PUBH 302 Exam1

Public Health

Population-focused efforts to protect, promote, and prolong life and prevent disease and injury.

What are the 3 guiding questions of public health?

1. What is the public health issue and why is it a problem? 2. What factors/determinants are involved? 3. What controversial or ethical concerns are involved?

WHO definition of health

A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.

What are dimensions of health?

Physical, mental, social, environmental, function, life satisfaction, happiness, well-being, mortality, morbidity, and quality of life/disability.

What makes a public health issue population-based?

It considers how many people are affected, where they are affected, and which vulnerable or priority groups are affected.

What are determinants of health?

Personal, social, economic, and environmental factors that influence health.

What are risk factors?

Factors that increase the likelihood of a health outcome and are more likely to be under individual control, such as behaviors.

What are risk conditions?

Factors less likely to be under individual control, such as age, sex, genetics, housing, and safe work conditions.

What is lifestyle?

Patterns of behavior, lifetime habits, and social circumstances.

What are common ethical concerns in public health?

Economic costs, values/religious beliefs/morals, and individual liberty versus the public interest.

What are the basic requirements for group survival?

Air, water, food, shelter, and care.

What was the ancient Greek view of health?

Health involved personal hygiene, bathing, hand washing, physical fitness, and balance between the person and environment.

Who was Hippocrates?

Known as the Father of Western Medicine; he emphasized causal relationships and believed disease resulted from an imbalance between people and their environment.

What environmental factors did Hippocrates associate with disease?

Climate, soil, water, lifestyle, and nutrition.

What terms did Hippocrates help introduce?

Acute, chronic, and epidemic.

What public health contributions did the Roman Empire make?

Sewage systems, aqueducts, public baths, water supplies, markets, and administrative systems.

How was disease commonly viewed during the Middle Ages?

Disease was often viewed as punishment or fate, with the Church playing an important role in care and charity.

What public health practice developed during the Middle Ages?

Quarantine of ships and isolation of people with disease.

What was the Black Death?

A devastating pandemic occurring from about 1346-1353 that caused enormous mortality.

How did global exploration affect public health?

Traders and explorers spread diseases such as smallpox, measles, and influenza, causing severe effects among Indigenous populations.

Who was Edward Jenner?

A physician who demonstrated vaccination using cowpox in 1796.

What was the effect of industrialization and urbanization on health?

Poverty, overcrowding, slums, disease, and high mortality increased.

What was the Great Sanitary Awakening?

A period during the 1800s-1900s when scientific knowledge and humanitarian ideas led to improvements in sanitation, water, sewage, and community health monitoring.

Who was Edwin Chadwick?

He published an 1842 report on sanitary conditions and advocated reforms involving sanitation, healthcare, and treatment of poor people, workers, and children.

Who was Lemuel Shattuck?

He promoted health records, vital statistics, sanitary reform, vaccination, public health information, and health education.

What are vital statistics?

Health-related records such as births and deaths used to monitor population health.

Who was Louis Pasteur?

A scientist who helped establish germ theory and demonstrated that microorganisms cause disease; he also contributed to vaccines.

What did germ theory replace?

The idea that disease was primarily caused by bad air or miasma.

Who was Robert Koch?

A scientist who identified the cholera vibrio, developed Koch's postulates, and identified the bacterium that causes tuberculosis.

What was the sanitation revolution?

Improvements involving clean water, sewage treatment, food inspection, hygiene, garbage collection, street cleaning, and health regulation.

What is population health?

The health of healthy people and populations, using evidence-based strategies to prevent disease, disability, and death and protect health.

What happened to life expectancy during the 20th century according to the course material?

It increased from about 45 years to about 75 years.

How much of the approximately 30-year increase in life expectancy was attributed to medical care in the course material?

About 5 years; most of the increase was attributed to public health improvements.

What public health improvements increased life expectancy?

Nutrition, occupational safety, housing, sanitation, and other public health interventions.

What is life expectancy?

The expected length of life, commonly measured from birth.

What is mortality?

Death or the rate of deaths in a population.

What is morbidity?

Illness, disease, or the rate of disease in a population.

What is infant mortality?

Death occurring before the first birthday.

How is the infant mortality rate calculated?

Number of infant deaths divided by the number of live births, multiplied by a standard multiplier such as 1,000.

What was the 2023 U.S. infant mortality rate shown in the course material?

5.61 deaths per 1,000 live births.

What is quality of life?

A multidimensional and subjective assessment of positive and negative aspects of life, including areas such as jobs, school, housing, and neighborhoods.

What is health-related quality of life (HRQoL)?

A person's perceived physical and mental health over time.

What are ADLs?

Activities of Daily Living: bathing, dressing, toileting, transferring, continence, and feeding.

What are IADLs?

Instrumental Activities of Daily Living: telephone use, shopping, food preparation, housekeeping, laundry, transportation, managing medications, and handling finances.

What are the Ten Great Public Health Achievements of 1900-1999?

Vaccination; motor-vehicle safety; safer workplaces; control of infectious diseases; decline in coronary heart disease/stroke deaths; safer and healthier foods; healthier mothers and babies; family planning; fluoridation of drinking water; recognition of tobacco as a health hazard.

What is primary prevention?

