Public Health Midterm Study Guide
Public Health Midterm Study Guide PBH205
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This 22 page Study Guide was uploaded by Lindsey Notetaker on Monday October 17, 2016. The Study Guide belongs to PBH205 at University of Nevada - Las Vegas taught by Dr. Jin in Fall 2016. Since its upload, it has received 16 views. For similar materials see Introduction to Public Health in Public Health at University of Nevada - Las Vegas.
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Public Health Midterm Study Guide Public Health Midterm Study Guide Notes: These are going to include all textbook notes and vocabulary that correspond to the chapters we have gone over and then it is going to focus on each course of the classes and break down what the professor said to pay attention to. Chapter 1: Public Healthpolitic, science, and preventions Textbook Notes People expect living conditions to be healthy in civilized societies th Public health has increased drastically since the mid19 century Charles Edward A Winslow’s definition of public health still valid today o “The science and art of preventing disease, prolonging life, and promoting physical and mental health and efficiency through organized community efforts for the sanitation of the environment, the control of community infections, the education of the individual in principles of personal hygiene, the organization of medical and nursing service for the early diagnosis and preventive treatment of disease, and the development of the social machinery, which will ensure to every individual in the community a standard of living adequate for the maintenance of health." Basically science and art of preventing diseases and increasing life A study called The Future of Public Health in 1988 made the definition more broad o Made of 3 core functions which are better defined as The Ten Essential Public Health Service Assessmentseeing what the issue is and what needs to be done Monitor health status to identify community health problem Diagnose and investigate health problems and health hazards in the community Policy developmentfigure out what laws or regulations will help to prevent further issues 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 Assuranceseeing how well the policies are working and if they are still effective Page 1 of 22 Public Health Midterm Study Guide 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 healthcare workforce Evaluate effectiveness, accessibility, and quality of personal and populationbased health services Medical care does NOT mean the same as public health o Medical care looks to cure the sickness as public health looks to prevent the sickness o Medical care tends to get more recognition as with public health it is often overlooked Life expectancy of American have gone from 45 to 75 years over the 20 century o 5 of the 30 year increased was due to medical advancements o 25 of the 30 year increased was due to public health Safer working areas Healthier food Public health has to go through the government for changes Public health workers must work with a lot of different people to track disease and to try to stop and prevent the spread of it o They also study social behavior to see if that plays a part To help prevent disease spread, public health workers break it down to a 5 parts o Define the health problem o Find risk factors based on the problem o Develop and test community level interventions to control and prevent cause of the issue o Implement interventions to improve health o Monitor interventions to decrease how intense it is and if it is still effective It has 3 levels of prevention o Primary preventionprevents the disease from occurring at all o Secondary prevention seeks to decrease how intense it is o Tertiary prevention provides medical care and rehabilitation for those that were affected. Primary prevention is out of the public health’s hand with terrorism but they provide secondary and tertiary Vocabulary Words Page 2 of22 Public Health Midterm Study Guide Public Health: as defined by The Future of Public Health, organized community efforts to ensure conditions in which the people can be healthy. Activities that society undertakes to prevent, identify, and counter threats to the health of the public Life Expectancy: the number of additional years of life expected at a specified point in time, such as at birth or at 45 Mortality Rate: the incidence of deaths per unit of time, most often per year, in a population Centers for Disease Control and Prevention (CDC): the main assessment and epidemiological agency for the nation, directly serving the population as well as preventing technical assistance to states and localities Epidemic: the occurrence in a community or geographic area of a disease at a rate that clearly exceeds the normally expected rate Epidemiology: the study of populations to seek the cause of health and disease. The study of the distribution and determinants of disease frequently in human populations Statistic: as a scientific discipline or method, a way of gathering and analyzing data to extract information, seek causation, and calculate probability Biomedical Science: the study of the biological basis of human health and disease, including genetics, immunology, infectious disease, chronic disease, and molecular approaches to treatment Environmental Health Science: those aspects of human health, diseases, and injuries that are