nursing exam 1

is one of the most important advances in history

public health

life span increased from ___ to ____

40 to 80 years

population

people with commonalities in a particular place

2 properties that make up a population

requires more than 1 individual,shares a common characteristic.

who defines health as

a state of complete physical, mental, and social well being, not just the absence of disease.

public health is a fundamental right 

regardless of race, economic or social condition, religion, or political belief 

the science of protecting and improving the health of families and communities through the promotion of healthy lifestyles, research for disease and injury prevention, and detection and control of infectious disease.

CDC definition of public health

the role of public health is to promote and protect the health of people and communities where they live, learn, work, and play

APHA definition of public health

the sciences of preventing a disease, prolonging life, and promoting health through the organized efforts and informed choices of society. organization, public and private groups, communities and individuals 

Dr. Charles-Edward Winslow definition of public health.

population health science is the study of

the conditions that shape distributions of health within and across populations,

population health sci vs public health

population health sci provides us with what we need to know about what causes health so then in public health we can intervene to make populations better

early days survival relied on

mobility - the ability to move around and find food

2 basic survival concerns

Assuring a safe water supply, disposing of wastes

what two essential public health tools were created for infectious disease

quarantine and isolation

Edwin Chadwick

advocated for improved living conditions which would improves the productivity of the population improving the economy

Lemuel Shattuck

developed the first system for recording vitals stats, data collection system

US public health system

resides with the executive branch of government

Health and human services HHS

to enhance and protect the well being of all americans

how does the HHS want to achieve their mission

range of health services, promoting advances in research, health policy

health related functions are also preformed by

department of defense, department of veterans, homeland security

achievements of health in the 20th century

control of infectious disease, decline in deaths by stroke, family planning, fluoridation of drinking water, healthy mothers and babies, motor vehicle safety, tobacco use, healthier foods, safe work place, vaccination

what did they do to decrease the deaths by heart disease and stroke

CPR, emergency medical response

fluoridation of drinking water

added fluoride to the public water, decline rates in children tooth decay

control methods for infectious disease

water purification, sanitation, antimicrobial therapies

prevention actions

spares people from developing preventable illnesses

core prevention concept

concerned with creating the healthiest population possible, ensure we do not get sick to begin with, healthy for as long as possible 

primordial/ primary prevention

aims to prevent the expression of a risk factor, lowers the amount if people developing a new onset disease

primordial/ primary approach

immunization, clean water, good food

secondary prevention

reduce the impact of a disease or injury in the earliest stages of occurrence. restoring to full health if possible

secondary screening approach

screening, regular examinations

screening sensitivity

% of persons with the disease who screen positive

screening specificity

% of persons without disease who screen negative

false positive fraction

% of people without the disease that screen positive

false negative fraction

% of persons with the disease that screen negative

screening rules

screening should only be done for diseases that have serious consequences, so screening can have a clear benefit to someone’s health

tertiary prevention

actions that reduce the impact of a diagnosed, ongoing injury or disease 

tertiary prevention purpose

to increase the individuals ability to function, quality of life, life expectancy

tertiary approaches

rehab

upstream

intervening to prevent the occurrence of risk factors

midstream

detecting and intervening on identified risk factors and subclinical diseases 

downstream

health has been compromised, improve function and well being

universal prevention

general population regardless of risk factors to prevent health issues before they arise

selective prevention 

individuals or sub groups that have a higher risk 

indicated prevention

those with signs and symptoms of diseases

local level

local government providing preventative services 

national level

broad polices and regulations that are meant to address widespread issues

Global level

WHO and other organizations, addresses multiple countries

clinical medicine

works with diagnosing and treating individual patients, curing and caring for the patient is the top priority 

prevention based public health

concerned with population, aims to minimize the need for clinical interventions

prevention based approach list

identifying a health problem, identifying the cause of the problem, controlling the cause of the problem through testing, monitor the interventions to asses their effectiveness

health equity principal

suggests that everyone can have the same health outcomes and revolves around social justice 

what must all social groups achieve for health and wellbeing 

a minimum level

Equity in health implies that ideally everyone should have a fair opportunity to attain their full health potential and, more pragmatically, that no one should be disadvantaged from achieving this potential, if it can be avoided."

Margaret whiteheads definition of health equity 

health equity is the _____

highest level of health for all people

health equity requires

valuing everyone equally, ongoing efforts to address avoidable inequalities

health disparities

differences that occur by gender, race, ethnicity…ect

overall meaning of health equity

special attention to those who are at greater risk of experiencing poor health

health equality

empiric measure, providing the same resources to everyone

health inequality

referrers to any differences between two groups

health inequity

modifiable, avoidable, unnecessary, unfair

health left behinds

with the increased in population health disparities continue to exist if the improvements are not distributed equally

main source of inequity

socioeconomic status- income, employment, education

health equities based on sexuality

homosexuals have a higher rate of suicide

are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies, and political systems."

social determinants of health (SDOH)

3 priority areas of national initiative

SDOH, health equity, health literacy

healthcare access and quality goal

increase access to comprehensive, high quality healthcare services

education access and quality goal

to increase educational opportunities and help children and adolescents succeed in school

economic stability goal

increase social and community support

neighborhood and build environment goal

create neighborhoods and enviorments that promote health and safety

Healthcare access and quality connection statement

The link between people's access to and understanding of health services and their own health outcomes.

education access and equality connection statement

The relationship between education and overall health and well-being.

Economic stability connection statement

The link between financial resources (income, cost of living, socioeconomic status) and an individual's health and well-being.

Social and community context connection statement

The relationship between characteristics of the environments where people live, learn, work, and play, and their health and well-being

Neighborhood and built environment connection statemnent

The link between a person's living conditions (housing, neighborhood, environment) and their health and well-being.

How to effectively target public health interventions around the social determinants of health?

no single intervention will be universally appropriate or effective for any given population

causal thinking

a fundamental pillar of population health science

2 central concepts for understanding population health

cause of events, production of health

causes of events

factors necessary for a event to occur and how it did

production of health

something that can be proactively promoted, potentiated, and produced

2 frameworks for understanding thinking at a population level

social ecological perspective, life course perspective

social ecological perspective

health is produced by a variety of interacting levels, from the individual to family, friends, neighbors, cities, and countries

life course perspective

health is produced throughout the sequential phase of an individuals life

individual behavior

at the core of the framework is the individual, where disease manifests or health is maintained

family/social networks

influences health outcomes based on the closest people you surround yourself with or where

neighborhoods/cities

cities and neighborhoods impact health by determining access to resources, services, and environmental conditions.

country/society

larger heath structures and policies that shape health outcomes through socioeconomic factors, health system accessibility, and cultural influences.

ages 0-14

perinatal, infancy, and childhood periods

ages 15-24

adolescent and young adult

ages 25-64

adulthood

ages 65+

older adulthood

critical period

certain exposures at specific critical developmental moment can strongly and perhaps singularly impact future health outcomes

sensitive periods

periods in life where exposures have a grater impact than other times

chains of risk

exposures that happen in a sequence, domino effect, could lead to fatal outcomes

accumulation of risk

assumes that cumulative exposures or “shocks“ through out life course increasing the risk of disease later in life, regardless of timing

matrix

visualizes how health and disease are produced at multiple levels relative to life stages, framework to plot interventions