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Study Guide for test 4 (final)

by: Amanda Green

Study Guide for test 4 (final) BPH 206

Marketplace > University of Miami > Public Health > BPH 206 > Study Guide for test 4 final
Amanda Green
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Study Guide covering; Public Health Preparedness, Global Health, Environmental Health, Environmental Risk Assessment, and Sea Level Rising, Affordable Housing and Where You Live, Food Access, Futur...
Introduction To Public Health
Alexis Koskan
Study Guide
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This 9 page Study Guide was uploaded by Amanda Green on Tuesday December 8, 2015. The Study Guide belongs to BPH 206 at University of Miami taught by Alexis Koskan in Fall 2015. Since its upload, it has received 83 views. For similar materials see Introduction To Public Health in Public Health at University of Miami.


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Date Created: 12/08/15
Study Guide Exam 4 Public Health Preparedness - Emergency vs. Disaster Emergency= requires immediate attention (could turn into disaster) but can be handled; have resources to deal with incident Disaster= need is greater than resources available (disrupts community) - Phases of a disaster (preparedness, response, etc.) o Mitigation prevention, immunization, risk reduction (ex. Learning from having generator on 1 floors of hospitals and moving them after flooding from Katrina) o Preparedness stock piling, planning, before disaster, education (mobilization of assets) o Response actual action of plan; deployment of assets o Recovery cleaning up mess; demobilization of assets - State of an Emergency- What is it? When is it “called”? o State of an Emergency occurs when the Mayor requests the Governor’s aid to activate a state EDC (emergency disaster control). The Governor then does a preliminary damage assessment and requests the President’s declaration of a state of emergency. o In a State of Emergency tax is at a discounted rate because of the Stanford Act (which uses government $ to get people to plan/respond) Global Health: - Millennium Development Goals 1. Eradicate Extreme Poverty and Hunger  World Bank’s strategy to eradicate poverty and hunger o Zero interest developmental grants o Safety nets and nutrition programs o Support for agriculture and food security o Boost spending on agriculture 2. Achieve Universal Primary Education  Barriers to attending school o Poverty o Child labor o Gender discrimination o Conflict o Disabilities o Language challenges 3. Promote Gender Equality and Empower Women  World Banks strategy to promote gender equality o Strengthen nutrition, disease prevention, and maternal health programs o Ensure education and life skills o Promote access to credit and economic opportunity 4. Reduce Child Mortality o Vaccinations o Strengthen national health systems o Expand immunization programs o Ensure the survival and health of mothers o Protect the poor from ill health and unaffordable costs of treatment 5. Improve Maternal Health o Quality care before, during and after childbirth o Safe blood supplies o Essential medicines such as antibiotics and oxytocin o Every death is counted and its cause recorded o Contraception and safe abortion services 6. Combat HIV/AIDS, Malaria and Other Diseases o Mass mosquito net campaigns o Community health workers and technology o Free HIV treatment campaigns o Training nurses and midwives in prevention of mother to child HIV transmission 7. Ensure Environmental Sustainability o Climate warnings 8. Global Partnership for Development o Promote debt relief o Develop IT infrastructure o Expand trade agreements o Improve access to affordable drugs o Increase poverty-reducing expenditures - How hunger and poverty affect health o Diseases can spread, people dying, losing jobs, impacting trade, gdp, impacts other countries o Help others for Humanitarian reasons - Know the key health status indicators o Infant mortality rate o Life expectancy at birth o Maternal mortality ratio o Neonatal mortality rate o Under-5 mortality rate Environmental Health, Environmental Risk Assessment, and Sea Level Rising - Why are rising sea levels a public health concern? o Salt water rise makes unsafe drinking water o Kills bio-diversity (environment effects) o Inundate wetlands/lowlands; erode shorelines; exacerbate coastal flooding; alter tide ranges; increase salinity of estuaries/aquifers; change the location where rivers deposit sediment; increase height of waves; decrease the amount of light reaching the bottom of waterways - What are some solutions we discussed in class related to reducing the impact on sea level rising? o To limit the long-term risks of sea level rise and the costs of adapting to it-- work toward deep reductions in the global warming emissions (primary cause of rising sea level) o Must decide to retreat or try to defend coastal properties and infrastructure with protective measures o Building sea walls, levees, or replenishing sand along eroded beaches--can help protect against flooding and damage but may not provide long-term protection. o Maintaining or restoring natural buffers, such as barrier islands, tidal wetlands, and mangroves, can also help defend coastlines o elevating and flood-proofing structures can help accommodate temporary flooding and gradual inundation. o Pump stations; salinity structures, BUILD AN ARC (current answer= pumps) - How will