determined or influenced by factors in the environment. This includes the study of direct pathological effects of various chemical, physical, and biological agents as well as the effects on health of the broad physical and social environment, which includes housing, urban development, land use and transportation, and industry and agriculture Socioeconomic Status (SES): a concept that includes income, education, and occupational status; a strong determinants of health Chapter 2: Why is Public Health so Controversial? Textbook Notes Public health has always been controversial Public health is a huge social movement of trying to create a healthier environment for the people Dan E. Beauchamp is a public health philosopher Page 3 of22 Public Health Midterm Study Guide o Says that there needs to be a way of doing justice for all o Views these as fundamental rights and public health is in charge of this for all Minimal income Basic housing Employment Education Health care o In 1988 it was accepted that these were the fundamental rights and they fell in the hands of public health professions There are three main issues that are debated repeatedly over in public health actions o Economics Typically causes tax increase, decrease of jobs, or increase prices Industries do not like change so they do not want to have regulations that cost them Americans find it hard to see the benefit in the long run so they get mad not seeing individual benefits o Individual Liberties Government in charge of protecting the most and it becomes an issue as to how much they infringe on the peoples own rights Example would be the smoking laws that says people can’t smoke in certain places because it does infringe on those who want to smoke “Tragedy of the Commons” A problem that occurs when individuals overuse a shared resource to the extent that demand overwhelms supply and the resource becomes unavailable to some or all. Garrett Hardin used the example that if every herdsman has as many cows as they want then the land would no longer be useful and most if not all the cows would die due to not enough food, but if they agreed to have the same number of cows then it would allow for the land to stay healthy and everyone gets to keep their cows Today the “commons” would be water, air, and elements like that that no one person can own Public health needs to focus on the whole and what will help the most over individual liberties Page 4 of 22 Public Health Midterm Study Guide Example with the smoking, that is why there are laws that businesses have smoking areas and nonsmoking areas for those that do and don’t smoke o Moral and Religious Opposition When it comes to sex education, many religious groups think it promotes immoral and bad behavior Another example would be AIDS No matter what people will find something to argue about The government interferes with science o February 2004, Union of Concerned Scientist released a report called “Scientific Integrity in Policymaking” which reported that the government had suppressed or misrepresented scientific information based on political agenda o Government had been known to replace credible scientist with people who had or has financial ties to the industries being investigated Vocabulary Words Communicable Disease: infectious disease that spreads directly from one person to another Acquired Immune Deficiency Syndrome (AIDS): the most severe phase of infection with the human immunodeficiency virus (HIV). People infected with HIV are said to have AIDS when they get certain opportunistic infections or when their CD4+ cell count drops below 200 Human Immunodeficiency Virus (HIV): the virus that causes acquired immune deficiency syndrome (AIDS) Chapter 3: Powers and Responsibilities of the Government Textbook Notes Government’s role is determined by law o All three levels need to follow the law Federal State Local Public health is primarily the state’s responsibility Federal government in charge of public health when it’s from state to state o FDA keeps the food traveling from state to state healthy for all Page 5 of 22 Public Health Midterm Study Guide o Has been widening their rule over public health by providing funding if the state follows their guidelines Funding for the interstate highway if the states make a law requiring helmets to be worn by motorcyclist Then started to decline in 1980 to give the states more power Police force is invoked and needed for public health assistance in three instances o To prevent a person from harming others o To defend the interest of incompetent persons such as a child or mentally retarded o To protect a person from harming himself or herself OSHA makes regulations for workers across the United States of America Funding health care is typically job of the state Health care agencies are separate from one another and it makes communication difficult o Environmental issues o Social services o Aging o Mental health Funding for state health departments come mostly by taxes and federal grants Surgeon General is the leading spokesperson on public health NIH is the greatest biomedical research complex in the world Not all agencies that play a part in public health are with the government o Many philanthropic foundations provide funding for research Vocabulary Words Food and Drug Administration (FDA): the federal agency that ensures the safety and nutritional value of the food supply; evaluate all new drugs, food additives, and colorings; and