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Midterm Study Guide

by: Katlyn Palka

Midterm Study Guide HTH 231

Katlyn Palka

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A study guide for the midterm each section is a new color
Population Health Determinants
Timothy Howley
Study Guide
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This 6 page Study Guide was uploaded by Katlyn Palka on Saturday October 15, 2016. The Study Guide belongs to HTH 231 at James Madison University taught by Timothy Howley in Fall 2016. Since its upload, it has received 206 views. For similar materials see Population Health Determinants in Health science at James Madison University.

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Date Created: 10/15/16
Midterm Study Guide ● Introduction and Measuring Population health  ○ What is health? ■ According to the WHO: a state of complete  physical, mental, and social well­being and not merely based on the  absence of disease of infirmity  ■ Population health: health outcomes of a group of  individuals, including the distribution of such outcomes with the group ■ Community health: health status of a defined  group of people and the actions and conditions to promote, protect, and  preserve their health  ○ Going upstream ○ Equality vs. Equity ■ Equality: everyone gets the same treatment  (doesn’t always mean you are equal) ■ Equity: everyone is treated fairly ○ TED talk: What Makes the US Get Sick? Look Upstream ■ Becoming upstreamists  ■ Living and working conditions ■ Looking beyond the symptoms (upstream) ○ Washington Post: Why the Wealthy Stopped Smoking but the  Poor Didn’t ■ Chronic stress levels ■ Income differences ■ Social factors ○ Origins of Population health: John Snow ■ Disease mapping ○ Important health measures ■ Life expectancy ■ Morbidity ■ Incidence ■ Prevalence ■ Mortality ■ Birth rates ■ Infant mortality ■ Health expenditure ○ Measuring health worksheet ■ Life expectancy ● US is ranked 43rd and the life  expectancy is 79.68 years ■ Infant mortality ● US is ranked number 167 and the  rate is 5.87 ■ Health expenditure ● US spends the most on health care ■ Leading causes of death ● 1. Heart disease ● 2. Cancer ● 3. Chronic lower respiratory disease ● 4. Accidents (unintentional injuries) ● 5. Stroke (cerebrovascular diseases) ○ Chapter 1 Questions from “Shorter Lives, Poorer Health” ● Population Health and Social Epidemiology ○ Social epidemiology: the branch of epidemiology that studies  how social position and context influence human health ○ Clinical epidemiology: focuses on risk factors with a host­agent  model  ○ Geoffrey Rose ■ The father of population health ■ 4 criticisms of the risk factor approach ○ Whitehall studies ■ Dr. Michael Marmot ■ Whitehall I: ■ Whitehall II: ■ Findings ○ Gradient in health ■ Pg. 58 in the textbook ○ Pg. 63 critical thinking questions 1 and 2 ● Determinants of health ○ Chapter 3 from “Shorter Lives, Poorer Health” ­ Framing the  Question ■ Chapter 3 questions ○ What makes us healthy? ■ Policy making (local, state, federal) ■ Social factors ■ Health services ■ Individual behaviors ■ biology/genetics ○ JMU health determinants ■ UREC ■ Hand sanitizer stations ■ Health center ● Individual Behaviors ○ Chapter 5 from “Shorter Lives, Poorer Health” ­ Individual  Behaviors ■ Quiz from this chapter (took it in groups) ○ Diet ■ Caloric intake relative to energy expenditure is a  major contributor to obesity and obesity related diseases  ■ Spain and France have lower rates of  breastfeeding infants ○ Physical activity ■ Weight­bearing exercise plays a role in maintaining  bone density and obesity ■ US and Poland had the highest proportion of adults age 50 and older who reported no moderate activity ■ We are in the bottom third of countries for children  exercising at least two times a week  ○ Alcohol, tobacco, and drug use ■ The US now has the lowest smoking rates of all the peer countries ■ Sweden is one of the lowest for the OECD  countries ■ Alcohol is implicated in 30% of violent injuries, 21% of road traffic incidents, 19% of poisonings, 16% of drownings, and 11%  of falls ■ Alcohol use during adolescence has an important  linkage to violence and homicide ○ Sexual Practices ○ Injurious behaviors ■ US had the lowest rates of people wearing  seatbelts, motorcyclists wearing