Public Health Midterm

Birthplace of public health.

China

Showed the first examples of quarantines.

Hebrews

Wrote the Code of Hammurabi

Egyptians

Promotion of individual health & fitness

Greeks

Had sewer & water networks and cleaned& repaired streets.

Romans

Who make the connection between environment and disease with “Airs, Watera & places”?

Greek Hippocrates

The time after the fall of the Roman Empire.

Dark Ages

Time period where communities thought the supernatural was the cause for diseases.

Dark Ages

Time period where disease was brought to America from colonizers.

Colonial America

He improved conditions for workers and performed sanitary awareness & social reform.

Edwin Chadwick

He created the template for many public health systems in the US.

Lemuel Shattuck

Discovered the cholera outbreak in London while also creating Miasma theory.

John Snow

Phase when…

• Specific diseases associated with specific organisms

• Understanding of communicable disease

Bacteriology (1880-1910)

Phase when…

• Growth of healthcare facilities and providers due to investors

• Social movements to improve health conditions

Health Resources (1910-1960)

Phase when…

• The federal government became involved and active in the world’s health.

Social Engineering (1960-1975)

Phase when…

• Educating the public on health matters and healthy life choices was encouraged

Health Promotion (1975 - present)

Phase when…

• Belief that disease originated from organic matter or foul smelling things

Miasma (1850-1880)

What phase are these a part of?

• Hill Burton Act

• Social Security Act

• Grants and investments

Health Resources

What phase are these a part of?

• Pure Food and Drugs Act

• Civil Right Act

• OSHA

• WIC

• Medicare & Medicaid
  

Social Engineering

What phase are these a part of?

• Childhood immunizations

• Teen pregnancy

Health Promotion

Health

 a state of complete physical, mental, and social well being and not merely the absence of disease and infirmity

Community Health

the health status of a defined group of people and the actions and conditions to promote, protect, and perceive their health.

Population Health

the health outcomes of a groups of individuals including the distribution of such outcomes within the group.

Global Health

describes health problems, issues, and concerns that transcend national boundaries, may be influenced by circumstances or experiences in other countries, and are best addressed by cooperative actions and solutions.

• Geography

• Community

• Industrial development

are examples of…

Physical factors that affect the health of a community

• Religion

• Socioeconomic status

are examples of…

Social & cultural factors that affect the health of a community

• Community coalitions

• Diversity of services

Organizational factors that affect the health of a community

• Migration

• Conflict

• Impoverishment

are…

Societal event factors contributing to disease emergence

• Transplants

• Antibiotics

• Immunosuppressant drugs

are…

Health care factors contributing to disease emergence

• Deforestation

• Global warming

• Flood

• Water ecosystem change

are…

environmental change factors contributing to disease emergence

• Sexual behaviour

• drug use, diet, travel

• recreation

• daycare

are…

Human behavior factors contributing to disease emergence

• Drug resistance

• Virulence

Microbial adaptation

Who was the first health officer?

Paul Revere

• Processing, packaging, and prep

• Globalization of food

Food production factors contributing to disease emergence

Reasons to study communicable diseases

• Emerging and reemerging disease

• To measure the health in the community

• General knowledge

Communicable disease

Biological agents can be transferred from human to human

Agent

The element that must be present for the disease to occur

Agent → Host → Environment

Epidemiological triangle

1. Resevoir

2. Portal of exit

3. Modes of transmission

4. Portals of entry

5. Susceptible host

Chain of Infection

Disease

A harmful departure from normal in Indvidual or populations

Zoonoses

An infection or infectious disease transmissible from animals to humans

Exposure to organism triggers immune system (achieved through vaccination, takes a while) describes?

Artificial active immunity

Antibodies produced in another person or animal are given to someone (effectively quickly, lasts a short time) describes?

Artificial Passive immunity

Through memory cells, species specific immunity describes?

Natural immunity

1. time

2. place

3. personal

comparison of data

1. demographic

2. health status

3. behavioral risk

4. clinical data

5. lab data

6. utilization data

7. health resources

Types of data

Rate

Number of events per population at risk

Incidence rate

used for the number of new cases during a specific time period.

Attack rate

Incidence rate for a specific disease specific period of time

Prevalence rate

Status of a disease in the population at a point in time

Surveys members about current diseases & exposures (not useful for showing cause & effect)

Cross sectional

Cross sectional is a type of ….

Descriptive study

 Studies group with the disease and someone without, retrospective, based on disease status, prone to recall bias

Case control

Case control is a type of …

Analytical study

 Prospective, based on exposure status, can assess a temporal relationship

Cohort study

Cohort is a type of …

Analytical study

 Implementing treatment or placebo on patients

Clinical trial

A ratio of two probabilities (cohort studies use this)

Relative risk

Ratio of two odds (used in case control studied)

Odds ratio

 When the people selected for a study vary from the target population

Selection bias

The interviewer's opinions interfering

Interview bias

People may exaggerate or not remember what happened

Recall bias

An outside factor that interferes with the correlation you are trying to make (ex: diet → heart disease, confounding: smoking)

Confounding variable

 Individual characteristics which influence behavior – knowledge, attitudes, beliefs, personality traits

Intrapersonal

Processes with family, friends. peers, who provide social identity, support, and role definition

Interpersonal

Rules, regulations, policies, and informal structures which may constrain or promote recommended behaviors

Institutional

Social networks and norms or standards among individuals, groups, or organizations

Community

Local, state, and federal policies and laws that regulate or support healthy actions and practices

Public Policy