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UMD / OTHER / SPHL 100 / sphl100 umd

sphl100 umd

sphl100 umd


School: University of Maryland - College Park
Department: OTHER
Course: Foundation Of public health
Professor: Dr. sylvette a. la touche-howard
Term: Spring 2019
Tags: Public and health
Cost: 50
Name: SPHL100- Study Guide-Exam1
Description: This study Guide contains questions from Week1-Week 5 Notes are from lectures and discussion. Good Luck!
Uploaded: 03/01/2019
20 Pages 12 Views 6 Unlocks

caitlinj3 (Rating: )

Study guide Exam 1:

When did the United nation general assembly recognized access to safe water and sanitation as basic human rights?


40% from the power points

30% from the book

30% from discussion  


Week 1: (Lecture 1)

1. When did the United nation general assembly recognized access to  safe water and sanitation as basic human rights

a. 2010

2. What was founded on 1970?

a. The environmental Protection agency

3. What is a sanitation facility?

a. Separation of the human waste from human contact

4. What would happen if we teach proper hand washing around the  world?

a. accelerate economic and social development in countries where  sanitation is a major cause of lost work and school days because  of illness

b. could reduce the number of deaths of young children by two  thirds

5. What is pandemic?

What was founded on 1970?

a. It is the worldwide spread of a new disease

6. When does influenza pandemic occur?

a. a new influenza virus emerges and spreads around the world b. most people do not have immunity.  

7. Where did viruses that have caused past pandemics originate from? a. From animal influenza viruses If you want to learn more check out biology 151

8. What are the public health disciplines?

a. Epidemiology

b. Statistics

c. Social and behavioral sciences

d. Environmental health science

e. Biomedical sciences

Week 1: (Lecture 2)

9. What is the difference between Public health and Medical care? a. Public health

i. Population/ community focus

ii. Prevention or public health emphasis

iii. Diagnoses the health of the community using public health  sciences

iv. Goal of Public health is to prevent disease and disability v. Out of the 30 years of increased life expectancy 25 years  can be attributed to public health

What is a sanitation facility?

b. Medical care

i. Individual patient focus

ii. Diagnosis and treatment emphasis

iii. Diagnoses the health of the individual using medical  interventions If you want to learn more check out hes 1600

iv. Goal of medicine is to cure

v. Out of the 5 year of increases life expectancy 25 years can  be attributed to public health

10. What is the core function of public health?

a. Assessment – knowing what needs to be done

i. Monitor health

ii. Diagnose and investigate

b. Policy development- being part of the solution to get it done i. Inform, educate, empower

ii. Mobilize community partnership

iii. Develop policies

c. Assurance- making sure it gets done

i. Enforce laws

ii. Link to/provide care

iii. Assure a competent workforce

iv. Evaluate  

11. Public health issues: Putting theory to practice

a. Defining the problem: SURVEILLANCE

i. Collect information/data about the rates

b. Identify causes

i. Risks. Factors influencing the action

c. Develop and test intervention

i. Can influence a combination of areas such as  

psychological, physical etc.

ii. Make sure intervention is safe, ethical and feasible

d. Implement intervention

i. Essential that how it is designed is how it will be  


e. Evaluate intervention Don't forget about the age old question of A ritualistic makeup palate depicting scenes of the pharaohs great acts.

i. Evaluation involves setting realistic goals and objectives  and must be incorporated into a program from its  


12. What are THE prevention and interventions?

a. Primary prevention prevents an illness or injury from occurring at all.

b. Secondary prevention minimizes the severity of the disease or  injury once it has occurred. We also discuss several other topics like bio e enzyme

c. Tertiary prevention minimizes disability by providing medical care and rehabilitation services.

 Week 1: (Discussion 1)

● 20th century public health achievements:

○ Vaccine preventable diseases

○ Prevention and control of infectious diseases

○ Tobacco control

○ Maternal and infant health

○ Motor vehicle safety

○ Cardiovascular disease prevention

○ Occupational Safety  

○ Cancer Prevention

○ Childhood Lead Poisoning prevention

○ Improved public health preparedness and response

● Worksheet 1: Public health achievement: Immunization

○ What led to this?

■ scientific research, outbreaks, people dying and efforts  being made to prevent it.

○ Why is this achievement important to the population health  nationally and globally?

