pubhlth 350 exam 1

What is colonial medicine?

Controlling disease to aid imperial expansion (19th-20th century)

What is missionary medicine?

Hospitals tied to Christian religious activities (19th-20th century)

What is global health?

Health issues that affect many countries; use multi-disciplinary approaches with significant involvement of local communities; health equity among nations is a major objective.

What is tropical medicine?

Medicine-dominated approach to health within a population in tropical regions (19th-20th century)

What is international health?

Efforts to improve health in developing countries exclusively, health equity is not a major focus.

What are the successes and failures of international health?

Success: smallpox eradication; Failure: malaria eradication.

What was the first transition in demographic changes?

Hunters and gatherers to farmers (agricultural transition). (before european settlement) (post era was colonial era to early 20th century)

What was the second transition in demographic changes?

Rural to urbanization (industrialization). (mid 20th century) (post era was late 20th century)

What is the third transition in demographic changes?

Current + future (associated with the word disparities). (post-era was 21st century)

What are the characteristics of the population pyramid pre second transition?

High fertility, high mortality.

What are the characteristics of the population pyramid during the second transition?

Declining mortality, high fertility.

What are the characteristics of the population pyramid post second transition?

Reduced fertility, reduced mortality.

What is demographic transition?

A shift from higher births/deaths to lower births/deaths when populations move from lower to higher income.

What is epidemiologic transition?

A shift from high burden of illness and death due to infectious diseases to high burden of illness and death from chronic and non-communicable diseases when populations move from lower to higher income.

When did the first transition occur?

Before European settlement.

When did the second transition occur?

Mid 20th century.

What diseases were the most common contributors to mortality in the US around 1900?

Pneumonia, tuberculosis, diarrhea.

What diseases were the most common contributors to mortality in the US around 2000?

Heart disease, cancer, stroke.

What diseases were the most common contributors to mortality in the US around 2022?

Heart disease, cancer, COVID-19.

When did the third transition occur?

Current and future.

What is a migrant?

Any person moving from one place to another (both in and outside the country) (can return home).

What is a refugee?

An individual fleeing armed conflict or persecution who crosses national borders to seek safety in other countries (cannot return home).

What is an internally displaced person?

Someone who leaves their home but remains in their home country due to conflict, natural disasters, etc.

What is an asylum seeker?

Someone seeking refugee status, but not yet legally granted.

What is an immigrant?

Movement for economic, political, social, or safety reasons.

What is a colonizer?

Take new territory or land by force, with political connections to home country.

What is a settler?

Move into new territory or land, potentially by force, but with fewer political connections to home country.

What is an indigenous person?

the original inhabitants of an area who lived there prior to colonization

What are push factors for migration?

War, disease, famine, discrimination, lack of economic opportunities.

What are pull factors for migration?

Worker shortages, family reunification, better social, economic, cultural, health environment.

What is the healthy migrant effect?

First generation migrants are often healthier than U.S. born residents who share similar ethnic or racial backgrounds.

What are explanations in favor of the healthy migrant effect being real?

Healthier behaviors, greater family support/social connections, good genes.

What are explanations against the healthy migrant effect being real?

Selection bias: healthy workers more likely to respond, salmon bias: returning to their birthplace to die.

What is the equation for measuring risk?

# of new cases/# of population at risk multiplied by 1,000/10,000/100,000 etc.

What is age adjustment of risk?

Isolates the effect of age by standardizing health across populations with different age distributions.

What should you use: crude, slightly age stratified, or age-stratified?

Completely age stratified.

What was the Indian Removal Act of 1830?

NA tribes leaders were pushed into signing treaties where they were moved across the Mississippi River.

What are the implications of the Indian Removal Act of 1830?

1. Displacement into a new climate 2. Added stress.

What was the Dawes Act of 1887?

US government cut up NA land into squares, each family was given one parcel of land.

What are the implications of the Dawes Act of 1887?

1. Assimilating groups, separating Native Americans.

What is traditional Chinese medicine?

Vital energy flowing through the body meridians (emphasis on balance).

