MCPHS:US Healthcare Exam 4
• Reportable "notifiable" diseases:
o Certain diseases, mostly infectious diseases, is required by law to be reported as soon as
they are diagnosed.
o Federal level - 60 diseases are notifiable by law. Some examples are: Tuberculosis,
measles, syphilis, etc. (complete table on page 51-53 Table 4-2)
o Some states require additional reporting of other infectious diseases (MA requires providers
to report food poisonings and toxicities-including mushroom toxicities, paralytic shellfish)
o List two other reportable conditions:________________________ and
_________________________ that states may require a provider to report
o Which infectious disease is currently in the news and would be classified as a reportable
disease? o Physicians, hospitals and clinical laboratories report these illnesses to the local
health department who in turn reports them to the: ______________________ and
________________ - ANS-Birth Defects
Cancer
Ebola
State Health Department
CDC
Are case-control studies more efficient then Cohort Studies? Why? Downfalls compared to
cohort study?
How are these studies preformed? - ANS-More efficient then cohort Study because short
amount of time to complete up lease accurate than cohort.
These studies use a RETROSPECTIVE study method. Investigators start with people that
ALREADY have the disease (cases) and looks back to determine exposure to
suspected/Hypothesized cause of diease.
CDC 1999 top ten list of public health achievements of the 20th century
What are they?
What advancements led to these achievements? - ANS--Routine use of vaccinations
-Improvements in motor vehicle safety
-More secure workplaces -Control of infectious diseases
-A decrease in cardiovascular disease deaths -Safer and healthier foods
-Better health for infants and mothers -Access to services for family planning and contraception
-Fluoridation of drinking water
-Positive trends in tobacco use
Challenges for the twenty-first century - ANS-Renewed threats from infectious diseases
-Antibiotic resistance
-Foodborne pathogens
-Climate changes caused by overpopulation and economic development
-Rising costs of medical care for the aging population
, -Alcohol and illicit drug use
-Increasing prevalence of obesity
Cutbacks in resources and support for preventive activities
-The trend to cure/treat health problems rather than prevent them
Disparities in health care (access, quality)
-The necessity to coordinate public health efforts at various levels of government, to develop
public-private partnerships in communities and to undertake strategic planning aimed at
achieving goals and objectives
Weaknesses in public health infrastructure revealed by events of -9/11
-Workforce
-Information systems
-Laboratories
Organizational capacity
Public Health: Science, Politics, and Prevention in Chapter 1 - ANS-Objectives -What is public
health (PH)
- 3 core functions of PH
-Difference between PH and medical care
- The science and political of PH
-6 disciplines of PH
-Prevention and intervention
5- step approach, 3 levels of prevention, chain of causation.
CHAPTER 2: WHY IS PUBLIC HEALTH CONTROVERSIAL? - ANS-Know difference between
social justice and market justice
Sources of controversy
-Economic
-individual liberty
-moral and religious concerns
-The influence of politics on science Chapter 3 - ANS-Objectives - Understand and define
The role of government in public health in the United States
- Federal vs State vs Local Authority
How the law works : Federal, State and Local
How public health is organized and paid for in the United States : Federal, State and Local
Nongovernmental role in public health
Determined by law
Government's public health activities must be authorized by legislation at the federal, state, or
local levels
The body of public health law is huge, consisting of all written statements relating to health by
any of the three branches of government
Chapter 4- Epidemiology: The Basic Science of Public Health - ANS-Objectives:
• Define epidemiology
• Describe how epidemiology works and how investigations are carried out. • List notifiable
diseases
• Describe epidemiology's role in determining/understanding the causes and prevention of
diseases. Including:
, o Infectious diseases (cholera, Hepatitis A, Legionnaire's disease, cryptosporidiosis
o Outbreaks caused by toxic substances
o Chronic diseases (heart disease and lung cancer)
• Define the following terms:
o Endemic, epidemic, pandemic
o Epidemiological surveillance
o Notifiable disease
o Chronic disease
o Risk factors
Chronic Diseases - ANS-Heart Disease
Lung Cancer Cohort studies are best for what? - ANS-Best for testing CAUSATION OF
DISEASE.
Groups of people are picked that are DISEASE FREE! Are then classified exposure to a
potential disease.
Track study over time
Two groups
Exposed group
Unexposed group
Objective is to track to see if exposed groups was more likely to develop disease over
unexposed group.
-Good for examining rare or uncommon exposure
Confidentiality of health data
Why is it good?
How does it interfere with public health policy development and enforcement? - ANS-All
information collected from individuals by governments for whatever purpose is considered
confidential and cannot be divulged without the consent of the individual
Information is generally entered into a database without any names, addresses or personal
identifiers
Exception: when someone has been exposed to a communicable disease they must be notified
Define
Bias:
Selection error: Recall Bias: - ANS-Bias: Is a systematic error in the design, conduct or analysis
of a study that results in a mistaken estimate of an exposures effect on the Risk of disease.
Selection bias: There is an error in choosing the individuals or groups to take part in study.
THIS IS OFTEN SEEN IN CASE-CONTROL STUDY
Recall Bias: An error caused by difference in the accuracy or completeness of the recollection
retrieve (recalled) by study participants regarding events or experiences from the past
ISSUE SEEN IN CASE CONTROL
Define a Chronic Condition Give some examples, such as an ANS—a disease with a long
duration or frequent recurrence, typically incurable but not necessarily fatal. Heart Disease and
Cancer of the Lung Define CI and state what it is used for.
What does the following mean?
If a CI=0.65
If a CI=4 - ANS-CI stand for confidence interval.
