appropriate treatments to limit their consequences, early detection and diagnosis having a yearly mammogram, going to the doctor, going to the dermatologist for skin exams, seatbelts - CORRECT ANSWER-examples of secondary prevention Tertiary Prevention - CORRECT ANSWER-specific interventions to assist diseases or disabled persons in limiting the effects of their diseases or disabilities taking chemotherapy for cancer, having surgery - CORRECT ANSWER-examples of tertiary prevention List 5 of the Ten Greatest Achievements in PH - CORRECT ANSWER-1.Vaccinationeffective vaccination programs 2. Motor-vehicle safety- cars are safer structurally, seat belts, driver's education 3. Safer workplaces4. Control of infectious diseases 5. Decline in deaths from coronary heart disease and stroke cradle of shame - CORRECT ANSWER-focusing on African American women in rural areas- most susceptible for higher infant mortality epidemiology - CORRECT ANSWER-·- The study of the distribution and determinants of health-related states or events in specified populations, and Epidemiology has been called "population medicine" - diagnose what the health population problems are of a population Epi as a "cornerstone" for PH - CORRECT ANSWER-Objectively examines factors, variables, statistics - evidence bases Examining trends over time Utilize data for prevention efforts Try to explain why some things happen to some people and not others Shift from traditional epi to wider uses We must target multiple causal factors and collaborate with multiple discipline We have to figure out ways to change behaviors and see what's going on and what types of behaviors lead to certain outcomes endemic - CORRECT ANSWER-the constant presence of disease or infectious agent within a geographic area epidemic - CORRECT ANSWER-the occurrence of a disease in excess of normal expectancy pandemic - CORRECT ANSWER-an outbreak of a disease over a wide geographical area, such as a continent what ways is health measured? - CORRECT ANSWER-mortality, morbidity, injury/disability, productive life years lost, lost opportunity, quality of life, healthy days of life, psychological measures the PH "problem" P.e.r.i - CORRECT ANSWER-"what" person/place Formula for rate - CORRECT ANSWER-number of events, cases, or deaths / population in the same area * for a specified time period death rate - CORRECT ANSWER-The number of deaths in a population in a certain amount of time adjusted rate - CORRECT ANSWER-a rate that is for a total population but is statistically adjusted for certain characteristics specific rate - CORRECT ANSWER-rate for a particular population subgroup such as for a specific disease (disease-specific) or for a particular age of people (age-specific) crude rates - CORRECT ANSWER-those in which the denominator includes the total population incident rate - CORRECT ANSWER-the number of and health-related events or cases of a disease in a population exposed to that risk in a given time period prevalence rate - CORRECT ANSWER-calculated by dividing all current (existing) cases of a disease (old and new) by the total population attack rate - CORRECT ANSWER-a special incidence rate calculated for a particular population for a single disease outbreak expressed as a percentage The Causes (Etiology) (P.E.R.I) of the PH Problem (the Why) E - CORRECT ANSWERdoes the cause precede the effect? what accounts for 54% of health influence? - CORRECT ANSWER-behavior multicausation disease model - CORRECT ANSWER-a model that explains the onset of disease caused by more than one factor socio-ecologic model (bull's eye) - CORRECT ANSWER-Diagram that demonstrates how individual and environmental causes affect a person's health § Inner circle - individual §Outer circle - environmental criteria for establishing contributory cause - CORRECT ANSWER-1. Cause is linked to effect (outcome) 2. Cause comes before the effect (temporal sequence) 3. Changing the causes, changes the effect (a relationship) list and describe the 4 health outcome considerations - CORRECT ANSWER-Strength o Relative risk: how strong is the relationship between developing lung cancer and cig smoking · Dose-response o Amount of exposure x time ex:The more cigs you smoke over more years increases your chance of lung cancer Consistency o Studies produce same results over time across different populations ex: Doesn't matter who you are or where you live · Biological plausibility o Known mechanisms (biological and otherwise) that explain relationships ex: Cig smoke enter lungs relative risk (relationship strength) - CORRECT ANSWER-The relative risk for persons with the factor/condition is greatly increased compared to those without -(probability of Y if X exists)/(probability of Y if X does not exist) Major Epi Trends in US (since 1900) - CORRECT ANSWER-overall health status improving life expectancy at birth increasing birth outcomes are better years of healthy life increasing Recommendations for Reducing/Eliminating the PH Problem (P.E.R.I) R - CORRECT ANSWER-What works to reduce the health impacts? What is the quality of the evidence for the intervention in terms of benefit and harms? What do we know based on past experience? What steps do we take (Implement)? (P.E.R.I.) I - CORRECT ANSWER-How can we get the job done? What should the implementation occur? At who should the implementation be directed?- the priority population How should the interventions be implemented? Framingham Heart Study - CORRECT ANSWER-learned cigarette smoking causes heart disease Schneider, Why is PH Controversial? - CORRECT ANSWER-PH measures are often controversial because they have an economic impact Health Equity and Social Justice - CORRECT ANSWER-Access is not always equity - health care professionals are prejudice to certain groups of people bioethics - CORRECT ANSWER--Application of individual and group values and morals to controversial areas Major Levels of Governmental PH - CORRECT ANSWER-National: federal health agencies such as DHHS and its components Tribal: Indian Health Service and others State: state health agencies such as health departments and human service agencies Local: local public health agencies, often called local health departments How has PH extended life expectancy? - CORRECT ANSWER-Assessment- what is going on (what's killing us, making us sick) Policy Development- Inform, educate, and empower people about health issues- build knowledge, shape attitudes; inform decision-making choices Assurance- Enforce laws and regulations that protect health and ensure safety social determinants of health - CORRECT ANSWER-The conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels How do social determinants impact health outcomes? - CORRECT ANSWER-- Diet, exercise, smoking habits, driving habits all impact health outcomes Describe the Tuskegee Study - CORRECT ANSWER-- Tuskegee study consisted of 600 black men 399 of which had syphilis who were told were being treated for "bad blood", men never received treatment and did not give informed consent. - led to the National Research Act National Research Act - CORRECT ANSWER-- : required all researchers to get voluntary consent from all participants Required establishment of Institutional Review Boards (IRBs) that review and decide whether studies meet ethical standards Institutional Review Board (IRB) - CORRECT ANSWER-A committee at each institution where research is conducted to review every experiment for ethics and methodology. Explain what ACEs are - CORRECT ANSWER-- Experiences that children 0-18 yrs have (abuse, neglect, household dysfunction) CDC-Kaiser ACE study - CORRECT ANSWER-- landmark study over 17,000 people found that ACE's are common- 2/3 people reported at least one ACE - Impacts on health: toxic stress from ACE's has a direct effect on brain development, resulting in changes in: 1. decision making 2. learning and growth 3. forming healthy relationships Dose response - CORRECT ANSWER-the longer/more exposed to something, the higher chance of having lasting impacts; more of the determinant=more likely to have negative outcome Stress response System - CORRECT ANSWER-prolonged release of stress hormones can have a negative impact on brain and other organs What are some prevention strategies for addressing ACEs and other social determinants of health? - CORRECT ANSWER-- early childhood home visitation - safe dating and healthy relationship skills programs - enhanced primary care SEEK MODEL