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Pub Health Exam1

Dr. Mittak's 1st Public Health Exam

What is health promotion? the science and art of helping people change their lifestyle to move toward a state of optimal health.
What are the 5 categories of health promotion? 1. Physical fitness: nutrition, self care, substance abuse control 2. Emotional: care for emotional crisis, stress mgmt 3. Social: community, family, friends 4. Intellectual/educational: achievement, career dev. 5. Spiritual: love, hope, charity
What is wellness? A state of optimal well-being that is oriented towards maximizing an INDIVIDUAL'S potential. It is a life-long process of moving towards enhancing your physical, emotional, social, intellectual and spiritual well-being.
Understand the learning styles explained in the notes. Visual Auditory Kinesthetic
What is the health belief model at the individual level? Focuses on the indiv. perception of the threat to their own health and well-being; Key concepts: Perceived susceptibility, severity, benefits if intervention occurs, self-efficacy
What is the stages of change model at the individual level? Focuses on indiv. readiness to change or attempt to change towards healthy behaviors/lifestyles; Key concepts: precomtemplation, contemplation, decision/determination, action, maintenance.
What is the social learning theory at the community level? Lifestyle/beh. is explained as a dynamic interaction of personal factors, environmental influences and beh.s that continually influence each other.
What are the key concepts to the social learning theory? Behavior capability, reciprocal determinism, expectations, self-efficacy, observational learning, reinforcement.
What is the community organization theory? Emphasizes active participation in and dev. of communities that can better evaluate and solve health and social problems.
What are the key concepts to the community organization theory? Empowerment, community competence, participation and relevance, issue selection, critical consciousness.
What is the organizaitonal change theory at the community level? Concerns processes and strategies for increasing the likelihood that healthy policies and programs will be adopted and maintained in formal organizations.
What are the key concepts for the organizational change theory? Problem definition (awareness stage) Initiation of action (adoption stage) Implementation of change Institutionalization of change
What is the discussion of innovations theory? Addresses how new ideas, products and social practices spread w/in a society or from one society to another.
What are the key concepts for the discussion of innovations theory? Relative advantage Compatibility Complexity Trial-ability Observability
Define culture. The sum total of the way of living; includes values, beliefs, standards, language, thinking patterns, behavioral norms, communication styles, etc. Guides decisions and actions of a group through time.
How do expressions of culture in health care affect health belief systems? (4) 1. Define and categorize health and illness 2. Offer explanatory models for illness 3. Based on theories of the relationship b/w cause and the nature of illness and treatments 4. Defines the specific "scope" of practice for healers
Explain the culture of western medicine. Mellorism: make it better Dominance over nature: take control Activism: do something Timeliness: sooner than later Therapeutic aggressiveness: stronger=better Future orientation: plan, newer=better Standardization: treat similar the same
Define cultural competence. A set of congruent behaviors, practices, attitudes and policies that come together in a system or agency or among professionals, enabling effective work to be done in cross-cultural situations.
Define cultural destructiveness. Forced assimilation, subjugation, rights and privileges for dominant groups only.
Define cultural incapacity. Racism, maintain stereotypes, unfair hiring practices
Define cultural blindness. differences ignored, "treat everyone the same", only meet needs of dominant groups (those who can pay)
Define cultural pre-competence. Explore cultural issues, are committed, assess needs of organization and individuals
Define cultural competence. Recognize individual and cultural differences, seek advice from diverse groups, hire culturally unbiased staff.
Define cultural proficiency. Implement changes to improve services based upon cultural needs, do research and teach.
What is the explanatory model? (Arthur Kleinman, Ph.D.) A culturally sensitive approach to asking about a health problem.
What is the LEARN model? (Berlin and Fowkes) Listen to the pt.'s perception of the problem Explain your perception of the problem Acknowledge and discuss differences/similarities Recommend treatment Negotiate treatment
Understand the qualifications, multiple roles and translation factors about working with interpreters. Also the caretaker's responsibilities. cultural and diversity in health care lecture. pg. 6-8
What is healthy people 2010? Organized national approach in public health planning. Designed to measure progress over time, defines a series of objectives to bring better health to all people in U.S. Promotes health while preventing illness, disability, and premature death
When did the healthy people initiative begin? 1979, it was a surgeon general's report on health promotion and disease prevention
How many objectives are there in healthy people 2010? 467
What are the goals of healthy people 2010? To increase the quality and years of healthy life and eliminate health disparities.
