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PBH-317 > Chapter 1 > Flashcards

Chapter 1 Flashcards

1
Q

Health Protection (Antiquity - 1830s): Focus of Attention

A

Authority-based control of individual and community behaviors

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2
Q

Health Protection (Antiquity - 1830s): Action Framework

A

Religious and cultural practices and prohibited behaviors

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3
Q

Health Protection (Antiquity - 1830s): Notable Events

A

Quarantine for epidemics; sexual prohibitions to reduce disease transmission; dietary restrictions to reduce food- borne disease

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4
Q

Hygiene Movement (1840–1870s): Focus of Attention

A

Sanitary conditions as basis for improved health

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4
Q

Hygiene Movement (1840–1870s): Action Framework

A

Environmental action on a community-wide basis distinct from health care

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5
Q

Hygiene Movement (1840–1870s): Notable Events

A

Snow on cholera; Semmelweis and puerperal fever; collection of vital statistics as empirical foundation for public health and epidemiology

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6
Q

Contagion Control (1880–1940s): Focus of Attention

A

Germ theory: demonstration of infectious origins of disease

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7
Q

Contagion Control (1880–1940s): Action Framework

A

Communicable disease control through environmental control, vaccination, sanatoriums, and outbreak investigation in general population

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8
Q

Contagion Control (1880–1940s): Notable Events

A

Linkage of epidemiology, bacteriology, and immunology to form tuberculosis (TB) sanatoriums; outbreak investigation, e.g., Goldberger and pellagra

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9
Q

Filling Holes in the Medical Care System (1950s–mid-1980s): Focus of Attention

A

Integration of control of communicable diseases, modification of risk factors, and care of high- risk populations as part of medical care

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10
Q

Filling Holes in the Medical Care System (1950s–mid-1980s): Action Framework

A

Public system for control of specific communicable diseases and care for vulnerable populations distinct from general healthcare system, beginning of integrated healthcare systems with integration of preventive services into general healthcare system

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11
Q

Filling Holes in the Medical Care System (1950s–mid-1980s): Notable Events

A

Antibiotics; randomized controlled trials; concept of risk factors; surgeon general reports on cigarette smoking; Framingham study on cardiovascular risks; health maintenance organizations and community health centers with integration
of preventive services into general healthcare system

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12
Q

Health Promotion/ Disease Prevention (Mid-1980s–2000): Focus of Attention

A

Focus on individual behavior and disease detection in vulnerable and general populations

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13
Q

Health Promotion/ Disease Prevention (Mid-1980s–2000): Action Framework

A

Clinical and population- oriented prevention with focus on individual control of decision-making and multiple interventions

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14
Q

Health Promotion/ Disease Prevention (Mid-1980s–2000): Notable Events

A

AIDS epidemic and need for multiple interventions to reduce risk; reductions in coronary heart disease through multiple interventions

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15
Q

Population Health (2000s): Focus of Attention

A

Coordination of public health and healthcare delivery based upon shared evidence-based systems thinking

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16
Q

Population Health (2000s): Action Framework

A

Evidence-based recommendations and information management, focus on harms and costs as well as benefits of interventions, globalization

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17
Q

Population Health (2000s):Notable Events

A

Evidence-based medicine and public health; information technology; antibiotic resistance; global collaboration, e.g., one health; tobacco control; climate change, and a full life cycle approach to improving community health

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18
Q

Historical: Health

A

Physical

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19
Q

Historical: Population

A

Geographically limitted

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20
Q

Historical: Example of Society-wide Concerns

A

Communicable disease

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21
Q

Historical: Examples of Vulnerable Groups

A

High-risk maternal and child, high-risk occupations

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22
Q

Current: Health

A

Physical and mental

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23
Q

Current: Population

A

Local, state, national, global, governmentally defined

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24
Q

Current: Examples of Society-wide Concerns

A

Toxic substances, product and transportation safety, communicable diseases, costs of health care

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25
Q

Current: Examples of Vulnerable Groups

A

Disabled, frail elderly, individuals with pain, uninsured

26
Q

Emerging: Health

A

Cosmetic, genetic, social functioning

27
Q

Emerging: Population

A

Defined by local, national, and global communications

28
Q

Emerging: Examples of Society-wide Concerns

A

Disasters, climate change, technology hazards, emerging infectious diseases

29
Q

Emerging: Examples of Vulnerable Groups

A

Immunosuppressed, genetic vulnerability

30
Q

High-Risk Approach

A

assumes that those with a high probability of developing disease are heavily concentrated among those with exposure to what we call risk factors

31
Q

Improving-the-Average Approach

A

Focuses on the entire population and aims to reduce the risk for everyone. Assumes that everyone is at some degree of risk and the risk increases with the extent of exposure.

32
Q

Neonatal (Birth to 28 days)

A

Highest death rate of any age group until over 50. Approximately 4/1,000. Nearly two-thirds of deaths during first year of life occur in this period

33
Q

Neonatal (Birth to 28 days): Major Causes of Death/Disability in the U.S.

