Final Flashcards
(125 cards)
1
Q
Top 4 reasons urban health will dominate public health in the 21st century?
A
- Urban population > rural population
- Higher disease rates and risk factors
- Worse outcomes in incidence and treatment
- Poor lifestyle (violence, unsafe sex, occupational disease)
2
Q
What year did urban residents outnumber rural?
A
2008
3
Q
Which 3 countries account for 37% of urban population growth?
A
- India
- China
- Nigeria
4
Q
Why can urban health statistics be misleading?
A
High-income countries skew data; some urban areas are worse off than rural ones
5
Q
What is the ‘triple threat’ in cities?
A
- Infectious diseases
- Chronic, noncommunicable diseases
- Unhealthy lifestyles
6
Q
Why is the socioeconomic transition model incorrect?
A
It assumes issues are addressed sequentially, but all disease types coexist globally
7
Q
What are DALYs used for?
A
To measure early death + morbidity → how many years of healthy life are lost
8
Q
Why are the top 5 environmental diseases important in urban health?
A
They are increasing and becoming dominant as urban populations rise
9
Q
What factor most affects lifespan in Louisville?
A
Income
10
Q
Why didn’t wealthy people die younger despite stressful jobs?
A
They could afford better coping strategies and stability
11
Q
How does job rank affect health in Louisville?
A
Health outcomes decreased gradually with income level
12
Q
Underlying reason for poor health in poor communities?
A
Chronic stress
13
Q
What did monkeys show about stress and health?
A
Lower-ranked monkeys had the most plaque in their arteries
14
Q
How did European countries improve health equity?
A
- Mixed-income housing
- Green spaces
- Shared resources
- Social support
15
Q
How do green spaces affect cardiovascular mortality?
A
They reduce mortality through exercise and stress reduction
16
Q
What’s the difference between health inequality and health inequity?
A
- Inequality: differences due to factors like age or sex
- Inequity: unfair, socially produced, modifiable differences (e.g., SES)
17
Q
Why are infectious diseases a threat in slums?
A
- Severe overcrowding
- Poor sanitation
- Limited healthcare
- Global travel
18
Q
How does urbanization change diets?
A
More access to calorie-dense, high-fat/sugar/salt foods
19
Q
How does urbanization impact physical activity?
A
People become more sedentary
20
Q
Which income groups have the highest road traffic fatality rates?
A
Lower- and middle-income countries
21
Q
What % of global road traffic deaths occur in LMICs?
A
90%
22
Q
Why are traffic deaths higher in LMICs?
A
Poor infrastructure and lack of safety regulations
23
Q
Under-5 mortality rate difference between rich and poor urban residents?
A
Factor of 2
24
Q
What % of maternal deaths occur in low-income countries?
A
99%
25
Which group has highest HIV rates in Sub-Saharan Africa?
Poor urban women
26
Difference in life expectancy between high- and low-income countries?
20 years
27
Difference in neonatal mortality rates?
10x higher in low-income countries
28
How has under-5 mortality changed over 20 years?
Decreased by 50%
29
Why does reduced child mortality stabilize population growth?
Parents have fewer children when survival is more certain
30
What is stunting?
Low height for age due to chronic undernutrition
31
Two sociodemographic factors associated with malnutrition?
* Parental education
* Wealth
32
Which regions have highest childhood overweight rates?
Middle East and North Africa
33
What’s surprising about immigrant CVD rates?
They’re lower than in the U.S. population
34
Why is this surprising?
Because immigrants face more stress and have lower income
35
What explains better immigrant health?
* Strong family ties
* Social networks
* Traditional diets
36
Why do immigrant health outcomes worsen over time in the U.S.?
They adapt to American lifestyles and become isolated
37
What is R₀ in infectious disease?
The average number of people one person can infect
38
What does R₀ > 1 mean?
The disease will spread exponentially
39
Why was SARS-CoV-2 harder to control than SARS-CoV-1?
It has asymptomatic transmission
40
What’s required to control infectious diseases in cities?
* Basic public health systems
* Treatment
* Prevention
41
Why are cities good for infectious disease control?
* High density for outreach
* Electricity and refrigeration
* More health workers and infrastructure
42
What causes disease outbreaks in urban areas?
* Travel/imported disease
* Clustering and poor sanitation
* High population density and risky behaviors
43
How do you control Dengue fever?
Remove water containers around homes (mosquito breeding)
44
What caused cholera in Haiti?
