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Introduction to Public Health Exam 1

by: Katelyn Davidson

Introduction to Public Health Exam 1 Sph-b150

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Katelyn Davidson

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SPH-B150, Dr. Robert Goodman, Indiana University, Tues./Thurs 2:30-3:45, Spring 2016
Introduction to Public Health
Robert Goodman
Study Guide
intro to public health, SPH-B150, Introduction to Public Health, Exam 1
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This 15 page Study Guide was uploaded by Katelyn Davidson on Tuesday February 9, 2016. The Study Guide belongs to Sph-b150 at Indiana University taught by Robert Goodman in Summer 2015. Since its upload, it has received 497 views. For similar materials see Introduction to Public Health in Public Health at Indiana University.


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Date Created: 02/09/16
Study Guide Chapter 1 SPH­B150 Intro to Public Health 1. What are the characteristics of the morbidity and mortality in the 19th  century as compared to the 20th century? a. 19th Century i. ~2 out of 10 newborn infants never reached  their first birthday ii. ~5 died before they were 6 years old iii. ~3 in 10 lived beyond 25 iv. TB was leading cause of death v. Cholera, typhoid, smallpox epidemics wiped  out communities making it unsafe to go outside b. 20th Century i. average life expectancy of Americans  increased from 45 to 75 ii. cleaner air, sanitation, vaccination iii. leading cause of death is lifestyle choices  (heart disease/heart attacks) 2. What are the important characteristics of the Winslow’s definition of public  health in the 1920’s and how are these characteristics still applicable today? a. Preventing disease, prolonging life, and promoting  physical/mental health 3. How did the Institute of Medicine 1988 report, The Future of Public Health, complement and add to Windsor’s definition of public health? How did the IOM  report define the functions of public health? a. “The fulfillment of society’s interest in assuring the conditions in which people can be healthy” through “organized community efforts  aimed at the prevention of disease and promotion of health” b. Assessment i. find the problem ii. epidemiologists, biostatisticians, Environmental health specialists c. Policy Development i. (find out how to) solve the problem ii. health educators, health policy analysts d. Assurance i. evaluate ii. social workers, health administrators e. Serving all functions i. research for new insights and solutions to  health problems 4. What are the important characteristics that distinguish public health from  medical care? what aspects are similar? a. Public health Medical Care focus on preventing illness focus on treating illness focus on community focus on individual trying to improve the health of the  healing patients population           b. Similar: carrying out core functions­ assessment, policy development,  assurance 5. How does the spending for public health in the US compare to that for  medical care? what percent of the health and medical care is spend on public  health? a. 3% spend on public health 6. Where are the main contributors to the increase of life expectancy in the  US from the 19th to the 20th century? a. discovery and increased access to antibiotics ­­ penicillin b. control of infectious disease c. biomedical research gaining understanding of major killers  and providing information and techniques to bring diseases under control d. increased emphasis on importance on safe air, water, and  food 7. Why is public health considered a coalition of professions? what are some of the professions that make up this coalition? a. One person can not be an expert in all areas of public health b. Examples in #3 8. What are the definition of primary, secondary, and tertiary prevention? a. primary prevention­ prevents an illness or injury from  occurring at all by preventing exposure to risk factors b. secondary prevention­ seeks to minimize the severity of the  illness or the damage due to an injury­causing event once the event has  occurred c. tertiary prevention­ seeks to minimize disability by providing  medical care and rehabilitation services Study Guide Chapter 2 SPH­B150 Intro to Public Health 1. Why is public health considered a social movement? a. According Beauchamp “ public health should be a way of doing  justice, a way of asserting value and priority of all human life” 2. How is it concerned with social justice? a. Social justice suggests that minimal levels of income, basic  housing, employment, education, and health are shoud be seen as fundamental  rights. It is a dream of social justice that preventable death and disability be  minimized 3. How is social justice in public health contrasted with market justice? a. market justice is emphasizes individual responsibility, minimal  obligation to the common good, and the” fundamental freedom to all individual be left alone” b. prevents a fair distribution of the burdens and benefits of society 4. What are the four issues that may cause controversy in the US regarding public  health measures? a. Economic impact b. Moral and religious opposition c. politics d. individual liberty 5. What are the examples