Public Health Exam

What is health

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

- determined by the determinants of health

What is public health

the science and art of preventing disease, prolonging life and promoting health through the organized efforts of society

biomedical

relating to both biology and medicine

paradigms

assumptions about how the universe works which allow you to make a sense of a particular phenomenon (a way of looking at something)

paradigm shifts

moving from one set of theories, beliefs, and assumptions about how the world works to another

mapping

the use of visual devices to keep track of people and things

cholera vibrae

a microbe that casuses a fatal illness that lives in fecaly-contaminated water

surveillance

keeping tabs on individuals or groups in the name of safety and security

germ theory

infectious diseases are caused by invisible microbes

miasma theory

bad air caused illness.

handwashing

medical intervention pioneered by Ignaz Semmelwies which impacted maternal mortality

sanitation

practice developed in the roman era of keeping spaces and people clean and free of waste

the broad street pump

Contaminated water from this pump caused a deadly cholera outbreak. John Snow is credited with taking action to stop this outbreak.

- london 1854

when was the first board of health established in canada

1832 - lower canada

1833 - upper canada

what happened in early 20th century

- emphasis on maternal/child health and immunization of children + youth

public health practice

maintains + improves the health of populations based on the principles of social justice, attention to human rights and equity, evidence-informed policy and practice, and addressing the determinants of health

building blocks of public health

1. evidence based

2. risk assessment

3. policy

4. program

5. evaluation

foundations of public health - social justice

ensures population has equitable access to public health initiatives

foundations of public health - health equity

consideration of equitable distribution of health services, culturally competent programming, and policy to meet requirements of population at risk

foundations of public health - social/ecological

conditions in which people are born, grow, live, work, and age

- shaped by distribution of money, power, and resources

foundations of public health - ecological/social

ecological process + natural resources essential for health and well-being

ex. adequate amount of oxygen, water, food

acute diseases

sudden, often severe and short lived but can progress into chronic condition

chronic diseases

slow onset, last longer

ex. health issue thats been going on 3+ months

non-communicable disease

not transmitted between people or animals (ex. asthma, cancer)

- can be hereditary or congenital

- leading cause of death worldwide

communicable (infectious) diseases

transmitted between people, animals, or things

- caused by a specific agent

ex. viral, bacterial, fungal infection

direct transmission

occurs through person-to-person contact or direct contanct with a contaminant

indirect transmission

occurs when disease spreads without direct contact between the source of infection and the host

- air (droplets)

- vector (secondary organism that transmits pathogen - ex. mosquito)

- fomite (inanimate object acts as vehicle for pathogen)

- oral transmission

public trust

public health directives rely on individuals to buy in to proposed plan (ex. getting tested for covid)

- high level of social trust is required

- can be codified into law (ex. seatbelts)

individualism

belief in the primacy of individual decision-making over collective bodies (government)

- poses important problems for public health

personal liberty

freedom of individuals to make decisions for themselves

bodily autonomy

the right to make decisions about one's own body.

vaccines

protect individuals from acquiring disease and protect larger population

innate immune response

Immediate, non-specific defense against pathogens.

- cells already exist in the body

- cells aren't the best bc of generalization

adaptive immune response

produces cells built specifically tailored to fight invading micro-organisms

- can be slow

how do vaccines work

introduces a small amount or component of a disease so the body's adaptive immune response can be stimulated (produce cells in a controlled setting)

- creates the kind of cells needed to fight of infection at hand

herd immunity

where a disease has difficulty spreading through a population because a large enough portion is immune to it (is vaccinated) or vice versa

- describes how a mass infectious disease or vaccination campaign has on a population

vaccine hesitancy

reluctance to receive vaccinations

- uneasiness with governmental control and fear of losing personal liberty and bodily autonomy

rates

helps compare health problems among populations that include two or more groups who differ by a selected characteristic

what do you need to calculate rate

- the number of cases of the illness

- the size of the population at risk

- the period during which we are calculating the risk

(number of cases/population at risk x 100)

disease distribution

quantitative picture of how a health issue is spread across a population

- can summarize data into a measure of central tendency (mean, median, mode)

measures of morbidity

the use of proportions and rates to help make better sense of public health data

count

most basic measure of a disease (a count of how many cases of disease exist)

ratio

relationship between the affected group and a largerpopulation

proportion

how many people in a given population have the disease in relation to the total number of people in the population

prevalence

a measurement of proportion that captures the amount of disease in a population

- does not count the development of new cases but measures the burden of disease within a community

point prevalence

a snapshot of disease burden that looks at prevalence at a single instance in time

period prevalence

provides a measurement of the burden of disease that takes place over a longer period of time

incidence

kind of rate that measures new cases in a population at risk during a particular specified time period

- how fast or often is a disease occuring?

cumulative incidence

denominators where the population is considered to have been observed for the full time period

crude rates

rate of a particular mortality event based on the approximate number of deaths within a population

