PHP 0320 Final - Last 3/3 of course

What are the ways pregnancy interacts with existing or potential health conditions

It can provoke new conditions, precipitate low-level problems, or unmask existing conditions

What is the "Social Stressor" aspect of pregnancy

• Spike in intimate partner violence

• Expenses, unstable housing, time off for leave, childcare

• Goals, education, sense of self

• Substance use - increased rates

What is the leading cause of death among pregnant people in the US

Mental health conditions (specifically the combination of suicide, homicide, and substance abuse)

Maternal mortality rate formula

Number of pregnancy-related deaths per 100,000 live births

When does blood pressure typically peak in the postpartum period?

Between 3 to 6 days postpartum (often after the patient has already gone home)

What is a major flaw in current cardiovascular risk stratification calculators?

They are based on studies of mostly men and do not include pregnancy-related hypertension or pre-eclampsia

What is the "Traditional" timing for a postpartum visit, and what is the problem with it?

6 weeks; however, up to 40% of people never attend this visit due to barriers like childcare, transportation, or loss of insurance.

Define the "Fourth Trimester."

The first 90 days after birth; a critical time for rest, recovery, and bonding that is often overlooked in US culture.

When do over half of maternal deaths happen

between 7 and 365 days postpartum

What are common screening tools used for perinatal mental health?

PHQ-9, Edinburgh Postnatal Depression Scale (EPDS), and GAD-7

What is a major limitation of current mental health screening tools in this field?

They were mostly designed for and validated in white populations and may not be culturally inclusive.

Why do OB/GYNs often struggle with treating Perinatal Mood and Anxiety Disorders?

• They receive minimal formal training in mental health treatment

• Global discomfort with prescribing during pregnancy/lactation.

list three policy changes that could improve maternal outcomes.

1. Paid parental leave

2. Extending mandatory insurance coverage

3. Access to full family planning/contraception

What are the benefits of using Telehealth in postpartum care?

Increased follow-up rates, improved outcomes, and decreased health disparities.

Name 4 institutional strategies to address disparities in the OB/GYN sector

• Standardize care

• Address implicit bias

• Implement disparities dashboards

• Detailed morbidity/mortality reviews

Marilyn Hughes Gaston - 1939 - present

• Pediatrician who proved daily penicillin could prevent sepsis in newborns with Sickle Cell Disease

• Led to a nationwide newborn screening program.

How did the Industrial Revolution (18th–19th centuries) impact child health?

Rapid urbanization led to crowded housing, poor sanitation, and child labor

Children faced nutritional deficiencies, workplace injuries, and infectious disease epidemics

Neonatal morality rate

deaths between birth and 28 days, per 1000 live births/year

infant morality rate

deaths between birth and 1 year of age, per 1000 live births/year

child morality rate

deaths between birth and 5 years of age, per 1000 live births/year

Child and adolescent morality rate

 deaths between 1 and 19 years of age per 100000 children and adolescents

What were the leading causes of death for children in the early 1900s?

Diarrhea, pneumonia, tuberculosis, diphtheria, and measles

Which age group has the highest mortality rate?

Neonatal

When do the highest number of childhood deaths occur

within the first year of life

What is surfactant

A substance that prevents lungs (alveoli) from collapsing

What are the top three causes of death in the post-neonatal period?

1. Congenital anomalies.

2. SIDS (Sudden Infant Death Syndrome).

3. Unintentional injuries

What is the primary intervention recommended to prevent Sudden Infant Death Syndrome (SIDS)?

back sleeping

Inez Beverly Prosser - 1897-1934

• first African American woman to receive a PhD in psychology

• Studied self-esteem in African American middle school children who attended segregated vs. integrated schools

Which age group has the highest rate of injuries?

Adolescents and young adults (ages 10–24)

What is the leading cause of death for ages 10–24?

Unintentional injuries

What is “Engineering” in injury prevention?

Designing safer products or systems (e.g., childproof caps, auto shut-off devices)

What does “Environment” refer to? - The E's and an L of injury prevention

Modifying surroundings to improve safety (e.g., playgrounds, bike lanes)

What are the The E's and an L of injury prevention 

• Education

• Enforcement

• Engineering

• Environment

• Evaluation

• Litigation

What is the leading type of gun-related death?

Suicide and self-harm

What are risk factors for firearm-related suicide?

Gun ownership, living in rural areas, being male, White, a veteran, and older age

What are risk factors for firearm-related homicide?

Being male, Black, and under age 30

What are three major gun violence harm reduction strategies?

