Public Health Exam 2

What impacts our health?

Biology, genetics, and social context

5 main categories of social determinants of health

income, occupation, neighborhood, gender, race

what 3 internal roles can hospitals play in addressing social determinants of health

screening, connecting patients to community resources, implementing hospital-wide initiatives 

what 3 external roles can hospitals play in addressing social determinants of heatlh

engaging with the community, partnering with the community, and investing in the community 

what are life chances

a theory in sociology referring to opportunities or access that individuals have to improve their quality of life

what are the 3 levels of causes of health problems and what do they mean?

Distal: wider circumstances like culture, national or international policies, laws, climate, conflict, etc.

Intermediate: communities, workplaces, schools, families, etc.

Proximal: Individuals themselves - behaviors, personal biology, attitudes, capabilities

what are the 3 recommendations for tackling social determinants of health by WHO

improve daily living conditions, tackle the inequitable distribution of power money and resources, measure and understand the problem and assess the impact of action 

what are health behaviors?

actions taken by individuals that affect health or mortality

what are macro determinants of health?

economic factors, demographic factors, social and cultural factors, political forces, natural forces, technological factors

what are micro determinants of health

individual factors like personality for example 

what are the two processes that influence health behaviors

socialization: learning norms of a society, and social control: regulation of behaviors to fit into society’s components

what are the 4 main risk factors impacting morbidity and mortality in the US

smoking, poor nutrition, physical inactivity, excessive alcohol use

what are the four types of social support

emotional support, instrumental support, appraisal support, informational support

what is the health belief model HBM and its five conditions?

promotive health behavior is more likely among people who satisfy these conditions: they perceive they are suscepitble to a health problem, the health problem could be serious, a promotive health behavior will prove beneficial, they have high self-efficacy, and they lack barriers to engaging in health behaviors

what are the 5 present day concerns of environmental health

polluted water, inadequate sanitation, poor air quality, climate change, urbanization

what are superfund sites

toxic waste dumps that are contaminated, but that the EPA has mandated the cleanup of 

what is the DPSEEA framework by WHO

Driving forces: upstream factors that affect society

Pressure: use/exploitation of the environment

State: quality of aspects of the environment

Exposure: varies and impacts health effects

Effect: outcomes

Action: what can be done

What is the bismarck model of health insurance

private - private companies, health care providers privately employed, citizens are required to belong to an insurance plan, government regulates costs

what is the beveridge model of health insurance?

Government provides and pays for health care through taxes 

what is the national health insurance model

mix of bismarck and beveridge, healthcare providers are privately employed, but government pays for most or all health care

how does the US use health insurance models?

bismarck model for people under 65, beveridge model for native americans, military veterans and active military, national health insurance model for medicaid and people over 65, and out of pocket model for uninsured residents

what is fee for service payments vs. capitation for employment based health insurance 

fee for service payments is when some specific services are paid for in full by the employer, and capitation is when a fixed number of dollars per month are paid to a physician to provide services regardless of what the service is 

what are the three indicators for measuring success in a healthcare system

quality, access, cost

what key questions to ask when doing evidence-based public health

problem (what’s the problem?), etiology (what is causing or contributing to it?), recommendations (what do we know works to help it?), implementation (how can we get this done?), evaluation (how well do we know that whatever we implement works?)

what is the RE-AIM framework

Reach, Effectiveness, Adoption, Implementation, Maintenance

what are the steps in a systems analysis

identify key influences or interventions on an outcome, indicate the relative strength of the influences or interventions, identify how these influences or interventions interact