public health ch. 1-14

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public health ch. 1-14
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ch.1-14
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  1. primary prevention
    activities that are intended to prevent the onset of a disease or injury
  2. secondary prevention
    activities intended to minimize the risk of progression or complications from a disease or to minimize damage from an injury
  3. tertiary prevention
    • activities intended to minimize disability caused by a disease or injury
    • ex.) rehabilitation
  4. public health
    organized community efforts to ensure conditions in which people can be healthy
  5. assessment
    • one of the 3 core functions of public health
    • -monitor health status to identify community problems
    • -diagnose and investigate a problem
  6. assurance
    • one of the 3 core functions of public health
    • -enforce laws and regualtions
  7. policy development
    • of the 3 core functions of public health
    • -inform, educate, empower people about health issues
  8. intervention
    • term used to describe a program or policy
    • -designed to have an impact on a health problem
  9. market justice
    emphazies individual responsibility, minimal obligation to common good and fundamental freedom to all individuals to be left alone
  10. social justice.
    minimal levels of income, basic housing, employment, education, and health care should be seen as fundamental rights
  11. tragedy of the commons
    dilemma arising from the situation in which multiple individuals act independtly and rationally consulting their own self interest which will lead to depelation of a shared limited resource
  12. core functions of public health
    • assessment
    • policy development
    • assurance
  13. biggest concern in public health for USA today?
    chronic disease
  14. public health vs. medical care what the difference?
    • public health- community as a whole
    • medical care- individual and cure
  15. how does public health: science and politics work?
    • science is how we understand threats to health and what intervention to make
    • politics is how we as a society make decisions about what policies to implement
  16. public health disiplines
    name 6
    • epidemiology
    • statistics
    • biomedical sciences
    • enviromental health science
    • social and behaviors science
    • health policy and management
  17. epidemiology
    • study of epidemics
    • aims to control spread of infectious diseases
  18. statistics
    collection of data in a population
  19. biomedical science
    how to treat infectious diseases, chronic diseases and genetics
  20. what is enviromental health science?
    health effects of enviromental exposures
  21. what is social and behavioral sciences
    • leading factors effecting peoples health
    • ex. tobacco, poor diet
  22. what is health policy and management?
    role of medical care in public health
  23. what are the three steps in public health prevention and intervention?
    • primary
    • secondary
    • tertiary
  24. what is the public health approach?
    • define health problem
    • identify risk factors
    • develop and test interventions
    • implement interventions
    • monitor interventions
  25. what is the chain of causation?
    • agent
    • host
    • enviroment
    • interventions
  26. describe some actions the govt has taken to ensure people are safer and healthier today than 100 years ago
    • cleaner water
    • technology
    • cleaner air
  27. how are the six disiplines of public health used to accomplish the core functions?
    each assess, make policies and give assurance with monitoring
  28. what are sources of controversy?
    • economic impact
    • individual liberty
    • moral and religious concern
    • politics vs. science
  29. what is economic impact?
    those who must pay may not be the ones that benefit
  30. when can govt restrict individual freedom?
    to prevent harm to other - generally acceptable
  31. example of a measure that would benefit public health but might be expensive to implement?
    • no smoking
    • benefit- everyone
    • pay the cost- tobacco companies and individual freedom
  32. Police powers
    • invoked for three reasons:
    • -prevent person from harming others
    • -defend interests of the incompetant persons
    • -protect person from harming self
  33. public health agency
    • varies from state to state
    • day to day responsibilities
    • ex.) health statistics, health education, sanitation, provide screenings and immunizations
  34. the role of the gov't is determined by _____?
    law
  35. who makes something a law?
    president
  36. what level of gov't has the law over public health?
    state
  37. what are the three branches of gov't?
    • legislative
    • executive
    • judicial
    • = inter play with each other
  38. what are the jobs of local public health agencies?
    • sanitation
    • screenings
    • monitor statistics
    • control programs
  39. where do funds come from for the state health department?
    state taxes
  40. what do nongovernmental public health organizations do?
    • lobby and educate
    • - american cancer society
  41. what do philanthropic foundations do?
    • help funding
    • ex) bill and melinda gates foundation
  42. what is epidemiology?
    • diagnostic disipline of public health
    • investigates causes of diseases
    • who-when-where
  43. what are the patterns of disease occurance?
    • who
    • when
    • where
  44. what is epidemic surveillance?
    recognition of a new disease
  45. what is endemic?
    different for different diseases vary with population growth and demographics
  46. what is epidemic?
    #'s above normal in population when above it
  47. what did John Snow do? 1st epidemiologist
    • cholera epidemic in mid 1850's
    • natural experiement
    • door to door correlation
    • between water and company
  48. what is the legions air disease?
