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Pub Health Midterm
| Term | Definition |
|---|---|
| Three core function of public health | Assessment, policy development, and assurance |
| Assessment | Public health makes diagnostic; gather, organize, analyzes, and spread information regarding the population Ex. Conducting community health needs assessment to determine high rates of obesity |
| Transmission | -Directly from one person to another -Aerosol/Airborne transmission -Contaminated objects -Contaminated water or food -Vectors -Mosquitos -Sexual contact -Carriers |
| Chain of Infection | Infectious agent → Reservoir → Portal of exit → Mode of transmission → Portal of entry → susceptible host |
| Pandemic | a widespread occurrence of an infectious disease over a whole country or the world at a particular time |
| Endemic | (of a disease) regularly occurring within an area or community. |
| Epidemic | a widespread occurrence of an infectious disease in a community at a particular time |
| HIV/AIDS | Prostitution and the presence of other sexually transmitted diseases (STDs) Haitians, Homosexuals, homeless, homosexuals |
| Epidemiology | Is the diagnostic discipline of Public Health Is a major part of Public Health’s assessment function Investigates causes of disease Identifies trends in disease occurrence Evaluates effectiveness of Medical and Public Health interventions |
| John Snow and Cholera | First example of epidemiology London had Cholera epidemics in mid-1800s Suspected an association with the water supply, the Thames RIver He conducted a “natural” experiment Most deaths were associated with on water supply company |
| Outbreak investigation | 1) Verify diagnosis 2)Construct case definition 3) Find cases systematically + apply active surveillance 4) Questions to describe the epidemic by person, place, and time 5) Consider the incubation period Look for common source of exposure |
| Disease Frequency | Count the number of people with disease and relate that to the population at risk PAR (denominator) may be the total population, or one gender or age group Two ways to measure frequency: Incidence or Prevalence |
| Incidence | Number of new cases, used for studying causes of disease All existing cases / total population |
| Prevalence | Number of existing cases, depends on incidence and prognosis |
| Prevalence rates | Useful in assessing the societal impact of a disease and planning for healthcare services |
| Intervention study | Impacted by quality of comparison group Experimental group (gets the intervention) Watch groups over time & compare outcomes Experimenter chooses who's in which group Two groups should be as similar so that the intervention is the only difference |
| Clean Air Act 1970 | Set Air Quality Standards, limited to some major pollutants, and mandated emission of autos and factories |
| 5 step public health process/approach to health problems | 1) Define the Problem 2) Identify risk factors 3) Develop intervention 4) Implement interventions 5) Evaluate outcomes |
| Epidemiology | Is the diagnostic discipline of Public Health Is a major part of Public Health’s assessment function Investigates causes of disease Identifies trends in disease occurrence Evaluates effectiveness of Medical and Public Health interventions |
| John Snow and Cholera | London had Cholera epidemics in mid-1800s Suspected an association with the water supply, the Thames River He conducted a “natural” experiment; door to door collecting data and making a map of cases Deaths were associated with a water well |
| Particulate matter | More visible form of air pollution |
| Disease Frequency | Count the number of people with disease and relate that to the population at risk PAR (denominator) may be the total population, or one gender or age group Two ways to measure frequency: Incidence or Prevalence |
| Incidence | Number of new cases, used for studying causes of disease/ sickness New cases / Population at risk |
| Notifiable Diseases | Type of Epidermic Surveillance that usually, healthcare providers, hospitals, and laboratories report cases of diseases. Then reports go to public health departments, which then pass information to national health agencies (CDC). |
| Intervention study | Experimental group (gets the intervention or exposure) and Control group Watch them over time and compare outcomes Experimenter chooses who is in which group Two groups should be as similar as possible so that intervention is the only difference |
