Public Health: EXAM 2- Stats, Infections, Disease, Social Determinants

All difficult information from slide shows for Intro to Public Health

What do biostatistics monitor in public health?

Monitors the health of populations

What are the 4 vital biostats collected for public health monitoring?

Birth and death rates, marriage and divorce, fetal health, infant mortality

What data is collected from the U.S Census? Why

age, sex, race, ethnicity, relationship to everyone in the household; to get a count of the American population

What is the American Community Survey? What information does it collect? Why is it conducted?

Conducted by early on a select representative sample (around 3.5 million households) by the U.S Census Bureau to assess social and economic characteristics like education, housing, employment, transportation, language, and ancestry; helps plan for housing, healthcare facilities, and social services

What is the National Center for Health Statistics? How do they collect data (2)?

A part of the CDC that collects, analyzes, and reports data on the health of Americans; They collect data by checking local records of birth and death rates and notifiable diseases and they also conduct national surveys

What is the Behavioral Risk Factor Surveillance System (BRFSS)?

Conducted by government about health related risk factors, behaviors, chronic health conditions, and use of preventative substances via telephone for adults; It is the largest continuously conducted health survey in the world

What is the Youth Risk Behavior Surveillance System (YRBSS)?

Survey of middle and high school students every 2 years to mentor violence, sexual activity, alcohol and drug use, dietary behaviors, physical activity to inform school and community programs

What is the National Health and Nutrition Examination Survey?

Yearly survey conducted on 5,000 adults and children that asses health and nutritional status using physical examinations and tests along with surveys

Define confidentiality in data collection

removal of identifying information on individuals that requires institutional review and data protection committees

What was the main cause of death in previous centuries?

Infection

What were the deadliest pandemics? (year and death count)

Plague in 1300 which killed 75-200 million death; 1918 Spanish flu that infected 1/3 word and 50 million people died

What did industrialization lead to in terms of disease?

endemic disease and periodic epidemics due to poor sanitation and waste disposal

Define Isolation

separating sick people with a contagious disease from people who are not sick

Define quarantine

separating and restricting the movement of people who were exposed to a contagious disease to see if they become sick

Who was Edwin Chadwick? What did his publication find?

Lawyer in London who conducted studied of working class in 1838 and entire UL in 1842 who published the General Report on the Sanitary Conditions of the Laboring Populations of Great Britain; He found that the average age at death for individuals from upper class were 36, tradesmen=22, laborers 16 years. Proposed that diseases were caused by foul air from decomposing waste and suggested building a drainage network to remove sewage and waste. which leads to the 1848 British Public Health Act which reformed sanitation in the UK

Who was Lemuel Shattuck?

Massachusetts bookseller who collected statistics of mass population and documented morbidity and mortality rates in different localities. Argued that states take responsibility for the environment and recommended surveys of local health conditions, supervision of water supplies and waste disposal, and establishment of health boards, Mass set up State Board of Health in 1869 and eventually American Public Health Association was founded in 1872

Who was Louis Pasteur?

Microbiologists who developed Pasteurization to kill microorganisms in food and beverage

What did Robert Koch discover?

Identified causative organism for tuberculosis and cholera?

Who is W.T. Sedgwick?

Father of modern public health movement in america, Professor at MIR who developed sewage treatment methods and studied the epidemic of typhoid in Lowell using John Snow’s epidemiological methods and concluded that the water supply in Lowell was unsafe because of Merrimack’s River’s contamination from towns upstream

What are the 7 public health measures that control infections?

Purification of water, Sewage disposal, Pasteurization of milk, Immunizations

Improved nutrition, Personal hygiene, Antibiotics

Define Chain of Infection

pattern by which an infectious disease is transmitted from person to person

Define reservoir

habitat where the pathogen lives and multiplies

Define Human reservoir

Some pathogens spread from one human to another and have no other reservoir, e.g., STIs, measles

What 2 infections live in soil?

clostridium tetani and cholera

What are the 4 strategies for interrupting the chain of infection?

Kill pathogen, eliminate reservoir, prevent transmission, increase resistance of host

What is contact tracing? What is this frequently done for?

 locate people who have been in contact with infected individual and notify them and administer treatment or screening as needed; Done for STIs and tuberculosis

Define control of infections

 reduction in the incidence, prevalence, morbidity or mortality of an infectious disease to a locally acceptable level

Define elimination in infection management; What is a caveat?

