Exam 1 Study Guide
Exam 1 Study Guide BPH 206
Popular in Introduction To Public Health
Popular in Public Health
This 5 page Study Guide was uploaded by Sarah Anderson on Monday February 8, 2016. The Study Guide belongs to BPH 206 at University of Miami taught by Alexis Koskan in Fall 2015. Since its upload, it has received 98 views. For similar materials see Introduction To Public Health in Public Health at University of Miami.
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Date Created: 02/08/16
EXAM 1 STUDY GUIDE: What is public health? Public health is the overall effort contributed by many parties to protect and improve the lives of communities, prevent different diseases, & to provide conditions in which people can live healthy lifestyles. 5 big areas- epidemiology, biostatistics, environmental health sciences, health policy & management, and social & behaviors sciences Behavior Infection Genetics Geography Environment Medical care Socioeconomic status Famous People in Public Health: John Snow (cholera), Edward Jenner (small-pox vaccine), James Lind (scurvy in sailors) Multi-level determinants and influences (Social-Ecological Model of Health) o Intrapersonal o Interpersonal o Organizational o Community o State o Global Evidence-based Public Health Problem (what is it) o Define health problem o What is burden of disease? (morbidity/mortality) o Distribution of disease Etiology (causes?) o Does cause proceed the effect? o Does altering cause alter effect? o Requirements for establishing contributory cause: 1. Individual association- case control studies 2. Cause proceeds effect- cohort studies 3. Altering cause alters effect- randomized control trials Recommendation (reduce health impacts) o Benefits/harm of interventions? o Quality of evidence? Implementation (how to get the job done) o Who to target? o How to go about it? Evaluation (how well did it work?) o RE-AIM- reach, effectiveness, adoption, implementation, maintenance Prevalence rate- # with disease at certain time (not just new but also existing cases)/population Incidence rate- # of new cases/population Morbidity- severity Mortality- deaths Infant mortality rate- # of deaths below 1 year of age Health Disparities and the Social Determinants of Health Equality and Equity o Compensates for individual’s situations Neighborhood and Built Environment o Access to healthy food, quality housing, crime/violence, environmental condition Health & Health Care o Access to insurance, health literacy, access to primary care Social & Community Context o Incarceration, institutionalization o Social cohesion o Civic participation o Perceptions of discrimination and equality Education o HS graduate rate, enrollment in higher education o Language/literacy Economic Stability o Poverty, employment o Home/food stability Frieden’s Health Impact Pyramid: o 5. Counseling & Education (nutritional counseling) o 4. Clinical Interventions (diabetes management, long term) o 3. Long-Lasting Preventative Interventions (vaccines) o 2. Changing the Context (eliminating lead paint and supersized drinks) o 1. Socio-Economic Factors (eradicate poverty) Role of Government in Public Health Governmental Goals in PH: o Prevent epidemics and the spread of disease o Protect against environmental hazards o Prevent injuries o Promote and encourage healthy behaviors o Respond to disasters and assist communities in recovery o Ensure the quality and accessibility of health services Assessment, policy, assurance o ESSENTIAL PUBLIC HEALTH SERVICES: Monitor health status to identify community health problems. Diagnose and investigate health problems and health hazards in the community. Inform, educate, and empower people about health issues. Mobilize community partnerships to identify and solve health problems. Develop policies and plans that support individual and community health efforts. Enforce laws and regulations that protect health and ensure safety. Link people to needed personal health services and assure the provision of health care when otherwise unavailable. Assure a competent public health and personal health care workforce. Evaluate effectiveness, accessibility, and quality of personal and population-based health services. Research for new insights and innovative solutions to health problems. Federal: o ensure that all levels of government can provide essential services o act when health threats spread beyond more than one region o act when jurisdiction for a solution is beyond state governments o assist states in emergency o help with public health goals o *** The Secretary of the US Department of Health and Human Services- Sylvia Mathews Burwell o Examples- FDA, NIH, SAMHSA (Mental Health), HIS (Indian Health Services), HRSA (Human Resources and Services Admin.), CDC, CMS (Medicare/Medicaid) Local/State o Immunizations o Disease surveillance o Collection of vital statistics o Run public health laboratories o Inspection and licensing of restaurants o Environmental health surveillance o Coordinating public health screening programs o Tobacco control o Public health preparedness and disaster response o 10 US “regions” Global o World Health Organization o UNICEF o UNAIDS o World Bank Social/Behavioral Influences on Public Health Health Belief Model: “it can happen to me” o Perceived barriers to health behavior o Perceived benefits to health behavior o Perceived susceptibility to health threat o Perceived seriousness or severity of health threat o Cues to action- mass media campaigns, advice, etc. Transtheoretical Model: o Steps: Pre-contemplation (unaware of problem) Contemplation (aware of problem and desired behavior change) Preparation (intends to take action) Action (practices desired behavior) Maintenance (sustaining behavior) PRECEDE-PROCEED Model o STEP 1- Social Assessment/Situational Analysis Looks at quality of life o STEP 2- Epidemiological Assessment 5 D’s- Death, Disease, Disability, Discomfort, Dissatisfaction o STEP 3- Educational/Ecological Assessment Pre-disposing Factors: (why action is done in the first place) Awareness, knowledge, beliefs, values, attitudes, existing skills, behavioral intention Rationale/motive for behavior Reinforcing Factors: (can be for old or new behaviors) Provide reinforcement, incentive to continue action Support from Family or Friends Employer actions and policies Health provider costs Community resources Enabling Factors: Facilitate or impede behaviors Skills, health care resources, effective use of information o STEP 4- Intervention Alignment and Administrative & Policy Assessment o STEP 5- Implementation For evaluation of a policy: Specific Measurable Action Verb Realistic Timely o STEP 6- Process Evaluation How well is program delivered compared to how it was conceptualized o STEP 7- Impact Evaluation Assesses immediate/short-term impact o STEP 8- Outcome Evaluation Long-term evaluation in accordance with 5 D’s Communicable Diseases and Vaccines Herd immunity- even when a whole community isn’t vaccinated for a particular disease (economic, religious, moral reasons), having a majority of the community lowers the chances of coming into contact with someone with the disease Why some people opt out of vaccines-economic standing, religious/cultural practice, falsified data about autism and MMR vaccine, “invasion of body”, Exemptions for vaccines decided by the state Communicable vs. Non-communicable Diseases o Communicable diseases can be spread directly or indirectly from person to person Conditions that lead to faster spread of disease: o Urban conditions, crowding, poor sanitation, low income, population growth, livestock production, migration Social implications of infectious diseases- o Disruption of families/social life o Discrimination o Denied of primary care Economic implications of infectious diseases- o Loss of revenue/tourism/travel o Cost of treating illness Human security problems with infectious diseases- o Bioterrorism Endemic- within normally boundaries of disease, not widespread Sporadic- random, few cases Epidemic- heavily concentrated in a region Pandemic- heavily concentrated worldwide Genetics/Epigenetics Epigenetics- parts of one’s genome can be affected by the environment without directly changing ones genetic coding Twin studies help examine this Animal studies (mice/cherry blossom example)
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