Final Flashcards
(80 cards)
1
Q
Health Professional Shortage Area (HPSA)
A
Geographic area, population group, or medical facility w/ shortages of healthcare professionals -> may not be able to offer full range of healthcare service
2
Q
Medically Underserved Area (MUA)
A
Area determined through calculation of a ratio of PCPs per 1000 people, infant mortality rate, % of population below poverty level, and % of population 65 or older
3
Q
Medically Underserved Population (MUP)
A
US federal designation for populations that face economic barriers or cultural/language barriers to access primary medical services
4
Q
Healthcare challenges for Rural Populations
A
- Transportation
- Increased poverty
- lack of providers
- takes > 1hr to reach trauma center = increased mortality
- older population = more likely to smoke, sedentary lifestyle = obesity
5
Q
Health Priorities for Rural Populations
A
- Access to quality healthcare
- Heart disease
- DM
- Mental health / disorders
- Oral Health
- Tobacco use
- Substance use
6
Q
7 A’s of Challenges for rural elderly pop - Availability
A
Insufficient number of services and providers
7
Q
7 A’s of Challenges for rural elderly pop - Accessibility
A
Geographic isolation -> Shortages of adequate and affordable transportation
8
Q
7 A’s of Challenges for rural elderly pop - Affordability
A
Poverty and the inability to pay for services
9
Q
7 A’s of Challenges for rural elderly pop - Awareness
A
Low levels of information dissemination and literacy issues
10
Q
7 A’s of Challenges for rural elderly pop - Adequacy
A
Lack of service STANDARDS and evaluation, EBP is compromised
11
Q
7 A’s of Challenges for rural elderly pop - Acceptability
A
Reluctance of people to ask for help , say for transportation to get to an appt
12
Q
7 A’s of Challenges for rural elderly pop - Assessment
A
Lack of an assessment on what the communities basic needs are and if they’ve been met
Lack of information on these communities
13
Q
7 Q’s of the challenges for rural elderly pop
A
Are there services available?
Can I get there?
Can I afford it?
Do I have health information?
Is it QUALITY care?
Will I ask for help?
Have the community’s needs been assessed?
14
Q
Populations in Jails and Prisons
A
- increased risk of communicable diseases (TB, HIB, STIs, HepC
- chronic health conditions like substance addiction, mental health disorders, risky behavior
- female prisoners often lack women’s healthcare / additional needs as mothers
15
Q
Homeless Population & Healthcare
A
- education/exams should be provided at a trusted facility like a homeless shelter
- takes time & work to build trust to deliver care
16
Q
Public Health nurses approach to Homeless
A
- Support primary care (advocacy)
- Secondary care (screenings like TB)
- Tertiary care (like a detox program)
17
Q
Trimorbidity
A
Substance abuse + mental illness + another chronic health problem (HTN, DM, etc)
18
Q
Healthcare for Farm & Migrant workers
A
- Exposed to dangerous conditions like extreme weather and chemicals like pesticides
- migrant workers often have language barriers, low health literacy, poor access to preventative care
- focus on teaching PREVENTATIVE CARE like decrease smoking, reduce sun exposure (or SPF), dietary modifications, S&S of depression, heart disease, DM, cancer)
19
Q
Trans “Broken Arm” Syndrome
A
- healthcare providers focus on individual being transgender or gender non-conforming rather than focusing on the medical condition (broken arm)
- Providers soul focus might shift to HRT or genitalia once they hear a pt is transgender
- Providers should Tx trans pts the same as everyone else
20
Q
A
21
Q
Unique needs for aging LGBTQ population
A
- before 2015, surviving spouses could not receive social security benefits
- Less likely to have children that may care for them
- Worry about discrimination in elder care
- many private healthcare facilities are religious-affiliated (may hide sexuality)
22
Q
Assessment of contaminants in an environment
A
Risk = Hazard + Exposure!
If EXPOSURE is disrupted, contaminant should NOT affect human health
23
Q
Exposure Pathway - Source of Contamination
A
- What type of contaminant?
- Where does it come from?
3 categories = Chemical (lead, mercury) Biologic (mold, anthrax, ricin) Radiologic (radium)
24
Q
Exposure Pathway - Environmental media & transport mechanisms
A
- how are people exposed?
- how does the contaminant move through the environment?
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Exposure Pathway - Point of Exposure
- Where do people come into contact with the toxin?
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Exposure Pathway - Route of Exposure
- How does the contaminant enter the body?
3 ways = **ingestion, inhalation, skin contact**
27
Exposure Pathway - Receptor Population
- what is the population of people that is likely to be exposed?
- Risk of Current exposure? Assessment of past or future exposure
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Does a complete exposure pathway guarantee someone will get sick?
