Final Exam Flashcards
(87 cards)
1
Q
Define public health
A
Public health is a role of local, state, and national governments to assure conditions in which people can be healthy.
2
Q
Public health is concerned with
A
improving health or preventing illness in a population, and it is usually implemented by a government or a group accountable to a community.
*Responsibility for PH is shared between government, health professionals, and community members.
3
Q
Population health
A
refers to a process of addressing the entire range of factors that determine health and is concerned with the entire population, not just ill or high-risk individuals
4
Q
basic concepts of public health
A
- focus on disease prevention and health promotion
- all members of a population have a basic need for health
- external environment affects individual’s health
5
Q
role of pharmacy in public health
A
- access to medications
- assuring safe and effective medications
- safely using/discarding medications
Ex: Pharmacy students disposing of medications for patients at a health fair.
6
Q
definition of health promotion
A
Health Promotion- occurs before exposure while individuals are health (to improve overall health, reduce risks, and increase resistance if exposed) and targets entire populations
7
Q
definition of disease prevention
A
Disease Prevention- reduce the risk that individuals will be exposed to a disease or condition that produce a disease; related to exposure and risk factors and targets at-risk individuals
8
Q
Compare public health, clinical prevention, and clinical treatment
A
Public Health focuses on health promotion and disease prevention for the POPULATION and interventions that create conditions that promote health.
Clinical Prevention focuses on health promotion and disease prevention for at risk individuals and individual intervention s to undertake activities that will promote health or prevent disease.
Clinical Treatment focuses on at risk individual disease diagnosis and disease treatment for health restoration as well as individual interventions to undertake activities that will modify the disease process or alleviate pain
9
Q
current pharmacist roles in public health
A
- provide education (clinical prevention) Ex: medications, disease states, lifestyle issues
- provide educational programs Ex: drug abuse, smoking cessation, diabetes management
- provide counseling on health promotion products Ex: sunscreens, dental hygiene, vitamins
- provide immunizations and health screenings
10
Q
Pharmacists have responsibilities in PH related to:
A
- medications and their use Ex: access to medications when there is no 24 hour pharmacy
- above average knowledge and training in health Ex: understanding how fluoride in water reduce cavities
- residents of the community Ex: because they live in the community they know that there are lots of stray dogs around
11
Q
10 major public health achievements in the 20th century
A
In the US from 1900-1999
- immunizations
- motor-vehicle safety
- safer workplaces
- control of infectious diseases
- decrease in deaths from coronary heart disease and stroke
- safer and healthier foods
- healthier mothers and babies
- family planning
- fluoridation of drinking water
- recognition of tobacco use as a health hazard
12
Q
10 major public health achievements in the 21st century
A
In the US from 2001-2010 (21st century)
- vaccine-preventable diseases
- prevention and control of infectious diseases
- tobacco control
- maternal and infant health
- motor vehicle safety
- CV disease prevention
- occupational safety
- cancer prevention
- childhood lead poisoning prevention
- public health preparedness and response
13
Q
Compare concerns from history to 21st century
A
Throughout history, primary concerns of PH were: supplying adequate nutritious and safe food, safe water, safe housing, and controlling infectious disease.
In the 21st century, same concerns still exist due to increased population levels AND additionally, lack of water, climate change, and chronic disease are issues.
14
Q
core functions of public health in relation to the community
A
3 main PH function:
- assessment (monitor health, and diagnose/investigate)
- policy development (inform educate and empower, mobilize community partnerships, and develop policies)
- quality assurance (enforce laws, link to/provide care, assure competent workforce, and evaluate)
15
Q
identify the essential public health services and its focus on community health.
