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72 Cards in this Set
- Front
- Back
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what is health? |
a state of complete physical, mental, social and spiritual well-being and not merely the absence of disease health represents a dynamic state with habits that promote health and lowering risk of any diseases |
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Dimensions health |
emotional health-feel and express emotions, self-esteem intellectual health-open mind and learn new things spiritual health-meaning and direction in life occupation health-relates to place of employment social health-relationship, interaction with others physical health-perform normal activities of daily life environmental health-external factors that affect health, water, air |
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what is public health? |
the fulfillment of society's interest in assuring the conditions in which people can be healthy organized community efforts aimed at the prevention of disease and the promotion of health |
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core functions of public health |
assessment policy development assurance (portect health and prevent disease) |
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public health vs. medical are |
in medicine the patient is the individual; in public health, the patient is the community public health diagnoses the health of the community using public health sciences treatment of the community involves new policies and interventions goal of medicine is cure; goal of public health is prevention of disease and disability |
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public health: science and politics |
science is how we understand threats to health, dtermine what interventions might work, and evaluate whether the interventions worked politics is how we as a society make decisions about what policies to implement |
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public health disciplines |
epidemiology (epidemics/obesity, prostate cancer in western countries and Asia), new diseases statistics (calculate risks, testing the new drug) biomedical sciences (AIDS, flu, Hanta virus, cancer...) environmental health science (new chemicals) social behavioral sciences (latino paradox) health policy management |
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epidemiology |
the basic science of public health study of epidemics aims to control spread of infectious diseases seeks causes of chronic disease and ways to limit harmful exposures
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statistics |
collection of data on the population these numbers are diagnostic tools for the health of the community the science of statistics is used to calculate risks, benefits |
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biomedical sciences |
infectious diseases-pathogens chronic diseases genetics |
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environmental health science |
health effects of enviornmental exposures air quality water quality solid and hazardous wastes safe food and drugs global enviornmental change |
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social and behavioral sciences |
behavior is now the leading factor in affecting people's health theories of health behavior: social environment affects people's behavior major health threats: tobacco, poor diet and physical inactivity, injuries maternal and child health-social issue |
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health policy and management |
role of medical care in public health cost of medical care in US is out of control US has a high percentage of population without health insurance-these people often lack access to medical care quality of medical care can be measured, and is often questionable |
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Public health: prevention and intervention |
primary prevention (prevent disease) secondary prevention (minimize the severity of the illness) tertiary prevention (minimize the disability, rehabilitations) |
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public health approach |
define the health problem indentify the risk factors associated with the problem develop and test community level inteventions to control or prevent the cause of the problem implement interventions to improve the health of the population monitor the interventions to assess their effectiveness |
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chain of causation |
agent host environment interventions can focus on any of these targets |
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social justice vs. market justice |
public health should be a way of doing justice, a way of asserting the value and priority of all human life public health as a social justice the common good (the value and priority of human life) individual responsibility questions about the scope of public health importance of economic factors for health-politically controversial |
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research on SES and public Health |
SES is such a powerful risk factor for negative halth outcomes that it is almost always controlled for in research but is rarely studies itself there is evidence that a correlation between SES and health exists at every step of the social hierarchy, not ismply for those at the bottom of the social ladder |
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biological factors that contribute to negative health outcomes |
biological factors that contribute to negative health outcomes exposures to pathogens, carcinogents, and other substances people with low SES more likely to smoke, more likely to live near sources of pollution |
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socioeconomic status |
SES is a composite measure that typically incorporates ecnomic status, measured by income; social status, measured by education; and work status, measured by occupation |
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sources of controversy |
economic impact individual liberty moral and religious concerns politics vs. science |
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economic impact |
buisnesses often resist public health meausre because they affect profits those who must pay may not be th eones who benefit costs may be short term while benefits may be long term costs easier to calculate than benefits in times of economic difficulty, people are often unwilling to pay short term cost in order to obtain a benefit in the long term