Prevention that occurs before a disease or health problem occurs.

Examples of primary prevention

Smoking cessation, healthy diet, sunscreen, and folic acid.

What is secondary prevention?

Early detection of disease or health problems.

Examples of secondary prevention

Mammograms and cholesterol testing.

What is tertiary prevention?

Intervention after a disease already exists to treat it or reduce its consequences.

Examples of tertiary prevention

Chemotherapy, surgery to remove a malignant tumor, and rehabilitation.

What is the easiest way to remember the 3 levels of prevention?

Primary = Prevent; Secondary = Screen/detect early; Tertiary = Treat/manage consequences.

What is epidemiology?

The study of the distribution and determinants of health-related states or events in specified populations and the application of this study to control health problems.

Why is epidemiology called the basic science of public health?

It provides the methods for studying health problems, their distribution, determinants, and control in populations.

What 5 questions do epidemiologists ask?

What, Who, Where, When, and Why/how.

In epidemiology, what does WHAT ask?

What is the health outcome or problem?

In epidemiology, what does WHO ask?

Who is the population at risk?

In epidemiology, what does WHERE ask?

Where is the health problem occurring?

In epidemiology, what does WHEN ask?

When is the health problem occurring or changing?

In epidemiology, what does WHY/HOW ask?

What are the determinants, causes, or modes of transmission?

What does P.E.R.I. stand for?

Problem, Etiology, Recommendations, Implementation.

What does P in P.E.R.I. stand for?

Problem: What, who, where, and when.

What does E in P.E.R.I. stand for?

Etiology: Causes and determinants.

What does R in P.E.R.I. stand for?

Recommendations: What works, evidence quality, past experience, benefits, and harms.

What does I in P.E.R.I. stand for?

Implementation: How, who, when, and at whom the intervention should be implemented.

Why do public health professionals measure health?

To track diseases and conditions, monitor health and quality of life, identify prevention opportunities, use surveillance systems, and distribute resources.

What is a rate?

The number of events, cases, or deaths divided by the population at risk during the same area and time period, usually multiplied by a standard number.

What is a crude mortality rate?

An unadjusted rate of death from all causes in a population.

Why can crude mortality rates be misleading when comparing populations?

They are influenced by differences in age distribution.

What is cause-specific mortality?

Mortality due to a specific cause.

What is age-specific mortality?

Mortality within a particular age group.

What is a combination-specific rate?

A rate calculated for a subgroup defined by multiple characteristics, such as disease plus age or race/ethnicity.

What is an adjusted rate?

A statistically adjusted rate, such as an age-adjusted rate, used to compare populations with different characteristics.

What is incidence?

The number of new cases or health-related events occurring in an at-risk population during a specified period.

What is prevalence?

The proportion or total number of people in a population who have a condition at a specified point or during a specified period.

What does endemic mean?

The constant presence of a disease or health condition within a geographic area.

What does epidemic mean?

The occurrence of a disease or health condition in excess of what is normally expected.

What does pandemic mean?

An outbreak that spreads over a very wide geographic area, such as across continents.

What is etiology?

The study or explanation of the causes or determinants of a disease or health problem.

What is a contributory cause?

A factor that contributes to a health outcome but may not be necessary or sufficient by itself.

What is temporal sequence?

The cause must occur before the effect.

What is relative risk (RR)?

The probability of an outcome when an exposure is present divided by the probability of the outcome when the exposure is absent.

What does RR greater than 1 mean?

The exposed group has a higher risk of the outcome.

What does RR equal to 1 mean?

There is no difference in risk between the groups.

What does RR less than 1 mean?

The exposed group has a lower risk of the outcome.

What is dose-response?

The relationship in which greater amount or duration of exposure is associated with a greater health effect.

What is consistency in epidemiology?

A relationship is observed repeatedly across different studies or populations.

What is biological plausibility?

A known biological or other mechanism can explain the relationship between a cause and an effect.

What are the four conditions that strengthen evidence for a contributory cause?

Strength, dose-response, consistency, and biological plausibility.

What is the multi-causation model?

The idea that many diseases and health problems can result from multiple contributing factors.

What factors can contribute to cardiovascular disease?

Age, smoking, inactivity, overweight, high blood pressure, high cholesterol, and family history.

What is systems thinking?

Looking at how multiple interconnected factors and levels influence a health problem.

What is the social-ecological model?

A model recognizing that health is influenced by factors at multiple levels, from individual/micro influences to broader social, environmental, and macro influences.

Why are multiple solutions often needed for public health problems?

Public health problems often have multiple causes operating at different social and environmental levels.

What are unique features of public health?

Its connection with government, scientific foundation, focus on prevention, expanding agenda, social justice perspective, and inherently political nature.

What is health equity?

The idea that everyone should have the opportunity to attain the highest level of health and that conditions should be created to support the best possible health.

What are the 3 broad components of health law and policy?

Traditional public health, healthcare, and social issues/bioethics.

What is federalism?

A system in which governmental powers are divided between the national government and state governments.

What does the 10th Amendment have to do with public health?

It supports state police power, giving states primary authority to regulate health and safety.

What are the four sources of public health law?

Constitutionally based law, legislatively based law, administrative law/regulations, and judicially based law/case law.