Note
Studied by 4 people
Community Health Exam 1
https://openstax.org/books/microbiology/pages/1-1-what-our-ancestors-knew
8/28
Community→ a group of individuals that share the same interests
Community Health→ the health status of the individuals in the groups
Factors that affect community health:
Physical→ Geography, environment, community size, industrial development
↳EX: more infectious diseases in the tropics because there are only two seasons ie dry and wet
Social and cultural factors→ beliefs, economy, politics, and religion
Ten Essential Public Health Services →imgres
Four Levels of organizations involved in community health → Local (Jewish Hospital), State, National (government agency→ FDA, NIH, CDC, EPA) Quasi-Government agencies, non-governmental agencies), and World Health Organization (T-B)
Worldwide public health→ the lead international public health agency
National:
USDA→ Inspects crops etc
EPA→ Inspect air and water quality
OSHA→ Establishes workplace safety standards
Homeland Security→ Protects US Homeland from foreign attack
CDC→ Started with the mission to control malaria in 1946
↳ today is involved in every aspect of human health
State:
Ohio department of health
↳counties and cities also have health departments
These departments have boards and different specialties
Notifiable Disease Scheme→ Imgres
Quasi-governmental Agency:
Clara Barton→ founder of the Red Cross
EX: American Cancer Society, CRS, and Bill and Melinda Gates Foundation
Healthy People 2030L
Vision→ a society in which all people live long healthy lives
Objective HDS-7: Reduce the proportion of adults with high total blood cholesterol levels
Target: 10% Improvement
Data: Percent of Adults 20 years and older with the total blood cholesterol levels of 240 mg/dl or greater
↳2005-2009 baseline 15% →Target 13.5 → 2009-2012 12.9 (target met early)
Higher protein in the blood, the lesser chance of heart attack
8/30
Lyme Disease→ ticks latch on deer who have the disease, then transmit it to other organisms
Epidemiology→ the study of how, when, and where diseases occur in the populations and communities
↳focus of how to prevent the spread
Disease→ any deviation from the state of health
↳ illness, injury etc
Symptoms are something you can feel
Signs are something someone else can see
Categories of Disease:
Infectious disease→ disruption of a tissue or organ caused by microbes or microbial products
↳ Infection is the establishment of a infectious disease agent in the host organism
Infectivity→ The ability of a biological agent to enter and grow in the host
Pathogenicity→ The ability of a microbe to produce a disease
Most infectious disease are communicable, but some are non-communicable
Communicable Disease→ disease causing agent spread from one host organism to another
EX: HIV, Salmonella, Blood-Borne Illness
Contagious Disease→ disease causing agent spreads easily from one host to another
EX: COVID-19, Tetanus
↳ Tetanus causes lockjaw and paralysis
Tetanus is found in soil
Sporadic because you never know when you are going to get it
Non-communicable disease→ disease-causing agent cannot spread from one host to another
EX: Cancer, Heart failure, liver disease
Acute Disease→ symptoms begin suddenly and stops in a short amount of time (typically infectious)
Chronic Disease→ Conditions that last over a year (Non-communicable)
Endemic→ Particular to a region and is always occurring (Always)
Sporadic→ infectious disease which occurs infrequently
Undetected outbreak→ outbreak that isn’t detected
Epidemic→ widespread occurrence of an infectious disease in a community (excess)
Pandemic→ widespread occurrence of an infectious disease across the world (global)
People get more respiratory diseases in the cold months of the year because they spend more time inside
How does epidemiology relate to public health?
