HLTH-240 QUIZ Test Review

what are some health trends in the 20th century that were affected by changes in the U.S. society over the

years?

• sanitation + clean water

• vaccines

• mother and child health

these all helped to increase life expectancy, changes in the leading causes of death, etc

what was the leading cause of death then and what did it shift to in the 20th century?

then: infectious/communicable diseases

20th century now: noncommunicable chronic diseases

what were the findings of the Seven Countries Study

• developed by Ancel Keys, a physiologist

• studied the association between blood cholestrol/fat intake level and risk for coronary heart disease + cancer across seven nations

• heart disease was not as common in Mediterranean countries due to the Mediterranean diet

• lifestyle risk factor like high blood pressure, smoking, and physical inactivity were universal predictors of heart disease across all populations

what does the mediterranean diet consist of?

plant-based foods such as whole grains, vegetables, legumes, nuts, seeds, olive oil, etc 

• fish, seafood, dairy and poultry are included in moderation

• red meat and sweets are eaten only occasionally

Primary prevention

interventions that take place before a person gets a disease or health condition

• goal is to reduce exposure to hazards and to prevent disease onset early

Secondary prevention

measures aimed at early detection, screening and prompt intervention to identify and treat disease (which is currently asymptomatic) or risk factors and slow its progression

Tertiary Prevention

interventions focused on managing existing, diagnosed chronic diseases or injuries to prevent further deterioration and to optimize function and quality of life

what was the early community health promotion program in North Karelia, Finland

a program used to help community in finland that had the highest rates of cardiovascular disease like heart disease in the world

• this was due to high smoking rates, unhealthy diets high in saturated fats, high blood pressure, high cholesterol, etc

• this was mostly among middle aged men

the program helped to change the community’s environment and habits

• encouraged healthier eating

• worked to reduce smoking

• trained healthcare workers

• used mass media to make information widely available

because of this smoking decreased, blood pressure decreased, etc

what is lifespan

the total number of yrs an individual lives from birth to death

what is healthspan

the # of yrs lived in good health, free from chronic disease, injury, etc

“healthspan is the new lifespan”

the major shift in public health where researchers now focus on how long a person lives in good health

what are the structural determinants of health

the macro-level social, political, and economic mechanisms that shape individual living conditions and drive health inequities across populations

what are the social determinants of health

the conditions in which people are born, grow, live, work, and age

• conditions are influenced by the distribution of power and resources (including intergenerational wealth and income)

social determinants of health framework

a way of looking at health that recognizes that health is influenced by more than just medical care and individual choices

health equity

implies a pledge to eliminate health inequities and their causes, most of which are rooted in the structural determinants of health

health inequity

systematic differences that could be avoided by reasonable means

health disparities

a concept used in the US to indicate measurable differences affecting disadvantaged population groups

examples of health disparities experienced by population groups

• black women and maternal mortality rates

• LGTBQ populations and higher rates of mental health issues

• Black, Hispanic, Native American, Pacific Islander people are more likely to be diagnosed with HIV or AIDS than White people

upstream approach

an approach in the medical field where doctors and professionals address the root cause of a health problem instead of dealing with it when the problem starts happening

CDC’s Whole Child, Whole School, Whole Community Model

framework for helping to address health in schools through physical fitness activities, providing free school lunches, etc

role of local health departments in health promotion

• coordinate programs covering areas like tobacco control, chronic disease prevention, etc

• conduct direct community activities such as blood pressure screenings, etc

role of nonprofit/voluntary organizations in health promotion

• help raise awareness

• focus their efforts around a specific health concern

• work alongside local and state health deps to address factors in the community that government agencies may not be able to resolve on their own

what is the history of health promotion and opportunities for health promotion in the workplace

• in early 20th century workplaces focused on worker safety, injury prevention, etc

• they started adopting wellness programs to encourage more activity and a healthier lifestyle due to employers recognizing lifestyle-related chronic diseases impacted employee productivity

• some programs led to developing fitness facilities, health screenings, and other programs for employees

healthcare/medical settings: opportunities, limitations

• healthcare setting focused primarily on secondary and tertiary prevention so they were just treating diseases rather than preventing them

• providers started to recognize the value of incorporating primary prevention into patient care to manage chronic condition and improve long-term outcomes

lack of staffing

training gaps

clinical preventive services

why do we study theories

they provide systematic framework for understanding, planning, evaluating, etc health programs

constructs of health belief model

• perceived susceptibility

• perceived severity

• perceived benefits

• perceived barriers

• cues to action

• self efficacy

constructs of Transtheoretical Model/Stages of Change

1. Precontemplation ( no intention)

2. Contemplation (starting to think abt it and the benefits)

3. Preparation (clear intentions to change behavior)

4. Action

5. Maintenance

6. Termination

7. Self-efficacy (confidence in ability to make change)

What does the TTM model recognize?

that slips (or also referred to as relapses) happen and that they are a normal part of the process

Social-Cognitive Theory

• describes a process in which “the social environment, the personal characteristics of the individual, and behavior interact and influence each other”

• theory has been influential in shifting the focus from asking why change unhealthy behaviors toward asking how to change unhealthy behaviors and replace them with healthy ones

socio ecological model

a framework used to explain how health behaviors and health outcomes are shaped by the interaction between individuals and their environment

• individual (intrapersonal)

• interpersonal (direct social environment and relationships surrounding the individual) ll

• organizational

• community

• societal

SMART goals

structured framework to ensure program objectives are clear, achievable, etc

what does SMART stand for?