of the controversies that each of the four issues cause? a. Economic­ milk producers resisted pasteurization b. Moral/religious­ sex education c. politics­ abstinence only Program by George W. Bush d. individual liberty­ seat belts and helmets 6. Why are the costs of public health measures usually easier to calculate than the  benefits that public health measures produce? a. it is difficult to put a dollar amount o the value of life and health 7. What is the “Tragedy of the Commons” and how does it relate to public health? a. tragedy of commons is when people have a limited amount of  resources and try to benefits the most from them, but EVERYONE is trying to get the most of them so the resource eventually becomes exhausted  b. government restrictions on behavior that causes indirect harm to  others is the way to prevent this 8. In today's industrialized world, what is the Commons according to the textbook’s  author? Why? a. the commons is the air, water, other elements of the environment  people share i. because no individual has the power to control the  quality of his or her own personal environment independent of the  behavior of his or her neighbors ii. government action is required to protect these  common resources 9. What is the libertarian POV concerning public health? a. the only purpose for which power can be rightfully exercised over  any member of a civilized community, against his will, is to prevent harm to  others 10. What aspects of public health does the libertarian view support and what aspects does it oppose?  a. acceptable to outlaw drunk driving but not drunkenness itself b. smoking indoors can be outlawed because it bothers others c. restrictions on individual liberty justified on the basis their purpose  is to protect others 11. Is the libertarian POV more associated with social justice or market justice? a. social justice­ public health is a way of doing justice, a way of  asserting the value and priority of all human life b. market justice­ emphasizes individual responsibility, minimum  obligation to the common good and the fundamental freedom to all individuals to  be left alone 12. How does Alexis de Tocqueville, a 19th century critic of the American character,  view the libertarian POV as it concerns public health? a. it “disposes [citizens] not to think of their fellows and turns  indifference into a sort of public venue”  Study Guide Chapter 3 SPH­B150 Intro to Public Health 1. By what authorities do the various levels of government have responsibilities for  the public’s health? a. Ultimate Law is the constitution b. broad decisions of the legislative and judicial branches of  government are worked out in detail by the executive branch 2. Why does the state level of government have a primary role in public health? a. public health is the state’s concern because it does not arise  under the constitution 3. What are the primary functions of state health departments? a. primary constitutional responsibility and authority for the protection of the health, safety, and general welfare of the population b. POSSIBLY different agencies for social services, aging, mental  health, environment, etc.  4. What are the primary functions of the local health department within states? a. collecting health statistics b. conducting communicable disease control programs and  sanitation c. providing screening and immunization d. providing health education services and chronic disease control  programs e. sanitary engineering f. inspection programs g. running school health programs h. delivering maternal and child health services and public health  nursing services 5. What are the sources of funding for public health at the state and local levels? a. State depend on federal money b. local rely on states or federal funds passed on from the state,  and/or local property and sales taxes, fees from the service charges by the  department 6. When does the federal government's authority for public health outstrip that of  the states government's authority? a. taxation purposes 7. What mechanisms does the federal government use to influence state in  supporting public health measures? a. federal grant 8. What are the three reasons that governmental public health agencies use  policing powers? Why are these powers important? a. To prevent a person from harming others; b.  to defend the interests of incompetent persons;  c. to protect a person from harming him or herself 9. At the federal level, how is the role of the US Centers for Disease Control and  Prevention different from that of National Institute of Health? a. NIH only does research 10. What are examples of non­governmental public health organizations cited by the  textbook author? a. American Heart Association b. American Cancer Society c. American Diabetes Association d. Alzheimer’s Disease and related Disorders Association 11. What are the roles of these non­governmental public health organizations? a. lobbying Congress for resources and policies to benefit their  causes b. doing research and educating people ⟴Video- 60 minutes ● cancer outpatient clinic (only in the area) closed down because it was not able to  support itself financially. It created problems for the community because many people  (middle  class, not able to receive free treatment or able to pay for treatment) were not getting the care they need.  ● National Institute of Health ○ mission is to seek fundamental knowledge about the nature and  behavior of living systems and the application of that knowledge to enhance  health, lengthen life, and reduce the risk of burdens of illness and disbility ○ GOALS are research related ● US Center for Disease Control and Prevention ○ mission is to collaborate to create the expertise , informations, and tools that people and communities need to protect their health  ■ monitors health ■ detects and investigates health problems ■ develops and advocates for sound public health  policies ■ implements prevention strategies ■ promotes safe and healthful environments ■ provides technical training ● Indiana Department of Health Services ○ Mission: promoting and providing essential public health services  to protect Indiana communities ■ enforcement powers (policing powers) are derived  from state statutes ● Monroe County Health Department ○ mission is to promote the best achievable scope and quality of  health services for the public. the health of every citizen is fundamental to their  happiness and well­being, and is essential to the security and prosperity of the  community, state, and nation.  Website about public health in Indiana amazon of public health Study Guide Chapter 4 SPH­B150 Intro to Public Health 1. What is the definition of an epidemiology? a. the study of the distribution and determinants of disease  frequency in human populations b. “The diagnostic discipline of public health” ­ Winslow c. Epi­ disease      demos­ population   ology­ the study off d. used to investigate causes of disease, those susceptible to  disease, disease trends to identify needed services, evaluate program  effectiveness for health intervention 2. What is the definition of an epidemic? a. an increase in the frequency of a disease above the usual  and expected rate 3. What is the definition of endemic level? a. the background level of disease in a population ­­  expected/normal level at any given time 4. How is the endemic level related to an epidemic? a. An epidemic is the agent and endemic level is the  environment? 5. Why is John Snow known as the father of modern epidemiology? a. he figured out cholera was caused by water the people were  drinking b. He took public health intervention by taking pump handles  off of pumps that took their water from the contaminated part of the river c. “Show leather epidemiology” ­ had to walk to investigate  problem 6. What did he do to earn this reputation? a. He took public health intervention by taking pump handles  off of pumps that took their water from the contaminated part of the river b. “Show leather epidemiology” ­ had to walk to investigate  problem 7. In order to test his hypothesis about cholera deaths, what did John Snow  require that is fundamental to most epidemiological studies? a. he asked each person what company they got their water  from 8. What distinguishes chronic disease from communicable diseases? a. chronic diseases can not be attributed to a single cause b. Risk factors c. long period which disease develops 9. How did the chronic disease and communicable disease rates for mortality change over the 20th century? a. decline in smoking and US  b. rates declines because of Framingham study linking cig’s to  heart disease and lung cancer 10.Why is the Framingham study important to public health epidemiology? a. found link between cigarette smoking and lung cancer b. can be concluded as accurate and reliable­­ followed large  numbers of people over extended period of time 11.What is the difference between LDL and HDL cholesterol? a. HDL ­ good cholesterol  b. LDL ­ bad cholesterol 12.How did epidemiologists determine that cigarette smoking was harmful to  the health of the public? a. The Framingham study ­­ asking patients about their  smoking habits (if any)  Study Guide Chapters 5 & 6 SPH­B150 Intro to Public Health Chapter 5 1. What is the definition of disease rate? a. the number of disease per population at risk 2. Why is the disease rate a more important concept in public health than the  number of cases of a disease? a. able to compare from one place to another because they are not  on similar  b. EXAMPLE: population may be 1000 with 300 cases and another  place may be population of 6000 with 300 cases. You can only compare things  that are on a similar level. They may have the same number of cases but 3/10  (6/20) and 1/20. Can not compare the two places 3. What are are the Two types of disease frequency measures? a. incidence rates i. rate of new cases of a disease in a defined  population over a defined period of time b. prevalence rates i. total number of cases existing in a defined  population at a specific time 4. Which is most similar to the death rate? a. incidence rate for most lethal diseases 5. What is the definition of disease distribution? a. the who when and where questions 6. Why is understanding disease distribution important to public health? a. gives clues about the determinants of disease 7. In comparing the epidemic curves for Legionnaires Disease (figure 5.1) with that  for the measle (Figure 5.2), what essential characteristics distinguishes one from the  other? a. Legionnaires