Provides data necessary for public health policy and regulations
Females live longer than males because the females hormones reduces risks for heart disease and the telomere’s for female dna is longer
Epidemiological Rate is:
Measure of illness, injury, disability, or death in a given population
Within a given time period and expressed as per unit of the population
Rate= # population events at a given time
—-----------------------------------------------
Population fjdklfldjskfdsjl
Incidence is important for infectious diseases, so we can track how fast the spread is
Prevalence is important for infectious disease because it provides an estimate of the diseases burden within the population
Rate is the only way we can compare data between different communities and countries
Primary Care→ illness, injury, acute medical problems, and referrals
Flu shot
Secondary care→ requires specialists
Tertiary care→Requires highly specialized equipment and care
Primary prevention→ aims to stop a disease before it occurs
Education and personal action/behavior
Public health measures
Controllable risk factors for noninfectious diseases:
Secondary prevention
Aim→ Stop the progression of a disease
Patients seek diagnosis after experiencing symptoms
Doctor then orders tests
Screening tests are secondary prevention
False negative results→ some people with the disease will test negative
False positive results→ some people without the disease will test positive
Examples of screening tests and follow up diagnostic tests:
Pap smear
Mammogram
Lipid profile
Rapid colorectal cancer screen
Tb skin test→ chest x ray is follow up
Agent→ factor whose agent or presence causes a disease
- Groups: Physical, Chemical, Biological, Genetic, Nutrient, and Psychological
Physical Agents→ forces that cause injuries
- EX: Impact(Car crashes), excessive heat/cold
Chemical Agents→ compounds that causes injuries and cellular damage
- EX: poisoning, burns, cancer, birth defects
- Many chemical agents have been associated with cancer
Biological Agents→ microorganisms and other parasitic organisms
- EX: Bacteria, viruses, fungi, worms, and protozoa
↳ the bacteria Streptococcus pyogenes causes strep throat, biological VSV causes shingles, fungal a fungus causes ringworm, protozoan causes malaria, worms and mites are parasites
Genetic Agent→mutated genes that cause disease
Can occur during fetal development and through genes from your parents
EX: a child develops cystic fibrosis if they inherit a mutant CFTR gene from their parents
Their genetic information can influence their risk of developing a disease or illness
Cystic fibrosis→ mutant CFTR gene causes excess mucus production that disrupts air flow and lung function
↳ disrupts release of digestive enzymes by pancreas
Reduces life expectancy by 40 years
Nutrient Agents→ a chemical compound found in food and lack of these compounds causes disease
Lack of necessary nutrients can result in nutritional deficiencies and diseases
EX: Lack of vitamin D can cause rickets– results in weak bones, abnormal bone development, and impaired growth
Sunlight, fish, and milk are very rich in vitamin d
EX: Lack of vitamin B3/niacin causes pellagra
Niacin is necessary for cellular processes
Pellagra is defined by the 4 D’s– Diarrhea, dermatitis, dementia, and death
Psychological Agents→cause mental disorders
Very difficult to define and measure
EX: Stress
↳ extreme stress resulting from a violent event can result in PTSD and chronic stress can result in depression
Susceptible host→ person with the certain characteristics required to develop a certain disease
Characteristics that influence susceptibility to an infectious disease are more understood than those that influence susceptibility to non-infectious disease
Non-specific innate defenses→ offer comprehensive protection against a wide variety of microbes
↳ EX: skin and mucous membranes provide physical barriers against invading microbes
↳EX: Body fluids (tears, saliva, urine) flush away invading microbes
Immune system→ a defensive system consisting of white blood cells and antibodies
↳ responsible for recognizing and attacking foreign items in the body
Molecules produced by white blood cells:
Antibodies
Signaling molecules
Immunocompetence→ ability of the immune to recognize and attack non-self cells and substances
Lack of immunocompetence that results in susceptibility
Immune Tolerance→ ability of the immune system to recognize and NOT attack its own systems
Lack of immune tolerance can lead to autoimmune diseases
Memory cells→ can remember what items were attacked in the past and can quickly respond and attack if those items re-enter the body
Active immunity→ resistance to an infectious disease due to having it before via immune system memory
↳EX: vaccination and infection
The immune system can recognize abnormal bodily cells and attack them
↳ attacks cancer
BRCA1 and 2:
Females with the BRCA1 and 2 gene have an 80% risk of developing breast cancer and a 20-40%(1) 10-20(2) risk of developing ovarian cancer
Age influences susceptibility ie the older you are the more likely to develop a chronic disease and the younger you are the more likely you are to become injured due to an unintentional injury
Medical conditions and their treatments can affect susceptibility(cancer and radiation treatment)
Lifestyle choices affect susceptibility (smoking, drinking, exercise)
Environment→ an external condition that can influence the development of disease
Natural environment→ landforms, bodies of water, climate, ecosystems, organisms
Built Environment→ housing quality, industries and businesses, urban vs rural, infrastructure, and pollution and waste disposal