    • air conditioning cooler in hotel had contaminated water
    • now all air conditioners have certain requirements
  49. federal vs. state authority
    • federal- most traditional public health activities other than enviromental
    • ex) HHS , CDC, FDA, NIH
    • state- primary constitutional responsibility and authority of the health, safety and general welfare of the population
  50. federal agencies involved with public health
    name 4
    • FDA- food and drug administration
    • CDC- center for disease control and prevention
    • HHS- department of health and human services
    • NIH- national institute of health
  51. what is endemic?
    usual prevelance of a disease with a geographical area
  52. what is epidemic?
    occurance in a community or geographical area of a disease at a tate that clearly exceeds the normally expected rate
  53. what is epidemic surveillance?
    • certain "notifiable" disease that is reported as soon as it is diagnosed
    • major line of defense in protecting the public against disease
    • sooner it kicks in sooner the epedemic stops
  54. epidemiology?
    • diagnostic displine of public health
    • study of populations to seek the causes of health and disease
  55. what is a notifiable disease?
    disease that the law requires to be reported to public health authorities as part of the public health survelliance system
  56. what are risk factors?
    characteristic that has been demonstrated statisically to increase a persons chance of developing a disease or being injured
  57. what is different about finding the causes of chronic diseases?
    • chronic diseases develop over time
    • more complicated
    • different factors
    • cannot be cured by a vaccine
  58. what is case control study?
    • epidemeology study
    • individuals affected by a disease with a comparable group of persons who dont have the disease.
    • to see the causes
  59. what is a cohort study?
    study of a group of people followed over time to see how some disease develop
  60. what is a disease?
    health outcome to be studied
  61. what is the distrubtion of disease?
    compomrised of answers: who, when, where questions
  62. what is exposure?
    state of being exposed to something
  63. what is incidence?
    measure of the new number of new cases reported in a given amount of time: usually a year
  64. what is an intervention study?
    • epidemiological study
    • the impact of interventions on one group of subjects in compared to the effect of placebo
  65. what is the odds ratio?
    ratio of odds of an event occuring in one group
  66. what is the placebo effect?
    improvement in health behavior not attributed to a medication
  67. what is the population risk?
    exposure to pathogenic agent under discussion and suspitibilty
  68. what is prevelance?
    proportion of persons in a population who have a particular disease or attribute at specified point in time
  69. what is randomized double blind clinical trial?
    doctor nor patient know who is in the control or experient group
  70. what is the rate?
    proportion of some disease or condition in a group per unit of time with numerator and denomentor
  71. what is the relative risk?
    comparison of two morbidity or mortality rates using calculation of the ratio of one to the other
  72. what are confounding variables?
    variables that researchers are unable to control
  73. what is informed consent?
    consent by patient to undergo medical treatment/experiement
  74. what is the institutional review board?
    comittee of people desginated to approve, monitor, research involving humans
  75. what is the recall bias?
    systemic error due to differences in accuracy or completeness to recall to memory or past events
  76. what is selection bias?
    error choosing individuals/groups to take part in study
  77. what is random variation?
    minor differences among individual people in the population
  78. what is epidemiology?
    • study of populations to seek the causes of health and disease
    • the study of distribution and determinants of disease frequency in human population
  79. what are the three major types of epidemiological studies?
    • intervention study
    • cohort study
    • case-control study
  80. why was the Tuskegee study significant?
    • raised ethical issues
    • deception
    • racist
  81. adjusted rate?
    way of comparing two groups that differ in some important variable by mathmatically eliminating the effect of that variable
  82. what is cost-benefit analysis?
    economic analysis assessed as health outcome per cost expended
  83. what is crude rate?
    actual rate of events in a population with out adjustment
  84. what is a false negative?
    mistaken identification of person being healthy or uneffected when in fact they have the disease or condition being tested for
  85. what is a false positive?
    mistaken identification of persons as affected by some disease or condition when in fact they are uneffected by disease or condition being tested for
  86. what is life expectancy?
    # of additional years of life expected as a specific point in time.
  87. what is probability?
    calculation of what may be expected based on what has happened in the past under similar conditions
  88. what is birth rate?
    # of live births per 1000 of the population per year
  89. death rate?