Disease came from a single source epidemic b. Measles was a person to person transmission ­­ you can tell by  the waves measles comes in 8. What is the definition of incubation period? a. the time when a person contracts a disease and the time when  they show symptoms 9. Why is it important in understanding the epidemiology of a disease? a. used to investigate causes of disease, those susceptible to  disease, disease trends to identify needed services, evaluate program  effectiveness for health intervention 10. What are the three types of epidemiological studies described by the textbook  author? a. Intervention studies i. think regular lab study ii. control group, randomized sample  iii. mostly done to test new treatment for disease b. Cohort Studies i. large numbers of people all healthy at the  beginning of study, are questioned concerning their exposures ii. observed over a period of time to whether those  who were exposed are more likely to develop the disease than those who were not iii. people themselves chose whether they belong to  the exposed or unexposed group (control group) c. Case­Control Studies i. start with people that are already ill and lookback to determine exposure  ii. focus on smaller number of people  11. What is the concept of relative risk? a. the ratio of the incidence rate for persons exposed to the factor to  the incidence rate for the persons in the unexposed group b. looking at people over time in Cohort studies c. the risk is the likelihood of something happening/not happening  later on and over time 12. What is the concept of odds ratio? a. estimate of what the relative risk would be if a cohort study had  been done b. dividing the ratio of exposed subjects to the unexposed subjects in the case group by the ratio of exposed subjects to unexposed subjects in a  control group c. Used in Case­Control Study­­ the likelihood of something  happening now if you do it right now Chapter 6 1. What are the major sources of error in experimental design, case control, and  cohort studies? a. experimental design­ presence of confounding variables i. factors that are associated with the exposure and  that may independently affect the risk of developing the disease b. case control­ not likely to report accurate details and selection  bias i. systematic error, choosing people to fit your  hypothesis c. cohort­ impossible to control the behavior of human beings by  random variation i. the association is merely due to chance 2. Why was the Tuskegee study a major lapse in public health ethics? a. 3. When do studies of new drugs have the potential for conflicts of interest? Study Guide Chapter 9 & 10 SPH­B150 Intro to Public Health What are the three major causes of infectious epidemics?  ● bacteria, viruses, and parasites Which of these three major causes of infection is responsible for (p.135?): Virus Bacteria Parasite Ebola E. coli Malaria AIDS Lyme Disease giardia Polio Legionnaires Disease Measles Typhoid Fever West Nile Tuberculosis Yellow Fever Cholera Smallpox Rabies 1. Why were viruses harder to detect than bacteria? ● smaller than bacteria, “hijackers”, invade living normal cells and use those cells  to multiply and produce other viruses like themselves 2. Why was the case of Typhoid Mary considered unique? ● first person in US identified as carrier of typhoid fever pathogen. She was forced  into isolation by public health authorities  ● Denial she got anyone sick through working as a cook ­ may have killed ~50  people ● now used as a term who spreads disease or some other undesirable thing 3. Why is SARS considered a particularly worrisome virus?  ● people don't realize they have it. Starts like a cold then feels like the flu. After this stage the body starts killing its own body cells.  4. Why has polio proven more difficult to eradicate smallpox?  ● “invisible” cases ● vaccine is not perfect and has to be administered several times before it  becomes effective ● on poverty stricken areas­ children are not able to become immune to it because  they have continuous intestinal infections 5. In theory, measles should be eradicated. Why hasn’t it been?  ● vaccine wears off as you get older (when vaccinated at infancy) ● not being vaccinated and if contracted not being reported 6. What is the main reason for the resurgence of malaria around the world?  ● Using of a pesticide called DDT reduced cases of malaria but campaign ran out  of funding ● Resurgence of disease with greater impact because it produced mosquito  resistant to DDT ● pathogen developed resistance to main antimalarial drug ● not being exposed to malaria (from vaccines, etc) decreases/eliminates immunity to malaria 7. What are the modes of transmission for the AIDS virus? ● sexual transmission ● blood to blood ­ needles ● mother to infant 8. What is the cause of hantavirus? ● found in deer mice, human had significant exposure to mouse droppings in  homes or places of work 9. What is the mode of transmission for West Nile? ● spread among birds by mosquito 10. What are the best methods for avoiding E. coli infection? ● thorough cooking of meats/ground beef   11. What are prions? ● particles which contain proteins but no nucleic acid and this no traditional genetic material


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