Occupational Environment→ what you do for work
Socioeconomic Environment→ general economic conditions
Cultural Environment→ religious beliefs, understanding of health related terms and issues, social norms, and willingness to act on health related advice
Maternal and Infant Health
Family Planning→ determining the preferred number and placement of children and choosing the appropriate means to accomplish it
↳ half of US pregnancies are unplanned
Benefits of Family Planning to Individual, Family, and Community Health:
More resources per child
↳ financial, clothing, food, educational, and medical/dental
Greater educational opportunities for females
Positives for individuals and families are positives for the community
Birth Control Methods:
Surgical Sterilization→ Vasectomy and tubal ligation
Birth control pills
Vaginal ring
IUD
Implant
Maternal, infant, and neonatal death rates are a measure of disease prevention and health promotion regarding diseases and illnesses relating to pregnant individuals and infants
An infant’s health is completely dependent on that of the mother
↳ the mothers health and health behaviors dictates that of the baby EX: drinking while pregnant can cause the baby to be born with FAS
Maternal Mortality→ deaths due to pregnancy and birth related causes
↳common causes of MM: infection, hemorrhaging, high blood pressure, etc…
Key Features of Prenatal Care:
Monitor and treat pre existing conditions
Screen for reproductive health infections
Assessment of mothers health and looking for developmental complications (Preeclampsia, gestational diabetes, etc…)
Make sure the fetus is developing correctly
Guidance for nutrition
Nutrients of Importance during Prenatal:
Folic acid→ prevents neural tube defects such as spina bifida
Calcium→ decreases risk for osteoporosis later in life, if mother doesn’t have enough during pregnancy the fetus will take from her bones
Iron→ provides oxygen for fetus through red blood cells
Infant Mortality Rate→ 5.9 deaths per 1000 live births
Neonatal Mortality Rate→ 4.1 deaths per 1000 live births
Leading Causes of Infant Mortality:
Birth defects/congenital malformations
Low birth weight
SIDS
Maternal complications
Unintentional injuries
Leading Causes of Neonatal Mortality (Birth to 28 days):
Low birth weight
Birth defects
Maternal complications
Complications regarding placenta, umbilical cord, and membranes
Blood infection
Low Birth Weight→ less than 5 pounds 8 ounces
Very Low Birth Weight→ Less than 3 pounds 5 ounces
Most Common Reasons for LBW/VLBW:
Premature birth
Maternal diet/ lack of weight gain
Lack of prenatal care → using drugs/alcohol while pregnant
New Concerns of Pregnancy:
Zika Virus→ spread by mosquitoes, pregnancies while infected can result in miscarriage +stillbirth, not all fetuses will develop birth defects due to zika
↳symptoms→ fever, rash, joint pain, red eyes, muscle pain, headache
Congenital Zika Syndrome→ severe microcephaly, decreased brain tissue with specific pattern of damage, damaged brain tissue during first trimester, damage to retina, joints with limited range of motion, too much muscle tone
Prevention of CZS and Zika:
Use of condoms and birth control
Controlling mosquito populations
Don’t travel to zika areas while pregnant
History of Public Health
There is evidence that some communities had bathrooms, drains, and sewer systems many years ago
Ancient Health Related Findings:
Code of Hammurabi→ included laws about physicians and health practices
Book of Leviticus→ provided instructions concerning hygiene, diet, sanitation, and separation from lepers
Ancient Greece Findings:
Emphasized individual health, exercise, and strength
They developed logical explanations for why disease occurred instead of supernatural
↳ not all the way true, some just began the development of the idea
Hippocrates→ Father of Medicine
Said that all things are made of 4 types of atoms:
- Earth atoms→ solid and cold
- Air atoms→ dry
- fire atoms→ hot
- water atoms→ wet
Stated that the body is made up of 4 types of humors
- Phlegm→ Earth and Fire atoms
- Yellow Bile→ Fire and Air atoms
- Black Bile→ Earth and Air atoms
- Blood→ Fire and Water atoms
↳ disease is a result of an imbalance of the four humors
Used for 2000+ years
Said that fever is a result of too much blood→ resulted in the treatment of bloodletting
He was the very first epidemiologist
- noted ways that disease might spread and found some explanations as to how it is spread→ Air/winds, geographical distribution and disease, water sources, and personal behaviors
His concepts were more correct than his treatments
Geographical diseases:
Lyme disease, yellow fever, malaria, dengue
His contributions to medicine included
Developed tools for surgery
Transformed medicine as discipline
Hippocratic Oath→ ethical basis for medical graduate- prescribe medicine to benefit patients
Described diseases based on observations and evidence rather than superstitions
Roman Empire:
Government instituted measures included→ building codes, sewers/drains, garbage collection and street cleaning, public baths, aqueducts, and education for physicians
Disease contributed to the roman empires collapse
↳ 500 years of malaria epidemics weakened the populations, then the bubonic plague killed 100 million people
The plagues death toll caused people to lose faith on fact based medicine and they turned to spiritual
Dark Ages:
All diseases were seen as a punishment by God for sins
Immoral to see one’s own body→ caused hygiene to be non existent
Famine was common
Medieval Period:
Idea of disease as God's punishment continues
Governments and individuals couldn’t prevent diseases
Black Death
