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what is nicotine?
- addictive absorbed by the linings of the mouth
- produces enhanced energy & alertness w/calming effect
what is second hand smoke?
someone who breathes in smoke just like smokers
what is tar?
provides flavor in cigarette smoke
what is the fairness doctrine?
counteracted the tobacco companies ads
what did the master settlement agreement (MSA) do
- got major tobacco companies to stop advertizing towards children
- industry agreed to restrict on advertising
what is the "truth campaign"?
campaigns against smoking targeting at youth
top two killers in the united states
what is a enviromental problem with smoking?
second hand smoke
why was there an increase in smoking?
industrial revolution- produced by machines
when did first surgeon generals warning come out about smoking?
what did Mr.Butts have to do with smoking?
leaked information to a scientist that the tobacco company knew the effects of smoking
what did california as a tobacco control program do?
mandated mass methods for effective ways to stop smoking
for the prevelance different races smoking what does it have to do with?
why do tobacco companies target youth?
need to recruit 2 million smokers a year to replace those that quit or die
why were taxes raised on ciggerates?
- teenagers are sensative to price
- cali used it to fund tobacco control programs
what did californias control program do that made cigerettes decline
- mandate mass media
what is body mass index?
calculated by dividing a persons wt in kg and squaring height in meters
what is waist to hip ratio?
waist measured at smallest point (hips) and at widest point (butt)
what is obesity?
complex condition influenced by genes as well as individual and social factors
why is obesity going to be hard to change?
- more behavioral
- eating habits ingrained
health risks of obesity?
- some cancer
what are some enviromental factors that discourage americans from eating and exercising correctly
- to far away
- to expensive
- lack of taste
- emergency visits
- episodes of injuries reported
the 3 E's of injury prevention
national highway traffic safety administration?
a law passed to empower set safety standards for new cars such as seat belts and dashboard padding
what is occupational safety and health adminstration?
law passed to empower safety standards, inspect workplaces, and impose penalties for workplace hazards
what are injuries a problem when a young person dies?
years of potential life loss
two categories of injury/death
what is chain of causation for injuries?
- host- you
- primary prevention -DD
- secondary prevention - seatbelt
- tertiary prevention - ambulance
who made the new safety rules for automobiles?
what is the strongest political public health issue with injuries?
what is the infant mortality rate?
indicator of health status of a population
what is low birth weight?
born under 5.5 lbs
what is the infant mortality rate?
infants dealth with in first year per 1000 live births
what is sudden infant death syndrome?
unexpected death after being born healthy related to sleeping on stomach
what is WIC?
provides vouchers for nutritious foods for pregnant women, lactating women, and children up to 5 years old
how to prevent low birth wt?
what is contrversal in contraception?
whether is should be used or not
what are carcinogens?
chemicals that effect someones health
what are neurotoxins?
chemicals that are hard to reconize because act over long period of time
what are polychlorinated biphenyls (PCB's)
- enviromental pesticides
- chemicals used in sealing systems
- enter through discharge of industrial waste
- most widespread chemical contaminant
what is the role of the goverment in envirmental health?
provide water, sewage systems that are clean
what is occupational exposure to workers issues?
exposed to large amounts of toxins on a regualar basis
what are issues in safe setting standards?
ensuring the safety of the enviroment
what is acid rain?
- produced by two common pollutants - sulfer dioxide & nitrogen dioxide
- react with water to form sulfric acid and nitric acid
what are chloroflurocarbins?
delepte ozone layer causing risks for the earth
what are the criteria air pollutants?
pollutants that are common and found all over
what is the greenhouse effect?
- carbon dioxide = in glass of green house
- sunlight gets trapped in side
what is the ozone?
highly reactive varient of oxygen
what is the ozone layer?
manifestation of global effects of certain air pollutants
what is particulate matter?
- most visible form of air pollution
- ex. soot
what is radon?
produced by natural radioactive decay of uranium
what is sulfurdioxide?
- produced by combustion of sulfer - containing fuels
- ex. coal
what is carbon dioxide?
