Untitled Flashcards Set

Below is a detailed response to your study guide outline for Test 2, covering all the listed topics and questions. I’ve organized it to align with your outline for clarity and conciseness, while ensuring comprehensive coverage of each point. Let’s dive in.

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### Infectious Disease Concepts

#### 1. Components of the Epidemiologic Triad in the Context of Disease

The epidemiologic triad consists of three components that interact to cause disease:

- Agent: The pathogen or cause of the disease (e.g., bacteria, virus, parasite). For example, Mycobacterium tuberculosis is the agent for tuberculosis.

- Host: The individual or organism susceptible to the disease, influenced by factors like age, immunity, or genetics. For instance, an immunocompromised person is a more susceptible host for influenza.

- Environment: External factors that facilitate disease transmission, such as sanitation, climate, or crowding. For example, stagnant water is an environment conducive to malaria transmission via mosquitoes.

These components interact dynamically; altering one (e.g., improving sanitation) can prevent disease.

#### 2. How Immunizations Prevent Disease at Individual and Population Levels

- Individual Level: Immunizations stimulate the immune system to produce antibodies against specific pathogens, preparing it to fight future infections without causing illness. For example, the measles vaccine primes the body to recognize and neutralize the measles virus.

- Population Level: Widespread immunization creates herd immunity, reducing the spread of disease by limiting the number of susceptible individuals. For instance, high polio vaccination rates prevent outbreaks, protecting unvaccinated individuals indirectly.

#### 3. Differentiate Between Active vs. Passive Immunity, Natural vs. Artificial Immunity

- Active Immunity: The body produces its own antibodies in response to an antigen.

- Natural: Occurs after exposure to a disease (e.g., recovering from chickenpox).

- Artificial: Induced by vaccination (e.g., HPV vaccine).

- Passive Immunity: Antibodies are transferred from another source.

- Natural: Transferred from mother to child via placenta or breast milk (e.g., maternal antibodies protecting a newborn).

- Artificial: Administered through antibody-containing products (e.g., immunoglobulin for rabies exposure).

#### 4. Three Most Common Types of Vaccines

- Inactivated Vaccines: Use killed pathogens (e.g., polio vaccine).

- Live-Attenuated Vaccines: Use weakened pathogens (e.g., measles, mumps, rubella [MMR] vaccine).

- Subunit, Recombinant, or Conjugate Vaccines: Use specific pathogen parts (e.g., hepatitis B vaccine).

#### 5. Direct and Indirect Modes of Transmission, Including Types of Vehicle-Borne Transmission

- Direct Transmission: Immediate transfer from person to person.

- Contact: Skin-to-skin or mucous membrane contact (e.g., herpes via kissing).

- Droplet: Respiratory droplets over short distances (e.g., influenza from coughing).

- Indirect Transmission: Transfer via an intermediary.

- Airborne: Pathogens in aerosols over long distances (e.g., tuberculosis).

- Vehicle-Borne: Contaminated objects or substances.

- Foodborne: Contaminated food (e.g., salmonella from undercooked poultry).

- Waterborne: Contaminated water (e.g., cholera from polluted water).

- Fomite: Inanimate objects (e.g., flu virus on doorknobs).

- Vector-Borne: Via organisms like mosquitoes (e.g., malaria).

- Vehicle-Borne Types: Foodborne, waterborne, and fomite transmission are the primary categories.

#### 6. Chain of Infection Model for Infectious Diseases

The chain of infection describes the process of disease transmission through six links:

- Infectious Agent: The pathogen (e.g., Vibrio cholerae for cholera).

- Reservoir: Where the pathogen lives (e.g., humans, animals, water).

- Portal of Exit: How the pathogen leaves the reservoir (e.g., feces for cholera).

- Mode of Transmission: How it spreads (e.g., waterborne for cholera).

- Portal of Entry: How it enters a new host (e.g., ingestion for cholera).

- Susceptible Host: A person at risk (e.g., someone without immunity).

#### 7. Ways to Reduce Disease Transmission by Breaking Links in the Chain

- Infectious Agent: Eradicate via treatment (e.g., antibiotics for bacteria).

- Reservoir: Eliminate sources (e.g., draining mosquito breeding sites for dengue).

- Portal of Exit: Block exit (e.g., masks to reduce respiratory droplet spread).

- Mode of Transmission: Interrupt spread (e.g., handwashing to prevent fecal-oral transmission).

- Portal of Entry: Protect entry points (e.g., condoms to prevent HIV).

- Susceptible Host: Increase immunity (e.g., vaccinations).

#### 8. Phases in the Natural History of Disease Model and Connections

The natural history of disease has four phases, linked to prevention, incubation, quarantine, and isolation:

- Susceptibility Phase: No exposure yet; risk exists.