regulates medical devices, vaccines, diagnostic tests, animal drugs, and cosmetics Medicaid: a federally aided, stateoperated and administered program that provides medical services to eligible lowincome populations Medicare: a national health insurance program for persons over age 65 and certain younger persons who are disabled Occupational Safety and Health Administration (OSHA): the federal agency, part of the Department of Labor, responsible for occupational health and the prevention of occupational injury Page 6 of 22 Public Health Midterm Study Guide National Institutes of Health (NIH): the primary federal agency for biomedical research. the NIH has its own laboratories and also provides funding to biomedical scientists at universities and research centers Environmental Protection Agency (EPA): the federal agency responsible for prevention and cleanup of water pollution and air pollution, control of toxic substances, and other issues of environmental contamination Chapter 4: Epidemiology The Basic Science of Public Health Textbook Notes Epidemiology is used to perform public health’s assessment functions o Meaning that they determine if public health interventions are working o They try to find why it is happening John Snow is the father of modern epidemiology o Discovered that cholera was spread by polluted drinking water Epidemiologic surveillance is when the CDC requires certain disease to be reported as soon as ONE case is found Epidemiologist have to ask the what, who, and where questions about diseases Sometimes a disease can be considered an epidemic with just ONE case o It depends how severe the case is High blood counts of white cells is called eosinophils Cancer, heart disease, and other diseases of aging do NOT have one singular cause o Tend to develop over time o Often chromic and disabling instead of rapidly fatal o Cannot be prevented or cured First major epidemiologic study of a chronic disease took place in Framinghan, Massachusetts of heart disease o Found 3 major risk factors High blood pressure High blood cholesterol Found 2 types of cholesterol o Highdensity lipoprotein Good Protects o Lowdensity lipoprotein Bad Smoking Found that heavy smoking increases chance of lung cancer Page 7 of 22 Public Health Midterm Study Guide “shoeleather epidemiology is “by local health departments provides the front line of defense against acute disease Vocabulary Alzheimer ’s disease: a degenerative disease of the brain characterized by mental deterioration. It is the most common cause of dementia in the elderly, and its prevalence increases with age Cancer: disease in which abnormal cells divide without control. Cancer cells can invade nearby tissue and can spread through the blood stream an lymphatic system to other parts of the body Chapter 5: Epidemiologic Principles and Methods Textbook Notes Epidemiology is “the study of the distribution and determinants of disease frequency in human population” Incidence rates are helpful in determining cause of a disease Prevalence rates are helpful in assessing the social aspect of a disease and planning for health care services Mortality rates are sometimes useful for disease o If a disease is not fatal then it is not at all o If a disease can be cured then it is somewhat helpful o If a disease is fatal then it is the same or close to incidence rates They make charts to figure out the dates of exposure of the disease and where it could have happened Prospective studies start in present and monitor the groups future o Sometimes start in past and work to current Retrospective studies look at past to find cause of current disease There are different kinds of epidemiologic studies o Interventionconducts experiments of treatments Patients are assigned randomly to the control and treatment group Doubleblind is when the doctor AND patient do not know who is receiving actual treatment o Cohortthe people choose whether they are exposed or not Helps contain relative risk Higher than 1.0 means increased risk Page 8 of 22 Public Health Midterm Study Guide Exactly 1.0 means no risk Lower than 1.0 means decreased risk o Casecontrol looks at the ill and trace where they were exposed More efficient than cohort studies Finds the odd ratio (exposed group relative risk)/(control group relative risk) Vocabulary Words Incidence: a measure of the number of new cases reported in a given amount of time, usually a year Prevalence: proportion of persons in a population who have a particular disease or attribution at a specified point in time or during a specified time period Mortality Rate: the incidence of deaths per unit of time, most often per year, in a population Intervention: a generic term used in public health to describe a program or policy designed to have an impact on a health problem Intervention Study: an epidemiologic study in which the effect of a intervention on one group of subjects is compared with the effect of a placebo or conventional therapy on a control group; for example, a clinical study Control Group (controls): a group of individuals used by an experiment as a standard for comparisons to see the effect of changing one or more variables in an experimental group Experimental Group: the treated group in a study, in contrast to an untreated or more conventionally treated control group Placebo: a supposedly ineffective pill or agent used in a control group to gauge the effect of an actual treatment in another group. Experimenters often