• specific

• measurable

• achievable or attainable

• realistic

• time-specific

motivational interviewing derives from

the transtheoretical model

what is motivational interviewing

a counseling method for promoting health behavior change

what is the goal of motivational interviewing

to get clients to build their intrinsic motivation to make behavioral changes

what are the Four Skills of Motivational Interviewing

• reflective listening

• asking open questions

• affirming

• summarizing

what are the counseling principles for motivational interviewing

• express empathy

• develop a discrepancy

• roll with resistance

• support self-efficacy

How many people use tobacco products in the US?

30.8 million people

What percent of adult smokers begin by the age of 18?

90%

what are the disparities in smoking rates?

• individuals with income below the federal poverty threshold have higher smoking rates by 20%

• many other group are left behind meaning they lack access for cessation programs and these groups are LGBTQ community, military, black people, those living in rural areas, etc

associated health problems with smoking

• cancer

• secondhand smoking exposure

• cardiovascular disease

• lung disease

different type of tobacco/nicotine products

• cigarettes

• e-cigarettes

• cigars

• puffbar

• juul

• vapes

• zyns

groups most at risk to these products

• young adults & children

• black people

• people exposed to secondhand smoking

Historical federal and state policies to reduce tobacco

federal policies:

• warning labels becoming stronger and clearer on packaging

• legal purchasing age (21 yrs old)

state policies:

• restriction to smoke in public places

• flavored tobacco bans

Master Settlement Agreement

a joint lawsuit settled by 46 states in November 1998

• required tobacco companies to pay approx $246 billion over 25 yrs

• restricted certain forms of tobacco advertising

• restricted event sponsorship and prohibited targeting youth

effect of Master Settlement Agreement

it reduced tobacco sales causing a 21% decline in tobacco sales

what are the leading anti-tobacco media campaigns

• Truth

• The Real Cost

• Tips from Former Smokers

what does Truth do

empowers young people to not start smoking and discourages vaping

what does Tips from Former Smokers do

features real ppl sharing the consequences they experienced from smoking encouraging smokers to quit

• caused a 12% increase in quit attempts

what does the The Real Cost do

educates young ppl about the health risks and consequences of cigarette smoking and vaping

CDC recommendations for Comprehensive Tobacco Control Programs/evidence-based practices

programs:

• community-based organizations

• cessation services

• local and state partnerships

evidence-based practices:

• smoke free establishments

• increased tobacco prices

• affordable + accessible cessation services

health benefits of quitting

• lowers risk of heart disease, stroke, cancer, lung disease

• improves circulation

what are some concerns abt e-cigarettes, pouches, flavored tobacco products, etc

• many of these tobacco companies are targeting and appealing to children and young adults through their flavors

• menthol products becoming more used now because they make cigarettes less harsh and easier to inhale, enhances nicotine addiction, makes quitting harder

• misleading advertising of menthol products being less harmful

• menthol products have also been heavily marked to Black communities

History of eating behaviors and reasons for unhealthy changes in eating habits

• farming practices would influence eating behaviors

• food industry and marketing had an impact too

• availability of high processed foods

• large portion sizes

• sedentary lifestyles (ppl being less active)

• time constraints

health risks from unhealthy eating (ADD TO CHEAT SHEET)

• heart disease

• stroke

• cancer

• diabetes

• obesity

what are some clinical markers for heart disease (ADD TO SHEET)

• high blood pressure

• high blood glucose

• high blood cholesterol (LDL) (HDL)

how is weight measured and how do u measure

body mass index (BMI)

• measure of a person’s weight in kilograms divided by the square of height in meters

• originally developed to assess population health, not individuals

overweight vs obesity

overweight - 25.0 - 29.9 BMI

obesity - 30 and above BMI

limitations/criticisms of BMI

• limited for those with high muscle mass, elderly, pregnant, petite, and some racial and ethinic groups

• was first used as a noninvasive tool to assess population health, rather than the fatness or health of an individual

• was created as an effort to reflect the “average man” at a population level

what are some factors that influence personal food choices/availability

• cost as healthy food can be expensive

• time as busy schedules can make convenient foods more appealing

• accessibility of healthy foods overall

• unhealthy foods being advertised

• schools and workplaces

obesity

excel accumulation of fat in the body and thru the use of the BMI

obesity trends

• 42% of Americans are obese

• obesity has increased over time

• higher obesity rates among certain groups (hispanics, african americans, and poor states

