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Mid Term Study Guide

by: Jasmine Guo

Mid Term Study Guide 2000

Jasmine Guo

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About this Document

Intro PH Guide Covers Chapters 1-11,13,14
Intro to Public Health
Study Guide
PublicHealth, GSU
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This 10 page Study Guide was uploaded by Jasmine Guo on Saturday October 1, 2016. The Study Guide belongs to 2000 at Georgia State University taught by Pechacek in Fall 2016. Since its upload, it has received 88 views. For similar materials see Intro to Public Health in Public Health at Georgia State University.


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Date Created: 10/01/16
Mid Term Study Guide Intro to Public Health Chapters 1-11, 13, 14 Book: Introduction to PH, Schneider 10 th edition Chapter 1: PH, Science, Politics, and Prevention – What is Public Health? Substance is “organized community efforts aimed at the prevention of disease and the promotion of health.” – 3 Core Functions of PH are? Assessment, Policy Development, Assurance – In PH, patient is “community” Disciplines are: Epidemiology, Statistics, Biomedical Sciences, Environmental Health Science, Social and Behavioral Sciences, Health Policy and Management Epidemiology: Epidemiology is the basic science of public health. • The study of epidemics • Focuses on human populations, usually starting with an outbreak of disease in a community. • Aims to control the spread of infectious diseases. • Seeks causes of chronic disease and ways to limit harmful exposures. Statistics: Government collects health data on the population. • These numbers are diagnostic tools for the health of the community. • The science of statistics is used to calculate risks and benefits. • Statistical analysis is an integral part of any epidemiological study seeking the cause of a disease. • Statistical analysis is an integral part of any clinical study testing the effectiveness of a new drug. Biomedical Sciences: Infectious diseases are pathogens. • Control of infectious diseases was a major public health focus in the 19th and early 20th centuries. • Biomedical research is important to understanding control of new diseases and noninfectious diseases. – Chronic diseases – Genetics • Environmental Health Science: Health is affected by exposure to environmental factors: – Air quality – Water quality – Solid and hazardous wastes – Safe food and drugs – Global environmental change Social and Behavioral Sciences: A theory of health behavior is that social environment affects people’s behavior. – Major health threats are tobacco, poor diet, and physical inactivity and injuries. – Blacks have a lower overall life expectancy than whites, even when incomes are similar. – Other ethnic minority groups are also at increased risk for a variety of health problems Health Policy and Management: This area of study examines the role of medical care in public health. • Cost of medical care in the U.S. is out of control. • U.S. has a high percentage of population without health insurance. – These people often lack access to medical care. – Quality of medical care can be measured and is often questionable Types of Prevention and Intervention • Primary prevention prevents an illness or injury from occurring at all. • Secondary prevention minimizes the severity of the disease or injury once it has occurred. • Tertiary prevention minimizes disability by providing medical care and rehabilitation services. Chapter 2: Why is PH so Controversial? Sources of Controversy: Economic Impact, Individual Liberty, Moral and Religious Opposition, Political Interference with Science – Businesses often resist public health measures because they affect profits – Restrictions to prevent harm to others is generally acceptable. – Paternalism is only acceptable for laws concerning children. Concerns: – Sex and reproduction – AIDS, STDs, teenage pregnancy, and low birth-weight babies are major U.S. public health concerns. – Public health solutions are often viewed as promoting immoral behavior. – Alcohol and drugs – Conservative control of federal government intensifies the conflict. – Criticism of Bush administration exists for going too far in misrepresenting science to support its policies. – CDC was ordered to remove effective information from its website. – EPA changed a section of a major report. – President’s Council on Bioethics was controlled Chapter 3: Powers and Responsibilities of Government • Branches of Government: Legislative – Legislature passes statutes. • Executive – Public health agencies carry out the law – They may issue regulations consistent with statutes. • Judicial • Laws and regulations can be challenged in court Local PH agencies, State Health Departments, Federal Agencies (CDC & NIH), Non-Governmental PH Organizations Chapter 4: The Basic Science of PH 1. Epidemiology is part of public health’s assessment function. 2. Epidemiology is the study of patterns of disease occurrence in human populations and the factors that influence these patterns. 3. Epidemiology studies disease occurrence by observing who gets a disease, and where and when the disease occurs. From this information, it may be possible to determine why the disease occurs. 4. Epidemiologic surveillance, a system requiring that certain notifiable diseases be reported, helps to detect epidemics at an early stage, permitting measures to be taken to control the spread of disease. 