hhsc 1700

weeks 1-6

What is the definition of public health?

Public health is the science and art of preventing disease, prolonging life, and promoting health through organized community effort.

What era of public health focused on organized community efforts for health promotion?

Health Protection (Antiquity-1830s)

What movement emerged in the mid-1800s emphasizing disease as a consequence of social conditions?

Hygiene Movement (1840s-1870s)

Who is known for establishing the importance of data collection in epidemiology?

John Snow

What significant public health intervention did John Snow implement to control cholera?

He closed down the contaminated Broad Street pump.

What did Ignaz Semmelweis contribute to public health?

He instituted a handwashing procedure that dramatically reduced maternal mortality from perpetual fever.

What theory was developed by Louis Pasteur in the late 1800s?

Germ theory of disease.

What was a key focus of public health from the 1950s to mid-1980s?

Assisting clinicians in delivering clinical services and integrating preventive efforts into medical practice.

What characterized the health promotion/disease prevention era from the mid-1980s to 2000?

A focus on individual responsibility for health and interventions targeting behavioral change.

What is the focus of population health in the 2000s?

Community-wide public health efforts and systems thinking to address health issues.

What is the difference between evidence and references in public health?

References are not evidence; evidence must explain causal logic and empirical patterns.

What is the high-risk approach in public health?

It focuses on individuals with the highest probability of developing disease to reduce their risk.

What does the improving-the-average approach assume?

That everyone has some degree of risk, with most disease occurring among those with modestly increased exposure.

What is the single most important factor influencing causes of death and disability?

Age.

What are the three general categories of health interventions?

Healthcare, traditional public health, and social interventions.

What does healthcare include in the context of public health?

Delivery of services to individuals, including clinical prevention like vaccinations and screenings.

What are traditional public health interventions focused on?

Population-based interventions targeting general communities, such as disease control and environmental safety.

What are social interventions aimed at in public health?

Achieving non-health goals like economic growth and social justice, which may indirectly improve health.

What evolutionary response affects the birth ratio of boys to girls?

A slightly higher chance of giving birth to a boy due to boys being more likely to die in childhood.

What has contributed to the recent population growth in the US?

In-migration.

What is the birth/replacement rate change from the 1800s to the early 1900s?

The average US woman had 7.04 children in the 1800s, which decreased to 3.56 by the first decade of the 1900s.

What has been the birth rate in the US since the early 1970s?

The birth rate has been below the replacement rate of 2.1, with 1.73 children per woman in 2018 and 1.66 in 2023.

What was the life expectancy at birth in the US in 2020?

78.28 years for the total population, 73 years for males, and 79 years for females.

What is a confounder in health studies?

A confounder is an unmeasured variable that influences both the dependent and independent variables, potentially skewing results.

What is heart disease?

A collective term for various diseases of the heart and blood vessels, affecting 47% of adults over 18.

What is atherosclerosis?

The thickening/hardening of arteries due to fat, cholesterol, and other substances, which can lead to strokes and heart attacks.

What occurs during a heart attack?

A coronary artery becomes blocked, preventing oxygen from reaching the heart, leading to chest pain and difficulty breathing.

What is angina?

Chest pain caused by narrowed arteries that restrict oxygen to the heart during high demand.

What is arrhythmia?

An irregular heartbeat that can lead to sudden cardiac death if extreme.

What are common symptoms of a heart attack?

Chest discomfort, shortness of breath, nausea, and in women, back or jaw pain.

What is cancer?

Any abnormal, uncontrolled multiplication of cells that can lead to death if untreated.

What are benign tumors?

Non-cancerous tumors that are only dangerous if they interfere with body function.

What is metastasis?

The spread of cancer cells from one part of the body to another.

What is the cohort effect in cancer studies?

Trends observed within a population range, often due to generational characteristics affecting health outcomes.

What are the major types of cancer?

Carcinomas, sarcomas, lymphomas, and leukemia.

What is the obesity prevalence in the US as of 2020?

41.9% of adults were classified as obese.

What are proximal and distal determinants of health?

Proximal determinants are immediate causes of disease, while distal determinants are more remote factors influencing health.

What does the acronym BIG GEMS stand for in determinants of disease?