■ Prevent future disease outbreaks

○ How is this achievement different in the 21st century?

■ Better technology and people are more aware about going  to get check ups and getting tested.

○ Challenges and barriers to moving forward?

■ People don’t vaccinate due to personal beliefs, beliefs and  attitudes prevent one from getting vaccinated. Don't forget about the age old question of mis degree plan uh

○ New public health achievements? We also discuss several other topics like busmgt 2320

■ Being prepared for disasters.

■ Everyday preparedness of people

Week 2:

13. What does health literacy define?

a. degree to which an individual has the capacity to obtain,  communicate, process, and understand basic health  

information and services to make appropriate health  


b. Providers, healthcare organization, business, government agencies.  

14. When does health literacy occur?

a. Health literacy occurs when a society provides accurate health  information and services that people can easily find,  

understand, and use to inform their decisions and actions. 15. What is the basic literacy and numeracy?

a. Text, numbers, technology, forms, graphs and table.

Week 2: (Discussion 2)

● Healthy People 2020  

○ It is a national management-by-objective approach that sets 10- year targets designed to guide national health promotion and  disease prevention efforts to improve the health of all people in  the United States.

○ Science based

○ 42 unique topic areas with more than 1,200 objectives

○ Who sets the goal?

■ U.S. Department of Health and Human Services

● Purpose of healthy people

○ Baseline for measuring program performance

○ Framework for program planning and development

○ Framework for goal setting and agenda building

○ Resource for teaching public health courses

○ Set of benchmarks for comparing state and local data

○ Resource to engage non-traditional partners

● Healthy people 2020

○ Launched in December 2010

○ Smaller set of healthy people 2020 called Leading Health  Indicators (LHI)

○ HP 2020 objectives can now change annually or every two years  in areas where targets have been met, rather than the previous  mechanism of publishing HP once every 10 years with a mid course review after five years

● Baseline Data, Target, Benchmarks

○ Baseline Data: value of a performance indicator before the  implementations of projects or activities

○ Targets: specific, planned level of result to be achieved within an  explicit timeframe

○ Benchmarks: document progress towards achieving results.

○ Indicator = measure that numerically portrays the health status  of a population in relation to a specific health issue.

● Worksheet 2 Example: UNDERSTAND CONCEPT ON EXAM 

○ https://www.healthypeople.gov/2020/leading-health


○ Leading health indicator is environmental quality

○ Impact of it is air pollution, asthma, can cause cancer and other  illnesses

○ Indicator: Air quality index exceeding index (AQI)

○ Baseline: 8.488 billion

○ Target: 7.638 billion

○ Benchmark: 3.327 billion

○ Target was achieved

○ Barrier to achieving or maintaining the target is air pollution or  unhealthy outdoor air, smoking rates are high for cigarettes, or  living near power plants or hydrofracking sites where oil and gas  is predominate.

Week 3:

16. What is Epidemiology?

a. Study of the distribution and determinants of health-related  states among specified populations and the application of that  study to the control of health problems. It is the diagnostic

discipline, but compared with other sciences is still in its  embryonic stage

17. What is the difference between Descriptive and Analytic  Epidemiology?

a. Descriptive: When was the population affected?

i. Where was the population affected?

ii. Who was affected?

b. Analytic Epidemiology

i. How was the population affected?

ii. Why was the population affected?

18. How to describe epidemiology?

a. What = health issue of concern  

b. Who = person  

c. Where = place  

d. When = time  

e. Why/how = causes, risk factors, modes of transmission 19. What is the function of Epidemiology?

a. • Discover the agent, host and environmental factors which  affect health

b. • Determine the relative importance of causes of illness,  disability and death

c. • Identify those sections of the population which have the  greatest risk from specific causes of ill health

d. • Evaluate the effectiveness of health programs and services in  improving the health of the population.

20. What is epidemic surveillance?

a. Is a major line of defense in protecting the public against  disease

b. • System was created to control spread of known disease but  also aids in recognizing new disease and bioterror attacks. 21. How can epidemiologists infer why a disease is occurring? What  is the goal?

a. Who is getting the disease?

b. When did they get the disease?

c. Where is the disease occurring?

d. The ultimate goal is to use this knowledge to control and prevent the spread of disease.

