PUBH final Actual questions and answers with 100% accuracy(VERIFIED BY PROFESSOR)

What makes us healthy - access to healthy care %

10%

What we spend on being healthy - medical services %

88%

What is the number 1 thing that makes us healthy

Healthy behaviors

Healthcare System cost per person

$14,570, increased 7.5% from 2022

Healthcare system cost is < or > than other industrialized nations

>

Healthcare system is geared toward ____ and lesser so ____

treatment and lesser so prevention

Competing goals with healthcare system

1. Access

2. Cost

3. Quality

When comparing United States and comparable country average, the US

Spends more on healthcare and lives shorter

Factors in the healthcare cost gap

- Prescription cost/use

- High-cost technology and procedures

- Rise in chronic disease

etc

US spends more money on healthcare but

Is not healthier !!! (life expectancy at birth)

% of nonelderly US population uninsured and no access to health care

8%

Characteristics of the nonelderly uninsured

Reasons for being uninsured among uninsured non elderly adults

1. Coverage not affordable 64.2%

2. Not eligible for coverage

3. Do not need or want

4. Signing up was too difficult or confusing

5. Cannot find a plant that meets needs

6. Lost job 4.5%

How much of US spending is spent on Public Health activities

2-5%

$4.9 Trillion from 3 main sources for healthcare services

1. Health Insurance

2. Out of pocket

3. Other (investments, third party payers)

Balanced Budget Act of 1997

Created Children's Health Insurance Program

Children's Health Insurance Program (CHIP)

Provides low-cost health insurance to children in families who earn too much to qualify for Medicaid

Who funds CHIP

Funded and run jointly by federal and state governments.

Medicaid meets the needs of the population it serves

- Low-Income Families

- Individuals with Disabilities

- Elderly Individuals

Amount of people enrolled in US Medicaid

81,696,742 people

Medicaid Covers 1 in _

1 in 6 adults

2 in 5 children

1 in 3 people with disabilities

Medicare covers

People who are 65 or over

People with certain disabilities

People with end-stage renal disease

Medicare Part A

Hospital Insurance

Medicare Part B

Supplementary Medical Insurance

Medicare Part D

Prescription drug coverage

Medicare Part C

Medicare Advantage plan offered by private companies

Who is covered by medicare

63.9 million Americans

Patient Protection and Affordable Care Act 2010

Improving quality and lowering health care costs

New consumer protections

Access to healthcare

Prior to ACA

46.5 million without insurance

In 2016 (insurance coverage)

26.7 million without insurance

January 2018 (insurance coverage)

Repeal of in the Individual Mandate

In 2023 (insurance coverage)

26 million without insurance)

* Escape Fire Themes

Paying more, getting less

Treating the whole person

Preventing disease

Overmedication

Overtreatment

An entrenched system

Reimbursement

Issues that make the health system a public health concern

Escape Fire Themes

* Why the US Healthcare system costs so much compared to the rest of the world (gap)

* Characteristics of the non-elderly uninsured population

More prominent in the south

Most full-time workers

The main reason for uninsurance is that coverage is not affordable

* The approximate level and components of national expenditures for all health activities

4.6 Trillion dollars

1. Health Insurance (73%)

2. Out-of-pocket (10%)

3. Other (16%)

* Role of Medicaid and Medicare

Medicaid: Provides health coverage for low-income individuals and families (need-based)

Medicare: Provides health coverage for people 65+ and some with disabilities (age/disability-based)

* PPACA expanded access to healthcare (Patient Protection and Affordable Care Act) "3 Legged Stool"

Insurance market reforms - insurers must cover people with pre-existing conditions

Individual mandate - most people must have insurance (or penalty, originally)

Subsidies/Medicaid expansion - financial help to make insurance affordable

Simple idea: All 3 are needed to keep the system balanced and prevent costs from rising too much.

Insurance market reforms

Insurers must cover people with pre-existing conditions

Individual mandate

Most people must have insurance (or penalty, originally)

Subsidies/Medicaid expansion

Financial help to make insurance affordable

* PPACA coverage gap

A situation where a person earns too much to qualify for Medicaid but too little to receive Affordable Care Act (ACA) subsidies, leaving them without affordable health insurance options, especially in states that did not expand Medicaid.

