Section 1
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Health Resources Development Period
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Section 1
(50 cards)
Health Resources Development Period
(1900-1960) growth of healthcare facilities and providers, reform phases, health education begins with the influx of immigrants, Great Depression and WWII, postwar
Shattuck recommendations
changes made when it comes to obtaining observations about phenomena in the atmosphere, preventative measures should be taken to prevent smoking nuisance, when it comes to creating new towns and cities, changes should be made in order to ensure that there is an ample supply of light, air, and clean water
Period of Health Promotion
(1974-present) identification that premature death is traceable to lifestyle/health behaviors, Healthy People established (2020), MAP-IT, National Prevention Strategy
endemic
a disease that occurs regularly in a population as a matter of course
attack rate
a specific incidence rate calculated for a particular population for a single disease outbreak; expressed as a percentage (food borne illnesses)
personal health activities
individual actions and decisions making that affect the health of an individual or his/her immediate family members or friends (decision to smoke)
natality (birth) rate
the number of live births divided by the total population
community health
health status of a defined group of people and the actions and conditions to promote, protect, and preserve their health
Period of Social Engineering
(1960-1973) federal government became active in health matters, Medicare and Medicaid established, influx of federal dollars accelerated rate of increase in cost of health care
epidemiology history
dates back to Hippocrates (300 BC),subsequent waves of infectious disease epidemics (plague, yellow fever, cholera), John Snow
community organizing
a process through which communities are helped to identify common problems or goals, mobilize resources, and in other ways develop and implement strategies for reaching the goals they have collectively set (not science, democracy)
earliest civilization health
many went unrecorded, practices may have involved rites and spirituality, archaeological evidence back to 2000 BCE of washing hands
global health
health problems, issues, and concerns that transcend national boundaries; best addressed by cooperative actions
population at risk
those susceptible to particular disease or condition or whole population (which gets defined)
second half of the nineteenth century
epidemic problems in major cities, many scientific discoveries
Twentieth Century
life expectancy less than 50 years, leading causes of death were communicable diseases, vitamin deficiencies and poor dental health common in slums
population health
health outcomes of a group of individuals, including the distribution of such outcomes within the group
National Prevention Strategy
released in June 16, 2011, aims to guide the U.S. in the most effective and achievable means for improving health and well-being; created by the Affordable Care Act
The Great Depression and WWII
the discovery of penicillin by Alexander Fleming in 1928; not used universally until 1940
health
a dynamic state or condition of the human organism that is multidimensional in nature, a resource for living, and results from a person's interactions with and adaptations to his or her environment
public health
actions that society takes collectively to ensure that the conditions in which people can be healthy can occur; most inclusive term
postwar years
the growth of hospitals/facilities to provide care, development of polio vaccine, issue of heart disease
world community PH issues
communicable diseases, poor sanitation and unsafe drinking water, migration and health
morbidity (sickness)
the number of people who are sick/ill divided by the total population at risk for the sickness/illness; calculated in a number of ways
community
a group of people who have common characteristics; characterized by membership, common symbol systems, shared values and norms, mutual influence, shared needs and commitment to meeting them, shared emotional connection
herd immunity
the resistance of a population to the spread of an infectious agent based on the immunity of a high proportion of individuals (reliance)
incidence rate
number of new health-related events or cases of a disease in a population exposed to that risk during a particular period of time, divided by the total number in the same population (morbidity)
Eighteenth Century
characterized by industrial growth; cities overcrowded, water supplies inadequate and unsanitary, problems with trash, workplaces unsafe, vaccination against smallpox, census
pandemic
outbreak over wide geographic area
epidemiologists
concerned with course of disease in a population, collect information about disease status of a community, uses it to prevent disease outbreaks or determine effectiveness of prevention efforts
social/cultural factors
beliefs, traditions, prejudices, economy, politics, religion, social norms, socioeconomic status
