PUBH 402 Quiz 4

What are the 3 levels of prevention?

• primary

• secondary

• tertiary

What does primary prevention focus on?

preventing conditions from arising by addressing root causes (vaccinations, healthy lifestyle)

What does secondary prevention focus on?

detecting diseases early and preventing progression (cancer screening)

what does tertiary prevention focus on

managing existing diseases to preven worsenings or complication (diates managements)

What are the 3 main strategies of prevention?

• addressing social determinants of health

• public health interventions

• clinical prevetive services

What are social determinants of health?

social and economic factors like housing, education, income, and environment that affects health outcome

What were the key features of the 1st epidemiologic revolution?

focus on infectious disease, preventions through sanitation, vaccines and antibiotics

What did the 2nd epidemiologic revolution focus on?

chronic disease (heart disease, cancers, stroke) and their lifestyles- related causes

What is the difference between individual and population focus in prevention?

• Individual focus emphasizes personal behaviors

• population focus targets social and environmental conditions that shape behaviors

What are examples of clinical preventive services?

counseling/education, screening, and chemoprophylaxis (vaccines and preventive medications) 

What does health counseling include? 

education on diet, exercise, injury prevention, and self-management for chronic conditions

What are screening services used for?

detecting early signs of a disease (mammograms, pap smears, colonoscopy) 

What is chemoprophylaxis?

use of drugs or vaccines to prevent disease (immunization, aspirin)

What is Wagner’s chronic care model?

a system-based approach to improve chronic disease care by integrating the community and the health system

What is the community-oriented primary care model?

combines clinical care with community health strategies to improve population outcome

Does prevention always save money?

not always, but primary prevention and many public health interventions are cost-effective.

What is the Healthy People Initiative?

a national program started in 1979, setting public health goals and tracking progress every 10 years

name some healthy people indicators

physical activity, obesity, tobacco use, mental health, injury prevention, immunization, acces to care

Which Healthy People 2020 targets were met?

adult physical activity, adolescent tobacco/substance use, material child health and insurance coverage 

Which target was not met in healthy people in 2020?

diabetes, nutrition, weight status, mental health, and access to usual care

What is long-term care (LTC)?

ongoing health, social and housing sercves for people who cannot live independently due to physical cognitiv or mental limitations

What determines the needs for LTC?

• limitations in activities of daily livings (ADLs)

• Instrumental activites of daily living (IADLs) 

what are activities of daily living (ADLs)

basic self-care tasks like eating, bathing, dressing, toileting, mobility 

what are instrumental activities of daily living (IADLs)

complex tasks for independent living, such as cooking, managing money, using transportation, and taking medications.

Is LTC only for the elderly?

no, younger adults and children with disability or chronic conditions may also need it

Who provides most long-term care?

infomral caregivers (mostly family members, often womens, providing unpaid care) 

what are community-based LTC services

in-home care, adult care, assisted living, and community programs 

What are institutional LTC services?

nursing homes and skilled nursing facilities(SNFs) providing 24 hour care

who pays for most long-term care in the US? 

Medicaid (about half of the cost), followed by out-of-pocket spending and limited medicare coverage

What is the difference between Medicare and Medicaid in LTC?

• Medicare covers short-term skilled rehab

• Medicaid covers long-term care for low-income, elderly and disabled individuals. 

what is a major issue in nursing homes quality?

inadequate staffing, falls pressure sores and medication management problems

what is nursing home compare?

a CMS star rating system for nursing homes based on staffing and quality measure

what are persistent issues in LTC?

financing challenges, regualtory limits, quality concerns, and workforces shortages

What workforces issues exist in LTC?

need for more skilled, culturally competents, and better paid staffs

How is the U.S. elder population changing?

becoming more diverse-by 2050 minorities will makeup about 41% elders

what are challeges for diverse older adults?

fewer financial resources, unequal health benefits, and needs for culturally appropriate care

What is palliative care?

holistic care to improve quality of life for patients with serious illness by relieving pain and addressing physical, emotional and spiritual needs 

What is hospice care?

end-of-life care for patients with life expectancy under 6 months, focusing on comfort rather then cure

how is hospice different from palliative care?

• hospice is for terminal illness

• palliative care can begin at any stage of a serious illness

What are common misconceptions about hospice?

that means “giving up” or receiving “no care.”

Where do most people prefer to die, and what usually happens?

most prefer to die at home, but many die in hospitals due to stigma, restrictions, or lack of awareness

What disparities exist in end-of-life care?

Non-white patients often receive more aggressive hospital care and use hospice less then white patients

what is the main takeaway about LCT and end of life care?

LTC supports daily living needs; palliatives and hospice care focus on comfort, dignity, and quality of life.