Intro to Population Health Exam #1 (Chapters 1-5)

population

multiple individuals that share common characteristics

health

state of complete physical, mental and social well-being (not the absence of disease or infirmity)

public health

the science of protecting and improving the health of communities

population health science

the study of conditions that shape distributions of health within and across populations

early humans

nomadic hunters/gathers, people depended on eachother

middle ages

established and isolation

around the 1700s

u.s. marine hospital service was established

around the 1800's

edwin chadwick - pushed for improved health for economic reasons

lemuel shattuck - made the first system to record statistics

around 1912

u.s. public health services were established

around 1952

u.s. department of health, education and welfare were established

around 1979

u.s. department of health and human services were established made by the executive branch

20th century public health achievements

control of infectious disease, decline in CVD deaths, family planning, fluoridation of drinking water, healthy mothers/babies, motor vehicle safety, recognition of tobacco as a health hazard, safer/healthier foods, safer workplaces and vaccinations

21st century public health achievements

cancer prevention, childhood lead poisoning prevention and improved public health prepardness

core principles of prevention

it is the cornerstone of public health, focuses on creating conditions that keep populations healthy, and how dramatic gains in life expectancy is related to economic growth, infectious disease control and sanitation

why prevention matters

prevents illness and injury before they occur, reduces healthcare costs, improves productivity and quality of life

universal prevention

aimed at general population

selective prevention

aimed at subgroups with biological, psychological & social risk factors

indicated prevention

aimed at those with detectable signs/symptoms of a disease

local level of prevention

local government providing preventive services

national level of prevention

national screening and surveillance programs

global level of prevention

world health organization (who) and others support countries to develop national prevention protocols

primordial prevention

prevent emergence of risk factors in the first place (healthy lifestyles in early childhood)

primary prevention

reduce incidence of disease or injury in individuals already exposed to risk factors (vaccines, smoking programs for current smokers)

secondary prevention

early detection and treatment (mammograms, colonoscopys, pap smears)

tertiary prevention

manage ongoing disease and reduce impact (cardiac rehab, diabetes management)

screening

to detect disease early for effective treatment; WHO - only screen for serious diseases with reliable tests and effective early treatments

sensitivity of screening

precent of people with disease who screen positive - the test's ability to correctly identify a person with a disease

specificity of screening

precent of people without disease who screen negative - the test's ability to correctly identify a person without disease

false-positive fraction of screening

precent of people without a disease who screen positive

false-negative fraction of screening

precent of people with a disease who screen negative

health equity

ensures everyone can achieve the highest level of health possible given their current circumstances, requires valuing all individuals equally

health equality

provides equal treatment to all patients, regardless of background

health inequity

avoidable, unnecessary and unfair differences in health, inequities between more or less advantaged groups (race, socioeconomic position, sexual orientation)

5 domains of social determinants

healthcare access & quality, social & community context, education access & quality, economic stability, neighborhood & built environment

social determinants of health (SDOH)

non-medical factors that influence health outcomes

healthcare access & quality

the availability and quality of medical services

social & community context

supports networks and community engagement

education access & quality

opportunities for learning and literacy

economic stability

income, employment and financial security

neighborhood & built environment

housing, transportation, safety and environemental conditions

social ecological perspective

recognizes that health is influenced by multiple levels, considers interactions between the individual, different relationships, the community and society, shows that these levels shape public health outcomes

life course perspective

recognizes that health is shaped across the lifespan, emphasizes how early life experiences/exposures influence long-term health outcomes, promotes interventions that focus on prevention/equity across all stages of life (critical & sensitive periods are childhood, adolescence and pregnancy)

critical period

infancy and childhood, model that suggests how certain exposures can strongly influence future health outcomes (pregnant mom who drinks alcohol)

public health interventions

health interventions can be mapped onto a matrix of life course stages and the social ecological framework, illustrating how strategies apply across age groups and societal levels

global health production

health is actively produced through policies and interventions, there are coordinated efforts at local, national and global levels to address population health challenges

chain of risks

involves a domino-like sequences of risks, overtime a serious or fatal outcome may occur

accumulation of risks

a model that assumes that cumulative exposures or shocks throughout the life course increase the risk of disease later in life

sensitive period

adolescence and young adulthood, periods in the lifespan where exposures have a greater impact than others