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individual liberty |
government should provide maximum health and safety for the community as a whole agreement: to restrict an individual's freedom to behave in such a way as to cause direct harm to others |
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when can government restrict individual freedom? |
to prevent harm to others-generally acceptable to protect individuals from their own actions, only to prevent harm to others |
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moral and religious opposition |
sex and reproduction PH approach: sex education, provision of contraceptives services, especially condoms opposition by certain groups: they believe that it promotes immoral behavior
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politics vs. science |
there is always the possibility of tension current conservative control of federal government intensifies the conflict
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local public health agencies |
county and city health departments day to day responsibility core public health functions often also have responsibility for providing medical care for the poor funding sources are variable; city or county legislatures may not understand importance of core functions mandates may be funded from state or federal governments |
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state health departments |
coordinate activities of local health agencies and provide funding collect and analyze data laboratory services manage medicaid license and certify medical personnel, facilities and services environment, mental health, social services and aging may be handled by separate agencies |
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Federal agencies |
Department of Health and Human services centers for disease control and prevention national institues of health food and drug administraton centers for medicare and medicaid services agency for healthcare research and quality environmental protection agency occupational safety and health administration department of agriculture national highway traffic safety administration |
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epidemiology |
the diagnostic discipline of public health a major part of public health's assessment function investigates causes of diseases identifies trends in disease occurence evaluates effectiveness of medical and public health interventions an observational science |
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patterns of disease occurrence |
who is getting the disease? when did they get the disease where is the disease occuring? can infer why disease is occurring |
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epidemic surveillance |
endemic vs. epidemic notifiable diseases recognition of new disease increased importance with threat of bioterrorism patterns of the disease, factors that influence these patterns increase the frequency of a disease above the usual and expected rate recognition of new disease increased importance with threat of bioterrorism |
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outbreak investigation |
verify the diagnosis construct a working case definition find cases systematically -active surveillance ask the who, where, and when question to describe the epidemic by person, place, and time, consider the incubation period look for common source of exposure |
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epidemiology and chronic diseases |
identify risk factors observe long terms trends heart disease-Framingham study lung cancer-Hammond horn study |
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define the disease |
death is easy to determine-death certicates have cause of death some disease need blood test or stool cultures to verify diagnosis some diseases are hard to define sometimes definition changes as more is learned
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disease frequency |
count number of people with diesase and relate to population at risk PAR (denominator) may be total population or exposed population, or one gender or age group; often comes form census two ways to measure frequency incidence-number of new cases over a defined period of time prevalence-number of existing cases at a specific time incidence is used for studying causes disease if causes or risk factors increase, incidence and prevalence increase if ability to diagnose increases, incidence and prevalence increase prevalence depends of incidence and prognosis |
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determinant of disease |
why is distribution as it is? can make inferences from distribution risk factors |
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kinds of epidemiologic studies |
goal is to determine as association between an exposure and a disease or other health outcome may be prospective or retrospective intervention study cohort study case-control study |
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intervention study |
closes thing to an experiment start with two groups: experimental (gets the intervention or exposure) and control group watch them over time and compare outcomes experimenter chooses who is in which group two groups should be as similar as possible so that intervention is the only difference randomized, double blind, placebo control is the ideal phamaceutical companies conduct many clinical trials for new drugs |
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Cohort study |
for situations when doing an intervention study would be unethical or too dificult considered the next most accurate choose a large number of healthy people, collect data on their exposures, and track outcomes over time the only difference from intervention is that people choose their own exposures |
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case-control study |
choose people who already have disease choose a healthy control groups of individuals as similar as possible to cases interview them all and ask for their previous exposures advantage: faster and cheaper least accurate approach |
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sources of error |
news reports random variation (results by chance) confounding variables bias selection bias reporting bias or recall bias |
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factors that lend validity to results |
strong association dose-response relationship known biological explanation large study population consistent results from several studies |