22. How are rates important?

a. Rates help us compare health problems among different  populations that include two or more groups who differ by a  selected characteristic

23. What is the rate formula?

a. To calculate a rate, we first need to determine the frequency of  disease, which includes  

i. •the number of cases of the illness or condition •the size of the population at risk •the period during which we are  

calculating the rate

24. Who is John snow?

a. When London had cholera in mid 1800s.  

b. He conducted a natural experiment to see if the problem is  associated with water.

c. He questioned households where cholera death occurred d. Most deaths were associated with one water supply company.  25. How does epidemiology study the human population?

a. Epidemiology studies human population, usually using  observational rather than experimental methods.

26. What is the biomedical approach?

a. Uses animal models to investigate the causes of disease.  Experiments conducted on animals can yield to answers (cause  and effect)

b. It is unethical for experiments to be done on humans

27. What are the Kind of epidemiologic studies?

a. Goal is to determine an association between exposure and a  disease or other health outcome.

b. • Studies may be prospective or retrospective

c. • Intervention study

d. • Cohort study  

e. • Case-control study⇒ Subjects identified as having a disease or  condition are compared with subjects without the same disease  or condition  

28. How to set up a case-control study?

a. • It is done to follow up on a hypothesis generated by “shoe leather” epidemiology.

b. • Choose people who already have disease and Choose a  healthy control group of individuals, as similar as possible to  cases.  

c. • Interview them all and ask for their previous exposures.  

d. • Estimate the strength of the association between exposure and disease by calculating an odds ratio.

29. What is cohort study? How to set it up?

a. Are for situations when doing an intervention study would be  unethical or too difficult.  

b. Choose a large number of healthy people, collect data on their  exposures, and track outcomes over time.

c. The only difference from intervention is that people choose their  own exposures.

30. Why discuss problems and limitations of epidemiology? a. Every epidemiological tool has limitations

b. Awareness of these limitations is crucial to making the correct  decisions about what to ask of epidemiologists, which studies to  commission, and when and how to interpret findings.

c. Epidemiology depends on valid data.

i. Gathering data is restricted from lack of resources. Also,  may be due to difficulties in communication and transport  to remote areas.

d. : Epidemiology is also constrained by the rapid changes in the  health and nutritional status of many emergency-affected  populations.  

e. There are several expectations of Program Evaluation

i. •Policy-makers sometimes expect that organizations  delivering a certain intervention will be able to  

demonstrate an "impact" on health that is unequivocally  traceable to that intervention alone

f. Epidemiology and the data gathered by epidemiologic  methods are routinely ignored.  

i. Major decisions are NOT made on evidence.  

31. What are some Challenges we face when studying humans? a. •Intervention study problem:

i. •Subjects may not follow prescribed behavior throughout  study period.

b. •Cohort study problem:

i. •Sometimes it is hard to isolate which of many factors are  responsible for health differences.

c. •Case-control study problems:

i. •Control group may not be truly comparable.

ii. •Errors may exist in reporting or recalls.

32. What are the sources of error?

a. Random variation- Results due to chance not relationship  between the variables

b. Confounding variables- a factor associated with an exposure that may independently affect the risk of developing the disease.

c. Selection Bias- •error due to systematic differences in  characteristics between those who are selected for a study and  those who are not.

d. •Reporting bias or recall bias

i. •error that occurs when there is a differential level of  accuracy in the information provided by compared groups

ii. •in a cohort study, it occurs when exposed subjects are  more or less likely than unexposed subjects to recall and  report subsequent disease;

iii. •in case-control studies, it occurs when cases are more  or less likely than controls to recall and report prior  


33. Which state has the highest rates of unisured women in the  nation? What did this lead to?

a. South carolina. This leads to limited access to healthcare for  early daignosis and treatment for breast and cervical cancers.

34. Who did help the black corals program to increase the breast and cervical cancer screenings in the community?

a. The Community guide

35. What are factors that lend validity to results?

a. •Strong association

b. •Dose–response relationship

c. •Known biological explanation

d. •Large study population

e. •Consistent results from several studies

f. •High relative risk or odds ratio

36. What does the cohort study result say about Hormone  Replacement Therapy?

a. Thet were confounded by associated factors that made women  taking HRT healthier, even without the therapy.

