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ph midterm

midterm study materials

Public Health The totality of all evidence-based public and private efforts that preserve and promote health and prevent disease, disability, and death
Public Health Changes over Time Now is the “Era of Population health”.
Events Germ Theory has led to: Scientists were able to diagnose TB through skin testing, bacterial culture, and chest X-rays. Concepts of vaccination advanced. Antibiotics and other effective cures come about.
Germ Theory of Disease The demonstration of infectious origins of disease
Health protection Quarantine for epidemics; sexual prohibitions to reduce disease transmission; dietary restrictions to reduce food-borne disease
Hygiene movement (1840-1870’s) Snow on Cholera; Semmelweis and puerperal fever; collection of viral statistics as empirical foundation for public health and epidemiology
Contagion control (1880-1940’s) Linkage of epidemiology, bacteriology, and immunology to form TB sanatoriums; outbreak investigation, e.g., Goldberger and pellagra
Filling holes in the medical care system (1950’s-1980’s) Antibiotics; randomized clinical trials; concept of risk factors; Surgeon General reports on cigarette smoking;
Health promotion/ Disease prevention (Mid 1980’s-2000) AIDS epidemic and need for multiple interventions to reduce risk; reductions in coronary heart disease through multiple interventions
Population health (21st Century) Evidence-based medicine and public health; information technology; medical errors; antibiotic resistance; global collaboration, e.g., SARS, tobacco control, climate change
High Risk approach focuses on those with the highest probability of developing the disease and aims to bring their risk close to the levels experienced by the rest of the population
Improving the Average approach focuses on the entire population and aims to reduce the risk for everyone
Determinants of Disease Behavior Infection Genetics Geography Environment Medical care Socio-economic-cultural
P.E.R.I framework types of info to describe evidence based public health approach. Drawn as Problem --> Etiology-->Recommendations--> Implementation--> Problem
PERI Problem Etiology Recommendations Implementation
Incidence rate Measure chances of developing a disease over a period of time, generally one year. Calculated as Incidence rate = # of new cases of a disease in a year/ # of people in the at-risk population
Prevalance rate the proportion of individuals who have the disease. # living with a particular disease/ # in the at-risk population
Case Fatality rates estimates the chances of dying from a disease once it is diagnosed. (mortality/ incidence)
3 Requirements to establish contributary clause 1) The cause is associated with the effect at the individual level 2) The cause precedes the effect 3) Altering the cause alters the effect
Case Control Study Establishes "the cause is associated with the effect".
Cohort Studies Establish "the cause precedes the effect".
Randomized Clinical Trials Establish "Altering the cause alters the effect".
Hills Criteria for Causation 1) Strength of relationship 2) Dose-response relationship 3) Consistency of the relationship 4) Biological plausibility
Recommendation scores A= Must B= Should C= May D= Don't I= Indeterminent, insufficient or I don't know
Primary Intervention Prior to disease
Secondary Intervention Prior to symptoms
Tertiary Intervention Prior to irreversible complications