 Reduction to zero of the incidence of an infection in a defined geographical area, i.e., infection is no longer continuously present, but Preventive measures (e.g., vaccines) are still required

What are examples of diseases that have been eliminated from the U.S ? (2)

Polio and measles

Define eradication in infection control; What is one infection that has been eradicated?

permanent reduction to zero of the worldwide incidence of infection caused by a specific agent Intervention measures (i.e., vaccines) are no longer needed; surveillance will continue; example is Smallpox

What are the criteria for eradication of an infection?

Biologic feasibility of eradication – if humans are the only reservoir for the disease

Availability of effective, practical intervention (e.g., drug, vaccine, etc.)

Burden of disease, disability and death should be high to justify eradication measures

Cost-effectiveness of eradication versus ongoing control

Operational and technical feasibility of implementing eradication strategies

Global capacity for political, financial, managerial and technical support needed for a worldwide initiative

What 3 diseases have the potential to be eradicated?

Smallpox, Polio, Measles

What causes smallpox? What is the mortality? When was it considered eradicated?

Variola virus; 30% mortality, 1980

Poliomyelitis – cause, mode of transmission, consequences, treatment, prevention, effort and challenges for polio eradication

Caused by poliovirus, spreads through fecal-oral route, effects nervousness system leading to paralysis mainly in children with no treatment available. Only Afghanistan and Pakistan have endemic polio

What are the challenges in polio eradication efforts? (5)

Myths about vaccine, Invisible cases, Vaccine must be administered several times, unsanitary conditions in developing nations, Political unrest

Measles – cause, chain of infection, consequences, eliminated from US – but elimination status at risk, MMR vaccine, challenge with vaccination

Highly contagious (90% of susceptible hosts will get infected upon exposure), spreads through coughing/ sneezing and contaminated surfaces, causes a rash, eliminated in 2000 but resurgence is happening with around 3,600 new confirmed cases in 2026

How many antimicrobial resistant infections occur in the US each year and how many people die?

2.8 million, 35,000 people die as a result

What causes antibiotic resistance?

Unnecessary prescription

Non-adherence to prescription

Unnecessary antibiotics used in agriculture

How can countries start trying to curb antibiotic resistance?

Lower antibiotic prescription, improve labs to identify organs and properly treat them, proper quarantine for patients with antibiotic resistant strains, collect and share data globally

Define emerging infectious diseases

infectious diseases that have newly appeared in a population or have existed but are rapidly increasing in incidence or geographic range

What are some examples of newly emerging/ re-emerging infections?

HIV, SARS, C.diff, MRSA, Ebola, Zika, COVID-19

What are factors within Pathogens that lead to the emergence of an infection?

Microbial agents’ genetic adaptation and change, Development of resistance to drugs

What are factors within Host that lead to the emergence of an infection?

Human behavior: e.g., international travel; IV drug use; vaccine hesitancy, Human susceptibility to infection (immunosuppression)

What are factors within World/ Environment that lead to the emergence of an infection?

ecological damage+ close contact with wildlife, Agricultural practices – extreme crowding of livestock, International distribution of food and exotic animals, Breakdown of public health infrastructure because of insufficient funding, political climate, war or other emergency, Change in climate and weather – affects vector-borne diseases

Define chronic disease

Conditions that last longer than a year and require ongoing medical care

Why are chronic diseases a public health concern?

8/10 causes of death are chronic disease and 6/10 Americans live with at least one chronic disease

What are the risk factors for heart disease? (3)

high blood pressure, high cholesterol, and smoking

What are some risk factors for various forms of cancer?

alcohol, tobacco, HPV, and obesity

What are 2 vaccines that can lower risk of cancer?

HPV and Hep B

What are some complications of diabetes? (3)

blindness, kidney disease, amputations of extremities

What are the 4 modifiable behaviors that can prevent a leading cause of death?

Tobacco use & exposure to secondhand smoke, Unhealthy diet, Physical inactivity, Excessive alcohol consumption

What is an intrapersonal factor for determinants of health?

Characteristics of the individual that influence their behavior

Example: Attitude of person, education level, age, gender, etc.

What is an interpersonal factor for determinants of health?

Interpersonal relationships of the person.

Example: Family and peers

What 3 things fall under socioeconomic status?

education, income and occupation

What are physical determinants of health?

Natural environment, worksite, housing, schools recreation settings etc

Define health equity

When everyone has the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of their social position or other socially determined circumstances