A

Most deaths due to conditions present at birth including premature birth, low birthweight, and birth defects.

34
Q

Infancy (1–5 years)

A

Infant mortality rates approximately 6/1,000 live births with approximately 2/1,000 after 1 month

35
Q

Infancy (1–5 years): Major Causes of Death/Disability in the U.S.

A

Sudden infant death syndrome and infectious diseases are important causes of death after 1 month.

36
Q

Early Childhood (1–5 years)

A

Death rates fall dramatically in the U.S. and developed countries where infectious disease and malnutrition deaths are low. Rates approximately
0.2–0.4/1,000 per year

37
Q

Early Childhood (1–5 years): Major Causes of Death/Disability in the U.S.

A

Unintentional injuries are the leading cause of death and disability.

38
Q

Childhood (5–14 years)

A

Lowest death rates of any period with most years approximately 0.1/10,000

39
Q

Childhood (5–14 years): Major Causes of Death/Disability in the U.S.

A

Unintentional injury remains the leading cause of death and disability, with cancer being the second leading cause of death. Suicide is the third leading cause of death among those 10–14.

40
Q

Adolescents & Youth (15–24 years)

A

Increasing death rates with nearly 1/1,000 deaths per year by age 24

41
Q

Adolescents & Youth (15–24 years): Major Causes of Death/Disability in the U.S.

A

Dramatic increase in unintentional injuries and intentional injuries with homicide and suicide as the second and third leading causes of death. Behavior and mental disorders are the single largest cause of disability, and remain so until after age 65.

42
Q

Working Age (25–65 years)

A

Rates gradually increase from approximately 1/1,000 at age 30 to 1.5/1,000 at age 40 to 3/1,000 at age 50 to 8/1,000 at age 60 to 12/10,000 at age 65

43
Q

Working Age (25–65 years): Major Causes of Death/Disability in the U.S.

A

Causes of death change with increases in cancer and heart disease as the first and second leading causes of death by age 45 and remaining so through age 65. Chronic obstructive pulmonary disease is the third leading cause of death by age 55 and remains so until age 85.
Muscular-skeletal diseases are the greatest cause of disability during this period.

44
Q

Senior citizens (66–85 years)

A

Rates gradually increase from approximately 20/10,000 at age 70 to 30/1,000 at age 75 to 50/1,000 at age 80

45
Q

Senior citizens (66–85 years): Major Causes of Death/Disability in the U.S.

A

Cancer remains the leading cause of death until age 80 when it is exceeded by heart disease. Strokes and Alzheimer’s increase as cause of death and disability after age 75.

46
Q

Old Elderly/ Frail elderly (85+years)

A

Rates rapidly increase from approximately 80/1,000 at age 85 to 140/1,000 at age 90 to 225/1,000 at age 95 to 300 per 1,000 at age 100

47
Q

Old Elderly/ Frail elderly (85+years): Major Causes of Death/Disability in the U.S.

A

Heart disease and cancer remain the first and second leading causes of death followed by Alzheimer’s and strokes until age 95 when Alzheimer’s becomes the second leading cause of death. Alzheimer’s becomes the leading cause of disability in this age group.

48
Q

Health Care: Characteristics

A

Systems for delivering one-on-one individual health services, including those aimed at prevention, cure, palliation, and rehabilitation

49
Q

Health Care: Examples

A

Clinical preventive services, including vaccinations, behavioral counseling, screening for disease, and preventive medications

50
Q

Traditional Public Health: Characteristics

A

Group- and community-based interventions directed at health promotion and disease prevention

51
Q

Traditional Public Health: Examples

A

Communicable disease control, control of environmental hazards, food and drug safety, reduction in risk factors for disease

52
Q

Social Interventions: Characteristics

A

Interventions with another non-health-related purpose, which have secondary impacts on health

53
Q

Social Interventions: Examples

A

Interventions that improve the built environment, increase education, alter nutrition, or address socioeconomic disparities through changes in tax laws; globalization and mobility of goods and populations

54
Q

Contributory Causes

A

immediate causes of disease

55
Q

Determinants

A

underlying factors, or “causes of causes” that ultimately bring about disease.

56
Q

BIG GEMS

A 
Behavior
Infection
Genetics
Geography 
Environment
Medical care 
Socioeconomic-cultural
57
Q

Behavior

A

implies actions that increase exposure to the factors that produce disease or protect individuals from disease.

58
Q

Infection

A

the direct cause of disease

59
Q

Genetics

A

roles that genetic factors play in the development and outcome of disease

60
Q

Geography

A

Geographic location influences the frequency and even the presence of disease.

61
Q

Environment

A

Environmental factors determine disease and the course of disease in a number of ways.The unaltered or “natural” physical world around us may produce disability and death from sudden natural disasters. The altered physical environment produced by human intervention includes exposures to toxic substances in occupational or nonoccupational settings.

62
Q

Medical Care

A

Access to and the quality of medical care can be a determinant of disease

63
Q

Socioeconomic-cultural

A

In the United States, socioeconomic factors have been defined as education, income, and occupational status

PBH-317 (6 decks)

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