UN soldiers from Nepal contaminated water supplies
45
What percent of child deaths are from diarrhea?
1 in 10 (10%)
46
What does a relative risk of 0.21 mean for diarrhea?
79% reduction from improved water sources
47
What % of people wash hands after contact with excreta?
19%
48
AIDS control goal by 2030?
90-90-90 target (90% tested, 90% treated, 90% virally suppressed)
49
What’s needed in cities to meet the 90-90-90 goal?
Education and resources in slums
50
Top 2 causes of death in AIDS patients?
* TB
* Pneumonia
51
What was the major conflict in AIDS control ideologies?
Condom promotion vs. abstinence strategies
52
Which country had the biggest AIDS reduction?
Uganda
53
What was Uganda’s strategy?
ABC (Abstain, Be faithful, Condom use)
54
Why are condoms only ~80% effective in trials?
Still risk in high-prevalence communities
55
Where did condoms work best as a control method?
Gay men in San Francisco
56
What fraction of deaths is from NCDs?
~60%
57
What disease causes the most NCD deaths?
Cardiovascular Disease (CVD)
58
Why are NCDs more prevalent in cities?
Unhealthy food, sedentary life, alcohol, tobacco
59
Two ways aging affects NCD burden?
* More elderly people
* Younger people developing disease earlier
60
Where will 80% of elderly live by 2050?
Low- and middle-income countries
61
Two reasons NCDs trap people in poverty?
* High treatment costs
* Missed work/income
62
Leading cause of NCD deaths by gender?
* Women: Breast cancer
* Men: Cardiovascular disease
63
Modifiable risk factors for CVD?
* Diet
* Inactivity
* Smoking
* Hypertension
* Obesity
* Stress
64
Non-modifiable risk factors for CVD?
* Age
* Gender
* SES
* Family history
* Genetics
65
Why did Laotian community have high early heart disease?
Stress, poor diet, little exercise
66
4 Richmond factors increasing NCDs?
* Lack of open space
* Pollution
* Food insecurity
* Poor housing
67
3 ways High Point broke the link?
* Improved housing
* Security
* Community areas
68
What’s a 'breathe-easy' home?
Ventilated home with air filtration to reduce asthma triggers
69
% of men who smoke globally (2020)?
37%
70
% of women who smoke globally (2020)?
8%
71
How many global deaths are from smoking?
~8 million/year
72
Is smoking prevalence rising or falling?
Prevalence falling, but absolute numbers rising
73
Country with most female smokers?
United States
74
Areas with highest adolescent female smoking?
Western and Central Europe
75
Why is the number of smokers rising?
Increased population and disposable income
76
What is PM2.5?
Best indicator of health impact from air pollution
77
Why was London Smog (1952) important?
Linked air pollution directly to mortality
78
5 WHO diseases linked to air pollution?
* COPD
* Lung cancer
* ALRI
* Pneumonia
* Stroke
79
Effects of air pollution during pregnancy?
* Low birth weight
* Early birth
* Poor brain/lung development
* Birth defects
80
Most prevalent chronic respiratory disease (2015)?
Asthma
81
What did the Harvard 6 Cities Study show?
* PM correlated with death
* Indoor air > outdoor
* PM10 stronger than SO2
82
Why is asthma increasing in the US?
Growing incidence + more COPD
83
Why are asthma rates high in Black children?
Stress + poor housing/environment
84
Household asthma triggers?
* Dust mites
* Mold
* Pets
* Roaches
* Air pollution
85
Asbestos reaches deep lung = aligns with airflow?
86
In lungs → scarring → stiff, painful breathing?
87
Smoking + asbestos = how much higher risk of lung cancer?
10x higher
88
Cleaning = protective measures?
* Suits
* Wet methods
* Respirators
89
Lead reduced via what?
* Gasoline removal
* Paint removal
90
Blood lead concern = top what percentile?
2.5%
91
Higher lead levels in which demographic?
Black children
92
LA lead sources?
* Candy
* Toys
* Ceramics
93
Effects of lead?
* Lower IQ
* Behavioral issues
94
Lead → what effect on adult brain?
* Smaller
* Fewer dendrites
95
Lead → more violent crime due to what?
Low IQ
96
What % of child deaths are from diarrhea?
1 in 10 (10%)
97
What is the effect of scarring in the lungs?
Stiff, painful breathing
## Footnote
Scarring in the lungs can lead to restrictive lung disease, causing difficulty in breathing.
98
How much does smoking combined with asbestos increase the risk of lung cancer?
