SOCI 172: E1-Study Guide 2

The historical period when spikes in infectious diseases become more predictable and less 

frequent and life expectancy increases to roughly 50 years is referred to as __________.

A) the Age of Receding Pandemics

B) the Age of Pestilence and Famine

C) the Age of Degenerative and "Man-Made" Diseases

D) the Age of McDonald’s

A

Why are data sets such as the National Longitudinal Study of Adolescent to Adult Health (Add Health) and the Health and Retirement Study so important?

A) These accurately determine the health of individuals at one point in time, then never again.

B) These studies track how having a hobby in elementary school, such as playing basketball or

painting pictures, influence survey participation 10 years later.

C) These studies were the first to compare mortality rates in the United States with that of other high-income countries, such as Sweden and Australia.

D) These studies follow individuals across the life course, rather than just at one point in time.

E) These studies provide interventions to one-half of the sample and not the other to best determine what happens when population health experiments are conducted.

D

Based on their scientific work, Case & Deaton developed possible explanations for increases in midlife mortality among non-Hispanic Whites in the United States that included both ____ and ____ factors.

A) water-based and soil-based
B) genetic-based and technological-based
C) demand-side and supply-side
D) sanitary-focused and filth-focused
E) religious-based and pagan-based

C

An e20 value of 57.8 in the last column of a life table means that:

A) People in Eritrea live, on average, 57.8 years

B) Citizens of Egypt typically acquire their first chronic disease at age 57.8

C) 57.8% of Americans have ear-related health problems (e.g., hard of hearing)

D) People who are aged 20 and live in the eastern portion of the country have a 57.8% chance of living to age 100

E) Based on current age-specific death rates, people who are 20 years old can expect to live an additional 57.8 years

E

Population health data collected by the National Center for Health Statistics are:

A) unavailable to the public

B) available to the public, including you and me

C) sold to the public by subscription

D) biased and useless; the private sector collects much better health data in our country

E) no longer made available to the public because the US government does not want the public to understand the true extent of the country’s health problems

B

What is the issue with cohort life expectancy?

You have to wait for everyone to die first

How do you calculate cohort life expectancy?

30,60,90… 30+60+90…/3…=60

A disease or health issue that affects a large number of people within a community, population, or region

Epidemic

-Estimate 481,000 people/year in US are dying from cigarettes
->50% of US adults smoked in 1950s (just 11% now)
-1964 surgeon general report brought first widespread attention to pandemic
-Master Settlement Agreement of 1998: Tobacco companies pay billions to states. Ads, marketing, cartoons, etc. regulated. Tobacco company documents made public. Fund truth initiative

Smoking pandemic

-Most prominent recent national response
-Signed into law by Trump on 10/24/18
-Nearly unanimous bipartisan support in both House & Senate
-Enhanced package screening for fentanyl
-Increased funding for opioid use prevention
-Some funding increases for treatment
-Research to create non-addictive medications
-Funding for states to buy back unused pills

The SUPPORT for Patients and Communities Act

Opioid Epidemic

-Opioids poured into a vulnerable US market (flooding market with pills approved by FDA/gov)
-Prescriptions written more extensively for Whites than for members of racial minority groups
-Geographically concentration before becoming more widespread (pill mills - walmart, walgreens, cvs)
-Rapid increases in availability/supply of heroin and synthetic pain drugs
-Since early 2000's...Cheap alternatives to prescription opioids
-Alcohol supply and gun supply increase rapidly over last 20 years

Essentially a band-aid solution; seeing a problem in population health and using a short-sighted solution to fix it, which may lead to other problems. An example would be the SUPPORT act. It attempts to fix an opioid epidemic by enhancing screening of such medications, without actually getting to the heart of the issue (e.g. why people overdose with pills in the first place, why they need to take it, etc.)
-In short, to win at population health, you don't just keep smacking symptoms -- you change the game entirely by addressing root causes.

Whack-a-Mole lesson

Adolescents who believed they had a 50% or lower chance of surviving to age 35 faced a significantly higher risk of premature death, especially among females. This association was partly explained by socioeconomic factors, mental and physical health, risky behaviors, and exposure to violence.

Key Findings: Gazing into the Crystal Ball (Graham et al. 2024)

Significantly reduced the uninsured rate in the U.S. from 16.0% in 2010 to 8.2% in 2024 by expanding Medicaid in some states, allowing young adults to stay on parental plans until age 26, and providing tax credits for insurance exchanges. Continued efforts, including increased ACA Exchange enrollment (7.2% in early 2024 vs. 4.5% in 2020) and pandemic-era policies, have helped maintain coverage, though uninsured rates remain higher among lower-income households.

Impact of Affordable Care Act on Health Insurance Coverage in the US

Five Key Recent Trends in US Pop Health (pp. 24-40 in text)

1. Life Expectancy Stagnation:
-After decades of improvement, life expectancy in the U.S. has plateaued and even declined in recent years, particularly among certain demographic groups.
2. Widening Socioeconomic Health Disparities:
-Health inequalities based on socioeconomic status have increased, with lower-income individuals experiencing poorer health outcomes compared to their higher-income counterparts.
3. Persistent Racial and Ethnic Health Disparities:
-Significant health disparities persist among racial and ethnic groups, with African Americans and Native Americans facing higher mortality rates and poorer health outcomes compared to White and Asian Americans.
4. Rise in "Deaths of Despair":
-There has been an increase in mortality due to drug overdoses, suicides, and alcohol-related diseases, particularly among middle-aged White Americans without a college degree.
5. Geographic Health Disparities:
-Health outcomes vary significantly by geography, with individuals in certain regions, such as the Southeast and Appalachia, experiencing worse health outcomes compared to those in other parts of the country

Five Key Recent Trends in US Pop Health (pp. 24-40 in text)

had little to do with the declines in infectious disease & infant, child, and maternal mortality during the period

Modern medicine and epi transition

those caused by pathogenic microorganisms, such as bacteria, viruses, parasites, or fungi; the diseases can be spread, directly or indirectly, from one person to another.

Infectious/Parasitic Diseases

Stage 1: Pestilence and Famine
Stage 2: Receding Pandemics
Stage 3: Degenerative Diseases
Stage 4: Delayed Degenerative Diseases

The stages of the epidemiologic transition

A contract in which the major cigarette manufacturers in the United States agreed not to engage in certain advertising strategies

Master Settlement Agreement

MLK on Population Health

Martin Luther King Jr. famously claimed that health inequity "is the most shocking and the most inhumane" of all forms of inequality.

- Disease with worldwide distribution
- Over 60% of the worlds HIV+ population lives in Africa
-Prevention, programs, and treatment have vastly improved since mid 1990s
-In US racial/ethnic minority and gay/bisexual men are by far at highest risk now
-Incidence, prevalence, and deaths still highest in Sub-Saharan Africa

HIV/AIDS Pandemic

The health outcomes of a group of individuals, including the distribution of such outcomes within the group

Population Health

Mean life expectancy at other ages (e20)

-81.1 for women, 75.8 for men
-Better in 2023 than 2022 by 0.9 years

The three ways the demographers think about time.

-Age refers to the group of individuals between a certain age
-Period refers to a single-time
-Cohort refers to following groups of people as they get older through time

Collection of certain biological factors from individuals (urine, saliva, blood, etc.) to be used as raw data for prospective researchers to use.

Biomarker data