    # of residents deaths per 100,000 population
  90. what is sensitivity?
    ability of a test to avoid false negatives, its ability to identify a disease or condition in those who have it
  91. what is National Center for Health Statistics?
    componant of the CDC charged with providing statistical information that will guide actions, policies to raise health in america
  92. what are vital statistics?
    systemically collected statistics on life events, measuring progress or lack of it against disease
  93. what is BRFSS?
    us health survey that looks at behavioral risk factors
  94. what is the census?
    collects data about different types of health insurance coverage
  95. what us confidentiality of data?
    is whether the information stored on a system is protected against unitended or unauthorized access
  96. what are statistics?
    numbers that describe the health of a population
  97. science that is used to interpret statistics?
    • incidence
    • prevelance
  98. for statistics P= .05 or lower is significant or not?
    significant
  99. what is power of the study?
    probability of finding an effect if there is in fact an effect
  100. large numbers in a power of effect will?
    more likely to have effect
  101. example of screening test?
    mamography
  102. when sensitivity test is done there are fewer what?
    false negative/positives
  103. what does YPL stand for?
     years of potential life loss
  104. what is easier to calculate than benefit?
    cost
  105. what are the uses of data?
    • assess health of a community
    • raw material for research
  106. what are some collections of data?
    • local records- death birth
    • surveys- done by CDC for census planning
  107. what is the census?
    • serves as denominator for most public health data
    • every 10 years
  108. what effects the public health of the community stats taken by census?
    • population
    • age
    • ethnicity
    • education
  109. aerosol?
    water droplets produced when infected person coughs or sneezes
  110. bacteria?
    one celled microorganism of the plant kingdom
  111. fecal-oral route?
    route of transmission from feces to oral
  112. host?
    a living cell in which a virus reproduces
  113. immunization?
    stimulating immunity to an infectious disease by exposing an individual to a weakened or dead pathogen
  114. parasites?
    organisms that live in or on another host and benefits by deriving nutrients at the hosts expense
  115. pathogen?
    bacteria, virus, microorganism that can cause disease
  116. reservoir?
    place where a pathogen lives and multiples before invading non infected person
  117. viruses?
    small pathogen that is not capable of independent metabolism can only reproduce in a living cell
  118. chain of infection?
    • way infections spread 
    • leave host-transmission-to new host
  119. rabies?
    • contagious and fatal virus disease of dogs 
    • saliva to humans
  120. small pox, measles, polio
    infectious disease unique to humans
  121. antibiotic resistance?
    type of drug resistance where organism is able to survive exposure
  122. AZT?
    first antiviral therapy for HIV/AIDS
  123. bioterroism?
    terrorism involving release of toxic biological agents
  124. E.Coli 0157:H7
    dangerous form of e.coli that lives in human colon
  125. emerging infections?
    incidence in humans has increased the past decade
  126. influenza?
    contagious viral infection of the respitory passages
  127. multidrug-resistant tuberculosis
    resistant to common antiTB drugs
  128. prions?
    particles contain protein but no nucleic acid and no traditional genetic material
  129. retrovirus?
    RNA virus that inserts DNA copy of its genome into host in order to replicate
  130. T4 cells?
    T helper cells, sub group of lymphocytes
  131. how is typhoid fever, small pox, malaria, rabies spread among human populations?
    • one person to another
    • water, food, vectors, objects
  132. why do public health practitioners not recommend that ever person be immunized by rabies?
    • epidemiological surveillance
    • -relatively rare
    • vaccine expensive
    • inconvient to deliver
  133. how could small pox, polio and measles be eliminated from the earth?
    • vaccine 
    • -no human resevoir
  134. how is AIDS, hantavirus, influenza spread within human populations?
    • blood
    • person to person
    • aerosol
    • feces
    • vectors
    • enviromental factors
  135. why does the immunization against influenza not remain effective from year to year?
    • RNA virus constantly changing
    • replicating to become stronger
  136. what are three public health measures that could reduce the probability that bacteria will develop resistance to antibiotics?
    • dont put antiobiotics in cow feed
    • finish antibiotic
    • unnessary prescriptions to antibiotics
  137. what are some infectious diseases that were major killers?
    • bubonic plague
    • small pox
    • measles
    • typhoid
  138. how were the infectious diseases conquered?
    • immunization
    • vaccine
  139. infectious agents?
    • bacteria
    • viruses
    • parasites
  140. what the chain of infection?
    • pathogen
    • reservoir
    • transmission
    • host
  141. why do we talk about chain of infection in public health?
    try and break chain is what public health does
  142. what are kochs 4 postulates
    why dont they work on viruses
    • found in abundance
    • must be isolated
    • introduce disease to healthy suspect
    • must be resisolated, diseased host again, identical

    virus goes thru filter paper
  143. means of transmission?
    • aerosol
    • touching
    • contaminated water food
    • vectors
    • sexual contact
  144. how can you interupt the chain of infection?