- Prevention: Primary prevention (e.g., vaccinations, health education).

- Subclinical Phase: Exposure and incubation (pathogen multiplies, no symptoms).

- Prevention: Secondary prevention (e.g., screening); Incubation Period: Time from exposure to symptoms; Quarantine: Separating exposed individuals to prevent spread.

- Clinical Phase: Symptoms appear.

- Prevention: Secondary prevention (e.g., early treatment); Isolation: Separating sick individuals to prevent transmission.

- Resolution Phase: Recovery, disability, or death.

- Prevention: Tertiary prevention (e.g., rehabilitation to reduce complications).

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### Theoretical Frameworks for Health Behaviors

#### 9. Define Constructs

Constructs are specific, measurable components of a theory or model that explain or predict behavior. For example, in the Health Belief Model, perceived susceptibility is a construct measuring an individual’s belief about their risk of a health issue.

#### 10. Six Constructs of the Health Belief Model (HBM) and Application

The HBM explains health behavior based on perceptions:

- Perceived Susceptibility: Belief about personal risk (e.g., “I might get flu if unvaccinated”).

- Perceived Severity: Belief about the seriousness of the condition (e.g., “Flu can lead to hospitalization”).

- Perceived Benefits: Belief in the effectiveness of a health action (e.g., “Flu vaccine prevents illness”).

- Perceived Barriers: Obstacles to action (e.g., “Vaccine shots are painful”).

- Cues to Action: Triggers prompting behavior (e.g., flu season news).

- Self-Efficacy: Confidence in performing the action (e.g., “I can get vaccinated easily”).

- Application: To promote flu vaccination, a campaign could highlight susceptibility (“Flu is common”), benefits (“Vaccines protect”), and reduce barriers (free clinics).

#### 11. Characteristics of the Five Stages of Change in the Transtheoretical Model (TTM)

The TTM describes behavior change as a process:

- Precontemplation: No intention to change; unaware of problem (e.g., smoker denies health risks).

- Contemplation: Aware of problem, considering change (e.g., smoker researches quitting).

- Preparation: Planning to act soon (e.g., smoker buys nicotine patches).

- Action: Actively changing behavior (e.g., smoker quits).

- Maintenance: Sustaining change, preventing relapse (e.g., smoker avoids triggers).

#### 12. Constructs of the Theory of Planned Behavior (TPB)

The TPB predicts intention to perform a behavior based on:

- Attitude Toward the Behavior: Beliefs about the behavior’s outcomes (e.g., “Exercise improves health”).

- Subjective Norms: Perceived social pressure (e.g., “My friends value fitness”).

- Perceived Behavioral Control: Belief in ability to perform the behavior (e.g., “I can make time to exercise”).

#### 13. Differentiate Between Main Ideas and Approaches of Models

- Health Belief Model (HBM): Focuses on individual perceptions of risk and benefits; assumes rational decision-making. Approach: Education to change beliefs (e.g., campaigns emphasizing vaccine safety).

- Transtheoretical Model (TTM): Emphasizes stages of readiness for change; recognizes behavior change as a process. Approach: Tailored interventions for each stage (e.g., motivational interviewing for contemplation).

- Theory of Planned Behavior (TPB): Centers on intention driven by attitudes, norms, and control. Approach: Addressing social influences and barriers (e.g., peer support for exercise).

- Key Difference: HBM targets static beliefs, TTM focuses on dynamic stages, and TPB emphasizes intention and social factors.

#### 14. Connect Interventional Approaches to Specific Model Constructs

- HBM: Increase perceived susceptibility via risk education (e.g., STI campaigns highlighting prevalence).

- TTM: Match interventions to stage, like goal-setting in preparation (e.g., smoking cessation plans).

- TPB: Strengthen subjective norms with peer-led programs (e.g., community fitness challenges).

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### Health Communication

#### 15. Define Health Communication

Health communication is the study and use of communication strategies to inform and influence individual and community decisions that enhance health.

#### 16. Steps of the Health Communication Program Cycle

1. Planning and Strategy Development: Define goals, audience, and channels.

2. Developing and Pretesting Materials: Create and refine messages.

3. Implementation: Deliver the campaign.

4. Evaluation: Assess impact and effectiveness.

5. Feedback and Refinement: Adjust based on results.

#### 17. Four Components to Identify in Planning and Strategy Development

1. Audience: Target population (e.g., teens for vaping prevention).

2. Goals: Desired outcomes (e.g., reduce vaping rates).

3. Messages: Key information to convey (e.g., vaping harms lungs).

4. Channels: Delivery methods (e.g., social media).

#### 18. Two Examples of Common Health Communication Goals

1. Increase awareness of health risks (e.g., smoking causes cancer).

2. Promote behavior change (e.g., encourage regular mammograms).

#### 19. Three Categories of Health Communication Channels and Examples

- Mass Media: Broad reach (e.g., TV ads for flu shots).