Behavior, Infection, Genetics, Geography, Environment, Medical Care, Socioeconomic-Cultural.

How does smoking relate to health risks?

Smoking is a significant risk factor for cancer, emphysema, and premature death.

What is the difference between sex and gender?

Sex refers to biological characteristics, while gender refers to societal roles and behaviors associated with being male or female.

What is the impact of a sedentary lifestyle on health?

It increases the risk of chronic conditions, especially heart disease.

What are the signs of a heart attack in women?

Chest discomfort, shortness of breath, nausea, and pain in the back or jaw.

What is remission in cancer?

The disappearance of signs and symptoms of cancer.

What is the role of genetics in cancer?

Genetic factors can contribute to the development and progression of cancer, but are not always the most important determinant.

What is coronary bypass surgery?

A surgical procedure to restore blood flow to the heart by diverting blood around blocked arteries.

What are the common risk factors for chronic diseases?

Age, sex, smoking, obesity, and a sedentary lifestyle.

What is the significance of socioeconomic status in health?

Lower socioeconomic status is associated with shorter life expectancies and higher rates of illness.

How does alcohol affect men and women differently?

Men become less intoxicated at a given level of alcohol intake, while women become more intoxicated.

What are the health risks associated with alcohol use?

Alcohol use is a huge risk factor for liver disease and STIs.

What smoking-related health issue affects women more than men?

Women have lower rates of smoking but higher rates of lung cancer at a given level of exposure to smoke.

What is the relationship between obesity and chronic diseases?

Obesity is a significant risk factor for heart disease and diabetes.

How does income level affect health outcomes in the US?

Low-income families have a two to five times greater probability of developing disease than higher-income families.

What is the neonatal mortality rate associated with poverty status?

Poverty status is associated with a 60% higher rate of neonatal mortality.

How does ethnicity influence health outcomes in the US?

Ethnicity is linked to health outcomes independent of socioeconomic status, with effects varying across age and disease categories.

What is a biological difference that affects health in specific ethnic groups?

Certain diseases, like sickle-cell disease, are more common in specific gene pools, such as among people of African ancestry.

What cultural factors can influence health?

Cultural differences can affect diets, family relationships, and attitudes towards substances like tobacco and alcohol.

What are some health characteristics of Latinos in the US?

Latinos have lower rates of heart disease, cancer, and suicide but higher rates of infant mortality and diabetes.

What health issues are of special concern for Black/African Americans?

Higher infant mortality rates, high blood pressure, stroke, diabetes, asthma, and obesity.

What are the smoking rates among Asian Americans?

Lower overall smoking rates, with significant variation by country of origin; for example, 5% of non-Hispanic Asian adults smoke.

What are common health concerns for Caucasian/White Americans?

Higher levels of suicide and similar health concerns as Latinos, including diabetes and obesity.

What are the three key changes in populations that public health must consider?

Demographic changes, epidemiological shifts towards chronic disease, and nutritional shifts from malnutrition to obesity.

What are the four areas to consider when judging information in public health?

Validity, accuracy, completeness, and timeliness.

What are the five basic questions of the evidence-based public health approach?

1. Problem: What is the health problem? 2. Etiology: What are the contributory causes? 3. Recommendations: What works to reduce health impacts? 4. Implementation: How can we get the job done? 5. Evaluation: How well do the interventions work?

What does the burden of disease refer to?

The occurrence of disability and death due to a disease, also known as morbidity and mortality.

What is the difference between incidence rates and prevalence?

Incidence rates measure the number of new cases of a disease in a given time period, while prevalence measures the total number of existing cases at a specific time.

How is case-fatality calculated?

Case-fatality is calculated by dividing the mortality rate by the incidence rate.

What does high prevalence of a disease indicate?

High prevalence indicates that many individuals have the disease at a given time, often suggesting a need for healthcare services.

What demographic factors do epidemiologists investigate?

Epidemiologists investigate factors such as age, gender, race, and socioeconomic status to find patterns in disease frequency.

What does the term 'place' imply in epidemiology?

Geographic location and nonphysical connections between people, such as a university community or shared Internet site.

What are risk factors?

Factors that occur more frequently among groups with a disease than among groups without the disease.