What are treatments in traditional Chinese medicine?

Acupuncture, Reflexology, Herbal medicine, Qi gong.

What is Ayurveda?

Balance across all physical, mental, and emotional characteristics; Three energies in body: Vata (movement), Pitta (metabolism), Kapha (structure).

What are treatments in Ayurveda?

Diet, Herbal medicine, Massage, Yoga Meditation.

What is the basis of indigenous knowledge systems?

Uses local experiences, relies on accumulated knowledge, considers community needs.

What is the basis of Western scientific knowledge?

Focus on empirical evidence and scientific methods.

What are types of observational studies?

Cross-sectional studies and longitudinal studies (cohort).

What are cross-sectional studies?

Occur at one point in time.

What are limitations of cross-sectional studies?

Difficult to ascertain if exposure came before outcome.

What are longitudinal studies?

Duration of time at two or more points, better causation, must remove everyone who has the exposure at baseline.

What are types of experimental studies?

Randomized controlled trials.

What are randomized controlled trials?

Occurs at 2 or more points in time, randomization into different groups and compare outcome, remove everyone who has the exposure at baseline.

What are limitations of RCTs?

Ethical concerns, follow-up on participants is difficult.

What are examples of qualitative research?

1 on 1 interviews, focus groups, ethnography.

What are the pros and cons of 1 on 1 interviews?

Good for exploring a topic and individual decision-making; Bad for causality at a population level and generalizing experiences from 1 person to everyone.

What are the pros and cons of focus groups?

Good for shared norms and multiple perspectives; Bad for causality at a population level.

What are the pros and cons of ethnography?

Good for revealing real-world practices and understanding mismatches between policy and practice; Bad for generalizing beyond one location and potential bias as people know they are being observed.

What is the focus of quantitative studies?

Measurement and magnitude.

What is the focus of qualitative studies?

Meaning and process.

How many participants are typically in quantitative studies?

More.

How many participants are typically in qualitative studies?

Less.

What type of data is used in quantitative studies?

Spreadsheets from interviews, clinic visits, biological measurements, etc.

What type of data is used in qualitative studies?

Words.

What types of questions are used in quantitative studies?

Closed-ended.

What types of questions are used in qualitative studies?

Open-ended.

What do we mean by federal trust responsibilities?

Tribes gave up land in agreement for certain things from the U.S. government. One of the federal trust responsibilities is healthcare.

What are the four components of the Medicine Wheel?

Emotional, spiritual, mental, physical.

Comparing Western medicine and traditional Native American medicine, which focuses more on health as the absence of disease?

Western medicine.

What focuses more on balance, Western medicine or traditional Native American medicine?

Traditional Native American medicine.

What are 4 plants used in traditional healings or ceremonies?

Tobacco, Sage, Cedar, Sweetgrass.

What is historical trauma?

Cumulative emotional and psychological wounding across generations, including the lifespan, which stems from massive group trauma.

What are the 4 eras of federal policies?

Removal era, assimilation era, 20th century termination era, self-determination era.

What are the features of the removal era?

1830 - Indian Removal Act; Trail of Tears; 1887 - Dawes Act; Divided Tribal land into allotments.

What are the features of the assimilation era?

Late 1800s - Boarding Schools; Stripped of cultural identity; 1924 - Snyder Act; Granted U.S. citizenship to Native people.

What are the features of the 20th century termination era?

1950s/60s - Termination; Indian Relocation Act; Incentive to move to urban areas; Over 100 Tribes terminated.

What is the self-determination era?

1975 - Indian Self-Determination and Education Assistance Act; Opportunity to assume the responsibility for programs and services; 1976 - Indian Health Care Improvement Act (IHCIA); 1978 - American Indian Religious Freedom Act; Protects rights for traditional practices and ceremonies.

How does funding for IHS compare to other federal health services?

Indian health spending levels per capita were the lowest of all federal health care spending levels per capita (4,078).

what does land back mean

land back is a reparations framework calling for the return of indigenous land and power that was taken through colonization