Untitled Flashcards Set

Health promotion

Enabling people to increase control over, and to improve their health.

Health education

Combination of learning experiences that improve health knowledge and attitudes.

Wellness

The optimal state of health for individuals/groups, realizing full potential physically, mentally, socially, spiritually, and economically.

Healthy People 2030 vision

A society where all people can achieve their full potential for health and well-being across the lifespan.

National Prevention Strategy goal

Increase the number of Americans who are healthy at every stage of life.

4 strategic directions of National Prevention Strategy

Healthy environments, preventive services, empowered people, elimination of disparities.

7 priorities of National Prevention Strategy

Tobacco-free living, preventing drug/alcohol abuse, healthy eating, active living, mental/emotional well-being, reproductive/sexual health, injury/violence prevention.

ACA signing date

March 23, 2010.

Main goal of ACA

Expand access to preventive services and insurance coverage.

How does ACA promote prevention?

Requires insurance to cover USPSTF Grade A/B services without copay, funds primary care, emphasizes prevention nationally.

Social determinants of health (SDOH)

Conditions where people are born, live, learn, work, play, worship that impact health outcomes.

Examples of SDOH

Safe housing, access to nutritious food, education, transportation, literacy skills.

Clinical preventive services

Primary and secondary preventive health services like screenings, counseling, immunizations.

Examples of clinical preventive services

Mammograms, cholesterol checks, vaccines, counseling to stop smoking.

What does USPSTF do?

Evaluates preventive services and gives them grades (A, B, C, D, I).

USPSTF Grade A

Strongly recommended; high certainty of substantial benefit.

USPSTF Grade B

Recommended; high certainty of moderate to substantial benefit.

USPSTF Grade C

Offer selectively depending on patient situation; moderate certainty of small benefit.

USPSTF Grade D

Discourage use; moderate or high certainty service has no net benefit or harm.

USPSTF Grade I

Insufficient evidence to assess benefits vs harms.

Grades covered under ACA

Grades A and B.

What makes a good screening test?

Simple, rapid, inexpensive, safe, acceptable to patients.

Reliability in screenings

Consistency of a test across time, raters, and tools.

Validity in screenings

Accuracy of a test in identifying disease correctly.

Types of reliability in screening

Intra-subject, intra-rater, inter-rater, instrument reliability.

What is sensitivity in a screening test?

Ability of a test to correctly identify those with the disease.

What is specificity in a screening test?

Ability of a test to correctly identify those without the disease.

Difference between screening and diagnostic test

Screening = asymptomatic people; Diagnostic = confirms disease in symptomatic people.

BMI normal range

18.5–24.9.

Overweight BMI range

25–29.9.

Obesity BMI range

30 and above.

Waist circumference cutoff for men

40 inches.

Waist circumference cutoff for women

35 inches.

Normal blood pressure range

<120/<80 mmHg.

Fasting blood glucose normal

70–99 mg/dL.

Prediabetes fasting glucose

100–125 mg/dL.

Diabetes fasting glucose

126+ mg/dL.

Target A1c for diabetics

≤7%.

Total cholesterol desirable level

<200 mg/dL.

HDL cholesterol goal

40 mg/dL for men, >50 mg/dL for women.

LDL cholesterol goal

<100 mg/dL.

Definition of Metabolic Syndrome

Having at least 3 of: large waist, high glucose, high triglycerides, low HDL, high BP.

Top causes of death in the U.S.

Heart disease, cancer, stroke, chronic lower respiratory diseases, diabetes, Alzheimer’s disease.

Chronic disease

A condition lasting over a year, requiring ongoing medical attention or limiting daily activities.

Noncommunicable diseases (NCDs)

Chronic diseases not spread person to person (like heart disease, diabetes, cancer).

Modifiable risk factors for chronic diseases

Smoking, physical inactivity, poor diet, obesity, high blood pressure, high cholesterol.

Non-modifiable risk factors for chronic diseases

Age, genetics, family history, ethnicity.

Risk Arch from the Framingham Study

Shows how risk factors like high BP, cholesterol, and smoking predict cardiovascular disease.

Lifestyle medicine

Focuses on preventing, arresting, and reversing disease through behavior change rather than symptom management.

Examples of lifestyle interventions

Diet changes, exercise, smoking cessation, stress management, social support.

Alameda County Study findings

7 habits linked to better health outcomes.

