public health exam 2

3 ways that public health improved conditions/diseases by the 1960s

• immunization

• antibiotics

• public health measures

public health measures that improved conditions/diseases by the 1960s

• purification of water

• proper disposal of sewage

• pasteurization of milk

• improved nutrition and personal hygiene

types of infectious agents

• bacteria

• viruses

• parsites

the chain of infection

• agent

• reservoir

• portal of exit

• mode of transmission

• portal of entry

• susceptible host

agent

germs

reservoir

where germs live

portal of exit

how germs get out

mode of transmission

how germs get around

portal of entry

how germs get in

susceptible host

next sick person

ways public health can prevent the spread of disease

interrupting the chain of infection at whatever links are most vulnerable

how to interrupt the chain of infection

• kill pathogen with antibiotics

• eliminate the reservoir

• prevent transmission

• increase resistance of host by immunization

preventing transmission

• hand washing

• quarantine

• barriers methods (condoms)

public health measures

• epidemiologic surveillance

• contact tracing

• immunization and treatment of identified patients to prevent further spread

• quarantine if necessary

eradication

possible if there is a non human reservoir and if a vaccine exists

herd immunity

a sufficient proportion of a population is immune to an infectious disease

herd immunity is lost when

many people do not get vaccinated

HIV/AIDS spread

• sexual contact

• blood (sharing needles)

• parent to child in utero

cause of HIV/AIDS

a retrovirus that attacks the immune system

PrEP

pre exposure prophylaxis

PEP

post exposure prophylaxis

influenza

• an RNA virus like HIV

• constantly mutating

tuberculosis (TB)

the leading cause of infectious disease death worldwide

people with HIV are at an

elevated risk of TB

tuberculosis is transmitted by

aerosol

fatalility rate of untreated TB

50%

top two chronic illnesses in the US

1) cardiovascular disease

2) cancer

cardiovascular disease

• heart disease

• stroke

• hypertension

cancer

• arises from mutations in DNA

  • mutations are caused by chemicals, viruses and radiation

• diet and hormones play a role

teratogens

a substance or agent that causes birth defects

examples of teratogens

• infectious pathogens (syphilis, rubella)

• environmental chemicals (mercury contamination)

• drugs (alcohol, cocaine, heroin)

down syndrome

trisomy 21

folic acid can reduce risk of

spina bifida

all newborns in the US are screened for at least two conditions including

PKU and hypothyroidism

early screening and diagnosis

can prevent or reduce permanent damage

leading causes of death

• diagnosis at time of death

• result from a combination of genetic and external factors

actual leading cause of death

• often preventable

• targets for public health

examples of actual leading causes of death

• tobacco, diet, physical inactivity, alcohol consumption, microbial agents, toxic agents, motor vehicles, firearms, sexual behavior, drug use

• most are premature and caused by individual behavior

public health interventions

education and regulation

education

informs the public about healthy and unhealthy behavior

effective approaches for education

• health education in schools

• physicians recommendations

• use of advertising

• social norms approach

regulation

passing and enforcing laws and policies meant to prevent harm

examples of public health laws include

• laws against murder and assault

• traffic violations

• restrictions on alcohol, drugs, and tobacco

• laws to prevent minors from unhealthy behaviors

• laws requiring vaccination

socioeconomic status (SES)

• income

• education

• occupational status

SES and its relationship to health

• nutrition

• sanitation

• conditions of the physical environment

• levels of healthy behavior

• access to medical care

stress mortality increases after

• death of a spouse

• loss of a job

• divorce

stress increases the risk of

heart disease and common cold

stress creates more hassles at

lower SES

social support can be

protective against stress

health belief model

the classic frame of reference for understanding behavior change

four factors that affect ones health decisions

1) the extent to which the individual feels vulnerable to the threat

2) the perceived security of the threat

3) perceived barriers of taking actions to reduce the risk

4) the perceived effectiveness of taking an action to prevent or minimize the problem

self efficacy

the sense and belief of having control over one’s life and successfully completing tasks and goals

self efficacy is increased by

• previous successful performance

• seeing others successfully perform, especially if model is peer

socio-ecological model

describes five levels of influence that determine health related behavior

intrapersonal level

psychology

interpersonal level

family, friends, coworkers

institutional level

school and workplace

community level

churches and community organizations

public policy level

government regulations

industry tactics to advertise tobacco

the power wall

tobacco companies spend

billions each year to promote their products

tobacco ads are designed to

attract a wide variety of people

people who use tobacoo are shown as

young, attractive and cool

tobacco ads never show the

health effects from its use

tobacco is the single largest

leading preventable cause of disease and preventative death

nicotine

a colorless/slightly yellowish oily liquid that can be smoked, chewed and absorbed by the body

nicotine is a stimulant and highly

addictive

nicotine is carcinogenic, meaning it is

cancer causing

in 1997-1998, attorneys general and the tobacco industry agreed in a settlement to

• pay $206 billion to 46 states

• restrict advertising to kids

taxation of cigarettes affect

teenagers

e-cigarettes are advertised as

safe alternatives to cigarettes

e-cigarettes are still very

• addictive

• expensive

• bad for health