- Organization and Community: Group-focused (e.g., workplace wellness programs).

- Interpersonal: Personal interaction (e.g., doctor-patient counseling).

#### 20. WHO’s Six Factors for Effective Communication

1. Accessible: Easily available to the audience.

2. Actionable: Clear steps to follow.

3. Credible: Trusted source.

4. Relevant: Meaningful to the audience.

5. Timely: Delivered when needed.

6. Understandable: Clear and simple language.

#### 21. Define Health Literacy

Health literacy is the degree to which individuals can find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

#### 22. How Health Literacy Impacts Health Outcomes (Example)

- Example: Low health literacy may lead to misunderstanding medication instructions, causing improper use and worse outcomes (e.g., a diabetic patient misinterpreting insulin dosing).

- Individual Level: Poor literacy reduces adherence, increasing complications.

- Population Level: Widespread low literacy raises healthcare costs and disease burden (e.g., higher diabetes hospitalizations).

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### Social Determinants of Health and the Socio-Ecological Model

#### 23. U.S. Comparison to Other Countries

- Healthcare Spending: U.S. spends more per capita (~$12,555 in 2021) than peers (e.g., Canada ~$6,319).

- Life Expectancy: U.S. lower (~77 years) vs. Japan (~84 years).

- Obesity: U.S. higher (~42%) vs. France (~17%).

- Chronic Conditions: U.S. has higher rates (e.g., 60% of adults have at least one chronic disease).

#### 24. Define Social Determinants of Health (SDoH)

SDoH are conditions in the environments where people live, work, and play that affect health outcomes, such as income, education, and housing.

#### 25. Five Domains of SDoH

1. Economic Stability: Income, employment.

2. Education Access and Quality: Literacy, schooling.

3. Healthcare Access and Quality: Availability of services.

4. Neighborhood and Built Environment: Housing, safety.

5. Social and Community Context: Social support, discrimination.

#### 26. Apply Cliff Analogy to Levels of Prevention, SDoH, and Health Disparities

The cliff analogy illustrates health interventions:

- Levels of Prevention:

- Primary: Build a fence at the cliff’s edge (e.g., vaccinations to prevent disease).

- Secondary: Place nets halfway down (e.g., screenings to catch disease early).

- Tertiary: Ambulance at the bottom (e.g., treatment to manage disease).

- SDoH: The cliff’s height and slope represent social factors (e.g., poverty increases risk of “falling” into illness).

- Health Disparities: Some groups are closer to the edge due to SDoH (e.g., low-income communities face higher diabetes risk).

#### 27. Constructs of the Socio-Ecological Model (SEM) and Application

The SEM examines health at multiple levels:

- Individual: Knowledge, attitudes (e.g., personal belief in exercise benefits for obesity prevention).

- Interpersonal: Social networks (e.g., family support for healthy eating).

- Community: Local resources (e.g., access to parks for physical activity).

- Institutional: Organizations (e.g., workplace wellness programs).

- Policy: Laws and regulations (e.g., soda taxes to reduce consumption).

- Application: To address obesity, intervene at all levels—education (individual), peer groups (interpersonal), community gardens (community), school policies (institutional), and food labeling laws (policy).

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### Health Disparities

#### 28. Define Health Disparities

Health disparities are health differences strongly associated with social, economic, or environmental disadvantages.

#### 29. Upstream/Downstream Process Leading to Health Disparities

1. Power and Social Values: Systems and policies (e.g., discriminatory housing laws).

2. Differential Access: Unequal resources (e.g., limited healthcare in low-income areas).

3. Health-Harming/Promoting Factors: Exposures like pollution or healthy food access.

4. Biological Mechanisms: Stress or disease pathways (e.g., chronic stress raising cortisol).

5. Health Disparities: Outcomes like higher hypertension rates in marginalized groups.

#### 30. Define and Provide Example of Political Determinants of Health

- Definition: Policies and governance structures that shape health outcomes.

- Example: Voting access laws—restrictive laws may limit marginalized groups’ ability to elect officials who prioritize healthcare, worsening disparities.

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### Medicare, Medicaid, and the Affordable Care Act (Post-4/15 & 4/17 Updates)

#### 31. Is Healthcare a Right or a Privilege?

- Right: Argued as essential for human dignity; universal access ensures equity (e.g., supported by international declarations like WHO’s constitution).

- Privilege: Argued as a service earned through payment or employment; market-driven systems prioritize choice and competition.