37. What are some conflicts in Drug trials?

a. •Drug companies are required to conduct randomized  controlled trials on a new drug before it can be approved.

b. •Harmful side effects have frequently become obvious after  drugs were approved.

c. •There is evidence that drug companies sometimes suppress  negative findings.

d. •All clinical trials must now be registered in advance with a  public database.

Week 3: (Discussion 3)

● Ethics in public health research  

● Ethics is knowing the difference between what you have a right to do  and what is right to do.

● Key Ethical Questions in Public Health Research

○ Does the research have social value for the communities that  take part or from which the participants are drawn?

○ Who benefits from the research?

○ Are all groups in the population treated fairly?

○ Are the rights and well-being of individual research participants  protected?

● Tuskegee Syphilis Study

○ The intent was to study natural history of syphilis in black men. ○ Men were told they were being tested for bad blood.  

○ In 1947 penicillin treatment but the men were withheld from it. ○ In 1972 the study finally gained public attention.

○ Many individuals had died from it and the last participant died  January 2004.

○ The panel said how the study was unethical and officially ended  it a few month later.  

○ 65 year late apology made by Bill Clinton on May 16,1997. ⅝ of  the participants from the study attended the ceremony.

○ The survivors called for a permanent memorial so the children  and grandchildren of men in the study can learn what happened.  ● In this study the scientists had benefited from it they were the only  ones collecting the data. The US government also could have  benefitted since they were given access to the study.

● Not all the groups were treated fairly because the participants were not told fully about the experiment and they were just told they were being treated on because they have bad blood.

● No the rights of the research participants are not being protected  because there was no informed consent and human consent is really  important in the field of public health research.

● Racism and prejudice played a role in this study since they were  african americans they were not given full information about the study. For the Guatemala study racism and prejudice played a role because of them having no resistance /acceptance from the government system,  so it was easy to take advantage of them.

● The outcome/ethical violations of both studies impacted public health  research because it lead to the National Research Act. Now any  application to test with humans is a lot more rigorous in order for  people to do research on them. You have to explain how you would go  with your study you can’t do whatever you want. Along with that this  research set a precedent for others to know about understanding what  ethical research is.

Week 4:  

38. What are the 2 broad methods of reasoning as the deductive and inductive approaches?

a. Inductive: Observation ⇒ Pattern/generalization⇒ Tentative  Hypothesis⇒ Theory

b. Deductive: Theory⇒ Hypothesis ⇒ Observation ⇒


39. Empirical evidence= Epidemiology + Biostatistics 40. What are the functions of statistics in public health research?

a. Description of the property of the data you have (average, range, variance)

b. Statistical methods are required to ensure that data are  interpreted correctly and that apparent relationships are  meaningful (or “significant”) and not simply chance occurrences.

41. What is the statistical significance?

a. If you take repeated simple random sample from the population,  you will observe a distribution of the numbers.

b. Based on the repeated sampling and assumed distribution, how  unlikely do you observe what you observed(3 feet 5 inches) by  chance.

42. What is analytical epidemiology?

a. A validation if A can cause B.  

43. What is biostatistics?

a. To analyze, interpret and establish causal inference based on the  data collected through above studies.

44. ## Epidemiological studies are our attempts to recreate this  counterfactual scenario under a controlled environment. Unfortunately, we cannot achieve this goal by study design alone. Hence, we have  biostatistics.

45. What is statistical Inference>

a. In an ideal epidemiological study, the exposure group and the  control group are identical except the exposure status. In that  case, the difference in outcome between two groups is due to  only two reasons {Random Chance, and The effect of the  

exposure status. (e.g. hit by a car, whether you smoked or not)} 46. What is the use of statistics in Public Health research? a. Describe the problem

b. Account for the randomness in the world

c. Construct the counterfactual based on epidemiological data. 47. Why do we use data?

a. Helps us assess the health of a community  

b. Gives us raw material for research  

c. Helps us Identify special risk groups  

d. Helps us detect new health threats  

e. Helps us plan public health programs and evaluate their success f. Helps us to prepare government budgets

48. What are the data you need to know?

a. Local records are sources of data:

i. Birth certificates.  

ii. Death certificates.

1. Births and deaths are the most basic, reliable, and  

complete data collected  

iii. Notifiable diseases.

iv. Other vital statistics.  

b. Data is transmitted:

i. From local governments to states.

ii. From states to National Center for Health Statistics (NCHS  is part of CDC).  

c. Surveys are sources of data.

d. NCHS set up a computer system to link vital records of infants  because infant mortality is an important public health issue.

