PUBHLTH 200 EXAM 2 - UMICH

What impact do personal health behaviors have on premature deaths?

Half of all premature deaths are caused by health behaviors.

How much of health expenditures go towards health behaviors?

Only 4%

Why do people engage in unhealthy behaviors?

Lack of knowlege, psychological environment, Risk perception, Peer pressure/role modeling, Physical environment, Community norms,

Benefits immediate and costs deferred, Economic influences, Addiction and Habit, Policy environment, FUN

What are the 5 levels of influence in the ecological model?

Intrapersonal, Interpersonal, Institutional/Organizational, Community, Societal/Public Policy

Intrapersonal level of influence

Biological Factors (genetics), Beliefs, Knowledge, Personal Finances, Skills, Attitudes, Preferences, Self-efficacy

Interpersonal level of influence

Friends, Families, Partners, Role modeling, Peer pressure, Social support

Institutional/Organizational level of influence

Workplace, School, Religious groups, Social Groups

Community level of influences

Community initiatives, Neighborhood characteristics, Relationships between organizations, Community norms - example is sidewalk availability

Societal/Public Policy

Media, Zoning, Social norms, Laws, Enforcement of laws - example is smoking laws/policies

Overall, how are health outcomes influenced?

The interactive characteristics of individuals and environments, and INDIVIDUALS are embedded within larger social systems

What are major health behavior risks?

Smoking Tobacco, Poor diet, Lack of exercise, Alcohol use

What types of causes are alcohol-related deaths due to?

acute (quick) and chronic causes

Why is it challenging to talk about alcohol use in a public health perspective?

There's a U shaped relationship that shows drinking in moderation is better than drinking in heavy or non-existing rates. Moderate drinking is complicated to teach to the public, making it challenging

How much alcohol on average do consumers drink?

Majority of drinkers drink in moderation, then binge drinkers, then heavy drinkers

Which group is alcohol abuse the most common in?

Young adults (18-25); linked to a significant number of injuries among this group (death, assault, sexual assault/rape)

What is an example of a public health success?

Reduction of motor vehicle injuries through targeted safety efforts

What is an exampke of a public health failure?

Firearm Deaths

What are the health consequences of smoking?

1/5 of all US deaths, and leaves many Americans disabled

What are the major causes of Tobacco Related Deaths?

Lung cancer, Chronic Obstructive Pulmonary Disease (COPD), Cardiovascular Disease

What is the leading cause of cancer death in both men and women?

Lung Cancer

How many chemical compounds does smoking introduce in a humans body?

7000, 70 are known human causes of cancer

Name examples of chemicals in Cigarette Smoke

Arsenic, Carbon monoxide, formaldehyde, hydrogen cyanide, polonium 210

How has the rate of smoking changed in Adults and High School students?

Both declined, but smoking in kids is way lower now

How do you calculate Adult per Capita Cigarrette Consumption?

Total cigarretes/population 18 and older

What are the three policy interventions?

Information and Education, Incentives(tax increase), Laws and Regulations

What is the most effective policy intervention?

Tax increase, falling int Incentives

Why is it difficult to address the public health issue of smoking?

Very few people who want to quit smoking are successful, many are heavily addicted and have low SES/education, many are mentally ill, some people do not want to quit.

What are limitations of Tobacco control?

Tax and regulation limits on minimum price, only half of states remain in becoming smoke free, media campaigns are costly, cessation assistance requires better tools

How does the public health community view E-cigs?

Divided, half are opposed and half are in support

Who is in opposition of E-cigs?

PH Establishment (CDC, State, and local health depts.)

Who is in support of E-cigs?

Harm Reductionists

What are the two main FDA Nicotine Product Continuum of Risk Plan features?

Reduce nicotine in cigarettes to non-addicting levels, and encourage innovation in non-combusted nicotine delivery products

Who is still smoking? Why do they still smoke?

Poor, institutional, rural southern states

Why won't mental facilities attack the Tobacco companies that target mentally ill clients?

people are addicted to illegal substances, so it's better for them to be addicted to LEGAL tobacco products

Is there any emotional benefits proven, demonstrating why people still smoke?

Helps lower negative effects of nicotine withdrawal, gives people a false sense of satisfaction

Why is there a strong prevalence of smoking in the military?