• Universal background checks

• extreme risk protection orders

• assault weapons bans

What approach did Portugal take to drug policy?

Decriminalized personal possession of drugs - empowered police to engage in more effective, health-focused interventions

What is iatrogenesis?

Harm caused by medical activity, including treatment, errors, or interventions.

• Wrong limb amputation, drug interactions, chemotherapy side effects

How can policing have iatrogenic effects?

Removing individuals from society can harm families and communities

Public health approach to asthma

• E educating on asthma self-management

• X extinguishing smoking and second-hand smoke

• H home visiting for trigger reduction

• A achieving guidelines-concordant care

• L linking and coordinating systems of care

• E environmental policies to reduce asthma triggers

What is the most common STI in the U.S.?

Chlamydia

What type of infection is chlamydia, is it treatable, and can you get it again?

Bacterial, treatable with antibiotics, and reinfection is possible

What are the main symptoms and long-term complications of chlamydia in females?

Often no symptoms; can cause pelvic pain, ectopic pregnancy, and infertility

What are common symptoms of chlamydia in males?

Burning with urination and itching, though some have no symptoms

What type of infection is gonorrhea, is it treatable, and what is a major concern?

Bacterial, treatable with antibiotics, but antibiotic resistance is a concern

What are typical symptoms and complications of gonorrhea in females?

Discharge, painful urination, bleeding between periods; can lead to pelvic inflammatory disease and infertility

What are typical symptoms of gonorrhea in males?

Painful urination, colored discharge, swollen testicles; symptoms are usually noticeable

What type of infection is HIV, is it curable, and what are early symptoms?

Viral, not curable, and initially causes flu-like symptoms without respiratory symptoms

What type of infection is syphilis, is it treatable, and what is important about long-term effects?

Bacterial, treatable at all stages, but long-term damage may not be reversible

What types of climate and weather disasters did NOAA previously track as billion-dollar events?

Droughts, floods, heat waves, severe storms, tornado outbreaks, tropical cyclones, wildfires, and winter storms

What are Shared Socioeconomic Pathways (SSPs) in climate forecasting?

Scenarios that model future warming based on societal choices about emissions, development, and policy

What are the steps in the BRACE framework? - Building Resilience Against Climate Effects

1. Forecast impacts

2. Project disease burden

3. Assess interventions

4. Develop adaptation plans

5. Evaluate outcomes

David Satcher

• First African American surgeon general of the united states

• Top goal: address and eliminate disparities in health

What is considered the "modern origin" of public health policy?

• The British Public Health Act of 1848

• Focus on prevention, improving urban sanitation (separating clean/unclean water), and establishing a central board of health

What is the constitutional basis for state power in public health?

• The 10th Amendment

• powers not delegated to the federal government are reserved to the states or the people.

Beneficence

The duty to "do good" and provide a benefit.

Ethical Dimensions - Traditional biomedical ethics - The 4 Principles

• Autonomy

• Beneficence

• Nonmaleficence

• Justice

Non-maleficence

The duty to "do no harm" or minimize harm

Why was the "NYC Big Gulp Ban" struck down in 2014?

The court ruled it exceeded the scope of regulatory authority and interfered too much with personal autonomy.

What were the major ethical violations of the Tuskegee Syphilis Study?

• Violation of Beneficence/Non-maleficence: When penicillin became the standard cure in 1947, it was withheld from the men

• Justice: The study disproportionately burdened a specific racial group (Black men).

what sound frequencies can cause health problems

lower frequency sounds

Additive - sound

• Combined effect equals the sum of individual effects - 2 + 2 = 4

• they do not interact in a direct way

antagonism - sound

• combined effect of two or more exposures is less toxic than the individual effects

• one reduces the other

• 4+6 less than 10

potentiation - sound

• one exposure that does not normally have a toxic effect is added to another exposure, making the second exposure much more toxic

• 0 + 2 is greater than 2, not just 2

synergies - sound

• combined effect is much greater than the sum of each on their own

• 2+2 = 10x more than 4

Loretta Ross - 1953 - present

• co-founder of SisterSong

• co-created the framework for Reproductive Justice

W.E.B. Du Bois, 1868-1963

• Conducted ethnographic research that highlighted the importance of the social and health consequences of racism and discrimination against African Americans

• One of the founders of the NAACP

Min Chueh Chang (1908-1991)

• Reproductive biologist

• Helped develop birth control pill

Carlos Juan Finlay (1833-1915)

Epidemiologist who noted the correlation between yellow fever epidemics and increases in the mosquito population