↳ Evidence states that certain cities tried to limit the spread of it by isolating themselves
Renaissance Period:
Spirit of inquiry became common→ doctors began studying diseases and could start telling one disease from another
Increased travel, trade, and population which lead to the further spread of disease
↳during the 1500s there was a massive syphilis epidemic which spread to troops
Syphilis→ multistage disease, each stage has signs and symptoms
3 Concepts that came from Syphilis:
Diseases can come from certain behaviors
↳ sex rather than supernatural causes
Certain diseases can be treated through chemicals
↳ the quicksilver cure
Certain diseases can be prevented
↳ overcoat
Colonial Period:
Epidemics continued in Europe
↳ smallpox
Europe's diseases were brought to new lands (America’s) and killed many Natives
Small Pox→ contagious disease caused by the variola virus
Fatality rate is 30%
Smallpox impact on world history:
Killed several European monarchs
Assisted Colonialism
↳50% of Aztecs died in South America following the Eurpeans arrival, British soldiers gave Native Americans smallpox covered blankets (germ warfare)
Smallpox Prevention:
Variolation→ material from a lesion from a mild case of smallpox is inhaled, results in immunity, but there is a chance of getting smallpox
Bernardo Ramazzi, Occupational Health:
Interested in the relationship between work and health
- identified lead and mercury poisoning, lung disease due to inhalation of fine particles, and nerve damage can be caused from irregular motions and postures while working
Came up with the idea for workplace injury prevention (ventilation and eye protection)
Injured and sick workers were replaced easily, so his ideas weren’t taken seriously
James Lind, Nutrition and Health:
Investigated cause of scurvy in sailors
Believed that “thick” air caused it, but had an open mind
Conducted a diet study that separated sailors and put them in different groups in order to give them different diets
↳ found that sailors given citrus fruits recovered quickly from scurvy→ scurvy was able to become one of the first preventable diseases because of this
Edward Jenner, Vaccination and Disease Prevention:
Noticed that milkmaids who had cowpox seemed protected from smallpox
Demonstrated that skin inoculation with material from a cowpox lesion results in an immunity to cowpox
↳ safer than variolation because there is no risk of getting smallpox from inoculation
Smallpox Vaccination Result:
Became first disease to become preventable by vaccination
Vaccination led to a slow steady decline in smallpox cases over a period of 180 years
Was declared eradicated in 1977
Beginning of Modern Era:
In late 1800s people thought diseases were spread through miasmas (vapor)
Medical profession still followed hippocratic beliefs
Evidence began building that diseases were caused by microbes
Ignaz Semmelweis:
Suspected that doctors were transmitting childbed fever to women during childbirth
Required handwashing in chlorine solution
Cases of childbed fever dropped from 50% to 1%
He wasn’t believed and was ridiculed by other doctors
John Snow, Father of Epidemiology:
Mapped distribution of cholera in London, hoping to find the cause of the outbreaks
Found that 500 fatal cases occurred in 10 days within 250 yards of a specific intersection
Found that people who got water from the Broad Street pump were typically people who were infected with cholera→ people who got their water from other sources were not ill at the same rate
The Broad pump was removed→ Cholera epidemic ended soon after
Snow found the link between cholera and its spread without actually knowing its cause
Joseph Lister:
Used carbolic acid to clean up surgical dressings and instruments to control infection
Concept that cleanliness could prevent the spread of disease was finally accepted by doctors
Louis Pasteur:
Showed that microbes were everywhere including the air
Linked microbes to food spoilage
Demonstrated that heat could kill microbes→ Pasteurization
Suspected that microbes could cause disease
Discovered that microbes that were too weak to cause disease could be used for immunity
↳ his research group found vaccines against anthrax, rabies, and cholera
Germ Theory of Disease→ many diseases are caused by microorganisms
Robert Koch:
Provided the key evidence by demonstrating that a specific bacterial species causes anthrax in animals
Developed techniques for growing bacteria in labs
Discovered the bacterial causes for tuberculosis and cholera
Koch's Postulates:
Germ must be present in sick animals, but not in healthy ones
The microbes must be isolated from diseased organisms and grown in pure culture
The cultured microbes should cause disease when it comes into contact with a healthy organism
The microbes must be reisolated from the diseased experimental host and identified as being identical to the original one
Constraints of Koch’s Postulates:
Not all bacteria are culturable
Many bacteria can be found in both healthy and sick organisms
Doesn’t apply to viruses
The Great Sanitary Movement:
Based on the idea held by social reformers that many diseases could be prevented by removing “filth”
↳ dead animals, waste, and garbage
Provided evidence that dirty water was the cause of cholera
Massachusetts was the first state to create a board of health program, 39 other states would soon follow
Since 1900:
The work of social reformers showed that disease could be prevented with community wide improvements
Life expectancy increases dramatically
Progress with sanitation, hygiene, discovery of drugs to help illness, development of medical procedures to help disease/illness, development of vaccines
Lady Mary Montley Monagu→