GPH 714 Week 1 Notes
GPH 714 Week 1 Notes GPH 714
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This 5 page Study Guide was uploaded by Danielle Kraack on Thursday August 25, 2016. The Study Guide belongs to GPH 714 at University of New England taught by Jennifer Gunderman in Fall 2016. Since its upload, it has received 4 views. For similar materials see Principles of Public Health in Master of Public Health at University of New England.
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Date Created: 08/25/16
1. Define Public health a. Public Health is the physical, mental, and social well-being of a community 2. Identify key events and people in the history of public health a. Discovery of HIV/AIDS b. Dan E. Beauchamp i. Called for challenge to idea of market Justice c. Garrett Hardin i. The only way to fully support the health of the community is to restrict some freedoms of the individuals d. John Stuart Mill i. The only time you can exercise power over an individual is to prevent harm to others e. Alexis de Tocqueville i. Supporting private liberty over the well-being of the community is wrong f. Lead Poisoning i. Tetraethyl lead causing neurological damage in children g. Water Flouridation i. Adding fluoride to water prevents cavities ii. Joe McCarthy and Red Scare caused people to think they were being poisoned h. Automobile Safety i. Ralph Nader 1. Published Unsafe At Any Speed 2. Lambasted automobile industry for lack of concern about safety ii. Anti-Drunk Driving Movement 1. Doris Aiken, RID 2. Candy Lightner, MADD i. Tobacco i. Cigarette smoking originally considered sophisticated 1. Dangers were known, but ignored ii. Links between smoking and lung cancer reported 3. Describe the differences as well as linkages between public health and medicine/healthcare. a. The difference is in the approach. The Medical Model looks at the individual; The Public Health Model looks at the community and the bigger picture. i. WHY are people falling down the hill, do we need to put up a fence? 4. Summarize the infrastructure through which public health is administered at federal, state, and local levels. a. All three levels have PH responsibilities. i. Federal responsibilities lie in funding and emergency response. 1. CDC, NIH, FDA ii. States have the most responsibility. 1. They define the responsibilities of the local health departments 2. Coordination between local agencies 3. Laboratory services 4. Licensing and certifications of medical professionals and facilities iii. Local health departments manage health codes and day to day responsibilities 1. Collecting health statistics 2. Medical care for the poor 5. Learn and apply essential elements of writing research papers at a graduate level. 6. Describe how social and behavioral factors influence health. a. Humans are social creatures b. Behavior is strongly affected by their social environment c. Attitudes towards health, peer pressure, SES 7. Recognize the ecological model. a. 5 Levels i. Intrapersonal 1. Encompasses the knowledge, attitudes, and skills of the individual ii. Interpersonal 1. Family, friends, and co-workers 2. Families are the origin for a lot of health behaviors 3. Friends and peer pressure are a large factor in teen years iii. Institutional 1. Schools and workplaces a. Ideal setting for PH intervention 2. People spent ⅓ to ½ of their lives in this setting iv. Community 1. Significant factor 2. Can be positive a. Church groups promoting health-related interventions 3. Can be negative a. Tobacco industry in the south is a pillar of economy v. Public Policy 1. Encompasses the regulations and limitations on behavior 2. Tend to be most explicit and controversial 8. Describe social determinants of health. a. SES i. Socioeconomic Status ii. Biggest determinant iii. Includes income, education, and occupational status b. Demographic factors i. Race, gender, marital status c. Stress and social support 9. Identify examples of public health data and describe how it is used. a. Prevalence and incidence rates i. Incidence - The rate of new cases in a defined population over a defined period of time 1. Measures the probability that a healthy person in that population will develop the disease during that time 2. Useful for identifying the cause a. Example - Thalidomide in the 1960s ii. Prevalence - The total number of cases existing in a defined population at a specific time 1. Useful for assessing the societal impact of a disease and planning for healthcare services b. Distribution of the disease answers the who, when, and where i. Who - Characterizes victims by age, sex, race, SES 1. Leads to hypotheses on transmittal 2. Example - AIDS epidemic - Gay men and intravenous drug users ii. When - Crucial in tracking an outbreak 1. Epidemic curves can show outbreak and incubation periods 2. Example - Legionnaires’ disease in 1976 iii. Where - Statistics on causes of death in other countries can be very suggestive in generating hypotheses about the causes of disease 1. Example - Fluoridation of water led to less cavities iv. Gives clues to the determinants c. Studies i. Descriptive Epidemiology 1. The analysis of a cause of disease or source of an outbreak using the determinants 2. Prospective vs Retrospective ii. Intervention Studies 1. Only form of experimentation done on people a. Usually for a new treatment or preventative measure 2. Clinical trials a. Most convincing are randomized and double-blind iii. Cohort Studies 1. Large numbers of healthy people are questioned about their exposures a. Then they are observed over time to see if they get the disease they’re exposed to 2. Designed to determine association between exposure and disease a. Relative Risk i. 1.0 - No association ii. >1.0 - Increased risk iii. <1.0 - Decreased risk iv. Case-control studies 1. Start with people who are already ill and look back to determine their exposure a. More efficient than Cohort 2. Odds ratio - Estimate of what the relative risk would be if the Cohort Study were done 10. Identify concepts and terms used in epidemiology and biostatistics. a. Epidemiology - The study of the distribution and determinants of disease frequency in human populations b. Incidence Rate i. The rate of new cases in a defined population over a defined period of time c. Prevalence Rate i. The total number of cases existing in a defined population at a specific time d. Epidemic Curve i. Track outbreaks and incubation periods e. Descriptive Epidemiology i. The analysis of a cause of disease or source of an outbreak using the determinants f. Prospective i. Monitor a group moving forward g. Retrospective i. Looking into the past for causes h. Intervention Studies i. Clinical trials done to test a new treatment for a disease or a preventative measure i. Randomized i. Subjects are assigned to treatment/control groups randomly j. Double-Blind - i. Neither subject nor doctor know which group the subject is in k. Cohort Studies i. Large numbers of healthy people are questioned about their exposures and then observed over time to see if they get the disease(s) they are exposed to l. Relative Risk i. Shows association between exposure and disease m. Case Control Studies i. Start with people who are already ill and look back to determine their exposure n. Odds Ratio i. Estimate of what the Relative Risk would be if a Cohort Study were done o. Confounding Variables i. Factors that are associated with the exposure and that may independently affect the risk of developing the disease p. Bias i. Systematic error q. Selection Bias i. Not using a true random sample r. Reporting Bias i. When subjects of a reporting group and a control group systematically report the same s. P Value i. Used to express the degree of probability or improbability of a certain result in an experiment t. Confidence Interval i. A range of values within which the true result probably falls u. Law of Small Probabilities i. The most improbable things are bound to happen occasionally v. False Negative i. To find no effect when there actually is one w. False Positive i. When the study finds an effect that isn’t real x. Sensitive Test i. Yields few false negatives y. Specific Test i. Yields few false positives z. Adjusted Rates i. Adjusted so they can be compared to other rates aa. Risk Assessment i. Identifies events and exposures that may be harmful to humans and estimated the probabilities of their occurrence as well as the extent of harm bb. Dread i. The more dreaded the risk, the less acceptable cc. Knowability i. Unknown risks are less acceptable that known risks dd. Cost-Benefit Analysis i. Weighs the estimated cost of implementing a policy against the estimated benefit ee. Cost-Effective Analysis i. Compares the efficiency of different methods of attaining the same objective
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