No! **health effects depend on the dose!!**
29
Environmental Justice
Belief that no group of people should bear a disproportionate share of negative environmental health consequences (regardless of race, culture, income)
*communities w/o political or economic power are at GREATEST risk*
30
Toxicology
The study of the adverse affects of chemical, physical, or biological agents on people, animals, and the environment
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Bioavailability
Amount of a contaminant that actually ends up in systemic circulation
32
Health effects of Lead
Neurotoxicity, developmental delays in children
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Health affects of Asbestos
Lung cancer (mesothelioma) and lung disease (asbestosis)
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Health effects of carbon monoxide
Coma or death
35
Assessing Exposure Hx , “**I** PREPARE”
Investigate potential exposures.
- have you ever come in contact with a chemical, pesticide, or other substance?
- do you have S&S that improves when you are away from usual location?
36
Assessing Exposure Hx , “I **P**REPARE”
Present work environment
- do you wear PPE?
- What are you exposed to?
- are work clothes worn home?
37
Assessing Exposure Hx , “I P**R**EPARE”
Residence
- when was your home built?
- are you doing any remodeling?
- where does the drinking water come from?
- any mold, mildew, or water damage in the home?
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Assessing Exposure Hx , “I PR**E**PARE”
Environmental concerns
- are there environmental concerns in the neighborhood?
- what type of industries or farms are near the home?
- is the home near a hazardous waste site or landfill?
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Assessing Exposure Hx , “I PRE**P**ARE”
Past work
- what were your past jobs?
- ever been in the military or worked on a farm?
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Assessing Exposure Hx , “I PREP**A**RE”
Activities
- what activities do you and your family engage in?
- do you burn, solder, or melt any products?
- do you garden, fish, hunt?
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Assessing Exposure Hx , “I PREPA**R**E”
Referrals and Resources
- Association of occupational & environmental clinics
- EPA
- OSHA
- local health department / poison control center
42
Assessing Exposure Hx , “I PREPAR**E**”
Educate
- can you minimize risk of exposure?
- discuss prevention strategies
- what is the follow-up plan?
43
Environmental epidemiology
Filed of public health science that focuses on incidence and prevalence of disease or illness in a population
*nearly impossible to conduct experimental studies because its unethical to exposure participants to environmental hazards*
44
Climate change - direct health effects
Direct exposure to extreme weather events
- heat stroke
- drowning in a flood
- traumatic injury from strong winds
45
Climate change - indirect health effects
- changes in water availability
- changes in air quality
- changes in agriculture
- changes in infectious disease distribution (malaria causing mosquitos)
- changes in allergens
46
Climate change - mental health
- exposure to trauma from natural disasters
- extreme heat causes aggressive behavior, high rates of criminal activity, increased suicide
- natural disasters can lead to displacement, property loss, social disruption
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Vulnerable Populations to Climate Change - Pregnancy
- increased temps associated with with preterm birth
- evidence that increased humidity -> preeclampsia & eclampsia
- air pollution and worsening respiratory compromise
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Vulnerable Populations to Climate Change - Children
- strongly associated with respiratory diseases
- less able to adapt to extreme heat
- more susceptible to dehydration
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Vulnerable Populations to Climate Change - Elderly
- high risk for heat related death
- more likely to live alone , have limited mobility, cognitive constraints, reduced social contacts
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Vulnerable Populations to Climate Change - people living in poverty
- disruption of access to public services
- need to migrate/leave with limited transportation options
- less likely to have flood insurance
- may live in older building with poor ventilation and lack of AC
51
Epidemiologic Triangle/Triad
- Agent at the top, host bottom L, environment bottom R
- changes in 1 element influence the occurrence of disease by increasing/decreasing a person’s risk for disease/illness
52
Wheel of Causation
**GENETICS OF HOST ARE AT CENTER OF MODEL!**
- Risk of disease/illness is influenced by a person’s biological, social, and physical environments (outer circle)
*de-emphasizes agent as the cause of disease!*
53
Multiple Causation (web of causation)
- Emphasizes that there are MULTIPLE causes of disease, not just one agent
- better fit to describe multiple factors of underlying **chronic illnesses**
- pathways in model deepen understanding and provides guide for interventions to prevent disease
54
Natural History of Disease model
- follows natural progression of disease from **pre-pathogenesis period** through **pathogenesis** (disease is present)
- can be used for infectious disease AND chronic illness
- *levels of prevention noted on bottom of model & correlates to stages of disease!*
- Primary prev = entire population
- Secondary prev = early phases of pathogenesis
- Tertiary prev = rehab of pts w/ disease
55
Risk
Probability/likelihood that a disease or illness will occur in a group of people that presently are not affected
56
Risk factors
Characteristics/events that have been shown to increase the probability that a specific disease/illness will occur