helmets ■ US had the highest rates of road traffic deaths  attributable to alcohol ■ The US has the highest rate of firearm ownership  among the peer countries  ■ 48% of all violent deaths involve firearms  ● Biology and Genetics  ○ Biology ■ Sex (male/female) ■ Chromosomes ○ Genetics ■ Inheritance ■ Genetic predisposition ■ Family history ○ My Medical Choice (Angelina Jolie) ■ Her chances of developing breast cancer dropped  from 87% to 5% ■ Testing is very very expensive  ○ Alzheimer’s video ■ Late onset vs. early onset ■ The risk of getting the disease ● 10% chance when there is no family  history ● 20% chance when there is a family  history ● Social Factors ○ Income and Poverty ○ Income inequality ○ Education ○ Employment ■ Guranteed paid vacation  ■ Guaranteed paid sick leave ■ Paid parental leave (maternal and paternal) ■ Increased minimum wage  ○ Social mobility ○ Household composition ○ Race and ethnic identification ■ Privilege inventory ○ Upstream vs. Midstream  ■ Box 6­1 pg. 164 ■ Upstream societal factors: ● Laws, policies, and underlying  values that shape the following ○ Income and wealth ○ Education ○ Employment ○ Household  composition ■ Homel essness myths/fact quiz ● 1 . Domestic violence is a leading cause of  homelessness among women Fact ● 2 . In 2014, there were less than 100  homeless people in Harrisonburg Myth ● 3 . About a quarter of the homeless  population are children myth ● 4 . Cities are increasingly making  homelessness a crime myth ● 5 . Most of the adult homeless population are  US Veterans Fact ○ Experiences based  on race or ethnic group ○ Social mobility ○ Income inequality ■ Midstream societal factors: ● Factors that are strongly influenced  by upstream factors and that are likely to affect health: ○ Housing ○ Transportation ○ Other conditions in  homes, schools, workplaces, neighborhoods, and  communities, including conditions that produce stress and  family disruptions (parenting styles, parenting stress,  leisure time, quality of schooling, physical and  psychosocial working conditions) ■ Midstream societal factors are impacted by the  upstream societal factors  ○ Hopelessness and powerlessness ■ Hope is important ■ Hope can alleviate stress ■ Gives people something to believe in  ○ Reading levels ■ Students that don’t read proficiently by 3rd grade  are 4 times more likely to leave school without a diploma from high school compared to proficient readers ■ The number rises when those kids also come from  poverty  ○ Epigenetic ■ Social factors may also influence health by  interacting with a person’s genotype ■ Genes that may be related to obesity, heart and  lung disease, diabetes, and cancer ■ Living under chronic stress can be changing our  genetic structure, which makes u more prone to disease  ● Physical Factors  ○ Housing and neighborhood ■ Homes and health ● Safety standards ● Inadequate food storage and refuse  disposal ● Environmental hazards ● Inadequate heating and/or cooling  ■ Neighborhood and health  ● Deprivation amplification ● The more mixing there is at the  neighborhood level of richer and poorer people, the greater the  health of the average resident ● Poorer people do better when mixed with richer ones  ■ Urban design, the built environment and physical  activity ● Access to recreational facilities,  parks, and urban design features such as bike paths, sidewalks,  and adequate lighting at night deeply influence the physical  activity level of people  ■ Housing policy and health  ○ Table 9.1 pg. 205 Variables associated with homelessness ● American Indians and Aboriginal People ○ Time clock questions ○ Unnatural causes “Bad Sugar” ○ Social Determinants of health ­ A Comparative Approach, Chapter 6 ● Public health and medical care systems ○ US Health care strengths and weaknesses (table one pg. 128) ○ Insured vs. uninsured  ■ Figure 4­5 pg. 131 ○ The US spends 17.9% of the GDP in 2010 and it has gone up  since then ○ Health care is the number 1 cause of bankruptcy in the US today ○ The affordable Care Act ■ Led to 90% of people in the US are now insured  ○ The US spent the most per capita: $7,960 whereas the median for all OECD countries was $3,223 ● Unnatural Causes ○ Unnatural causes quiz  ○ Time clock questions  ○ The unnatural causes assignment 


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