| Placebo effect | Phenomenon where a person experiences improvement in their condition after receiving an inactive treatment, such as a sugar pill or a fake procedure. |
| Cohort study | Valuable for identifying chronic disease risk factors and understanding disease progressions Collect data on healthy people's exposures and track outcomes over time PEOPLE CHOOSE THEIR OWN EXPOSURES susceptible to selection bias |
| Case Control Study | Advantages: Faster and cheaper This is the least accurate approach It is commonly done to follow up on hypothesis generated by shoeleather epidemiology Choose people |
| Fundamental Steps in Conducting Public Health Research | Research question Literature review Study design IRB ensures ethical procedures Data collection and analysis Sharing results Adherence is crucial for precision and reliability of research findings |
| Informed Constant and Data Privacy | Telling the patient they are going to be experimented on Protecting their privacy |
| When (year) and where was the first Major public health litigation passed? (Hint: the “Public Health Act”) | England and Wales in 1848, Act established local boards of health and created the General Board of Health to improve sanitary conditions and prevent the spread of disease |
| Exposures, outcome, and population approach | This approach helps by serving as initial inquiry in research process. Creating a comprehensive research question that emerges from specific terms, addressing pivotal developmental questions and relevance to current clinical or community interests |
| Environmental hazards | Radiation Mercury Arsenic Asbestos Pesticides and industrial chemicals Lead |
| Environmental Protection Agency (EPA) | Federal government does research, sets standards for exposure limits, monitors, and enforces |
| Radiation | Sun’s UV light causes skin cancer + melanoma Radon is naturally radioactive + potentially causes lung cancer Radium regulation in patent medicines Chronic exposure to x-radiation in medicine + dentistry causes cancer Radiation effects of Japan |
| Mercury | Causes neurological damage Fever thermometers and school laboratory equipment Minamata, Japan Emissions from U.S. coal-burning power plants pollute water and air, contaminating fish Nursing mothers and young children should not eat fish |
| Arsenic | Solid Skin lesions, cancer Water filtration, limits, or bans "the king of poisons.” Long-term exposure leads to risk of diabetes and cancer. |
| Asbestos | Used for strength and insulation in roofing, gaskets, and brake linings Required in schools b/w 1940-1973 Causes scarring of lungs (asbestosis) + mesothelioma (cancer) Manville Corporation went bankrupt due to lawsuits World Trade Center clean-up |
| Pesticides and industrial chemicals | Cause cancer, neurological damage Bans/restrictions Found in farms/gardens, factories |
| Lead | Harmful to the brain and nervous systems, especially in children Bans/restrictions Caused poisoning since Rome Drinking water gets contaminated by pipes Paint used in old houses |
| Occupational Exposures | Workers often first to suffer effects of an exposure Carcinogens are recognized through occupational cancers Scrotal cancer in chimney sweeps Bladder cancer in dye factory workers Lung and lymphatic cancer from arsenic (copper smelters) |
| Factory Farms | Animals are crowded together and tended by automated systems Produce “lagoons” of waste They produce air pollution (ammonia, hydrogen sulfide, methane) and water pollution after rain Political power makes environmental regulation difficult |
| Criteria Air Pollutants | Participate matter-smoke, soot and ash Sulfur dioxide-feuls such as coal Carbon monoxide-motor vehicle exhaust Nitrogen oxides-smog Ozone-at low altitudes is harmful Lead-toxic metal |
| Indoor Air Quality | Condition of the air inside of a building. Measured by visual inspection or various tools. They test for things like allergens or microbes People spend more time indoors than outdoors |
| Formaldehyde | Insulation, particleboard, plywood, some floor coverings, and textiles Regulated by Dept. of Housing and Urban Development |
| Consumer products | Pesticides, drywall from china, dry-cleaning solvents, paints nad paint thinners, hair spray, and air freshener Use with caution |
| Microbes | Legionella Hantavirus |
| Allergens | Mold, house mites, and animal dander |
| Global effects of air pollution | Acid rain, Depletion of the ozone |
| Clean Water Act 1972, 1977, 1987 | Lakes and rivers should be fishable and swimmable All pollution discharges should be eliminated Minimize air pollutants deposited by rain |