What is the underlying premise of healthy people 2010? The health of the individual is almost inseparable from the health of the larger community and the health of every community in every state and territory determines the overall health of the nation.
Discuss the ecological model. The health of populations and individuals is influenced by the interaction of biological, environmental and behavioral factors.
Discuss the Determinants of health model. People will take advantage of health care if the opportunity presents itself; This framework incorporates elements of the ecological model and also includes policy and health care factors.
What are the health disparities that are trying to be eliminated in Healthy People 2010 in terms of gender? Men are at 2x higher risk of death from unintentional injuries and 4x higher risk of death from firearms
What are the health disparities that are trying to be eliminated in Healthy People 2010 in terms of race specifically African-Americans? African-Americans have a higher infant mortality rate, higher cancer death rates, higher HIV/AIDS death rates and higher homicide death rates
What are the health disparities trying to be remedied by Healthy People 2010 in terms of Hispanics? Hispanics have higher diabetes death rates, they counted for 20% of new TB cases and have higher rates of HTN and obesity than whites.
What are the health disparities trying to be remedied by Healthy People 2010 in terms of Native Americans and Alaska natives? American Indians and Alaska natives have a higher infant death rate and extremely high death rates from unintentional injuries and suicide.
What is the relationship between income and education and it's affect on health? Directly proportional; population groups that have the worst health status are also those that have the highest poverty rate and least education
What is the current trend for disability? Rates on the rise for younger individuals and lack access to health services and medical care.
What is the relationship between geography and health? Rural areas have higher death rate from injuries; they also have higher rates of heart disease, cancer and diabetes than urban areas; lack timely access to emergency services and specialty care.
Based on Healthy People 2010 what does sexual orientation have to do with overall health? Major health issues for homosexual men are HIV/AIDS, STIs, substance abuse and suicide; early evidence indicates taht homosexual women have higher rates of smoking, overweight, alcohol abuse and stress.
Define behaviors as it is used in public health. Individual responses or reactions to internal stimuli and external conditions...behaviors can have a reciprocal relationship to biology.
Define social environment as it is used in public health. Includes interactions with family, friends, coworkers and others in the community. Also encompasses social institutions such as schools, work, and places of worship.
Define physical environment as it is used in public health. That which can be seen, touched, heard, smelled and tasted. (tangible elements include toxic substances, infectious agents and physical hazards) May also contain intangible elements i.e. radiation, noise, etc.
Define policies and interventions as it is used in public health. Examples include health promotion campaigns, safety policies, disease prevention services. Can be implemented by a wide variety of agencies in the public and private sectors.
Have a general idea of the focus areas of Healthy People 2010. There are 28... Pg 8-9 in lecture 3
What are leading health indicators? 10 sets of measures used to track progress of Healthy People 2010 initiatives by providing a "snapshot" of the nation's health.
How is physical activity explained as a leading health indicator? Regular physical activity throughout life is important for maintaining a healthy body, enhancing psychological well-being and preventing premature death. The goal is to increase young people's vigorous activity and adult's moderate activity.
How is overweight and obesity viewed as a leading health indicator? Overweight and obesity are major contributors to many preventable causes of death. On average, higher body weights are associated with higher death rates. The goal is to reduce adult obesity and children who are overweight or obese
How is tobacco use viewed as a leading health indicator? Cigarette smoking is the single most preventable cause of disease and death in the U.S. Goal is to reduce smoking by adolescents and adults.
How is substance abuse viewed as a leading health indicator? Alcohol and illicit drug use are associated with many of this nation's most serious problems including violence, injury and HIV. Goal to increase # kids not using alcohol or drugs and reduce # adults using illicit drugs and binge drinking.
