Public Health final

Epidemic

What cases exceed the normal amount (endemic level) for a given area

Pandemic

When an epidemic goes global crosses national borders and spreads across nations and territories (clusters on different parts of wide areas, multinational)

Endemic

The normal level of disease for an area

Prevalence

The total number of cases in a define population (expressed as a proportion and is more commonly used for chronic diseases)

Five social determinants of health

Healthcare access and quality, education access and quality,, social and community context, economic stability, neighborhood and built environment

Social, economic and political factors

Racism, social cohesion, political participation, segregation, inequality, poverty

Living and working conditions

Housing, access to food, disease vectors, air, water and soil quality, working environment, jobs, wages and benefits, noise

Public services and infrastructure

Parks, education, community centers, transportation, economic dev, health care

Individual behaviors

Exercise, diet, addiction, coping

Individual factors

Age, Gender, genetics

What is the first thing we ask about an agent?

Size and morphology

Second thing we ask about an agent

Growth requirements (what does it need to grow/reproduce)

What is the 3rd thing we ask about an agent?

It’s ability to survive outside the host (can it live on surfaces for a while and spread more easily that way?)

4th question we ask about an agent

What is the spectrum of suitable hosts (how vulnerable are the general populations, if a wider spectrum of suitable hosts it will probably sperad more quickly, the hosts are more readily and widely available.

5th question we can ask about an agent

Virulence (how severe is an agent how strong of an effect does it have on health and how harmful is it)

6th question we can ask about an agent

Can it produce toxins?

Last question we can ask about agents

What is its ability to develop antibiotic resistance

Qualities of a host (ASRNGSPH)

Age, sex, race/ethnicity -based on geography, nutritional status, genetics, susceptibility/immunity, pre-existing disease, human behavior

Qualities of environment

Temp, humidity, crowding, ventilation, social as well as physical factors

Medicaid

Aid to the poor, 1965 welfare program

What funding is medicaid split between?

Federal and state funding

How does eligibility vary for Medicaid?

Varies state to state

What governments pay medical bills to providers at a low fixed rate for each service?

State or local govs.

Medicare is defined as

“care for the elderly”

When was medicare created? Was it mandatory or not?

1965 was mandatory insurance program

Who is eligible for medicare and SS benefits?

Citizens 65 and older and individuals with disabilities

Is medicare part of SS benefits?

Yes

Medicare: Workers pay to program throughout life through______ from their ______

deductions; paychecks

Part A of Medicare

Hospitalization (automatic)

Part B of medicare

Outpatient services- health care provider visits (pay additional premium)

When was Part C of medicare added?

Medicare advantage added in 1997

What was Part C of medicare?

Medicare advantage, added more flexibility in what health plan used (additional premium)

Part D of medicare

Prescription drug plan added in 2006 (additional premium)

Affordable care act is also known as

Obamacare

What act provides free preventative screenings?

Affordable care act

What did the affordable care act expand?

Insurance coverage so dependents can stay on their parents health insurance until age 26

What did the affordable care act require so people can shop for a fitting insurance plan.

Affordable exchange rates

Affordable Care act: Can’t cancel someone’s ___ when their costs rise (no lifetime ___)

insurance;ceiling

Affordable care act: Can’t deny someone insurance because of _______ conditions

pre-existing

Affordable Care act: No ____ on the basis of sex, race, sexuality____ _____, disability, national ___, color, age

discrimination;gender identity;origin

Affordable care act: Requires most insurers to cover the __ essential health benefits including ____ drugs and mental health

10; prescription

Affordable care act: Allowed states to expand _____ coverage up to ___% of Federal poverty level and remove categorical requirements that were a barrier for many ___-____ people in need of coverage.

Medicaid;138;low-income

Affordable care act: Required coverage of women’s _____ health services

Preventative

ACA: required pepke to have a right to ___ set of vaccinations recommended for them and made vaccination part of ___ medical visits

full; routine

ACA: Created ___, infant and ___ childhood home visiting program to support home visiting services to ___ people and parents with young children who live in communities that with higher risks and barriers to achieving ___ maternal and child health outcomes

Maternal; early; pregnant; positive

Are community health centers private or public health-care organizations?

Private

How do community health centers provide primary health services to residents

directly or indirectly

How are residents who receive care from community health centers determined as people to receive care?

Live in a defined geographic area that is medically underserved

What are community health centers a combination of for funding?

Federal, state and private grants and funding

What kind of insurance assist in funding community and health centers?