How did the distribution of lung cancer mortality differ between men and women in the 1930s-1950s?

Lung cancer mortality rates were dramatically higher among men than women, although rates among women began to increase by the 1950s.

What relationship was observed between cigarette smoking and lung cancer mortality?

The relationship was strongest in states where cigarette smoking was most common, suggesting an association between smoking and lung cancer mortality.

What is the significance of group rates in studying lung cancer mortality?

Group rates indicate that populations who smoke more frequently also have higher mortality rates from lung cancer, helping to generate hypotheses about causation.

What is the PERIE framework in epidemiology?

A stepwise approach to describe health problems and establish causal relationships: Problem, Etiology, Recommendations, Implementation, and Evaluation.

What is the first step in the PERIE framework?

Describing the health problem under study.

What is a case-control study?

A study that compares people with and without an outcome to assess exposure to risk or protective factors.

What is a cohort study?

A study that follows people over time to compare outcomes between exposed and unexposed groups.

What is a randomized controlled trial?

A study design that assigns different exposures to different groups to determine the effect of those exposures on outcomes.

What are the three criteria for establishing contributory cause?

1. The cause and effect occur more frequently in the same individual than expected by chance. 2. The cause precedes the effect in time. 3. Altering the cause alters the effect.

What does 'relative risk' indicate?

The probability of developing a disease if the risk factor is present compared to when it is not present.

What is the dose-response relationship?

A principle that suggests greater exposure to a risk factor is associated with a greater chance of developing the disease.

What does 'biological plausibility' refer to in epidemiology?

The ability to explain the occurrence of disease based on known and accepted biological mechanisms.

What is age adjustment in epidemiological studies?

A method to reduce the confounding effect of age by using a weighted average of age-specific rates.

What are common criteria for judging the quality of evidence in epidemiology?

Reproducibility, logical consistency, plausibility, and scrutiny.

How did the study of fluoride and cavities illustrate the impact of place on health hypotheses?

High incidences of brown teeth in Colorado Springs were linked to a common water source, leading to the hypothesis that fluoride might protect against cavities.

What is the significance of mortality data in studying lung cancer?

Mortality data can serve as a substitute for incidence data when evaluating the overall burden of lung cancer in a population.

What alternative explanation was considered for the increase in lung cancer mortality rates?

The possibility that increased mortality rates were due to an aging population rather than solely due to smoking.

What is the importance of consistency in epidemiological studies?

Consistency implies that studies across different areas and groups produce similar results, strengthening the evidence for causation.

What is the role of hypotheses in epidemiology?

To generate explanations based on observed associations between groups and health outcomes.

What is the relationship between interest in disease and observed rates?

Increased interest or ability to identify a disease can artificially inflate observed rates, necessitating careful analysis.

What is the significance of the historical context in understanding lung cancer trends?

Understanding historical trends helps to contextualize the relationship between smoking and lung cancer mortality over time.

What determines a person's sun sign?

A person's sun sign is determined by the zodiac constellation the sun was in at the time of their birth.

What is the difference between the sidereal zodiac and the tropical zodiac?

The sidereal zodiac divides the ecliptic into 12 regions based on constellations, while the tropical zodiac links the signs to the seasons.

What are the four elements associated with zodiac signs?

Fire (Aries, Leo, Sagittarius), Water (Cancer, Scorpio, Pisces), Earth (Taurus, Virgo, Capricorn), Air (Gemini, Libra, Aquarius).

What is the purpose of primary prevention in public health?

Primary prevention aims to prevent disease before it occurs, such as through sex education.

What is secondary prevention in public health?

Secondary prevention occurs after disease development but before symptoms appear, focusing on early detection and intervention.

What does tertiary prevention aim to achieve?

Tertiary prevention occurs after symptoms manifest, aiming to prevent severe progression of illness.

What does the RE-AIM framework evaluate?

RE-AIM evaluates the reach, effectiveness, adoption, implementation, and maintenance of public health interventions.

What are the 7 S's of quantitative sources of public health surveillance data?

Single case studies, Statistics, Surveys, Self-Report, Sentinel monitoring, Syndromic surveillance, Social media.

What is sentinel monitoring?

A surveillance system used to gather high-quality data about specific diseases from selected reporting units.