• Reportable "notifiable" diseases:
o Certain diseases, mostly infectious diseases, is required by law to be reported as soon as
they are diagnosed.
o Federal level - 60 diseases are notifiable by law. Some examples are: Tuberculosis,
measles, syphilis, etc. (complete table on page 51-53 Table 4-2)
o Some states require additional reporting of other infectious diseases (MA requires providers
to report food poisonings and toxicities-including mushroom toxicities, paralytic shellfish)
o List two other reportable conditions:________________________ and
_________________________ that states may require a provider to report
o Which infectious disease is currently in the news and would be classified as a reportable
disease? o Physicians, hospitals and clinical laboratories report these illnesses to the local
health department who in turn reports them to the: ______________________ and
________________ - ANS-Birth Defects
Cancer
Ebola
State Health Department
CDC
Are case-control studies more efficient then Cohort Studies? Why? Downfalls compared to
cohort study?
How are these studies preformed? - ANS-More efficient then cohort Study because short
amount of time to complete up lease accurate than cohort.
These studies use a RETROSPECTIVE study method. Investigators start with people that
ALREADY have the disease (cases) and looks back to determine exposure to
suspected/Hypothesized cause of diease.
CDC 1999 top ten list of public health achievements of the 20th century
What are they?
What advancements led to these achievements? - ANS--Routine use of vaccinations
-Improvements in motor vehicle safety
-More secure workplaces -Control of infectious diseases
-A decrease in cardiovascular disease deaths -Safer and healthier foods
-Better health for infants and mothers -Access to services for family planning and contraception
-Fluoridation of drinking water
-Positive trends in tobacco use
Challenges for the twenty-first century - ANS-Renewed threats from infectious diseases
-Antibiotic resistance
-Foodborne pathogens
-Climate changes caused by overpopulation and economic development
-Rising costs of medical care for the aging population
, -Alcohol and illicit drug use
-Increasing prevalence of obesity
Cutbacks in resources and support for preventive activities
-The trend to cure/treat health problems rather than prevent them
Disparities in health care (access, quality)
-The necessity to coordinate public health efforts at various levels of government, to develop
public-private partnerships in communities and to undertake strategic planning aimed at
achieving goals and objectives
Weaknesses in public health infrastructure revealed by events of -9/11
-Workforce
-Information systems
-Laboratories
Organizational capacity
Public Health: Science, Politics, and Prevention in Chapter 1 - ANS-Objectives -What is public
health (PH)
- 3 core functions of PH
-Difference between PH and medical care
- The science and political of PH
-6 disciplines of PH
-Prevention and intervention
5- step approach, 3 levels of prevention, chain of causation.
CHAPTER 2: WHY IS PUBLIC HEALTH CONTROVERSIAL? - ANS-Know difference between
social justice and market justice
Sources of controversy
-Economic
-individual liberty
-moral and religious concerns
-The influence of politics on science Chapter 3 - ANS-Objectives - Understand and define
The role of government in public health in the United States
- Federal vs State vs Local Authority
How the law works : Federal, State and Local
How public health is organized and paid for in the United States : Federal, State and Local
Nongovernmental role in public health
Determined by law
Government's public health activities must be authorized by legislation at the federal, state, or
local levels
The body of public health law is huge, consisting of all written statements relating to health by
any of the three branches of government
Chapter 4- Epidemiology: The Basic Science of Public Health - ANS-Objectives:
• Define epidemiology
• Describe how epidemiology works and how investigations are carried out. • List notifiable
diseases
• Describe epidemiology's role in determining/understanding the causes and prevention of
diseases. Including:
, o Infectious diseases (cholera, Hepatitis A, Legionnaire's disease, cryptosporidiosis
o Outbreaks caused by toxic substances
o Chronic diseases (heart disease and lung cancer)
• Define the following terms:
o Endemic, epidemic, pandemic
o Epidemiological surveillance
o Notifiable disease
o Chronic disease
o Risk factors
Chronic Diseases - ANS-Heart Disease
Lung Cancer Cohort studies are best for what? - ANS-Best for testing CAUSATION OF
DISEASE.
Groups of people are picked that are DISEASE FREE! Are then classified exposure to a
potential disease.
Track study over time
Two groups
Exposed group
Unexposed group
Objective is to track to see if exposed groups was more likely to develop disease over
unexposed group.
-Good for examining rare or uncommon exposure
Confidentiality of health data
Why is it good?
How does it interfere with public health policy development and enforcement? - ANS-All
information collected from individuals by governments for whatever purpose is considered
confidential and cannot be divulged without the consent of the individual
Information is generally entered into a database without any names, addresses or personal
identifiers
Exception: when someone has been exposed to a communicable disease they must be notified
Define
Bias:
Selection error: Recall Bias: - ANS-Bias: Is a systematic error in the design, conduct or analysis
of a study that results in a mistaken estimate of an exposures effect on the Risk of disease.
Selection bias: There is an error in choosing the individuals or groups to take part in study.
THIS IS OFTEN SEEN IN CASE-CONTROL STUDY
Recall Bias: An error caused by difference in the accuracy or completeness of the recollection
retrieve (recalled) by study participants regarding events or experiences from the past
ISSUE SEEN IN CASE CONTROL
Define a Chronic Condition Give some examples, such as an ANS—a disease with a long
duration or frequent recurrence, typically incurable but not necessarily fatal. Heart Disease and
Cancer of the Lung Define CI and state what it is used for.
What does the following mean?
If a CI=0.65
If a CI=4 - ANS-CI stand for confidence interval.