must allow for a placebo effect, a response causes by suggestion Randomization: division of a sample into two or more comparable groups by some random method that eliminated biased selection Clinical Trial: at its best, a study of the effect of some treatment on two (or more) comparable, randomly selected groups (eg. An experimental group that is treated and an untreated or otherwise treated control group) Cohort Study: a study of a group of people, or cohort, followed over time to see how some disease or diseases developed Page 9 of 22 Public Health Midterm Study Guide Relative Risk: a comparison of two morbidity or mortality rates using a calculation of the ratio of one to the other Case Control Study: an epidemiologic study that compares individuals affected by a disease with comparable groups of persons who do not have the disease to seek possible causes Chapter 6: Problems and Limits of Epidemiology Textbook Notes Most studies for chronic diseases are hard if not impossible to do o Very hard to alter people’s behavior over long periods Sometimes people do not know what to believe when studies contradict each other Most studies need to be large numbers to be trusted When doing a stud, need to look at the confounding variations There’s an issue with studies being bias o The one conducting the study could only pick people who could prove his or her point o Sometimes the ones being studied lie on the questions that they are asked To prove cause and effect there needs to be a HIGH relative risk factor High hormone injections are not healthy and the few benefits are not worth the risks Ethics play a huge part in conducting experiments on humans o The subjects need to know what they are getting into including possible risks and benefits o Subjects must give consent to be involved o Study needs to be approved by a review board to make sure it is described well With drug trails, they need to list possible side effects If a trail tests a drug against a placebo, there are drugs out for the issues already, it is not reliable to know if it actually helps If a company pays the people to do studies on new drugs, sometimes shows how bias the research will be Vocabulary Chronic Disease: a disease that is marked by long duration or frequent recurrence, usually incurable but not immediately fatal. Common disease that are considered chronic include cardiovascular disease, cancer, diabetes, Alzheimer’s disease, and recently acquired immune deficiency syndrome (AIDS) Page 10 of 22 Public Health Midterm Study Guide Cardiovascular Disease: disease of the heart and blood vessels, most commonly causes by atherosclerosis, deposits of fatty substance in the inner layer of the arteries of the heart and may lead to a heart attack. Cerebrovascular disease affects the arteries of the brain and may lead to stroke Confounding Variable: another factor or explanation may affect a result or conclusion Random Variation: the way a coin will successively turn up heads or trails if flipped in just the same way Bias: the influence or irrelevant or even spurious factors or associationscommonly called confounding variableon a result or conclusion Chapter 7: StatisticsMaking sense of Uncertainty Textbook Notes The science of epidemiology relies almost entirely on statistics Statistics help to make the information of cause and effect, health risks, and disease cures more understandable for people There is always some uncertainty with science o It does not help when some studies say one thing and there’s a study that contradicts another study Probability is used to describe the variety and frequency of past outcomes under similar conditions as a way o predicting s a way of predicting what should happen in the future o This helps to have an idea of what should happen, but statistics sometimes show that it does not always follow the rules When the probability is found to be 0.05 or less, the statistic is considered significant Power is the probability of finding an effect if there is one o A larger study has more power than a small study A good secondary preventive care for a disease is screening If tests are too sensitive they yield false negatives If tests are too specific they yield false positives Secondary tests are usually needed to follow up to find out if something is wrong o This is expensive and not very effective due to the first tests giving false results Lead time bias occurs when increased survival time after diagnosis is counted as success Over diagnosis bias occurs when the tumors that are detected by the screening are not likely to progress to the state that they cause symptoms and be life threatening It is smart to adjust the rats when comparing death rates, birth rates, and so on of different places or types so that the population that is being looked at is similar Page 11 of 22 Public Health Midterm Study Guide The Three Mile Island was a nuclear power plant in Pennsylvania that had many safeguards and experts did not except an accident to occur, but in 1979, an accident occurred but no one was harm Risks are on two scales o Dread The more dreaded the risk, the less acceptable it is o Knowability Unknown risks are less acceptable than known risks Vocabulary Words P Value: the probability that an observed result or effect could have occurred by chance if there had actually been no real effort False Negative: a mistaken identification of persons as healthy or unaffected when, in fact, they have the disease