| Safe drinking water Act 1974, 1996 | EPA should set standards for local systems States should enforce the standards |
| Point source pollution | Requirements for treating wastewater Sewage treatment plants or septic systems Treat with chlorine or other disinfectant Sludge: Congress prohibited ocean dumping Pretreatment of industrial wastes |
| Nonpoint-source pollution (NPS) | Agriculture runoff Urban runoff Air pollutants deposited by rain |
| Regulated Contaminants | Disinfectants: chlorine Disinfection byproducts: chlorite Inorganic chemicals: metals, asbestos, cyanide Organic chemicals: herbicides, pesticides, PCBs Microorganisms: bacteria, viruses, cryptosporidium Radionuclides Turbidity |
| Sanitary Landfills | High cost is in the northeast Big drawback is the large space used Groundwater contaminated Airpollution Odor Habitat destruction |
| Alternatives to Landfills | Reduce Reuse Recycle Waste to energy incineration Still a pollution concern |
| Resource Conservation and Recovery Act (RCRA), 1976, 1984 | All hazardous wastes accounted for “from cradle to grave” Wastes from petroleum refining, pesticide manufacturing, some pharmaceuticals Ignitable, corrosive, reactive, toxic wastes |
| Typhoid Mary | Irish immigrant, asymptomatic of thyroid in USA Forced to quarantine by NY public health authorities; isolated for years because she keep working as a cook, leading to outbreaks |
| Tuskegee Study | Deceived by being told they were receiving treatment for "bad blood" when they were withheld treatment No informed consent |
| Policy development | Scientific knowledge that enhances communities well-being Ex. Developing a smoke- free air law after finding high rates of lung disease due to secondhand smoke |
| Assurance | Mirrors actual treatment, community services Ex- Ensuring access to vaccinations for all children |
| Well-being (physical, mental, and social well-being) | The World Health Organization doesn't only include the absence of disease when defining health but also _- |
| Primary Prevention | Prevent illness or injury by preventing exposure to risk factors Only done by Public Health |
| Secondary Prevention | Minimize severity of illness or damage resulting from an injury-causing event once the event has occurred Done by Medicine and public health |
| Tertiary Prevention | Reduce disability by providing medical care and rehabilitation services Done by Medicine |
| Public health challenges that arose during Industrial Revolution | Industrial chemicals Occupational Exposures Arsenic Asbestos Mercury Air Pollution Events |
| Solutions to the public health challenges during Industrial Revolution | Clean Air Act Clean Water Act Safe Drinking Water Act Resource Conservation and Recovery Act |
| Ethical Principles of Belmont Report | Respect for Persons (informed consent), Beneficence (minimizing risks and maximizing benefits), and Justice (fair selection of participants) |
| What is Healthy People 2020: How would you describe/define it, and how are they developed; how often are the goals revised/re-developed? | Healthy people 2020: Nationwide, decade-long health promotion and disease prevention agenda for US |
| What are some factors that have contributed to greater overall health in modern times compared to 150 years ago? | Advances in medical technology (vaccines and antibodies), improved sanitation, and greater scientific understanding of disease and public health interventions |
| Case | individual who is identified as having the disease or health condition |
| Case definition | Standard set of criteria to determine if a person should be classified as a case in an investigation (do they fit these conditions) |
| Epidemiologic Investigation | Used for when a disease/health event is unusual, unexpected, or raises public health concerns; and the cause/transmission route is unclear |
| Framingham Heart Study 1948 | Linked lung cancer to smoking in Massachusetts Cohort study |
| Reasons to not use an intervention study | It can be unethical to withhold treatment from the control group 2) may be hard to prove that the benefits outweigh risks for participants 3) can be hard to obtain consent from every affected person (communities) |
| Recall Bias | case where participants don’t remember what happened within the experiment and this could lead to false memories or not being able to fully report their experience |