- often used to diagnose health status of a general pop.

ex. death, birth

specific rates

rates calculated using sub-groups (smaller, more comprehensive), called strata

cause-specific mortality rate

looks specifically at mortality caused by disease/health condition

proportionate mortality ratio

provides a measurement of how much mortality in a given period is caused by a disease/health issue

age-specific mortality rate

looks at mortality within a specific age group

environmental public health

explores the impact of the environment, and the environmental change on human health

1. immediate environmental disasters (droughts, floods)

2. directly causing illness through toxins or contaminants (chemical spills, air pollution)

ripple effects

occur when the impact of an immediate disruption or crisis impacts broader systems

ex. short term toxic exposures (smoke/chemical inhalation)

environmental management systems

series of systems that are governmental and non-governmental organizations that work to prevent and manage emergencies

1. prevention - avoiding emergencies

2. mitigation - reducing impact

3. preparedness - enhancing effectiveness of response

4. response

5. recovery - helping community recover from emergency

unions

groups of workers who band together to exert their collective power to exert change within a workplace

- protects all members

global public health

area of research and practice that seeks to improve health via the social determinants of health

global health inequalities

the different distributions of health issues across the globe, or the differences in population-level health status between countries

- based on access to resources (health care, education, nutrition, wealth)

- primary driver of global health disparities is wealth

- socially created and avoidable

globalization

worldwide spread of people, goods, ideas, and money

- can be seen as

1. social phenomenon - rapid spread of ideas, info, cultural practices

2. occurring through the interconnectedness of political landscapes

economic globalization

the interconnectedness and movement of money and business across the globe

- relies on exploitation of cheap labour and material goods

exploitation of vulnerable populations

aggravates inequality and global poverty

exploitatin and movement of goods

creates environmental issues

quantity

how much expected life has been lost to morbidity and mortality

quality

how much life has been affected by morbidity

life expectancy calculations

look at how long people in a particular region live

potential years of life lost (PYLL)

in ideal circumstances there is an average human life span and compare how many years of the lifespan have been lost due to premature death

disability-adjusted life year (DALY)

all the years lived by one might not have been in perfect health

- measure how many years of 'perfect health' have been lost to disease or disability

quality-adjusted life years (QALY)

calculate the number of years of perfect health gaiend through a population-level intervention

mental health

the state of your psychological and emotional well-being

- necessary for living a healthy life and main factor in overall health

biopsychosocial approach

understands mental health as dynamic and is influenced by 3 domains:

1. biological

2. psychological

3. social

biological factors - allostatic load

a term given to repeated and chronic forms of stress

- gives means to understand mental and physical health as inseperable

Fight-flight-freeze response

chronic toxins forms of stress activate the central nervous system which activates the release of chemical responses (cortisol)

- can be productive in small doses

eustress

productive type of stress

- can be harmful to body when activated too much

distress

- negative stress

- cycles amplify themselves

when stressful situation becomes even more stressful

positive coping mechanisms

relaxation techniques to help manage stress

negative coping mechanism

can cause harm

ex. substance use, self harm

psychological factors that impact mental health

- personal psychology in how we respond to our external environment (behaviours, social responses)

- pos/neg coping mechanisms

social factors that impact mental health

- how external/social environments impact mental health

ex. gender, race, housing, occupation, social status, early life experiences

mental illness

significant, pathological disruption in mental health that impacts one's ability to function

- disorders may overlap and intensify

affective and mood disorders

depression, anxiety, bi-polar, PTSD

psychotic disorders

schizophrenia and other forms of psychosis

personality disorders

narcissism and antisocial disorder

eating disorders

anorexia and orthorexia

substance use disorders

drug, alcohol, sex, gambling addictions

what is an infectious disease

disease caused by a pathogen (bacteria, viruses, parasites)

- also called communicable diseases

- are contagious and virulent (severity of disease)

novel infectious diseases

disease that had not been previously identified or is new to the population ( could be new pathogen or variant of pathogen)

outbreak

when cases of an infectious disease rise above the usual expected amount

- a single case can cause an outbreak (ex. rabies)

epidemic

sudden rise in cases beyond what is normally expected

- wider geographical spread than an outbreak

pandemic

a wide-reaching epidemic usually spanning across multiple different countries/regions

susceptible host

a body capable of being infected (has portal of entry)

reservoirs

environments (living or non) where they are able to replicate (has portal of exit)

mode of transmission

method through which the pathogen moves between a reservoir and a susceptible host

how to stop chains of infection

isolation and quarantine

isolation

the removal of an already-sick person from other people to keep them from infecting others

quarantine

keeping people who may have been exposed, but who are not sick yet, separate from others

what was the bubonic plague also known as?

the black death

what was the bubonic plague caused by

Yersinia pestis (bacteria)

how many people did the bubonic plague kill and where in the world?

- 1/3 to 1/2

- europe and asia