10x higher risk
## Footnote
The combination of smoking and asbestos exposure significantly elevates the risk of developing lung cancer.
99
What protective measures are recommended for cleaning hazardous materials?
Protective suits, wet methods, respirators
## Footnote
These measures help reduce exposure to harmful substances during cleaning.
100
What measures were taken to reduce lead exposure?
Gasoline & paint removal
## Footnote
These actions were part of initiatives to minimize lead contamination in the environment.
101
What percentile indicates a concern for blood lead levels?
Top 2.5% percentile
## Footnote
Elevated blood lead levels above this percentile signify a risk for health issues.
102
Which demographic has a higher prevalence of lead exposure?
Black children
## Footnote
Studies indicate that lead exposure is disproportionately higher among Black children.
103
What are common sources of lead in Los Angeles?
Candy, toys, ceramics, etc.
## Footnote
These items can be sources of lead contamination in urban environments.
104
What are the effects of lead exposure on children?
Lower IQ, behavioral issues
## Footnote
Lead exposure is associated with cognitive impairments and challenges in behavior.
105
How does lead exposure affect the adult brain?
Smaller, fewer dendrites
## Footnote
Chronic lead exposure can lead to neurological deficits in adulthood.
106
True or False: Lead exposure can lead to higher rates of violent crime.
True
## Footnote
Research suggests a correlation between lead exposure, lower IQ, and increased violent crime.
107
What caused the lead contamination in Flint's water?
Corroded pipes
## Footnote
The lack of corrosion control led to lead leaching from the pipes into the drinking water.
108
What bacteria is associated with Legionnaire's disease?
Bacteria in warm water
## Footnote
The bacteria thrive in warm water systems, leading to outbreaks of Legionnaire's disease.
109
What is malnutrition defined as?
Under + overnutrition
## Footnote
Malnutrition encompasses both inadequate and excessive nutrient intake.
110
What are the causes of low birth weight (LBW)?
IUGR or preterm
## Footnote
Intrauterine growth restriction (IUGR) and being born preterm are primary causes of LBW.
111
Where does IUGR cause the most problems?
LMICs (Low and Middle-Income Countries)
## Footnote
IUGR significantly impacts health outcomes in resource-limited settings.
112
What does the WHO curve provide?
Global consistency till age 6
## Footnote
The WHO growth standards ensure a uniform benchmark for child growth worldwide up to age six.
113
What is the trend of LBW rates globally?
Declining except Africa
## Footnote
While LBW rates are decreasing in many regions, they remain a significant issue in Africa.
114
What are the effects of low birth weight?
↑ fat, insulin resistance, ↓ energy, hypertension
## Footnote
LBW can lead to metabolic issues and long-term health complications.
115
What long-term impacts are associated with low birth weight?
Obesity, CVD, diabetes, HBP
## Footnote
LBW is linked to an increased risk of chronic diseases later in life.
116
What health issue is prevalent among teen slum dwellers?
Early type 2 diabetes
## Footnote
Poor living conditions and diet contribute to the early onset of diabetes in these populations.
117
What is the relationship between stunting and obesity in slums?
Stunting + obesity in same home
## Footnote
Families in slum areas can experience both stunting and obesity due to poor nutrition.
118
What causes stunting in children?
Poor maternal nutrition, poor infant diet, nutrient loss
## Footnote
Stunting is a multifactorial issue often linked to inadequate nutrition during critical growth periods.
119
What types of foods are subsidized?
Corn, wheat, soy
## Footnote
These staple crops often receive government subsidies, affecting food availability.
120
Why are fruits and vegetables less marketed?
Not profitable
## Footnote
The economic incentives lead to lower marketing and availability of fresh produce.
121
What marketing strategies target children?
Targets snack times, kids
## Footnote
Advertisements often focus on times when children are likely to snack, promoting unhealthy options.
122
What has changed in food consumption since the 1950s?
More processed food, less fresh
## Footnote
There has been a significant shift towards processed foods over fresh options in diets.
123
What can misleading food labels indicate?
High-sugar foods labeled as 'natural'
## Footnote
Marketing strategies can make unhealthy foods appear healthier than they are.
124
What did the Roseto, PA study show?
Low heart attacks from community lifestyle
## Footnote
The study highlighted how community ties and lifestyle choices can impact health outcomes.
125
Why did health decline in Roseto over time?
American lifestyle influence
## Footnote
The adoption of American lifestyle habits led to increased health issues in the community.