57
Rate
Primary measurement used to describe either the occurrence or the existence of a specific state of health or illness
58
Chain of Infection - Agent
Biologic agents capable of producing an infection
Bacteria, viruses, fungi, Protozoa, rickettsiae
59
Chain of Infection - Host
Susceptibility depends on age, sex, race, physical/mental health, immune status
**portals of entry/exit** = skin, resp tract, conjunctiva, GI & reproductive tracts
**incubation period** = time btwn exposure to agent & manifestation of S&S
**colonization** = presence and multiplication of infectious organisms without invading or causing damage to tissue
60
Chain of Infection - Environment
Reservoir, anything external to host
Humans, animals, plants, insects, water, soil
61
Chain of Infection - Transmission
How an agent moves from reservoir to host
**airborne** = microorganisms carried in air for a few feet (TB, measles, chickenpox, norovirus)
**Direct** = physical transfer of organisms from direct body surface contact (STIs, avian bird flu)
**Indirect** = contaminated inanimate object (bed linen, toys, food touched by soiled hands) or Vector transmission (animal/insect carrier of disease)
**Droplet** = droplets propelled short distances (< 3ft) from coughing, sneezing, talking (flu)
62
Communicable disease
There must be a **portal of exit** from infected person/animal, **means of transmission**, and a **portal of entry** to a susceptible host
63
Shingles
- highest risk for shingles > 60yo, immunocompromised, long-term stress
- *shingles is NOT contagious BUT! Can spread to someone as chickenpox if they’ve never had it or never been vaxxed
- S&S of shingles = itching, tingling, burning pain at site before rash (fluid filled blisters)
64
Shingles Vaccine
Shingrix
- protects against shingles and postherpetic neuralgia
- 2 doses separated by 2-6 months
- rec for adults > 50yo and the immunocompromised
- SE for 2 to 3 days = sore arm, fatigue, muscle pain, headache, fever, nausea, stomach pain
65
3 main reasons for vaccine refusal - Complacency
Not viewing disease as high-risk and/or vaccine as important
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3 main reasons for vaccine refusal - Convenience
Hurdles to receive the vaccine, not easy access
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3 main reasons for vaccine refusal - Confidence
Lack of trust in vaccine safety and in the healthcare system
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CASE for vaccine hesitancy
C = **C**orroborate concerns and have a respectful conversation with the parent
A = tell parent **A**bout yourself and your level of expertise
S = refer to evidence from **S**cience
E = **E**xplain and advise
69
Effects of violence on health
- premature death
- disability
- poor mental health
- high medical costs
- lost productivity
70
Violence prevention - Primary
- **BEFORE** violence occurs
- reduces likelihood of someone becoming a perpetrator or a victim
Examples:
- Gun laws
- educational programs
- school drills for mass shooting
- metal detectors
- anti-violence campaigns
71
Violence Prevention - Secondary
- SCREEN people w/ high risk factors or hx of violent behavior
- address alcohol use
- DV shelters, counseling
- Orders of protection
- have safety plans
72
Violence Prevention - Tertiary
- ONGOING support for victims
- ONGOING accountability for abusers
- mental health Tx and support groups
73
8 categories of Power & Control IPV Wheel
- Using economic abuse
- using coercion and threats
- using intimidation
- using emotional abuse
- using isolation
- minimizing, denying, and blaming
- using children
- using male privilege
74
Lethality Assessment for IPV
- is there a gun in the house?
- is the woman’s partner unemployed?
- What is the worst thing the partner has ever done to the victim?
- Do they feel their partner in capable of hurting them? Of carrying out threats?
- has the partner ever been arrested?
- Is the partner using drugs or drinking excessively?
75
Elder maltreatment (abuse & neglect) definition
Intentional actions that cause harm or create serious risk of harm to a vulnerable elder by a caregiver or other person in a trusted relationship with the elder
*includes failure to provide basic needs! Like glasses, walker, dentures, hearing aid, meds or protect from harm!*
76
Elder abuse screening questions
- do you live alone?
- who does your cooking?
- who controls your finances?
- how often do you see or go out with friends?
- are you afraid of anyone?
- does anyone slap you, pull your hair, hit you, or act rough with you?
77
Graduated driving laws
- started in late 1990s, designed to slowly introduce new drivers to progressively more difficult driving situations
- intent is to protect new teenage drivers while they are learning
- **ONLY for teenage drivers!**
- state laws determine driving laws
3 stages:
- Learner’s permit (supervised)
- Intermediate (restricted unsupervised)
- Full license (unrestricted)
78
8 danger zones for Teenage drivers
1. Inexperience
2. Teen passengers (distraction)
3. Nighttime driving
4. Not wearing seat belts
5. Distracted driving (phone)
6. Drowsy driving
7. Reckless driving
8. Impaired driving (substances)
79
Car seat guidelines for Children
**Birth-2yo** = REAR FACING car seat, backseat
**2-5yo** = forward facing car seat, backseat (4way harness until 4yo)
**5-8yo** = booster seat until proper fit of vehicle belts
**when belt fits properly** = based on child’s growth, middle of backseat is SAFEST. *no one under 13yo in front seat!!*
*car seats expire! Have to be replaced after expiration or accident*
Seat belt laws apply to ALL occupants and are subject to primary enforcement! (Meaning police can stop & ticket JUST for not using seatbelt)
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