or condition being tested for False Positive: a mistaken identification of persons as affected by some disease or condition when in fact, they are unaffected by the disease or condition being tested for Life Expectancy: the number of additional years of life expected at a specified point in time, such as birth or at age 45 Years of Potential Life Lost (YPLL): a measure of the impact of disease or injury in a population, YPLL is years of life lot before a specified age (usually age 75). This approach places additional value on deaths that occur at earlier ages Rick Factor: a characteristic that has been demonstrated statistically to increase a person’s chance of developing a disease or being injured Risk Assessment: a quantitative estimate of the degree of hazard to a population presented by some agent or technology or decision. A riskbenefit assessment attempts to weigh possible risks against possible benefits Cost Benefit Analysis: an economic analysis in which all costs and benefits are converted into monetary values and results are expressed as dollars of benefits per dollar expended Cost Effectiveness Analysis: an economic analysis is assessed as health outcome per cost expanded Chapter 8: The Role o Data in Public Health Textbook Notes Page 12 of 22 Public Health Midterm Study Guide Statistics are the base line of public health to see what the issue is and if the policies are working or not The two main centers that collect data from states is the Centers for Disease Control and Prevention (CDC) and National Center for health Statistics (NCHS) A lot of their information comes from birth and death certificates o Birth certificates are generally more accurate because the mother is the one reporting first hand, but with death certificates it often gets reported not as accurately depending how well the person reporting knew the one who had died For statistics, it is important to make sure that you know the population that is being looked at and if you’re comparing two different statistics to each other, they are in the same category o Examples such as people of the same age group, race and ethnicity, gender With the census, more often than not, people get countered twice or people get miscounted o In 2010, they think they missed 10 million people for the census and counted 36,000 people twice They take surveys often to help keep updated of new possible risk factors When surveys ask the people to self report on themselves, sometimes it is unreliable because people don’t report the 100% truth Although people want less government and to cut back on data collection, it is not beneficial because it will cause public health professions to lack data and they might not be able to catch an epidemic before it starts The statistics have to do with what is reported and how the person taking the data is reporting it There are uncertainty with reporting, even with births and deaths o They are not doing autopsies on the dead anymore Everything is kept confidential when taking the information Vocabulary Words Statistics: as a scientific discipline or method, a way of gathering and analyzing data to extract information, seek causation, and calculate probabilities Notifiable Disease: a disease that the law requires to be reported to public health authorities as part of the public health surveillance system Chapter 13: Do People Choose Their Own Health Page 13 of 22 Public Health Midterm Study Guide Textbook Notes The leading causes of death have significantly changed from the 1900 to 2008. o Top three in 1900 were pneumonia and influenza, tuberculosis, and diarrhea, enteritis, ulceration of intestines o Top three in 2008 were heart diseases, cancer, and chronic lower respiratory diseases Public health professions found that the three actual causes of death are tobacco, poor diet and physical activity, and alcohol consumption Some study shows that being a little overweight is healthy for older people but it still causes premature deaths Public health professions attempt to educate and regulate the leading causes of deaths but they can only do so much o For education they teach and label the foods based on their nutritional value this works in children with health programs but no evidence it helps to make sure that they actually behave like that sexual education is a big debate as well because some think it is not a good idea because then it encourages it o For regulation they are the laws that must be enforced to help protect the people Seat belt laws Motorcyclist have to wear helmets No drunk driving Minimum age for alcohol and tobacco Prohibition works in a sense to lower the use of something, but it also causes the black market to have the prices increase through the roof The D.A.R.E. (Drug Abuse Resistance Education) program does little to no effect on the war on drugs It is hard to get people to change their behavior even when they are given the facts and health risks associated with their behavior Chapter 14: How Psychosocial Factors Affect Health Behavior Textbook Notes It is more beneficial to focus on the social environment than the individual usually because sometimes the individual will blame the environment Page 14 of 22 Public Health Midterm Study Guide People with the lower socioeconomic status has the higher mortality rate so they are correlated based on education, gender, income, etc o Even if they have health insurance that is not a big factor Blacks tend to be more likely to have