Miami be affected by rising sea levels? o May need to consider retreating from the rising seas o Could potentially be completely underwater soon; have to deal with flooding o billions of dollars' worth of property along the coastline could be ruined o fresh-water table -- the drinking water source for millions -- that could soon be infiltrated by rising seawater - How is human health threatened by rising sea levels? o Increased outbreaks of disease; drowning; lose of jobs, food, housing o Less access to clean water Affordable Housing and Where You Live: - Housing and its relationship to infectious and chronic disease Infectious o Features of substandard housing, including lack of safe drinking water, absence of hot water for washing, ineffective waste disposal, intrusion by disease vectors (e.g., insects and rats) and inadequate food storage have long been identified as contributing to the spread of infectious diseases. o Crowding is associated with transmission of tuberculosis and respiratory infections. o Lack of housing and the overcrowding found in temporary housing for the homeless also contribute to morbidity from respiratory infections and activation of tuberculosis o Poor housing conditions are associated with a wide range of health conditions, including respiratory infections, asthma, lead poisoning, injuries, and mental health Chronic o Damp, cold, and moldy housing is associated with asthma and other chronic respiratory symptoms, associations have been made between damp and moldy housing and recurrent headaches, fever, nausea and vomiting, and sore throat o Old, dirty carpeting, often found in substandard housing, is an important reservoir for dust, allergens, and toxic chemicals. Exposure to these agents can result in allergic, respiratory, neurological, and hematologic illnesses o Pest infestations, through their association with asthma, provide another linkage between substandard housing and chronic illness (ex. Cockroaches) o Deviation of indoor temperature beyond a relatively narrow range has been associated with increased risk of cardiovascular disease. Living in cold housing has been associated with lower general health status and increased use of health services o Exposure to toxic substances found in homes can result in chronic health problems. The association of passive exposure to indoor tobacco smoke with respiratory disease - In what ways is housing a public health issue? o Inhalation-- Demolition and renovation activities generate fumes/dust—once inhaled deep into lungs can remain for long periods and be absorbed into blood over time o Ingestion-- Lead exposure from paint in older homes etc. (especially harmful to children “pica”) - What is meant by residential racial segregation? o The physical separation of the races by enforced residence in certain areas is an institutional mechanism of racism that was de- signed to protect whites from social interaction with blacks. o residential segregation remains extremely high for most African Americans in the United States primarily because of racial differences in socio-economic status by determining access to education and employment opportunities. - What have been health concerns and quality of life concerns of those lower income neighborhoods o Lower income schools found in lower income neighborhoods have; lower average test scores, fewer students in advanced placement courses, more limited curricula, less qualified teachers, less access to serious academic counseling, fewer connections with colleges and employers, more deteriorated buildings, higher levels of teen pregnancy, and higher dropout rates. These conditions contribute to peer pressure against academic achievement and in support of crime and substance use. o racial residential segregation leads to racial differences in high school dropout and graduation rates; competencies and knowledge of high school graduates; preparation for higher education; and the probability of enrollment in college. o areas that do not offer ready access to high-paying entry- level jobs. It has also led to a “skills mismatch” in which the available jobs in the urban areas where African Americans live require levels of skill and training that many do not have o there were more athletic tracks, playing fields, and swimming pools in economically advantaged neighborhoods than in economically disadvantaged one’s research also reveals that a lack of recreational facilities and concerns about personal safety can discourage leisure time physical exercise. o people living in more economically deprived neighborhoods were more likely to smoke, less likely to consume healthy foods (such as fruits, vegetables, and whole grain bread), more likely to consume unhealthy foods (such as sweets, cakes, processed meats, and french fries), and less likely to exercise than their counter- parts in wealthier neighborhoods. o Not surprisingly, residents of more economically deprived neighbor- hoods were shorter, had higher body mass indexes, larger waist circumferences, and higher waist-hip ratios than their peers in more economically advantaged residential areas o Less access to affordable medical care Food Access - Food deserts= an area, particularly lower­income neighborhoods and communities,  where access to affordable, quality, and nutritious foods is limited - How are they linked to population/individual health outcomes? o Typically located in urban and rural low-income neighborhoods, where resident are less