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Ethical Issues |
new rules-informed consent new rules-instituional review boards importance of clinical trials possibility of conflict of interest by medical providers who stand to profit |
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Conflicts of interest in drug trials |
drug companies are required to conduct randomized controlled trials on any new drug before it can be approved harmful side effects have frequently become obvious after drugs were approved there is evidence that drug companies sometimes suppress negative findings all clinical trials must now be registered in advance in a public database |
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Statistics |
the numbers that describe the health of the population the science used to interpret these numbers |
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probability |
the probable is what usually happens |
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power of a study |
the probability of finding an effect if there is in fact an effect large numbers confer power |
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rates |
relate the raw numbers to size of population ex) birth rates, mortality rates crude rates, adjusted rates, group specific rates |
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cost benefit analysis |
cost is easier to calculate than benefit what monetary value to put on a life saved often controversial cost effectiveness analysis |
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uses of data |
assess the health of a community raw material for research |
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Collection of data |
local records (birth certificates, death certificats, notifiable diseases, other vital statistics) transmitted from local governments to states transmitted from parts to National Center for Health Statistics (CDC) surveys |
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the census |
serves as the denominator for most public health data (age, sex, race, ethnicity) every 10 years american community suvey done in between, ongoing basis (education, housing, health insurance) |
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Accuracy and availability of data |
data collection is imperfect, census is mot accurate; still there are overcounts and undercounts, information technology increases accuracy and availability |
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confidentiality of data |
governments have safeguards to protect individual use of data may involve removal of indentifying information on individuals use of data requires institutional review boards or data protection committees |
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infectious diseases were conquered by 1960s |
immunization vaccination antibiotics active and passive immunization |
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active immunization |
the vaccine prevents an infectious disease by activating the body's production of antibodies that can fight off invading bacteria or viruses |
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passive immunization |
antibodies against a particular infectious agent are given directly to the chidl or adult, is sometimes appropriate, antibodies taken from donor |
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Koch's postulates |
organism must be present in every case of the disease the organisms must be isolated an grown in the lab when injected with the la-grown culture, susceptible test animal must develop the disease the organism must be isolated from the newly infected animals and process repeated |
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bacteria |
single living organism bacilli (rod shape), cocci (round) spirochete (corkscrew shape)
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viruses |
not complete cells, complex of nucleic acid and proten, can survive extreme conditions, reproduce themselves by taking control of cell's machinery, killing the cell |
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parasites |
roundworms, tapeworms, hookworms, pinworms |
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means of transmission |
aerosol touching contaminated objecting and putting hands to mouth, nose or eyes contaminated water or food: fecal-oral route vectors sexual contact |
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chain of infection |
pathogen (infectious agent) reservoir (pathogen can live, rodents, flea-plague, racoon, bats-rabies) means of transmission susceptible host interrupt chain of infection at any link 1-4 |
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interrupting chain of infection |
kill pathogen with antibiotics eliminate reservoir prevent transmission increase resistance of host by immunization |
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immune system |
caloric intake lipids Fat |
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public health measures-control the spread of infectious disease |
epidemiologic surveillance-watch for disease threat contact tracing immunization and treatment of identified patients to preven further spread quarantine if necessary |
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factors that lead to emergence of new infections |
human activities that cause ecological damage and close contact with wildlife modern agricultural practices international travel international distribution of food and exotic animals breakdown of social restraints on sexual behavior and intravenous drug use |
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public health response to emerging infections |
global surveillance improve public health capacity veterinary surveillance reduce inappropriate use of antibiotics need for new vaccines need for new antimicrobial drugs control of vector borne and animal borne diseases |
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threat of bioterrorism |
approach to bioterrorism is the same as that for natural disease outbreaks will probably first be recognized by surveillance best defended against by same methods as natural outbreaks |
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chronic diseases |
now leading causes of death and disability multiple cuases-risk factors long period of onset possibility of secondary prevention primary invention |
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environmental teratogens |
infectious pathogens` |