49. What is the census?

a. Is mandated by the U.S. Constitution.  

b. Serves as the denominator for most public health data:  i. Age, sex, race, ethnicity.  

c. Is conducted every ten years.

d. Determines the political composition of the U.S. Congress 50. What is the rate formula?

a. To calculate a rate, we first need to determine the frequency of  disease, which includes  

b. •the number of cases of the illness or condition

c. •the size of the population at risk  

d. •the period during which we are calculating the rate

51. What is quality Adjusted life years (QALY)?

a. QALY measures the quality of life in health gain  

b. • Expresses the additional number of years a person lives as a  result of receiving treatment, taking into account the quality of  life of those years.  

c. It generates an estimated number of years that can be added to  a life if an intervention is given

52. List and explain the type of surveys?

a. National Maternal and Infant Health Survey

i. objective of the National Maternal and Infant Health Survey (NMIHS) was to collect data needed by Federal, State, and  private researchers to study factors related to poor  

pregnancy outcomes, including low birthweight, stillbirth,  infant illness, and infant death.

b. National Health Interview Survey (NHIS)  

i. has monitored the health of the nation since 1957. NHIS  data on a broad range of health topics are collected  

through personal household interviews.

c. National Health and Nutrition Examination Survey (NHANES)  

i. program of studies designed to assess the health and  nutritional status of adults and children in the United  

States. The survey is unique in that it combines interviews  and physical examinations.

d. Behavioral Risk Factor Surveillance Survey (BRFSS)  

i. State-by-state, with results transmitted to NCHS  

ii. nation’s premier system of health-related telephone  

surveys that collect state data about U.S. residents  

regarding their health-related risk behaviors, chronic health conditions, and use of preventive services.  

e. Youth Behavioral Risk Factor Survey  

i. monitors six categories of health-related behaviors that  contribute to the leading causes of death and disability  

among youth and adults,

ii. State-by-state with results transmitted to NCHS  

f. Surveys done by other government agencies

53. How accurate is the datas?

a. Data collection is imperfect.  

b. • Census is most accurate.

i. • Still, there are overcounts and undercounts

ii. Information technology increases accuracy and availability. 54. How accessible is the data?

a. • Public health informatics has vastly improved the accessibility  of public health information for public health workers and the  general public.

b. • The CDC and most other federal and state public health  agencies make information available over the Internet

55. How confidential is the data?

a. Governments have safeguards to protect information on  individuals.

b. Use of data may involve removal of information identifying  individuals.  

c. Use of data requires permission granted by an institutional  review board or data protection committee.  

56. What are the uses of data?

a. Assessment of the health of a community  

b. Raw material for research

c. Identification of special risk groups

d. Detection of new health threats  

e. Planning of public health programs and evaluation of their  success

f. Preparation of government budgets

Week 4: (Discussion 4)

● How rates are used in public health

● Role of data in public health

○ Rates: The frequency of demographic events in a population in a  specified time period

○ Prevalence rates: measures the frequency of all current cases of  disease (old and new)

○ Incidence rates: measures the rapidity with which a disease  occurs or the frequency of addition of new cases of the disease  for a given period of time.

● Rate

○ Rates measure the probability of occurrence in a population of  some particular event such as cases or deaths due to infectious  diseases Rate (or ratio or proportion) = x/y x k

○ If x = number of cases of disease, or deaths, occurred in a  population of size y, how many would be expected to occur in a  population of size k?

● Incidence

○ Refers to the number of new cases in a population over a period  of time.

○ I= number of new cases/ total population x 100,000

● Prevalence Rate

○ Refers to the number of new and pre existing cases in a specified point in time.

○ P= OLD+NEW cases/ population during the same time period x  100,000.

● Ratio

○ simply expressions of one measure relative to another.