a bigger impact of health issues Stress has a big impact on the health of a person because it impacts their physical and mental state o Social support is one of the greatest ways to help with stress The health belief model is assuming people act in rational ways when dealing with stressful situations o The extent to which the individual feels vulnerable to the threat o The perceived severity of the threat o Perceived barriers to taking action to reduce the risk o The perceived effectiveness of taking an action to prevent or minimize the problem o Sometimes self efficacy is viewed as one To help with self efficacy it is better to have the younger students of anyone be taught by someone who they can relate to The transtheortical model to help change behavior of people o Precontemplation They have no intent on changing their behavior and it is getting them to change their it o Contemplation Person becomes more aware of the benefits from change but also aware of the difficulties of change o Preparation Have an idea or plan to actually make the change o Action Having them follow through with their plan o Maintenance Accomplished goal but still need to work to keep up the behavior The ecological model of health behavior focuses on changing the social environment of people and has five levels o Intrapersonal factors Skills, attitude, and knowledge of the person o Interpersonal factors Family, friends, and coworkers o Institutional factors School and workplaces o Community factors Page 15 of 22 Public Health Midterm Study Guide If the community promotes healthy behavior it has positive impacts on the people but it can also be vice versa o Public policy Regulations and limitations on behavior Health promotion programs aim to target groups that do risky behaviors and change their behavior so others do not follow their path o This has to take place every generation because each one is different and how they respond are different o Getting the whole community involved tends to increase the chance of success of a program Vocabulary Words Sexually Transmitted Disease (STDs): infections caused by bacteria or viruses that are primarily transmitted through sexual activity. Examples of bacterial STDs are syphilis, gonorrhea, and Chlamydia. Viral STDs include HIV, genital hers, and the human papilloma virus Socioeconomic Status (SES): a concept that includes income, education, and occupational status; a strong determinant of health Stress: a psychological and emotional state of tension: “a state that occurs when persons perceive that demands exceed their ability to cope.” Specific Course Ideas to Pay Attention to Course 1 o What is public health The science of preventing disease and making people live longer. Attempts to get the community to help promote a healthy life style that makes them live longer o 3 core functions of public health Assessmentlook at what the overall health of the community is and investigate health problems that the community has Policy Development get people to want to help out and teach them about the issues of the health concern and promote a healthier living Assurancefollowing through and having laws and policies enforced to keep the community healthy Page 16 of 22 Public Health Midterm Study Guide o Difference between medical care and public health Public Health Medical Care Patient is the community Patient is the individual Diagnose the community’s health Diagnose the individual’s health Treatment involves new policies and Treatment is the patient’s choice interventions Goal to prevent diseases Goal to cure the illness o Know the branches of public health and what they do Epidemiologystudies who gets it and why; aims to control the spread of diseases Statisticsallows us to see the magnitude and scope of the issue Biomedical Scienceslooks at all diseases and how they different Infectious Chronic Genetic Environmental Health Sciencelooks at the water, air, food, and anything that has to do with the environment Social and Behavioral Scienceslook at why people choose to do unhealthy behavior Health Policy and Managementlooks at how medical care is accessible to others o 3 levels of prevention Primarymaking a disease not occur at all Secondaryminimize the damage of the illness Tertiaryminimize damage and allow those effected to get medical care o Chain of causation (the triangle) Page 17 of 22 Public Health Midterm Study Guide o Course 2 o Difference between social and market justice Market Justice individual responsibility, freedom Social Justice common good, fundamental rights o Comments of air and water This is a public good so they need to find ways to keep it clean so that everyone can use it without getting ill o How public health has to limit people liberties To prevent harm to others Limits on what people under 18 can do or buy To protect form owns action o Different levels of public health • Federal Agencies Department of Health and Human Services o Centers for Disease Control and Prevention o National Institutes of Health o Food and Drug Administration State Health Departments o Nevada Division of Public and Behavioral Health Page 18 of 22 Public Health Midterm Study Guide Local Public Health Agencies o Southern Nevada Health District o Know role of nongovernment agencies Some nongovernment agencies are focused on diseases which try to raise awareness and money to finding the cure of the illness that they promote Some nongovernment agencies are focused on professional