    • antibiotics
    • eliminate resevoir
    • prevent transmission
    • increase resistance
  145. what are some public health matters to watch for infectious diseases?
    • epidemiologic surviellence
    • contact tracing
    • quarintine
    • immunization
  146. how was SARS controlled?
    vaccine?
    how treat?
    • classic public health measures
    • no vaccine
    • tx symptoms
  147. what is eradication?
    what is eraditcated?
    • completely get rid of
    • small pox
    • measles
  148. what is the fear of vaccines?
    urban myths created about autism SIDS
  149. what is herd immunity?
    more immunized the better
  150. chronic deaths:
    leading cause of ______ and _______
    _____ causes - risk factors
    _____ period of onset
    possiblility of _____ prevention
    importance of _____ models
    • death and disability
    • multiple
    • long
    • secondary
    • animal
  151. what are some secondary preventions for chronic diseases?
    • blood test
    • mamogram
    • papsmear
  152. why is there importance for animal models?
    • short life span
    • more ethical
    • some of the same genetics
  153. who is mainly effected by chronic diseases?
    • elderly
    • 45-65  years
  154. why is it better to use animal models than a petri dish?
    • different risk factors
    • isolation= problem
  155. major factor of cardiovascular?
    widespread use of ______ for secondary prevention
    • genetics
    • statins
  156. what is atherosclerosis?
    hardening of the artieries from plaque
  157. what is hypertension?
    high blood pressure
  158. how does a heart attack happen?
    carbon monoxide binds to hemoglobin and cuts off the oxygen to the heart and lungs
  159. what does cancer arise from?
    what are mutations caused by?
    • mutations
    • chemicals, viruses, radiation
  160. what is a carcinogen?
    chemicals and radiation
  161. what cancer is from a virus?
    • cervical cancer
    • hepatitis
  162. what is the primary prevention in cancer?
    prevent exposure to carcinogens
  163. what are 4 complications of diabetes?
    • blindness
    • kidney failure
    • poor wound healing
    • amputations
  164. what are some medical approaches to saving lives from cardiovascular disease?
    • CABG
    • stint
    • public health says: exercise and eat healthy
  165. when does huntingtons disease strike?
    midlife
  166. who has the trait for huntingtons disease?
    father
  167. who is the most effected population of sickle cell anemia ?
    african americans
  168. if both mother and father have sickle cell anemia what does it cause?
    recessive gene
  169. what are teratogens?
    infectious pathogens that effect fetus
  170. what did thalidomide (no more morning sickness) do to babies?
    abnormalities - no arms no legs
  171. what effects genetics diseases?
    genetics and teratogens
  172. who does tay-sachs effect?
    dominant or recessive?
    • jewish populations
    • recessive
  173. what is done for newborn screenings?
    what does it prevent ?
    • test of blood for metabolic abnormalties
    • reduce or prevent damage
  174. what is carrier screening?
    • screens for recessive genes in highrisk populations
    • ex. tay sachs
    • sickle cell anemia
  175. what is genomic medicine?
    human genome project
  176. what is the human genome project?
    are there benefits?
    • determine what sequence that makes up DNA
    • mapping of the genes of human genome

    BENEFITS: understand human evolution
  177. genetic screening is only beneficial when there is ______ and _______ for infant
    treatment and followup
  178. what is prohibition?
    U.S gov't trying to regulate the behavior of its citzens
  179. what is education?
    informs the public about healthy and unhealthy behaviors
  180. what is regulation?
    intent to restrain people from harming themselves
  181. what is RDA?
    listing of daily values of the 6 food groups a person should consume in a day
  182. what ways do people choose their own health?
    • eating habits
    • participation in activties
    • recreational activites
  183. what way is peoples health effected by factors they dont do?
    • someone else is doing it
    • enviroment
    • genetics
  184. what is the ecological model?
    • the way to look at a social enviroment
    • 1.intrapersonal-attitudes
    • 2.interpersonal-family friends
    • 3.institutional
    • 4.community
    • 5.public policy
  185. what is the health belief model?
    several factors that determine whether a person is likely to change a behavior when faced with a health threat
  186. what is locus of control??
    individuals belief that they can control what effects them
  187. what is self efficacy?
    sense of having control over ones life
  188. what is social support?
    physical or emotional comfort given to us by friends or family
  189. what is socioeconomic status?
    concept that includes income, education, occupational status = all strongly associated
  190. what is stress?
    adverse physical and social conditions associated with lower SES
  191. would the health belief model help predict whether someone would quit smoking?
    depends on the stage
  192. ecological model to explain why US has high rate of adolescent pregnancies?
    all 5 steps of the ecological model are included to explain the high rate

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