○ R= a/b

○ Ex: 20:80= 1:4 or ¼



57. What is Bacteria?

a. Made up of only one cell.

b. Example;Tuberculosis; Cholera; Syphilis; Common Cold;  Streptococci; Bubonic Plague;

58. What is virus?

a. Viruses are not cells. They consist of one or more molecules of  DNA or RNA which contain the virus’ genes surrounded by a  protein coat.

b. Example; HIV; Smallpox; Ebola; Influenza; Rabies; Nipah;  Japanese Encephalitis;

59. What is protozoa?

a. Are a group microscopic one-celled animals. Protozoa can be  parasites or predators.

b. Example; Malaria; African sleeping sickness; Chagas disease 60. What is Prion?

a. Prions are an abnormal or ‘rogue’ form of a naturally occurring  cellular protein, known as the prion protein.

b. EXAMPLES: Mad Cow Disease; Creutzfeldt–Jakob disease; Kuru  disease;

61. Which of the above disease could kill the most people? a. Virus

62. What disease have the greatest capacity to kill one person? a. Prion

63. Which of the above diseases caused most death in human  history?

a. Malaria

64. What is Reservoir?

a. Reservoir: the reservoir is a place where the pathogen lives and  multiplies.  

65. What are the methods of transmission?

a. Contact:

i. Direct: Touching, Sexual

ii. Indirect: Contaminated Object

b. Droplet: Sneezing, Coughing  

c. Vector: Mosquito Bites

d. Common Vehicle: Food/Water, Medications

66. Why didn’t smallpox destroy humanity?

a. The availability of vaccine.

b. Disease is limited to human, no animal reservoir.  

c. Easily diagnosed at early stage, visible symptoms.

d. Long-term immunity after infection

e. Vaccination confers long-term immunity.  

f. Vaccination effective post-exposure

67. why didn’t polio destroy humanity?

a. The availability of vaccine.

b. OPV: Vaccine Induced polio  

c. Disease is limited to human, no animal reservoir.

d. Easily diagnosed at early stage, visible symptoms

e. Not like smallpox  

f. Long-term immunity after infection  

g. Vaccination confers long-term immunity.  

h. Vaccination effective post-exposure • No

68. What are reasons for trends of diseases(HIV)?

a. Poverty: Competing Priorities

b. Gender Imbalance

c. Incarceration Rates

d. Dynamics of Black Sexuality

e. Historical & Persistent Trauma  

69. What are some challenges we might face in such trends in (HIV)? a. Stigma

b. Sexual risk behavior

c. Substance use

70. How is being black MSM makes one a dual minority? How could  this impact an individual?

a. Based on racial and sexual identities.

b. Developing an understanding of the mechanisms through which  men who occupy this position of being a double minority impacts their mental and physical health and subsequent behavior.

71. What are some substance use measures?

a. Marijuana, Crack cocaine, Powder cocaine, Methamphetamine,  and alcohol.

72. What are some outcome measures?

a. Sex Risk Measures:

i. Condomless insertive anal intercourse

ii. Sex while under the influence of drugs  

iii. Sex while under the influence of alcohol  

iv. Involvement in exchange sex

73. What are Vulnerability factors?

a. Depression (Self-report ever diagnosed)

b. Suicidality  

c. Number of male and female sex partners

d. History of incarceration

e. Forced sex  

f. Early sexual debut

74. What are the outcome measure after 12 months? a. Self-reported history of STIs

b. High number of sex partners (Based on median split)  c. Partner concurrency

d. Condom use  

e. Involvement with exchange sex

75. What is a public health concern in the US that happens among  men having sex with men, and men having sex with women?

a. HIV

76. How can be HIV transmission be prevented?

a. Abstain from Sex

b. Use Condoms

c. Don’t share needles

d. Medications ⇒ • PrEP • TaP

Week 5: (Discussion 5)

● Why do new pathogens keep appearing?

● Vaccination Debate

● Measles  

○ Leading cause of death among young children even though a  safe and cost effective vaccine exists.

○ During 2000-2016, measle vaccinations prevented about 20.4  million deaths.

● Vaccination Debate

○ Pros for vaccines (benefits)

■ decreases infection

■ can save children's lives

■ the ingredients in vaccines are safe to use in the amount  used

■ vaccines protect the community

● Herd immunity is a form of immunity that occurs  

when the vaccination of a significant portion of a  

population (or herd) provides a measure of protection

for individuals who have not developed immunity.

○ Cons for vaccines (adverse conditions)

■ religious beliefs  

■ many people on medications can get really sick from the  vaccination. Cause them to get symptoms of redness,  

sweating, pain.

■ Not affordable or accessible for everyone some people  

might not have health insurance

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