- Both perspectives debated: “Right” emphasizes fairness; “privilege” emphasizes personal responsibility.

#### 32. Groups Receiving Healthcare as a Right

- Medicare beneficiaries (65+, disabled).

- Medicaid and CHIP enrollees (low-income, children).

- Veterans via VA healthcare.

- Federal employees and military personnel.

#### 33. Major Payor Groups for Healthcare in the U.S.

- Private insurance (employer-based, individual plans).

- Public insurance (Medicare, Medicaid, CHIP).

- Out-of-pocket payments.

- Other (e.g., VA, workers’ compensation).

#### 34. Proportion of Adults <65 by Coverage

- Private Insurance: ~65%.

- Public Insurance: ~20% (Medicaid, CHIP).

- Uninsured: ~15%.

#### 35. Population Most Likely to Be Uninsured

- Young adults (18–34), often low-income, non-citizens, or in non-expansion states.

#### 36. Population Most Likely to Have Public Insurance

- Low-income families, children, pregnant women, and disabled individuals (via Medicaid/CHIP).

#### 37. Medicare Eligibility and Four Parts

- Eligibility: Age 65+ or specific conditions (e.g., ESRD, ALS).

- Parts:

- Part A: Hospital insurance (inpatient care, hospice).

- Part B: Medical insurance (outpatient, doctor visits).

- Part C: Medicare Advantage (private plans combining A, B, often D).

- Part D: Prescription drug coverage.

#### 38. Purpose of Medicaid and Administration

- Purpose: Provide healthcare to low-income individuals.

- Administration: Joint federal-state program; states manage within federal guidelines.

#### 39. Target Populations for Medicaid, Medicare, CHIP

- Medicaid: Low-income adults, children, pregnant women, elderly, disabled.

- Medicare: Age 65+, disabled, ESRD/ALS patients.

- CHIP: Children in families with incomes too high for Medicaid but unable to afford private insurance.

#### 40. What is CHIP?

Children’s Health Insurance Program provides low-cost health coverage to children (and sometimes pregnant women) in families ineligible for Medicaid.

#### 41. What is a Federally Qualified Healthcare Center (FQHC)?

FQHCs are community-based centers serving underserved areas, offering comprehensive primary care on a sliding fee scale, funded partly by federal grants.

#### 42. What is an “Expansion State”?

A state that expanded Medicaid under the ACA to cover adults with incomes up to 138% of the federal poverty level.

#### 43. Association Between Medicaid Expansion and Uninsured Rates

Expansion states have lower uninsured rates (e.g., ~8%) compared to non-expansion states (e.g., ~15%), as more low-income adults gain coverage.

#### 44. Four Aims of the ACA

1. Expand insurance coverage.

2. Improve healthcare quality.

3. Reduce healthcare costs.

4. Enhance consumer protections.

#### 45. ACA Actions to Increase Insurance Coverage

- Medicaid expansion.

- Creation of the Health Insurance Marketplace.

- Subsidies for low-income individuals.

- Individual mandate (originally).

#### 46. ACA Requirements on Insurance Companies

- Cover pre-existing conditions.

- No lifetime/annual coverage limits.

- Cover essential health benefits (e.g., preventive care).

- Allow dependents to stay on plans until age 26.

#### 47. What is the Marketplace?

The Health Insurance Marketplace is an ACA-created platform where individuals can compare and purchase private health plans, often with subsidies.

#### 48. What is Expansion?

Expansion refers to states adopting ACA’s Medicaid expansion to cover more low-income adults.

#### 49. ACA and Public Health Controversies

- Individual Liberty vs. Collective Good: Individual mandate (controversial for requiring coverage).

- Role of Government: Medicaid expansion (debated as government overreach).

- Moral Values: Contraceptive coverage requirements (opposed by some religious groups).

#### 50. ACA Element Passed in 2010 but Repealed/Changed

- Individual mandate penalty repealed (effective 2019).

#### 51. Two Key ACA Elements Currently in Place

- Pre-existing condition coverage.

- Marketplace subsidies.

#### 52. HMO vs. PPO

- HMO (Health Maintenance Organization):

- Payment: Per person (capitation).

- Structure: Requires primary care provider referrals, limited network.

- Incentive: More focus on preventive care to reduce costs.

- PPO (Preferred Provider Organization):

- Payment: Fee-for-service.

- Structure: Flexible network, no referrals needed.

- Incentive: May encourage over-treatment due to fee-based payments.

- Preventive Care Incentive: HMO, as fixed payments encourage cost-effective care.

- Over-Treatment Incentive: PPO, as providers earn per service.

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This covers all the topics in your study guide comprehensively. If you need further clarification on any point or additional details, let me know! Good luck on your test!