Types of disease

Infectious and non-infectious

Infectious disease

Disease caused by different classes of pathogenic organisms (germs)

Infectious disease producing germ/agent such as

Virus or bacteria

Non-infectious disease

Any disease not caused by a pathogen

Examples of non-infectious disease

Asthma

CVD

Obesity

Why should we care about Infectious diseases

A leading cause of death worldwide, particularly in low-income countries, especially in young children

Amount of deaths associated with respiratory diseases from seasonal influenza

650K

Amount of deaths from diahhreal disease

1.2 million (390K were among children under 5)

Although we have eliminated many indectious diseases, some still are a major public health problem, for example

Pnemonia

Influenza

HIV

STI/STDS

TB

Zoonotic

Diseases caused by infectious agents that can be transmitted between animals and humans

Antimicrobial resistance

Bacteria evolve to be resistant to antibiotics

Emerging infectious diseases

New diseases and diseases increasing in incidence

One Health:

"Achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment"

WHO priority diseases

"Diseases that pose the greatest public health risk due to their epidemic potential and/or there is no or insufficient countermeasures."

There is an urgent need for accelerated research and development for :

COVID-19

Crimean-Congo

Ebola

Lassa fever

MERS-CoV and SARS

Nipah and henipaviral diseases

Rift Valley fever

Zika

Disease X

Communicable diseases

An infectious disease that may be passed from individual to individual

Communicable diseases vs infectious diseases

Not all infectious diseases are communicable (ex. Lyme, tetanus, infected cut)

Communicable disease is an infectious disease that is easily spread

Contagious disease

A very communicable disease

An infectious disease that very rapidly spreads from person to person

Types of agents

Bacteria

Viruses

Fungi

Protozoa

Helminths

Bacteria

One-cell microorganisms

Multiply quickly

May release chemicals which can make you sick

Examples of bacterial infections

TB

Tetanus

Cholera

Whooping cough

Viruses

Capsules that contain genetic material and use your own cells to multiply

Example of viral infections

Flu

HIV

Fungi

Primitive vegetables

Mushrooms, mold, yeasts

Examples of fungal infections

Histoplasmosis

Athlete's foot

Helminths

Parasitic worms that cause disease and illness

Examples of helminth infections

Tapeworm

Pinworm

Roundworm

Hosts (Reservoirs)

Non-vector and Vector

Non-vector hosts

Humans

Other vertebrates

Birds, bats

Vector hosts

Asymptomatic carriers of pathogens

Mosquitoes

Ticks, flies

Routes of transmission

Mouth and nose

Eyes

Skin

Genitals and urinary tract

Digestive tract

Direct routes of transmission

Skin-skin

Mucous-mucous

Across placenta

Through breast milk

Sneeze-cough/aerosolized

Indirect routes of transmission

Food-bourne

Waterbourne

Vector-borne

Air-borne/Aerosolized

Aerosolized direct routes of transmission

Person to person

Influenza

TB

Aerosolized indirect routes of transmission

Person to object

Chickenpox

Colds

Water-borne indirect routes of transmission

Cholera

Direct across the placenta routes of transmission

Rubella

HIV

Direct mucous-mucous routes of transmission

STIs

Environmental factors of disease

Land use

Infrastructure

Changes in food production and handling (antibiotics in animal farming)

Increased use of immunosuppresives/antibiotics

Global air travel

Ownership of exotic pets/interaction with animals

Natural disasters

Infrastructure environmental factors of disease

Air filtration

Screens on windows

Access to clean water

Epi Triad

Agent, host, environment

Agents of Epi Triad

Infectivity

Pathogenicity

Virulence

Immunogenicity

Antigenic stability

Survivial

Environment of Epi Triad

Weather

Housing

Geography

Occupational setting

Air/water quality

Food

Host of Epi Triad

Age

Sex

Genotype

Behavior

Nutritional status

Health status

Why can some diseases be eradicated and not others

Type of reservoir

Ability to live outside of humans

Carrier state (host shows symptoms)

Disease produces long-term immunity

Vaccine available to produce long-term immunity

Herd immunity achievable

Ease of disease to change

Control measures

Water treatment

Vector control

Rodent reduction

Barrier Protection

Isolation, quarantine

Immunizations

Introduces antibodies (injection, nasal) to stimulate immune system to produce own antibodies

Vaccine benefits

Herd immunity: the concept of protecting a community against certain diseases by having a high% of the community's population immunized

Personal Protective Equipment (PPE)

Gloves

Masks

Gowns (hospital settings)

Eye protection

Boots (agricultural settings)

Avoid touching nose, mouth, eyes, and surfaces (cross contamination)

Framework question one

Define the public health issue and why

Framework question two

What are the factors involved in this problem

Framework question three

What controversial or ethical concerns may be involved

Biological Plausibility

There's a reasonable scientific reason something could happen in the body.

Consistency

The same result is seen again and again in different studies and groups of people.

Dose-response

The more you are exposed to something, the bigger the effect or risk.

Amount of exposure x duration time

Strength

The relative risk for persons with the factor/condition is greatly increased compared to those without

"A smoker has more than 10x the chance of developing lung cancer than a non smoker"