- highly toxic gas
- most produced by motor vehicle exhaust
what is nitrogen oxides?
chemicals responsible for yellow brown smog
what is lead?
highly toxic metal that can damage the nervous system
what is indoor air quality?
concentrations of many pollutants trapped inside a building
what are strategies for meeting standards?
- each chemical must be regulated seperatly
- each must have significant economic impact
public health is an intersection between ____ and ____
politics and science
what is the gov't role in enviromental health?
- standards and regulations
what is the cause of pollution?
where did mercury come from?
coal burning power plants
what did lead come from?
why are asbestos used?
what are factory farms?
animals crowded together and tended by automated systems
what do factory farms produce?
large volumes of wastes- lagoons
what does overregulation cause?
what are air criteria air pollutants?
- particulate matter
- sulfer dioxide
- carbon monoxide
- nitrogen oxide
what does particulate matter do?
smaller particles penetrate deeper into lungs
what does sulfur dioxide do?
- irritates respitory tract
- creates acid rain- kills forest and fish
what does nitrogen oxide do?
- acid rain
- caused by motor vehicles
what is the ozone produced by?
sunlight acting on other pollutants
what are some strategies for motor vehicles?
- public transportation
- tailpipe limits
- inspection of car
what are strategies for industrial sources?
- scrubber on smokestacks
- less polluting fuels
what is the emergency planning and community right to know act?
have to publish results to see how much a business is polluting
what are some problems with indoor air quality?
- tobacco smoke
- radon- basements
what are the global effects of air pollution?
acid rain damaging
what is the clean water act?
lakes and rivers should be fishable and swimmable
what is the safe drinking water act?
EPA set standards for local systems
what is point source pollution?
identify source of pollution
what is nonpoint pollution?
ways to remove water
what are some dilemmas with compliance?
try to protect watershed
what is involved with a sanitary landfill?
- dry clay
- lined with plastic
- drain for liquids
- vents to control gases
- tipping fee
what was love canal?
houses built on industrial waste dump
what is times beach?
agent orange in oil sprayed onto dirt roads
what are two hazaderous wastes?
biological and radiological
what is a superfund?
- emergency cleanup of old waste sites
- paid for by a tax on industry
where does coal ash come from?
left over from burning coal
what is NIMBY?
- not in my backyard
- make sense of what to do
what is phase 1 in drugs testing
new drug is given to a small number of people who are extensively tested to measure absorption, distribtion, metabolism, excretion and to look for side effects and toxicties
what is phase 2 in drug testing?
tests a larger number of patients for signs that the new drug is effective
what is phase 3 in drug testing?
full scale controlled trial - assigned randomly to two groups
what is the j-curve of population growth?
population expands rapidly past the carrying capacity and then crashes because once the carrying capacity is exceeded, the enviroment is degraded and the carrying capacity is reduced
what is the s-curve of population growth?
enviromental pressures increase gradually as the population approches the number known as the carrying capacity- the number of organisms that can be supported in a given enviroment without degrading the enviroment
what is HACCP?
- preventative approach to meat and seafood
- analysis of every step in the process of food productions, processing, and preperations
what causes food borne illnesses?
contaiminated food with bacteria, viruses and parasites due to inappropriate sanitations and food handling
what is the FDA ?
ensure foods are safe, wholesome and properly labeled
what is the USDA?
meat and poultry foods are safe, wholesome and properly labeled
what is the NDA?
new drug application for an investigational new drug providing evidence that the drug has the desired effect in animal and satisfies some basic safety criteria
what is carrying capacity?
population size that the earth can support without downgrading
birth rates tend to fall in response to falling death rates
what is global warming?
an effect of greenhouse effect
what are greenhouse gases?
gas that absorbs radiation of specific wave lengths
what is the ozone layer?
protects the earths surface from ultraviolet radiation
why use medical care?
- prenatal care
- testing for risk factors
- treat injuries
- deal with failures of public health
when is medical care a public health responsibility?
- preventing spread of communicable diseases
- emergency services
how is medical care paid for in US?