21st century achievements
reductions in child mortality, vaccine-preventable deaths, access to safe water, control of malaria, HIV/AIDS, tuberculosis, neglected tropical disease and tobacco, global road safety and improved preparedness
epidemic
unexpectedly large number of cases of an illness, specific health-related behavior, or event in a particular population
varying health
can mean different things to different people, so healthcare is exists in varying degrees and is specific to each person
mortality/fatality (death) rate
the number of deaths in a population divided by the total population
20th Century Achievements
vaccination, motor vehicle safety, control of infectious diseases. decline of deaths from CHD and stroke, healthier mothers and babies, safer and healthier foods, safer workplaces, family planning, fluoridation of drinking water, recognition of tobacco use as a health hazard
Nineteenth Century
better agriculture leads to improved nutrition, laissez-faire govt. with emphasis on local health, Shattuck Report began Modern Era, Germ Theory, relationship with microbes and disease
Shattuck Report (1850)
one of the major documents of public health in the U.S and the first systematic use of birth and death records and other demographic data to describe the health of a population (Massachusetts System); recommendations became base of Sanitation Movement
epidemiology
the study of distribution and determinants of health-related states or events in specific populations
individual behavior
takes the concerted effort of many individuals to make a program work
physical factors
geography, environment, community size, industrial development
rates
number of events in a given population over a given period of time or given point in time
Healthy People 2020
the federal government's prevention agenda for building a healthier nation; a statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats
cases
people afflicted (those who are sick)
health factors
gestational endowments (genes), social circumstances (employment, education, income, etc.), environmental conditions, behavioral choices, availability of quality health care
U.S. PH issues in 2000s
health care delivery, environmental problems, lifestyle diseases, communicable diseases, alcohol and other drug abuse, health disparities, disasters, and public health preparedness
community health activities
activities aimed at protecting or improving the health of a population or community (no smoking in certain areas, keeping records)
London cholera epidemics and Dr. John Snow
father of public health, tried to figure out why there was cholera (dirty water illness) by a map, found that there was no cholera and in non-water drinking places (distilleries), told them to close the water pump and cholera went down (1800s)
Healthy People goals
attain high-quality lives free of disease and disability, achieve health equity, create environments that promote good health, promote healthy behaviors
four foundations of Healthy People
general health status, health-related quality of life and well-being, determinations of health and disparities
Section 2
(50 cards)
single epidemic curves
can be used to calculate incubation period
leading causes of death in 2016
heart disease, cancer, accidents, chronic lower respiratory disease
Morbidity and Mortality Weekly Report (MMWR)
reports morbidity and mortality data by state and region of U.S., reports outbreaks of disease, environmental hazards, unusual cases, or other (CDC)
descriptive studies
describe epidemics with respect to person, place, and time
cause-specific mortality rate
measures death rate for a specific disease
The National Health and Nutrition Examination Survey (NHANES)
assesses health and nutrition status through mobile examination center
odds ratio
a probability statement about the association between a particular disease and a specific risk factor, result from a case/control study
acute
diseases in which peak severity of symptoms occurs and subsides within three months (cold, pneumonia, mumps)
epidemiological studies
investigations carried out when disease or death occurs in unexpected or unacceptable numbers
specific rates
measure morbidity and mortality for particular populations or diseases
Statistical Abstract of the United States
book published annually by the Bureau of Census; summary on statistics on social, political, and economic organization of the United States
The National Health Survey Act of 1956
authorized continuing survey of amount, distribution, and effects of illness and disability in the U.S.; health interviews of people, clinical tests, surveys of medical care places
cohort
a group of people who share an important demographic characteristic
case fatality rate
the percentage of cases of a particular disease that result in death
agent
cause of disease or health problem
life expectancy
average number of years a person from a specific cohort is projected to live from a given point of time (at birth, at 65, at 75)
descriptive who
case count, followed by who is ill (children, men, women, race, etc.)