Because of the history, free cigarette packs caused young men to be addicted

What factors have contributed to the decline in rates of smoking among young people?

many policies prevent consumption/purchase, young people are more likely to take up vaping, the social norms have changed

What is the difference between smoking and e-cigarette/vaping?

Smoking has the combustable forms of tobacco, meanwhile e-cigarette has e-liquid

Is vaping advertisement targeting young people legal?

No, certain things that attract children like flavors and video games are removed by the FDA

List nicotine containing products in the order of least harm to most harm

No affiliation, FDA approved gum/pouches, E-cigarettes/non-combusting vaping, Tobacco combusting smoking

Why is vaping so controversial? How does vaping connect to other issues?

The US hyperfocuses on protecting young people from vaping addiction, some people are not willing to put their kids at risk to lower smoking rates

What does research show on vaping harms?

As of now chemical profile for each product is different with different effects; increased heart rate and signs of addiction; are not harmless; biomarkers are not zero but are way lower than smoking; VAPING IS NOT AS DANGEROUS AS SMOKING

What is obesity?

A complex or reoccuring state of excess adipose tissue that may affect health resulting from a variety of factors

What factors contribute to obesity?

Genetics, Diet/Nutrition, Physical Inactivity, Sleep, Environmental exposures

What is the Dietary Reference Intake (DRI)?

Amount of energy or nutrients on average an individual should consume per day to stay healthy

What are the Dietary Guidelines for America (DGA)?

A detailed report for professionals that provide resources in hopes of promoting healthy behaviors to prevent chronic disease, and to provide tools for individuals to monitor food intake

What are the Physical Activity Guidelines for Americans?

Provides benefits like disease prevention, sleeping better, feeling better, and performing daily tasks better

What is the Diabetes Prevention Program (DPP)?

It was a nationwide randomized trial with 3200 overweight/obese PRE-diabetic adults; placed in 3 prevention groups that ranged in intensity

Results were a 58% reduction in diabetes incidence with lifestyle intervention, and a 31% reduction with metformine (Medicine)

Why was there a Mandatory fortification of folic acid in wheat flours and cereals?

Lack of folate intake was inversely associated with occurrence of Neural Tube Defects in newborns (NTD), the fortification has caused a huge drop in NTD cases

What are other examples of Fortification efforts in the US?

Iodine in salt, Vitamin D in dairy products, Biacin/riboflavin, iron, calcium in flours, natural fortification of cows

Why is Mental Health a Public Health Issue?

50% of people will experience a mental health disorder in their lifetime; it's a leading cause of disability/morbidity/death; college students will shape our future

What is the most common cause of disability for young adults?

Mental health issues

What are the 2 main data sources in the MH lecture?

Healthy Minds Society and Hope Center Basic Needs Survey

How many college students experience a diagnosable mental health concern?

Around 10.5 million

What has contributed to the rise in Mental Health prevalence?

COVID - increased severe depression/academic impairments/barriers to care, decreased binge drinking/accessibility of student services

Social Media

Sociopolitical events (2016 election)

What are Mental Health Risk Factors?

Financial Stress, Sleep problems, Abuse/assaults, Discrimination

What students are at a higher risk of Mental Health?

Gender minorities, Sexual minorities, International students, Students of Color

In comparison to 4-year institutions, what are inequities among community colleges?

Higher prevalence of Mental health, Lower odds of receiving services, less likely to offer counseling/providers/crisis hotlines

What are possible public health approaches that schools could take?

Adress basic student needs (housing, food), promote social networking (support systems among students), provide and enhance mental health services to make them more accessible

What is effective in improving mental health?

Screening, skill training with supervised practice, means restriction (better infrastructure)

What is ineffective in improving mental health?

Psychoeducation, Gatekeeper

What is Mental Health?

A state of mental welbeing that enable people to cope with stresses of life, realize their abilities, learn and work well, and contribute to their community

What impact does Mental Disorders have on our society?

They are among the leading causes of disability, and among the costliest health conditions

What are barriers to receiving mental health care?

Insurance, stigma, lack of diversity in providers, system distrust, inadequate health service support in safety net settings (medicaid, or uninsured)

What are mental health disparities between?

Attention to mental health is less than other Public health issues; the health of mentally ill patients in lower than those who are not; popilations with respect to Mental Health and quality, accessibility, and outcomes of care; RACIAL MINORITIES BEAR A HIGH BURDEN OF MENTAL DISORDER CAUSED DISABILITY

What are the Social Determinants of Health?

