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What are the 5 basic “determinants of health”
- 1. Biology/Genetics
- 2. Access
- 3. Social circumstances
- 4. Environment
- 5. Behavior
Describe different ways that we can define “health”
(WHO vs authors in textbook)
WHO - a state of complete physical, mental, and social well-being
Authors - A dynamic state or condition of the human organism that is multidimensional and exist in varying degrees depending on the individual
Identify ways that the definition of health “matters”(e.g. leads to planning)
- 1. Measures progress
- 2. Identify contributing factor
- 3. Assess outcomes
- 4. Monitor changes
- 5. Influence Behavior and Actions
- 6. Sets goals and standards
What are important differences between personal and community health activities?
Personal Health - Actions or decisions affect individual and may be preventative or curable but seldomly affect the behavior of others
Community Health - Aimed at protection or improving health of a population or a communtiy
What are some social factors that can influence patterns of health and disease?
- 1. Geography
- 2. Individual Behavior
- 3. Age
- 4. Gender
- 5. Ethnicity
- 6. SES
How much life expectancy has changed since 1900?
- 1. Public Health Knowledge
- 2. Public Health Resources
- 3. Life expectancy rose
- 4. Overall death rate declined
- 5. Leading cause of death changed
What was the leading causes of death in 1900?
Pnumonia or Influenza
What is the major differences in leading causes of death (1900 vs. 2000).
1900 - Pneumonia or Influenza
2010 - Heart disease or Cancer
Name 3 major achievements for public health in the U.S. past (100 years)
- 1. Flu vaccine 1942-1945
- 2. Antibiotic for Penicllin 1928-1940
- 2. Medicare/Medicaid established 1965
What are the key differences (for funding, leadership, and setting priorities) between 3 types of organizations (governmental, quasi-governmental, and non-governmental).
- Non-Government - Funding by Private
- Government - Funding by Public
- Quasi-government - Funding by both public and private
What is the hierarchy of organizations for tracking diseases and infections
- 1. WHO (World Health Organization)
- 2. DHHS (Department of Health & Human Services)
- 3. NYSDOH (NYS Department of Health)
- 4. NYCDHMH(NYC Department of Health & Mental Hygiene)
Who is in charge or the Government sector of Health organizations?
Name the 11 departments within DHHS (Dept of Health and Human Services) with examples of their roles and
- 1. AOA (Administration on Aging) - service adults +65
- 2. ACF (Admin for Children & Families - Family assistance;child support
- 3. AHQR (Agency Health Research & Quality)- Monitor helath care cost; enforce patient safety guidelines
- 4. ATSDR (Agency for Toxic Substances) - focus on Harzadous Waste
- 5. CDC (Center for Disease Control/Prevention) - Research epidemics and disease prevention
- 6. CMS (Centers for Medicare & Medicaid)
- 7. FDA Food & Drug Administration - Monitors & approves food safety, medical devices and drugs
- 8. HRSA - (Health Resources & Service Admin)
- Essential health care services of the low income uninsured population
- 9. IHS (Indian Health Services) Health services for "tribal lands"
- 10. NIH (National Institues of Health) - Focus on research and treatment outcomes
- 11. SAMHSA - Substance Abuse & Mental Health - Prevention and treatment of addiction and disorders
What are the key functions of epidemiology?
- 1. Study populations not just individuals
- 2. Investigate outbreaks (epidemics)
- 3. Cause and factors
- 4. Keep illness and disease at a minimum
Describe the importance of “rates” compared to just the number of cases
The number of people that are affected in a given population within a period of time divided by the entire population
What is prevalence?
Old and New cases
What is incidence
Only new cases
What is "attack"?
The percentage of sick among those exposed
Diseases that do not occur regularly
Disease the DO occur regularly especially in a given population. ex.- Malaria in Africa & Norway
What is Analytical Studies?
Test the relationship between health problem and risk factor
What is Descriptive studies?
Examines the data, demographic, SES of a population
Can be transferred from one individual to another. A Chain of infection
What are some ways in which diseases can be classified and categorized
- Mode of Transport - airborne, waterborne, STD
- Organ system affected - Heart or Lung
- Duration of illness - accute vs. chronic
- Causative agent - viral, bacterial, chemical, injury
What is an accute illness and an example of some?