relative risk
a statement of the relationship between the risk of acquiring a disease when a specific risk factor is present and the risk of acquiring the same disease when the risk factor is absent
case/control studies
compares those with disease to those without but with similar background and/or prior exposure to certain risk factors
The National Health Interview Survey (NHIS)
conducted by NCHS, questions respondents about their health
analytic studies
aimed at testing hypotheses
descriptive when
time of onset for each case, epidemic curves created
incubation period
period of time between exposure to an infectious agent and onset of symptoms
mortality statistics
most reliable measure of population health status
secondary data
data collected by someone else, possibly for another purpose, useful in planning of public health programs and facilities
determining causation
questions exposure causing development of disease; guidelines, not rules, criteria includes strength, consistency, specificity, temporality, biological plausibility
cohort studies
classified by exposure to one or more risk factors and observed to determine the rate of disease development
crude rate
a rate in which the denominator includes the total population
proportionate mortality ratio
percentage of overall mortality in a population that is attributable to a particular cause -- the percentage of deaths caused by a certain disease out of all deaths (ex: heart disease is responsible for 24% of deaths in the U.S.)
Health-Adjusted Life Expectancy (HALE)
number of years of healthy life expected, on average, in a given population or region of the world
descriptive where
determine residential address and travel history
communicable diseases
the diseases for which biological (living) agents or their products are the cause and that are transmissible from one individual to another (common cold, pneumonia, measles, AIDS)
Monthly Vital Statistics Report
measures vital statistics, published by the National Center for Health Statistics, calculates death rates by race/age
crude death rate
number of deaths in given year from all causes, divided by midyear population
epidemic curves
graphic display of the cases of disease according to the time or date of onset symptoms; point source, continuous source, propagated
Framingham study
most famous cohort study, made to study the impact of several factors on incidence of cardiovascular diseases with exposures of blood pressure, smoking, diabetes, body weight, etc. with multiple outcomes of coronary heart disease, stroke, congestive heart failure, etc.
crude birth rate
number of live births in given year, divided by midyear population
U.S. Census
enumeration of population taken every 10 years, gathers data on race, age, income, employment, education, etc.
years of potential life lost (YPLL)
number of years lost when death occurs before one's life expectancy; subtract the person's age at death from life expectancy, young deaths count more
notifiable diseases
infectious diseases for which health officials request or require reporting for public health reasons-- can become epidemics
prevalence rate
number of new and old cases of disease in a population in a given period of time, divided by the total number in that population; useful in study of chronic diseases
chronic
diseases or conditions in which symptoms continue longer than three months (AIDS, diabetes, tuberculosis)
reporting
physicians, clinics, and hospitals required to report births, deaths, and notifiable diseases; reported to CDC via NETS, various challenges in maintaining accurate data
Disability Adjusted Life Years (DALY)
measures burden of disease; one = one lost year of healthy life
noncommunicable diseases
those illnesses that cannot be transmitted from one person to another (appendicitis, injury, diabetes); cause is hard to find because of many factors
experimental studies
investigator allocates exposure and follows the development of disease, carried out to identify the cause of disease or determine effectiveness of vaccine, drug, or procedure
vital statistics
summaries of records of major life events, such as birth, death, marriage, divorce
Disability-Adjusted Life Expectancy (DALE)
years of life with disability (aka Global Burden of Disease)
age-adjusted rates
used to make comparisons of relative risks across groups and over time when groups differ in age structure
observational studies
investigator observes natural course of events, noting exposed vs. unexposed and disease development
Section 3
(50 cards)
intervention
effort to control disease in progress; taking action during an event
CHIP
targets uninsured children whose families do not qualify for Medicaid
unintended pregnancies
nearly one-half of pregancies, 43% ending in abortion, associated with negative health behaviors such as delayed prenatal care, inadequate weight gain, smoking, alcohol and other drug use, increasing in low income women
Maternal and Child Health Bureau (MCHB)
established in 1990 to administer Title V funding; accomplishes goals through four core public health services-- infrastructure building, population-based enabling, and direct health care services
environment
factors that inhibit or promote disease transmission
Title V
only federal legislation dedicated to promoting and improving health and mothers of children
new host
susceptible to new infection being established
chain of infection
step-by-step model to conceptualize the transmission of a communicable disease from its source to a susceptible host; pathogen → reservoir → portal of exit → transmission → portal of entry → establishment of infection in a new host
pathogen
a disease causing agent (virus, bacterium, etc.)