A
10 essential U.S. PH Services
(DR E DILEMMA)
1. Diagnose and investigate- Health problems and health hazards in the community
2.Research- For new insights and innovative solutions to health-problems
3.Evaluate-Effectiveness, accessibility, and quality of personal and population-based health services
4.Develop policies and plans- That support individual and community health efforts
5.Inform, educate and empower- People about health issues
6.Link- People to needed personal health services and assure the provision of healthcare when otherwise unavailable
7.Enforce- Laws and requirements that protect health and ensure safety
8.Monitor- Health status to identify and solve community health problems
9.Mobilize- Community partnerships and action to identify and solve health problems
10.Assure- Competent public and personal health care workforce
16
Q
role of government in public health
A
HHS (Department of Health and Human Services) *Primary federal agency for PH
Roles:
- sets national priorities for health and PH
- interacts with international partners to promote health
- monitors health of the nation
- supports and funds programs and research
(SIMS)
17
Q
what the CDC is and what it is responsible for
A
Centers for Disease Control and Prevention (leading national public health institute) is a federal agency under HHS that develops and applies disease control and prevention. The main focuses are infectious disease food borne pathogens environmental health occupational safety and health health promotion injury prevention educational activities designed to improve the health of United States citizens.
18
Q
WHO and what it does
A
World Health Organization:
the directing and coordinating authority for health within the United Nations system.
Function:
-provide leadership on important health matters
-partner with other public or private organizations as needed
-shape the research agenda and ensure new knowledge is disseminated
-develop standards, set norms, and monitor implementation
-promote policy options that are ethical and evidence-based
-provide technical support and expertise
-monitor and assess trends in health
-promote change and support the development of its own sustainable institutional capacity
19
Q
what APHA is and does
A
American Public Health Association
- support the influx of more pharmacists trained in public health
- urging Congress to have the Centers for Medicare and Medicaid Services recognize pharmacists as healthcare providers to function in PH capacities and be eligible for reimbursement in such capacities
20
Q
ecological framework behind public health
A
Concerned with the environment surrounding the individual as well as the characteristics or behavior of the individual Environment includes: -social surroundings -physical surroundings of the community -state -nation -world (global)
21
Q
definition of health determinants
A
The conditions or factors associated with health are known as health determinants.
Depends on the:
-Interaction of the person with their environment
-Internal factors
-External factors
22
Q
Interaction of person with their environment
A
Positive interactions result in health or maintenance of health. Negative interactions result in disability and disease
23
Q
Internal factors
A
characteristics of the individual (May be inherited or learned, May be physical, social, psychological, or behavioral)
24
Q
External factors
A
characteristics of the community where the individual lives and works
(May be physical, social, economic etc.)
25
Levels of Health Determinants
Health determinants within an ecological framework will be used to guide the discussion of health promotion
- Individual
- Community
- State/National
- Global
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Individual Level
(An individual person)
- Physical characteristics
- Socioeconomic status
- Educational attainment
- Psychological Factors
- Behaviors
27
Community Level
- Economics
- Food Supplies
- Water and sanitation
- Housing
- Physical environment
- Social environment
- Education & social services
- Local government
- Primary Care
28
State/National Level
- Communication networks
- Government
- Public Health System
- Health insurance and health systems
29
Global Level
- Communications
- Public health organizations
- Violence
- Global Climate Change
30
Examples of health determinant levels
Individual-level of education
Community-availability and accessibility of primary health care services
State-laws promulgated by the state legislature to improve health
National-availability of grant programs to improve local services
Global-availability of organizations that can coordinate global responses
31
5 determinants of health on the individual level
| physical
Physical:
- genetic susceptibility to breast cancer
- immunity against specific diseases
- low physical fitness increases back injury risk
32
5 determinants of health on the individual level
| socioeconomic status:SES
SES:
- poverty has been identifies as "greatest single killer' by WHO
- Lack of economic resources is related to other factors that affect health (ex. adequate nutrition)
33
5 determinants of health on the individual level
| educational attainment
- maternal educational level is strongly related to children's health
- increased education is related to behaviors that improve health (ex. smoking cessation)
34
5 determinants of health on the individual level
| physiological factors
- childhood abuse or neglect increases likelihood of poor health as an adult
- stress is associated with diseases including cardiovascular disease, cancer, or other chronic diseases
35
5 determinants of health on the individual level
| behaviors
- behaviors w/ neg. impact on health (smoking
| - behaviors w/ pos. impact on health (exercise)
36
cultural competence
- Attitude, knowledge, and skill that enable you to act in a manner that is respectful and responsive to the needs of others.