Economic stability, Neighborhood and Physical Environment, Education, Food, Community and Social Context, Health Care System

What are injuries?

intentional or unintentional harm that is influenced by behavior of a person, social and physical environments; IS NOT AN ACCIDENT

What is the leading cause of death for Americans ages 1-24? What specific injury?

Unintentional injuries; Gun violence

Why is everyone not at the same risk for injury?

Race, SES, environment/neighborhood, gender all impact how those groups of people recover from injury, their acces to treatment, and proper injury recovery/care knowledge

What are the 3 levels of prevention?

Primary, Secondary, and Tertiary

What is Primary Prevention?

Overall preventing injury or illness before it occurs (pre-injury)

What is Secondary Prevention?

detecting illness at its earliest stage to prevent progression to serious disease (during injury)

What is Tertiary Prevention?

condition is already present, goal is to avoid death or further disability (post-injury)

What has lowered rates in occupational injury and death?

challenges in policy/law, enforcement of policy/law, and shift in the nature of work (child labor, etc.)

What types of substances contribute to poisoning related deaths/injury?

Opioid, alcohol, cocaine, etc.

How have opioid related injuries and deaths changed as of recently?

Have greatly increased in 2020, likely due to the COVID-19 pandemic.

How is opioid poising different in men and women?

Men are more likely to die from opioid use, but women have had steeper increases in opioid deaths

What are overdose health disparities?

Black people are more likely to die from any cause overdose compared to white people; American Indian/Alaskan Natives are more likely to die than white/black people from any drug

What has caused a notable decrease in motor vehicle traffic accidents?

Changes in driving environment, strides in policy, and improvements in vehicle safety

What is the Haddon Matrix used for?

to help understand, prepare for, and respond to a broad range of public health emergencies; consists of pre/during/post injury and agent/evironment(s)/host categories

What are Traumatic Brain Injuries?

Brain injuries that range in severity from mTBIs/concussions to death

What are short term consequences of Traumatic brain Injuries?

Brain fog, headaches, nausea, mood swings, dizziness

What are long term consequences of Traumatic Brain Injuries?

Lasting physical symptoms, changes in mood, trouble thinking, depression

What are heath inequities in relation to TBIs?

awareness of symptoms and access to healthcare may differ by race, education levels, and financial resources

What is Intimate Partner Violence (IPV)?

Physical, emotional, or sexual abuse by a current or former intimate partner

What is the trend between TBIs and IPV?

Physical injury is common; women are more likely to be injured by intimate partners, and more likely to have worse outcomes after a TBI

How prevalent is gun ownership in the United States?

It's present in less than the majority of households, yet those who live in a home with a gun are 3 times more likely to die by homicide and 7 times more likely to die by suicide.

What are gun related deaths and injuries consisting of?

Intentional (suicide and homicide) and unintentional (accidental) injury

Who is more likely for domestic homicide?

Women

What are the three different types of environmental stressors?

Physical, Chemical, and Biological stressors

What are examples of Chemical stressors?

Cleaning products, Cigarette smoking, Lead in drinking water, Carbon Monoxide, Bisphenol A

What are examples of Physical stressors?

UV Radiation, Cellphone Radiation, Musculoskeletal, Vibration

What are examples of Biological stressors?

Animals, Salmonela, Influenza, Tuberculosis, Zika

How many chemicals are in US Commerce?

around 85000 organic or inorganic substances that are used in products or present in the environment

What is High Production Volume (HPV)?

The 3000 chemicals we produce or import the most (at 1,000,000 pounds/year)

What are the 6 basic tests/screenings used to determine roughly a chemicals toxicity?

Acute toxicity, Chronic Toxicity, Ecotoxicity, Mutagenicity, Developmental and reproductive toxicity, an Environmental Fate

How many HPV miss 1 or more tests? How many miss all of them?

97%; 43%

How much of the world population is impacted by polluted water?

5 billion or 67% of population

How has the US been impacted by polluted water?

The US is not secure on clean water due to the overuse of aquifers and contamination

How does Air Pollution impact Americans?

127 million or 37% of americans live in areas that exceed National Ambient Air Quality Standards; WHERE YOU LIVE DETERMINES THE AMOUNT OF AIR POLLUTION YOU'RE EXPOSED TO