| Lost-to-Follow-up (attrition) For which study design(s) would you worry about it? | Happens when participants stop or lose contact before the study can be completed. This is a bias where the ones who leave are different from the ones who stay in a way that affects the outcome Cohort and case control |
| Give an example of an intervention, a cohort, and a case-control study. What are the possible problems associated with each one? | - Kingston-Newburgh study of fluorine preventing tooth decay -Doll+Hill British Doctors’ study, info on smoking habits, follow group for >50years, tracking COD - D+H study, hospital patients w/ lung cancer, compare their smoking habits to patients w/o |
| When calculating the rate of a disease, which of the following is generally the denominator of the calculation? | Population at risk - sometimes total population |
| What is the primary role of epidemiologists during a disease outbreak? | Observe, identify, and track the disease |
| Null hypothesis | default assumption in hypothesis testing where there is no effect, no difference, or association between variables |
| Statistically significant | Based on p-value If probability below 0.05, considered unlikely to have occurred by chance |
| Screening test | Look for signs of potential disease in people that don't have symptoms, aiming for early detection |
| Diagnostic tests | Performed on people with known symptoms to confirm/rule out specific illness |
| BRFSS | Collect state-level data on health-related behaviors Self reported data Cross sectional study |
| NHANES | Access health and nutritional status of adults and children in US In person interview, physical examination, or lab tests Cross-sectional survey w/ physical and lab assessments |
| NHIS | Monitor health of non-institutionalized US population In person household interviews of a selected sample Cross-sectional household survey |
| USDA | Focus on farming and agriculture Bigger budget Regulates 20% of food |
| FDA | smaller budget Regualtes 80% of food Regulates imported food More than 80% of seafood is imported |
| Flint Michigan (2014) | Majority Black city H2O switched to Flint River w/o proper treatment Complaints ignored until research proved high lead lvls in H2O+kid's blood+Legionnaire disease Returned to Detroit H2O but damage done, crim charges+recov efforts+distrust w/gov |
| Love Canal | Dumping ground for nearly 22,000 tons of chemical waste Filled in and houses built on it, then state officials detected the leakage of toxic chemicals from underground into the basements of homes in the area. |
| Health outcomes of climate change | Air pollution → Asthma Extreme Heat → Heat related illness/death Increasing Allergens → Respiratory problems Water Quality → Cholera, cryptosporidiosis |
| Additives in foods and deficiencies prevented | Iodine in table salt → prevents goiter and thyroid problems. Vitamin D in milk → helps prevent rickets and supports bone health Niacin added to bread → prevents pellagra Folic acid to flour and rice products → helps prevent birth defects in babies |
| Food handlers frequently transmit | Hepatitis A Norovirus |
| Possible result from the use of antibiotics in animal feed | Cause antibiotic resistance in humans |
| Focus groups and interviews | Qualitative research methodology in public health |
| Paris agreement | Doesn't have powers to enforce commitments to reducing emissions of greenhouse gases |
| Rachel Carson's message in Silent Spring (book post WWII) | Argicultural chemicals and pesticides polluted streams |
| Strategies for industrial pollution sources | Scrubbers/smokestacks Limits on high-sulfur coal Buy/sell pollution allowance |
| 10 | US is mandated by the constitution to conduct a census every __ years |
| Retrospective | past |
| Prospective | future |
| Morbidity | illness |
| Behavioral risk study | Examines behaviors linked to an increased likelihood of negative health outcomes, injuries, or social problems Salary was not accessed in this study |
| Edward Jenner | Who performed first study that lead to smallpox vaccine |
| Penicillin | Antibiotic not given to men in Tuskegee Study Main cure for syphillis |
| Hiv | Infects certain red blood cells and damages immune system |
| 1932 | Year of Tuskegee Study |
| Barriers to treating HIV | Constant medication Keeping appointments Stigma deterring people from seeking help |
| 1977 | When was smallpox eradicated |
| 2023 | Warmest year ever recorded |
| Health outcomes of climate change | -Incr in asthma & respiratory disease -Incr in heat related illnesses -Incr in PTSD |
| Secondary Prevention | Early detection would be which level of prevention |
Created by:
phillipchristopherr