Public Health Exam 2

5 Social Determinants of Health

economic stability, education, social context, health care access, neighborhood

What percent of health outcomes are driven by social determinants of health

80%

Structural SDOH Factors

Class, education, income, race, gender

Environmental SDOH Factors

Housing, neighborhood, occupation

Life chances concept

Your social position determines access to resources that affect health

What is the social gradient in health?

Health worsens the lower your socioeconomic class

6 things creating social inequalities

Income, education, class, power, discrimination, unequal access

levels of causes of health problems

Upstream (social structure), midstream (community), downstream (individual disease outcomes)

How to deal with SDOH

improve conditions, reduce inequities, measure progress, engage community, cross-sector action, investing in prevention

What are promotive behaviors

Exercise, vaccination

What are risk behaviors

Smoking, poor diet, alcohol, inactivity

Macro determinants of health

Societal level factors like policies, economic conditions

Micro determinants of health

Individual level factors like genetics, lifestyle choices, and immediate personal circumstances

Two processes influencing health behaviors

Social processes like norms and inequality and individual processes like beliefs and motivation

What is the broken window theory

Visible signs of disorder can create an environment that further worsens norms which leads to public health problems and unhealthy behavior

4 CDC risk behaviors

smoking, poor diet, inactivity, alcohol

Trends in risk behaviors

lower income, less educated, rural areas, and men are at HIGHER risk

3 main social factors that affect health behavior

socioeconomic status, culture, and family

4 types of social support

Emotional, instrumental, informational and appraisal

5 parts of the health belief model

perceived susceptibility, severity, benefits, barriers, and cues to action

What are the 3 types of evidence?

Scientific research, professional expertise, and community values

5 main environmental health concerns

Air pollution, water safety, climate change, chemical exposure, waste management

What is a superfund site?

EPA program for cleaning up hazardous waste sites

Goals of a superfund

Protect human health and the environment, hold polluters accountable, clean and reuse land

DPSEEA Framework stands for…

Driving force, pressure, state, exposure, effect, action

Purpose of DPSEEA Model

to link environmental causes to health effects and guide policy actions

What is the RE-AIM process used for?

To evaluate how well specific interventions work and how accepted they are in practice

What is sustainability?

Meeting current needs without harming future generations

3 aspects of sustainable development

Economic, social, and environmental

What are sustainable development goals

Global goals to improve health, environment, and equality

9 planetary boundaries

climate change, ocean acidification, stratospheric ozone depletion, nitrogen cycle, global freshwater use, change in land use, biodiversity loss, atmosphere aerosol loading, chemical pollution

Factors associated with climate change

Greenhouse gases, ozone layer, changes in temperature, changes in precipitation

Difference between weather, climate and climate change

Weather is short term, climate is a long term average, and climate change are long term shifts due to human activity

What is urban advantage

Urban areas have a higher life expectancy, better access to healthcare and jobs

Urban disadvantages

Pollution, crowding, poor housing, inequity, higher stress

What is a health care system?

Organization of people, institutions, and resources delivering health services

4 main US insurance programs

Medicaid (low income), Medicare (elderly), VA/IHS (veterans and indigenous), employment based (private)

4 parts of Medicare

Hospital insurance, medical insurance, Medicare advantage, and prescription drug coverage

What is the affordable care act do

It expands coverage, reduces the number of people unemployed, and prevents discrimination for pre-existing conditions

Who is uninsured

Low income adults with Medicaid, part time workers

4 hypothesis for US health disadvantage

Access, behavior, inequality, weak policy

3 main challenges in US health care delivery

Cost, access, quality

Indicators of a successful health system

Life expectancy, infant mortality, equity

What is evidence based public health

Using data and evidence to guide interventions and policy

4 components of evidence based public health

Define problem, gather evidence, implement, and evaluate

What does the PERIE process stand for?

Problem, etiology, recommendations, implementation, and evaluation

5 step approach to establish contributory cause

Association, temporality, altering causes changes effect, plausibility, consistency

3 study types for contributory cause

Case control, cohort, and randomized trials

What does the PERIE process determine

how a range of public health problems are approached and resolved

What is ecological fallacy

Assuming group data applies to individuals

What are confounding variables

3rd unmeasured factor that affects both exposure and outcome

What is a system

Interconnect parts working together toward a purpose

What is systems thinking

Analyzing interactions within a system rather than individual parts

Characteristics of systems

Feedback loops, delays, interconnections, adaptability

What is a feedback loop

Process where outputs loop back to influence inputs

What are bottlenecks

Constraints

What are leverage points

Small change with big impact

How is systems thinking used in public health

Identify disease interactions, multiple interventions, and weak spots in systems

CHAP vs HIP

Community health assessment identifies needs while Health improvement plan sets strategies

What is One Health

Integrating human, animal, and environmental health

What is poverty tax

poor neighborhoods pay more for basics

Why do people stay in bad neighborhoods

Jobs, affordability, social roots

What are the solutions implemented so people leave bad neighborhoods

Affordable housing, local initiatives, green space, policy changes