membership which are people of the same profession meeting and finding ways to advance their fields more so Some nongovernment agencies are focused on philanthropic foundations which try to just raise money for their causes Some nongovernment agencies are focused on consumer goods which tries to make things that people buy healthy o Know role of governmental agencies The role of governmental agencies are to enforce the laws and policies that the public health professions put into place to help the community o The history of the diseases James Lind discovered the cause of scurvy. Not enough Vitamin C in their diet Edward Jenner discovered the first vaccine for smallpox John Snow found that cholera was spread through the dirty water, so it lead to a better water filtration William Budd found that typhoid was also spread through the dirty water Florence Nightingale found that by cleaning the medical supplies with clean, hot water it reduced how many soldiers died from infectious diseases Course 3 o What is epidemiology the study of the distribution and determinants of disease frequency in human populations o What the mission of epidemiology Identify the cause of a new syndrome or disease Identify risk factors for known diseases Assess the risk associated with a harmful expose Evaluates the effectiveness of preventive interventions Identifies needs and trends in the use of health services o The modes of transmission Direct is when it’s like skintoskin Page 19 of 22 Public Health Midterm Study Guide Indirect is when it’s airborne, in the food, or through a vector (insect or mammal) o Purpose of epidemiology surveillance To help keep the community healthy and they watch if any disease starts to show up at higher rates than normal and then investigates why that is o Why notifiable diseases Diseases that can cause a huge epidemic, so to avoid that they have certain diseases that are easily spread but can be prevented have to be notified as soon as someone is diagnosed with it o Disturbances of gender Women tend to live longer than men o Study designs A study design may be prospective, retrospective, crosssectional Prospective which is looking into the future Retrospective which is looking into the past Crosssectional which is taking a snapshot in time There are four specific types of study designs that we focused on Intervention is when there are two groups ad one group is the experimental and the other is the control Cohort is when it is a big group and they people choose what they are exposed to and then the experimenters look and track them for a time Case study is when they interview people who are already exposed to the disease and look at their exposure and then try to find a healthy group that is the most similar to the exposed group to be the control o Issues with doing it on humans and the common errors People can lie about their exposure and behavior Could not follow the instructions People could drop out The control group could not be not that similar to the expose group Course 4 o Understand how to calculate the odds ratio Take the ratio of an outcome in exposed versus the nonexposed sample o The p value The chances of seeing the results in nature o Screening tests and the full measures of them Page 20 of 22 Public Health Midterm Study Guide False positives show that there is an effect on someone when in reality there is not False negative show that there is not effect on someone when in reality there is Sensitivity is the probability of showing the disease to those effected Often has false positives Specificity is the probability of showing disease free to those without the disease Often has false negatives o Crude and age adjusted rates Age adjusted is more accurate because it looks at the most similar group of people and then allows them to compare if the location they live has an impact on the statistic o Calculate and interbred relative risk It is the ratio of two probabilities which look at the risk of disease/death among those that have been exposed compared to the risk of disease/death among those not exposed If it equals 1 then there is no difference for the disease between those who are exposed or not If it is negative then it would mean that exposure is protective If it is positive then it would mean that exposure is not protective Course 5 o Main way to get data Any local records Birth and death certificates Surveys o How they get them Local governments give to states government who can give to national government Course 6 o Leading cause of deaths Heart disease is the top Then cancer is the second The third is Chronic lower respiratory diseases o Leading actual causes of deaths Tobacco is the top Poor diet and physical activity is the second Accidents are the third o Public health intervention Page 21 of 22 Public Health Midterm Study Guide Educationteach about unhealthy behavior and promote the good behavior Regulationmaking laws of what is acceptable behavior and punishing those that do not follow Prohibition o Socioeconomic status A pretty good indicator of one’s health because it is based on income, education, and occupation o Models that are in Health belief model Perceived susceptibility Perceived severity Perceived benefits Perceived barriers Cues to action Self efficacy Ecological model Intrapersonal factors Interpersonal factors Institutional factors Community factors Public policy Page 22 of 22
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