• obesity is linked to other health problems

food insecurity

not having physical and economic access to sufficient safe and nutritious foods that meets dietary needs and food preferences for an active and healthy life

what percentage of American households in 2023 were food insecure

13.5%

how did COVID affect food insecurity?

it increased rate of food insecurity by 4%

recommendations from the 2020 Dietary Guidelines

1. eat variety of vegetables (dark green and orange veggies, legumes, and starchy vegetables

2. choose whole fruits

3. make at least half of grains whole grains

4. choose fat-free or low-fat diary

5. eat variety of protein foods (seafood, poultry, eggs, beans, soy products, etc)

6. limit saturated fats, trans fats, added sugars, and sodium

7. stay within appropriate calorie level

criticisms of dietary guidelines

• cultural representation

• accessibility and inequality

• limitations of MyPlate

what are the limitations of MyPlate

• doesn’t give enough guidance on choosing the most nutrient-dense foods

• doesn’t show physical activity or emphasize enjoyment of food

concerns abt 2025 Dietary Guidelines

• too much emphasis on protein, especially animal protein

• less emphasis on whole grains and fiber

• contradictory fat recommendations

nutrient dense foods

foods and beverages that provide vitamins, minerals, and other substances that contribute to adequate nutrient intake or have positive health effects, w/ little or no solid fats and added sugar, refined starches, and sodium

eating for heart health

• leading cause of death in the US but a healthy diet helps reduced risk

• limited saturated fat, trans fat, sodium, added sugars, etc

• eat more fruits, veggies, legumes, seafood, etc

• choose omega 3 fatty acids from food sources

• physical activity

• mediterranean diet

fad diets

a popular or trendy diet that is intended to serve as a “quick fix” that results in weight loss

healthy eating patterns tips

• emphasize food and nutrients to include instead of avoid

• variety of veggies, whole fruits, whole grains, protein foods

• choose nutrient dense foods

• limit added sugars, saturated + trans fats, and sodium

tips for eating for a healthy planet/sustainability (Healthy Plate/Healthy Planet PPT)

• sustainable diets

• emphasize plant-based foods

• reduce food waste

• choose sustainable protein sources

reasons for change in physical activity patterns

• sedentary lifestyles and jobs

• white collar jobs

• screen time

• time contraints

rise in sedentary behavior

• societal changes in the 20th century

• 25% of American sit for more than 8 hrs a day

• explosion in screen time

even those who engage in exercise sessions but sit for most of the day are at risk for what

• type 2 diabetes

• heart disease

• overweight/obesity

• poor mental health

• musculoskeletal dysfunction

benefits of physical activity

lowers risk of:

• early death

• heart disease

• stroke

• type 2 diabetes

• high blood pressure

• better cognitive function

• better functional health

• reduced abdominal obesity

• increased bone density

• improved sleep quality

Physical Activity Guidelines for adults

• 150 mins of moderate intensity activity or 75 mins of vigorous intensity activity each week ( or combination)

• muscle-strengthening activities involving all major muscle groups 2 or more days weekly

• move more, sit less through the day

Physical Activity Guidelines for children

• 60 mins or more of moderate to vigorous physical activity daily

• as part of it they should do muscle strengthening physical activity at least 3 days/week

• also bone strengthening physical activity on at least 3 days/week

moderate exercises examples

• biking on level ground

• canoeing

• brisk walking

• doubles tennis

• baseball, softball, volleyball

vigorous exercises examples

• biking faster than 10mph

• jumping rope

• running

• swimming laps

• hiking uphill

• basketball, hockey, soccer

moderate vs vigorous

if you can talk or sing while doing your exercise, it is moderate, if not it is vigorous

muscle strengthening benefits

• allows body to perform tasks of daily living with less stress

• reduces risk of injury

• reduces lower back

• alleviates arthritis

• promotes psychological well-being

• improves cholesterol levels

what are the four components of physical activity

• aerobic (endurance) activity

• muscle strengthening

• bone strengthening

• stretching

examples of muscle strengthening

• weightlifting

• push-ups and sit-ups

• squats and lunges

bone strengthening benefits

improve bone density by causing impact

bone strengthening examples

jumping rope, running, walking, resistance training

benefits of physical activity for older adults

• reduces chances of developing chronic pain

• lower pain scores overall when participating frequently in moderate to vigorous physical activity

• able to better block pain receptors

barriers to physical activity

• lack of time

• lack of motivation

• cost

• limited access

• lack of social support

facilitators to physical activity

• social support

• access to facilities

• motivation

• workspace or school programs that encourage physical activity

Thirdhand smoking

when smoking leaves chemical residues on surfaces where smoking has occurred, which can persist for a long time and then an individual can ingest these residues

the four biggest tobacco companies are referred to as….

Big Tobacco