7 health habits from Alameda Study

No smoking, daily exercise, 7–8 hours sleep, healthy weight, moderate alcohol, breakfast daily, no snacking.

Main finding of EPIC study

Following 4 behaviors dramatically reduced death risk.

China Study findings

Plant-based diets are associated with lower rates of heart disease and cancer.

Metabolic Syndrome

Cluster of risk factors increasing risk for heart disease and diabetes.

Criteria for Metabolic Syndrome diagnosis

At least 3 of: increased waist circumference, elevated fasting glucose, elevated BP, elevated triglycerides, low HDL.

Percent of U.S. medical spending on chronic diseases

About 86%.

Examples of lifestyle medicine in action

Mediterranean diet for heart disease, Diabetes Prevention Program with diet + exercise.

5 components of Lifestyle Medicine

Plant-based nutrition, regular physical activity, stress management, avoiding risky substances, healthy relationships.

Reasons for rise of chronic disease in past century

Sedentary lifestyles, processed foods, tobacco use, longer life spans.

Mediterranean Diet benefits

Reduced cardiovascular disease events.

Key dietary shifts leading to chronic disease

Increase in processed foods, refined sugars, and saturated fats.

How fast can lifestyle changes impact chronic disease?

Sometimes within 30 days.

Difference between secondary and primary prevention for heart disease

Secondary = treating after disease appears; Primary = preventing disease from developing.

Statin use in primary vs secondary prevention

Effective for secondary prevention but less benefit for primary prevention.

Criticisms of statin use

Risk of side effects, minimal benefit in low-risk patients.

Best proven way to prevent chronic disease

Healthy diet, physical activity, no smoking, moderate alcohol use.

Epigenetics

How lifestyle and environment affect gene expression without changing DNA sequence.

Example of epigenetics and lifestyle

Exercise can turn off genes linked to disease.

Benefits of healthy lifestyle on cardiovascular disease

Lowers blood pressure, reduces LDL cholesterol, reduces heart attacks and strokes.

Coronary artery bypass surgery survival impact

Only about 10% of patients extend life significantly.

What happens to grafts after coronary artery bypass?

Many fail within 12–18 months.

Stenting vs lifestyle changes

Lifestyle changes are better for long-term survival unless done immediately after a heart attack.

3 cause of death in the U.S.

Adverse drug reactions (prescription drugs).

Key point about chronic diseases

They are mostly preventable but poorly managed.

1 preventable cause of death in the U.S.

Tobacco use.

Chemicals in cigarette smoke

Over 7,000, with at least 250 harmful substances.

Most dangerous components of tobacco smoke

Nicotine, tar, and carbon monoxide.

Nicotine’s primary effect

Stimulates dopamine release = pleasure and addiction.

What does tar in tobacco smoke do?

Contains carcinogens that cause cancer.

What does carbon monoxide in tobacco smoke do?

Interferes with blood’s ability to carry oxygen.

How fast does nicotine reach the brain after inhaling?

7–10 seconds.

What neurotransmitter does nicotine primarily affect?

Dopamine.

Half-life of nicotine

About 2 hours.

Half-life of cotinine

About 16 hours.

Why do withdrawal symptoms occur?

Brain receptors reset during absence of nicotine.

Common nicotine withdrawal symptoms

Irritability, anxiety, increased appetite, insomnia, cravings.

When do nicotine withdrawal symptoms peak?

2–3 days after quitting.

When do nicotine withdrawal symptoms usually subside?

Within 2–4 weeks.

What is Pack-Year History?

(Packs smoked per day) × (Years smoked).

Example of pack-year calculation

1 pack/day for 20 years = 20 pack-years.

High-risk smoking history based on pack-years

30+ pack-years.

Importance of pack-year history

Guides lung cancer screening and cardiovascular risk assessment.

What is the Fagerstrom Test used for?

Measures nicotine dependence.

Fagerstrom score indicating high dependence

≥5.

Two key Fagerstrom questions for screening

Time to first cigarette after waking, and number of cigarettes per day.

Nicotine withdrawal symptoms to teach patients

Cravings, mood swings, trouble sleeping, hunger.

Why do people smoke?

To cope with stress, emotions, habits, addiction.

Special considerations for adolescent smokers

Highly influenced by peers, underestimate addiction risk.

Special considerations for pregnant smokers

Increased risk of miscarriage, preterm birth, low birth weight.