An illness that last less than 3 months...Flu, common cold. Chickenpox, measles mumps, broken foot
What is a chronic illness and an example of some?
An illness that last more than 3 months...Cancer, Heart disease, hypertension, diabetes
Cannot be transferred from one individual to another. ex- Cancer, diabetes, hypertension
What is the order for "chain of infection"
- Portal Entry
- Infection in Host
- Portal Exit
Describe ways that chain of infection can be “broken”
at different steps in the cycle
Pathogen>VACCINE>Non-Infection of Host
Exit Portal>Barrier(Condom)>Non-Entry Portal
Match types of transmission (airborne, waterborne, direct, indirect) with definitions and examples.
- Waterborne - bacteria on contaminated material
- Airborne - Respiratory tract illness (bronchitus) (COPD)
- Vector-borne - Malaria, Yellow Fever, West Nile Virus
- Direct - Touching, sneezing, sexual contact
- Indirect - Wet surface or standing water
Preventing the onset of illness or injury before the disease process begins
Management of the disease before the disease becomes advanced ex. screening, treatment
Intervention after the disease has caused disability. ex- surgery and/or rehab
Identify steps and sequence in general model for program planning
- 1. Assessing Needs
- 2. Setting Goals and Objectives
- 3. Developing an Intervention
- 4. Implementing the Intervention
- 5. Evaluation (progress and outcomes)
Describe differences in 2 approaches for decision-making
1. Top-Down Approach - If the NYC department of health tells you what problems you have in your community.
2. Grass-Root Approach - you and your neighbors tells the NYC department of health what problems you want addressed
Identify differences in resources and “building blocks (primary, secondary, potential)
- 1. Primary: in the neighborhood and in residents
- e.g. knowledge, skills, personal property
- 2. Secondary:in neighborhood, but controlled by outsiders
- e.g. schools, hospitals, real estate
3. Potential: outside the neighborhood, and controlled by outsiders..e.g. data, information, media, funding
Identify definitions and match examples of goals vs. objectives.
- Goals: Long-term (take longer to achieve)
- More general in nature and scope
- Not easily measured (on their own)
- Objectives: Shorter-term
- More specific in scope
- Written to be more measureable (as steps)
Identify different goals and methods in “health education” vs “health promotion.”
Health Education: Provide information/tools for behavior change....e.x. - Dangers of Smoking
Health Promotion: Change in policy or resources (services). Change harmful physical or social conditions
Describe differences between process and outcome evaluation.
Process Evalution: Progress Notes
Outcome Evalution: Assessment after process is completed
Identify definition and key elements of a “coordinated school health program” (CSHP).
An organized set of policies, procedures, and activities designed to protect and promote the health and well-being of students and staff (to promote learning).
Identify the potential duties of a school nurse
- 1. Conduct health services
- 2. A Health school environment
- 3. Refer for Health conditions
- 4. Promote Policy
- 5. Screen and refer for health conditions
Describe essential steps for implementing school health policies
- 1. Create written policies
- 2. Distribute to team members
- 3. Publish in school handbooks
- 4. Present at public meetings
- 5. Build awareness/support
- 6. Use press releases to:
- 1.Share and publish policies
- 2.Explain priorities
- 3.Notify public of changes
Identify three types of school health services recommended by AAP
1)State Mandated: Verify immunization, Report infections, Health screenings
2) Assess “minor” health complaints:Administer required medications, Care for special needs
3) Emergency services:urgentcare
Identify examples of physical school environment
- Physical Environment: Location/age of buildings
- Traffic patterns/transportation, Indoor air quality, Pest/rodent, management, Temperature
- control lighting, heating, acoustics
- Water supply/quality
- Sanitation and food services
- Playground safety
Identify examples of pychosocial school environment
- Attitudes of teachers and staff
- Behavior of teachers
- Interactions among students
- Feeling safety and secure
- Promoting learning
- Open communication
- Reducing anxiety and stress
- Awareness of rules/standards
Identify recommended topics in a school “health
- Mental and Emotional Health
- Injury Prevention
- Sexual heath
- Healthy eating
Identify potential barriers to “comprehensive” school education
- Contraversial Topics
- Health and behavioral issues not seen in the past
- Lack of Resources