How is responsible sexual behavior viewed as a leading health indicator? Unintended pregnancies and STDs including infection w/ HIV can result from unprotected sexual behaviors. Goal to raise # adolescents who abstain from sex or use condoms if sexually active and to raise # people using condoms.
How is mental health viewed as a leading health indicator? Approximately 20% of this nation's population is affected by mental illness during a given year. Goal to raise # adults with recognized depression who receive treatment.
How is injury and violence viewed as a leading health indicator? More that 400 Americans die daily from injuries d/t MVAs, firearms, poisonings, suffocation, falls, fires and drowning. Goal to reduce deaths caused by MVAs and to reduce homicides.
How is environmental quality viewed as a leading health indicator? An estimated 25% of preventable illnesses worldwide can be attributed to poor environmental quality. Goal to reduce # persons exposed to air that doesn't meet EPA standards for ozone and reduce # nonsmokers exposed to smoke.
How is immunization viewed as a leading health indicator? Vaccines are among the greatest public health achievements of the 20th century. They can prevent disability and death from ID and can help control the spread of infections w/in communities.
How is access to health care viewed as a leading health indicator? Strong predictors of access to quality health care include having health insurance, higher income and a regular pcp or other source of ongoing health care. Goal to increase # persons with health care, ongoing care and prenatal care in 1st trimester
What is the Vision of healthy people 2020? A society in which all people live long, healthy lives.
What is the mission of healthy people 2020? 1. Identify nationwide health improvement priorities 2. Increase public awareness (educate) 3. Provide measurable objectives applicable at the national state and local levels 4. Engage mult. sectors to take actions (ins. co.) 5. ID data collection nee
What is different in Healthy People 2020's objectives from 2010's? Adolescent health Blood disorders and safety Early and middle childhood Genomics (most important) Global health Health IT Nosocomial infections Hearing and sensory disorders Quality of life and well-being Social determinants of health
What is being reaffirmed in Healthy People 2020? Increase quality and years of healthy life and Eliminate health disparities.
What is being evaluated in Healthy People 2020? Promote quality of life, healthy development and healthy behaviors across life stages Create social and physical environments that promote good health.
What will be monitored to assess the general health status of the U.S. population? (7) 1. Life expectancy (compared internationally) 2. Healthy life expectancy 3. Years of potential life lost (YPLL) 4. Physically and mentally unhealthy days 5. Self-assessed health status 6. Limitation of activity 7. Chronic disease prevalence
What is life expectancy with international comparison? A summary of mortality measure often used to describe the overall health status of a population. Defined as the average number of years a population of a certain age would be expected to live, given specific death rates in a year.
What is the difference between life expectancy and life span? Life expectancy is a SUMMARY Life span is a CONTINUUM
What are the 2 life expectancy measures for Healthy People 2020? Life expectancy at birth; life expectancy at age 65.
What is healthy life expectancy? The average # of healthy years a person can expect to live if age-specific death rates and morbidity rates remain the same through his/her lifetime. A snapshot of death and illness patterns and illustrates long range implications.
What 3 methods does Healthy People 2020 use to track healthy life expectancy? 1. Expected years of life in good or better health 2. Expected years of life free of limitation of activity 3. Expected years of life free of selected chronic diseases
What is Years of Potential Life Lost (with international comparison)? A summary measure of premature mortality. It represents the total number of years not lived by people who die before reaching a given age. Deaths among younger persons contribute more to YPLL measure than deaths among older persons.
What is YPLL based on? The number of deaths at each age up to some limit. e.g., in the U.s. age limit is often 75. People who die before age 75 are defined as having lost some potential years of life. YPLL has declined in the U.S.
What is the United States rank for YPLL? 29th for females and 27th for males (out of 31 countries)
What is the United States rank for life expectancy? 27th for females and 26th for males (out of 33 countries)
What are the top 2 causes of YPLL? Cancer MVAs
What is the average number for physically and mentally unhealthy days and what is the trend of both with respect to age? 3.6 physically unhealthy days 3.4 mentally unhealthy days Physically unhealthy days increases with age and Mentally unhealthy days decreases with age (18-24 y/o 4 days/month; >75 y/o 2 days/month)
In the United States what is the majority report for self-assessed health status? Fair with people 65+ reporting fair or poor health.