likely to have access to supermarkets or grocery stores that provide healthy choices. o For communities with few food retailers or supermarkets that stock little or no fresh produce, low-fat dairy, whole grains, and other healthy foods, those populations may be more likely to suffer from high rates of diabetes, cardiovascular disease, and obesity. - What influences the creation of food deserts? o Could relate to/be defined from: distance, to price, and/or time cost o Nutritious food whether it be fresh, or frozen and canned o The closeness to fresh/nutritious food/ grocery stores - SNAP Program (Supplemental Nutrition Assistance Program) o SNAP, or “food stamps”) is the largest nutrition assistance program administered by the United States Department of Agriculture (USDA) and the first line of public policy defense against hunger and under nutrition in the nation o Monthly issues of food stamps or money that can be used to buy food for meals o SNAP has been associated with reduced childhood food insecurity and reduced negative impact on  cognitive and academic development as they grow older.  o According to physicians and medical researchers, SNAP “is one of America’s best medicines to  prevent and treat childhood food insecurity.”  - Community Interventions to create food access o Green Carts= mobile food carts that offer fresh produce in New York City neighborhoods with limited access to healthy foods. A Green Cart only sells fresh fruits and vegetables. - Items you can/cannot buy on SNAP program o Food stamp trafficking= trading benefits for money or non-food goods - Questions/Answers from movie o Couples receive $75 per week but actually turns out to be $40-50 dollars o Lentals o Top three foods on dirty dozen  Cherries, Pears and Strawberries o SNAP program Future of Public Health and Revisiting Major Public Health Topics - Reductionist vs Systems Thinking- know this well Reductionists= Cause Effect 1. One intervention at a time 2. Straight-line or linear projects 3. One-point-in-time or static analysis Systems Thinking o System Thinking: what makes a system different from an individual piece? 1. Multiple simultaneous interventions 2. Measuring complex interactions 3. Changing or dynamic models of analysis - Public health “mistakes from the past”- lessons we learned from them o Intervention vs. Preparation o Lesson Learned: Avoid implementing interventions when preparation is enough o Safety of Large Scale Interventions (1960s and 70s- Dalkon Shield) o Lesson Learned: Make sure your interventions do more good than harm o Expectation of Disease Elimination o Lesson Learned: control of a disease is often possible, elimination is rarely realistic Steps 1. Identify Key influences or interventions on an outcome (BIG GEMS) 2. Indicate the relative strength of the impact of each of these influences and interventions 3. Identify how these influences or interventions interact 4. Identify the dynamic changes that may occur in a system by identifying the feedback loops that occur in the system 5. Identify bottlenecks that limit the effectiveness of the system 6. Identify leverage points that provide opportunities to greatly improve outcomes - Three major types of “transitions” that will affect the future of public health DEMOGRAPHIC TRANSITIONS- impact of falling childhood death rates and extended life spans on the size and age distribution of populations EPIDEMOLOGICAL TRANSITIONS- as social and economic development occurs, different types of disease become prominent NUTRITION TRANSITION- countries frequently move from poorly balanced diets often deficient in nutrients, to a highly processed terrible diet Revisiting Major themes of the Class - P.E.R.I.E Approach o Problem  Burden of disease o Morbidity & Mortality o , Etiology, Recommendations, Implementation, and Evaluation - Belmont Report o The principles of the Belmont Report govern all research supported by the U.S. Government. o The ethical principles outlined in the report are the basis for subsequent regulations designed to ensure protection of human subjects in research. o Focused on the key issues of defining informed consent and the selection of participants o Principles: of Belmont Report 1. Respect for Persons-  Incorporates 2 ethical convictions and 2 moral requirements o Individuals should be treated as autonomous agents o Do not use people as a o Allow people to choose for themselves o Provide extra protections to those with diminished autonomy (i.e. Prisoners, Children, Cognitively Impaired, etc.) 2. Beneficence-  Treating in an ethical manner not only by respecting their decisions and protecting them from harm, but also by making efforts to secure their well-being  Treatment (2 rules as expressions of beneficent actions) o Do no harm (non-maleficence) o Maximize possible benefits and minimize possible risks 3. Justice  Treat people fairly  Fair sharing of burdens and benefits of the research  Injustice occurs when: o Benefits to which a person is entitled are denied without good reason o When burdens are imposed unduly - Social determinants of health o conditions in which people are born, grow up, live, work play, etc. as well as the systems put in place to deal with illnesses that affect health and quality of life o Behavior, Infection, Genetics, Geography, Environment, Medical care, Socio- economic culture - Socio-Ecological model of health - Frieden’s Health Impact Pyramid


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