Federal and private insurance

Community health centers serve __% of low-income persons which is about __% of the US population.

20;8

How many community health center are in the US?

1400

10 essential public health services (AI SUCC BIBE)

Assessment

1. Assess and monitor population health

2. Investigate, diagnose, and address health hazards and root causes 

   Policy Development

3. Communicate effectively to inform and educate

4. Strengthen, support, and mobilize communities and partnerships

5. Create, champion, and implement policies, plans, and laws

6. Utilize legal and regulatory actions

   Assurance

7. Enable equitable access

8. Build a diverse and skilled workforce

9. Improve and innovate through evaluation, research, and quality improvement

10. Build and maintain a strong organizational infrastructure public health

What are the three levels of prevention

Primary, secondary, tertiary

Prevention: Primary

Prevent risk factors (prevent the disease before it happens)

Examples of primary prevention

Nutrition, exercise, vaccinations

Prevention: Secondary

Early detection or a cure (identify the disease before problems become serious)

What are examples of secondary preventive measures?

Mammograms, pap smears, colonoscopies, physical exams, BP tests

Prevention: Tertiary

Reduce impact of a disease; maintain/improve quality of life (preventing complications of the disease)

Examples of tertiary prevention

Disability imitation and rehabilitation (stroke, CVD), substance abuse treatment, comfort measures (hospice and palliative care), physical therapy (scoliosis)

Do public health laboratories do more diagnostic or reference testing?

Reference (but still do both)

Public health laboratories ___ and detect health threats ranging from rabies and ___ fever to radiological or ___ contaminants, genetic disorders in newborns and terrorist ___

Monitor; dengue; chemical;agents

Public health laboratories provide what kind of support?

Emergency response support

Public health laboratories are a part of 24/7 laboratory network to respond to novel ___ of disease, natural disaster, chemical ___, foodborne ___ and other health emergencies.

strains;spills;outbreaks

Public health laboratories use ____ research

applied

Public health laboratories also do workforce development and ___

Training

The goal of public health laboratories is to protect and improve public health by:

Testing samples, providing expertise, and communication scientific information

Public health laboratories are equipped with specialized instrumentationa and staffed by highly trained ____ to deliver services that may be ____ or cost-prohibitive elsewhere

scientists; unavailable

What are 3 public health milestones?

Genome mapping, smallpox vaccine, john snow (cholera)

First person to see bacteria

Antonie van Leeuwenhoek

Guy that created first bills of mortality and created early statistical analysis tracking early diseases in London and categorized it by cause

John Graunt

Dude who was involved with the public health act in England- big sanitation reform

Edwin Chadwick

Bro who realized sanitation matters, poor sanitation led to infection which led to death in civil war troops

Dr. Charles Nathaniel Hewitt

Is there more investment in public health or healthcare?

Health care

Is there a higher return on investments for public health or healthcare?

Public health even though isn’t as obvious

We spend more than any other country on healthcare but have some of the __ health outcomes in the world.

Worst

6 principles of CERC

Be first, be right, be credible, express empathy, show respect, promote action

Be first

The first source of information often becomes the preferred source

Be right

Accuracy establishes credibility

Be credible

Honesty and truthfulness shouldn’t be compromised in a crises

Express empathy

Addressing what people are feeling builds trust

Show respect

Respectful communication promotes cooperation

Promote action

Giving people things to do that calms anxiety

herd immunity

Most people are immune (vaccinations) we protect people who can’t get immune

What branch of government creates laws that promote public health

Legislative/congress

What are some examples of laws congress has made?

Safe drinking water laws

What branch execute the laws that are made?

Executive

Who is involved in the executive branch?

Governors, mayors and president

What branch is police power and agencies who oversee laws made by legislature and are ensured that they are being followed and carried out

Executive

What are some legislatures who ensure laws are being carried out?

FDA, USDA

Legislation and regulations both have the power of what?

Law

Legislation is made by congress and approved by ___

Congress

who are regulations made by?

The president/exec branch

Who are regulations approved by?

The public

Impact of cigarette smoking

cancer, death, neonatal problems, bad. (Emily lol)

What problems can secondhand smoke create?

Cancer, respiratory problems

What other diseases do tars cause?

lung diseases damage cilia

What does damage to cilia cause?

Increases susceptibility to infectious diseases like bronchitis, flu, pneumonia and diseases brought on by chronic diseases such as emphysema and asthma

Smoking can also have negative effects on what system?

Cardiovascular

What does nicotine cause that effects the cardioasuclar system?

Blood pressure and heart rate