What is self-assessed health status? A measure of how an individual perceives his/her health rating it as excellent, very good, good, fair or poor.
What is limitation of activity? Refers to a long-term reduction in a person's ability to do his/her usual activities. Person is asked about their limitations in ADL; Instrumental ADL; play, school, work; remembering; other activities unable to do d/t physical, mental or emotional issues
What are the top 6 chronic diseases reported? Cardiovascular disease Arthritis Diabetes Asthma Cancer COPD
What is Health-Related Quality of Life and Well-being? A multi-dimensional concept that includes domains related to physical, mental, emotional and social functioning. Focuses on the impact health status has on quality of life and measures effects of chronic illness.
How will Healthy People 2020 evaluate the monitoring of Health-related quality of life and well-being? 1. Patient reported outcomes measurement information system (PROMIS - most common) 2. Well-being measures 3. Participation measures
What are the determinants of health questions in Healthy People 2020? What makes some people healthy and others unhealthy? How can we create a society in which everyone has a chance to live long, healthy lives?
How will Healthy People 2020 explore the determinants of health questions? Developing objectives that address the relationship b/w health status and biology (genomics), individual behavior, health services, social factors and policies. Emphasizing an ecological approach to disease prevention and health promotion.
What are the broad categories that form determinants of health? Policymaking Social factors Health services Individual behavior Biology and genetics
What sectors can be important allies in improving population health? Education, housing, transportation, agriculture and environment.
How can policy making improve population health? Policies at the local, state and federal level affect individual and population health. i.e. increasing taxes on tobacco or national traffic and motor vehicle safety act
How can social determinants of health reflect the health of a nation? Social factors and the physical conditions in the environment in which people are born, live, learn, play, work and age. AKA social and physical determinants of health can impact a wide range of health functioning and quality of life outcomes.
What are some examples of social determinants of health? Availability of resources to meet daily needs Social norms and attitudes Exposure to crime, violence and social disorder Social support and interactions Exposure to mass media and emerging technologies Socioeconomic conditions Quality schools Trans
What are some examples of physical determinants of health? Natural environment Built environment Worksites, schools and recreational settings Housing, homes and neighborhoods Exposure to toxic substances and physical hazards Physical barriers Aesthetic elements
How are health services addressed in Healthy People 2020? Access to health services and quality of that service can affect health. Addresses access to health services as a topic area and incorporates quality of health services throughout a number of topic areas.
What is included in barriers to accessing health services? Lack of availability High cost Lack of insurance coverage Limited language access
What do barriers of accessing health services lead to? Unmet health needs Delays in receiving appropriate care Inability to get preventative services Hospitalizations that could've been prevented.
What are examples of individual behavior determinants of health? Diet Physical activity Alcohol, cigarette and drug use Hand washing
What are examples of biological and genetic social determinants of health? Age Sex HIV status Inherited conditions (sickle cell, hemophilia, CF) Carrying BRCA1 or 2 gene Familial hx of heart disease
How does Healthy People 2020 define health equity? The attainment of the highest level of health for all people. Requires valuing everyone equally w/ focused and ongoing societal efforts to address avoidable inequalities, past/present injustices, and health/health care disparities
How does Healthy People 2020 define health disparity? Type of health difference that is linked with social, economic &/or environmental disadvantage. Obstacles d/t race, religion, socioeconomic status, gender, age, mental health, disability...
What are other influences of health in America? A high-quality education Nutritious food Decent, safe housing Affordable, reliable public transportation Culturally sensitive health practitioners Health insurance Clean water and non-polluted air
What rates will be assessed for Healthy People 2020 in relation to what demographic factors? Illness, death, chronic conditions, behaviors, other types of outcomes; Race and ethnicity, gender, sexual identity and orientation, disability status or special health care needs, geographic location
What is the freedom of initiation act? A federal statute that allows individuals to request access to federal agency records, except to the extent records are claimed as exempt from disclosure under 1 or more of 9 exemptions of the act.
Created by: kabrown