- fee for service
- hospital has flat rate
- submit bill to insurance
what is medicare?
provides insurance for elderly and disabled youth
what is medicaid?
welfare type program for the poor
what is licensing and regulation?
- providing high quality care
- disipline practioners for misconduct
ethical issues in medical care?
- assisted suicide
- right to die- karen ann quilin- nancy cruzan
- baby doe rules
what are ethical issues in medical resources allocation?
End stage renal disease- funded dialysis tx for all americans without selection critera
what are baby doe rules?
mandated tx of all new borns with birth defects
what is community health center?
another source of basic medical care for the poor
what is fee for service
permits doctor to make decisions about patients care without considering cost
why do cost rise in medical care?
- aging population
- new technology
- many providers
- fee for service
what are the attempts to control cost of medical care?
limit new facilites and technology
what is managed care?
monitor patients health and evaulate quality of care
what is the managed care backlash?
loss of ability to manage care in cost concious way
what is rationing?
trying to cover more people by limiting services
what is diagnosis related group?
amount based on the illness category of the patient
what is HMO's?
insurer and provider
what is PPO?
more choices, health insurance less affordable
what is the oregon plan?
public and private partnership to ensure access to health care for all of orgeon
what is Agency for Health Care Policy & Research
guidelines for treatment
what is health services research?
small area analysis- large variations in practice style by geographical area
what is outcomes research?
analysis data generated by everyday practice of medicine
what is small area analysis?
more variation for conditions on which evidence for appropriate therapy exists
what is the field of dreams effect?
- avaiablity of services leads to more use of these services
- more surgeons more surgerys
what is the National Committee for Quality Assurance (NCQA)?
the more surgeries that are done the better the surgery getst done
What is the relative importance of medical care
for public health?
- care plans are easier to evaluate than other plans
- lead to improvement in outcomes
what is the Compression of Morbidity ?
live till you die at the end of life
what is the Compression of Mortality?
dying towards the end of your life
what is Estrogen Replacement Therapy?
believed to have anti-aging effects
what is Osteoporosis?
risk of broken bones leading to disability
what is Alzheimer’s Disease & Dementia?
- memory loss
- risk increase with increase age
Identify the trends of the aging of the population?
- people are living longer
- more females
What are the top 5 causes of death for the
- respitory problems
- cerebrovascular disease
What are general approaches to maximizing health
in old age?
diet and exercise
What issues exist concerning medical costs of
- system growing at slower pace
- costs are less predictable
what is the Incident Commend System (ICS)
puts one person in charge for managing and coordinating the response at the scene
what are in the Category A Bioterrorism Agents
what is the Strategic National Stockpile (SNS)
includes medical supplies antibiotics vaccines and antidotes for chemical agents
What was the greatest failure in New York City’s response to the World Trade Center Attacks?
failure of communication and coordination
what is a diaster plan (triage)?
- plan for good communication
- focus on the order of who should be attended to first
- immediate- right now
- delayed- wait
- expectant- going to die
what is the biggest problem when it comes to bioterrism preparedness?
reconize when under attack
what is the model state emergency health powers act?
suggested provisions include measures to encourage planning for emergencies, survalliance, managing property to ensure availability of vaccines and hospitals
what are clues of survalliance that someone/something is being attacked?
- emergency room visits
- calls to 911
- pharmacy records
- vetinary diseases
what is Healthy People 2000 ?
- objectives set targets for individual behavioral change, enviromental, and regulatory protections and access to preventive health services
- quality of life
- equal health
what is the Healthy People 2010?
- quality and years of healthy life
- eliminate disparities
What are the top 10 public health achievements of the 20th century?
- routine vaccines
- safer workplaces
- safer and healthier foods
- healthier mothers and babies
- fluoride in water
- control of infectious disease
List the challenges for public health for the 21st century?
- climate change
- rising cost of medical care for aging population
- understanding and altering human behavior
- renewed threats from infectious diseases
what is the PHIN?
what are the five componants?
- framework to improve the capacity of public health to use and exchange information electronically by promoting the use of standards and defining the functional and technical requirements.
- management of outbreaks
- exchange of data
- promoting collaboration
- build local tracking networks