abortion
majority unmarried or women aged 20-29, highest among black women
prevention
planning for and taking action to prevent or forestall onset of disease or health problem
infants
less than one year
leading cause of infant death
congenital abnormalities, preterm/low birth weight, Sudden Infant Death Syndrome (SIDS)
family planning
determining the preferred number and spacing of children and choosing the appropriate means to accomplish it
pathogenicity
capability of a communicable agent to cause disease in a susceptible host; the ability of an agent to cause disease after infection, measured as the proportion of persons infected by an agent who then experiences clinical disease
childhood morbidity
unintentional injuries, child maltreatment, infectious diseases
Title X
the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services, aims to reduce unintended pregnancy by providing contraceptive and other reproductive health care services to low-income women (The Family Planning Act)
families
the primary unit in which infants and children are nurtured and supported regarding healthy development
primary prevention
forestall onset of illness/injury during prepathogenesis period
transmission
how pathogens are passed from reservoir to next host
zoonoses
diseases for which the reservoir resides in animal populations (rabies, Lymes disease)
reservoir
favorable environment for infectious agent to live and grow (human, animal, etc.)
portal of exit
path by which agent leaves host
secondary prevention
early diagnosis and prompt treatment before disease becomes advanced and disability severe
vehicles
non-living objects by which agents are transferred to a susceptible host
maternal health
effect of pregnancy and childbirth on women important indicator of health
portal of entry
where agent enters susceptible host
multicausation disease model
a model that explains the onset of disease caused by more than one factor (genetic host, behavioral choices, and complex environment)
eradication
total elimination of disease from human population
Women, Infants, and Children Program (WIC)
clinic-based program designed to provide nutritional and health-related goods and services to pregnant, postpartum, and breastfeeding women, infants up to 1 years of age, and children under 5
prenatal health care
medical care from the time of conception until birth process, leads to healthier births
maternal, infant, and child health (MIC)
health of women of childbearing age from pre-pregnancy through pregnancy, labor and delivery, and the postpartum period, and the health of the child prior to birth through adolescence
Medicaid
low-income individuals and families; children are slightly more than half of all Medicaid beneficiaries
criteria of importance
number of people who will die from a disease, number of YPLL, economic costs to society associated with disease
tertiary prevention
aimed at rehabilitation following significant pathogenesis; retrain, reeducate, rehabilitate
anthroponoses
diseases for which humans are the only known reservoir (rubella, smallpox)
teenage pregnancies
more likely to result in serious health consequences for mother and baby, less likely for prenatal care and more likely for unhealthy behaviors; decreased with sex ed and better societal norms
children
1-9 years, broken up in 1-4 and 5-9 because of schooling
indirect transmission
transmission involving an intermediate step (airborne, vehicle-borne, vector-borne, biological)
child health
good health during childhood years are essential to a child's optimal development
control
containment of a disease; prevention and intervention measures
infectivity
ability of a biological agent to enter and grow in the host
direct transmission
immediate transfer of disease agent between infected and susceptible individuals (touching, biting, kissing, sex)
virulence
the ability of an infectious agent to cause severe disease, measured as the proportion of persons with the disease who become severely ill or die; a quantitative trait representing the extent of the pathology caused by a microorganism, expressing the interaction between a pathogen and its host
infant mortality
measure of a nation's health, decline due to improved disease surveillance, advanced clinical care, improved access to health care, better nutrition, increased education
gag rule
prohibited health care professionals in Title X family planning clinics from providing any abortion-related information or referrals, even when specifically requested to do so
infant health
depends on mother's health and prenatal care, quality of delivery, environment after birth, nutrition, and immunization
host
susceptible person or organism invaded by an infectious agent
preconception care
medical care provided to women of reproductive age to promote health prior to conception
childhood mortality
most severe measure of health in children, decline, unintentional injuries are leading causes
Section 4
(25 cards)