5. While most notifiable diseases are infectious diseases, epidemiology has also helped to identify the causes of some chronic diseases such as heart disease and lung cancer by linking the occurrence of a disease with exposure to risk factors Chapter 5: Epidemiologic Principles and Methods Epidemiology is defined as “the study of the distribution and determinants of disease frequency in human populations • Step1: Define the Disease • Measure Disease Frequency in 2 ways – Incidence, number of new cases – Prevalence, number of existing cases • Distribution of Disease – Who ( sex, age) – When (season, year) – Where (neighborhood, countries, states, counties) • Kinds of Studies – Intervention Study (Control Group and Experimental Group: gets intervention or exposure) – Cohort Study (Choose a large number of healthy people, collect data on their exposures, and track outcomes over time. The only difference from intervention is that people choose their own exposures) – Case Control Study (Choose people who already have disease. Choose a healthy control group of individuals, as similar as possible to cases. Interview them all and ask for their previous exposures. Estimate the strength of the association between exposure and disease by calculating an odds ratio. Chapter 6: Problems and Limits of Epidemiology Sources of Error • Random variation • Confounding variables • Bias • Selection bias • Reporting bias or recall bias Ethical Issues • Nazi experiments on humans • Tuskegee syphilis study • AIDS epidemic • Bone marrow treatment for advanced breast cancer • New rules – Informed consent – Institutional review boards • Importance of clinical trials • Possibility of conflict of interest with medical providers who stand to profit Chapter 7: Statistics, Making Sense of Uncertainty Probability • The probable is what usually happens. • Probabilities are used to describe the variety and frequency of past outcomes under similar conditions as a way of predicting what should happen in the future. • A p-value: – When p ≤ 0.05, it is usually means that a result is statistically significant. – When p = 0.05, there is still a 5% chance that the result is wrong. • Key concepts are: – Confidence interval – Law of Small Probabilities Rates • Rates relate raw numbers to the size of the population being considered. – Birth rates – Mortality rates • Other rates commonly used as indicators of community health are: – Infant mortality rate – Maternal mortality rate • Crude rates • Adjusted rates – Age adjusted • Group specific rates – Gender specific Chapter 8: Role of Data in PH Uses of Data • Assessment of the health of a community • Raw material for research • Identification of special risk groups • Detection of new health threats • Planning of public health programs and evaluation of their success • Preparation of government budgets Collection of Data • Local records are sources of data: – Birth certificates. – Death certificates. – Notifiable diseases. – Other vital statistics. • Data is transmitted: – From local governments to states. – From states to National Center for Health Statistics (NCHS is part of CDC). – Surveys are sources of data The Census • Is mandated by the U.S. Constitution. • Serves as the denominator for most public health data: – Age, sex, race, ethnicity. – Is conducted every ten years Survey • Behavioral Risk Factor Surveillance Survey many others Chapter 9: The Conquest of Infectious Disease Infectious Agents • Bacteria – Tuberculosis, cholera, typhoid, tetanus, diphtheria, dysentery, syphilis, streptococci, staphylococci • Viruses – Smallpox, poliomyelitis, hepatitis, measles, rabies, AIDS, yellow fever • Parasites – Malaria, cryptosporidiosis, giardiasis, roundworms, tapeworms, hookworms, pinworms Chain of Infection • The transmission pattern is composed of links: – Pathogen (infectious agent) – Reservoir – Means of transmission – Susceptible host Means of Transmission • Directly from one person to another • Aerosol • Touching contaminated object and putting hands to mouth, nose, or eyes • Contaminated water or food – Fecal-oral route • Vectors • Sexual contact • Carriers Interrupting Chain of Infection • Kill pathogen with antibiotics. • Eliminate the reservoir. • Prevent transmission: – Hand washing – Quarantine – Condoms • Increase resistance of host by immunization. Chapter 10: Resurgence of Infectious Diseases Factors that Lead to Emergences of Diseases • Human activities that cause ecological damage and close contact with wildlife • Modern agricultural practices • International travel • International distribution of food and exotic animals • Breakdown of social restraints on sexual behavior and intravenous drug use PH Response to Emerging Infections • Global surveillance • Improved public health capacity • Veterinary surveillance • Reduction of inappropriate use of antibiotics • Institute of Medicine recommendations: – New vaccines – New antimicrobial drugs – Measures against vector-borne diseases Chapter 11: Biomedical Basis of Chronic Diseases • Risk factors lead to death Chronic Diseases • Cardiovascular Disease • Hypertension: High Blood Pressure • Cancer • Diabetes • Mental Illness • Arthritis • Alzheimer’s Disease Chapter 13: Do People Choose Their Own Health Types of Intervention: Education and Regulation Education: • Education informs public about healthy and unhealthy behavior. – Smoking’s bad effects – Recommended dietary allowances • Effective approaches include: – Health education in schools • Sex education is controversial. – Physicians’ recommendations – Use of advertising – Social norms approach Regulation: • Regulation is warranted when its intent is to restrain people from harming others. • Public health laws include: – Laws against murder and assault – Traffic regulations – Restrictions on alcohol, drugs, and tobacco – Laws to prevent minors from unhealthy behaviors – Laws requiring vaccination • Sexual behavior is hard to regulate. – Premarital screening for STDs Chapter 14: Psychosocial Factors Affect Health Behavior • Important Predictor: Socioeconomic Status • Health is also affected by gender, marital status, race, and ethnicity. • U.S. racial and ethnic minorities have poorer health than whites. • Stress play a major role in health behavior Health Belief Model – I am vulnerable to the threat. – The threat is serious. – By taking action, I can protect myself Self- Efficacy Model – The sense of having control over one’s life. – Increased by previous successful performance. – Increased by seeing others successfully perform, especially if the model is a peer. Trans theoretical Model • Process involves progress through five stages. – Precontemplation – Contemplation – Preparation – Action – Maintenance Ecological Model of Behavior • Intrapersonal level – Psychology • Interpersonal level – Family, friends, coworkers • Institutional level – School, workplace • Community level – Churches, community organizations • Public policy level – Government regulations • Changing the environment is helpful when making changes to individual health behavior


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