- Being able to provide services that are respectful and responsive to the needs of the community.
37
what it means to have cultural competence
- No universal culture as culture is influenced by local conditions
- Differs from professional competence; a person can be professionally competent but not culturally competent and vice versa
- Recognize that culture is related to ethnic background or race but that other factors also contribute to culture
38
health disparities
Difference in life expectancy and health status related to racial and ethnic populations.
Examples:
-Infant mortality is twice that of whites among African-American and American Indian populations
-American Indians and Alaskan Natives are 2.3 times as likely to have diabetes
Impact on overall health of Americans
39
difference between interpreters vs. translators
Interpreters: SPOKEN language (verbally convey what one person says in one language to a second person in a different language)
Translators: WRITTEN language (resend a document written in one language into a document written in a second language)
40
how cultural characteristics are related to health
- History (especially immigration patterns and originating countries)
- Language (strongly influenced by educational level)
- Religion
- Foods
- Dress
- Social Rules
- Folk Medicine (use of home remedies, teas or healing rituals and OTC meds)
- Beliefs about health and illness
- Use of Western biomedicine (includes the social norms related to the use of home remedies and when to consult a medical practitioner)
41
pyramid of cultural competence
base- Attitude: Beliefs related to cultural issues and their relationship to health (Attitudes form the base of the pyramid; enabling attitudes allow the development of knowledge and skill)
middle- Knowledge: Represents specific facts related to culture
top- Skill: Have the ability to modify services so that they are culturally appropriate for the local population (Represents the apex of the pyramid as practitioners can have appropriate attitudes and knowledge but fail to change services)
42
health promotion
Defined as actions affecting one or more determinants of health
•Goal is to enable people to maintain or improve their physical, mental, or social well-being
43
strategies used for health promotion
* Education—including general literacy as well as health literacy
* Modifying the external environment to encourage interactions that promote well-being rather than interactions that promote disease
* Combination of the two strategies—provide education and modify the environment
44
health literacy
Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.
Health literacy is dependent on individual and systemic factors: Communication skills of lay persons and professionals.
45
abilities required to be considered “health literate.”
•Incorporates a range of abilities:
–Read, comprehend, and analyze information
–Decode instructions, symbols, charts, and diagrams
–Weigh risks and benefits
–Make decisions and take action
•Includes the ability to access needed health information and the capability of using that information
46
pharmacy health literacy
•Able to understand the instructions about medications
(Including dosing and side effects)
•Be aware of alternate treatments that might also be considered
•Able to evaluate the effects of the medication and adverse effects related to the drug
•Motivated to take the medication as directed
•Negotiate health care systems for follow-up and further treatment
47
health education
Any activity intended to produce changes in knowledge or ways of thinking that facilitates skill acquisition or behavior change related to health
- Most health promotion activities involve at least some education
- Education may be aimed at community members or policymakers
48
health-to-death continuum
```
Various levels of healthiness, sickness, and death.
-Activities to reduce disease and increase health by where they are initiated on the continuum
(left start:
perfect health
mod health
marginal health
exposure/risk
early disease
late disease
death right end)
```
49
difference between health promotion and disease prevention
- Health Promotion: optimize overall health. LEFT side
| - Disease Prevention: reduce occurrence and impact of specific diseases. RIGHT side
50
Knowledge Needed for Health Promotion
1. Awareness- knowledge that a health issue exists
2. How-to Knowledge- the skill to use the knowledge to promote health
3. Knowledge of principles- why the action promotes health; without knowledge of why, health promotion knowledge may be misused
51
different levels of prevention.
Primary
Secondary
Tertiary
52
primary prevention
Reduce risk of developing disease in those at higher risk of exposure and/or increased susceptibility to disease by reducing exposure rates and increasing resistance which can reduce number of new cases (prevent disease occurrence)
evaluated by incidence of exposure
53
secondary prevention
Reduce number of new or severe cases in those who have been exposed to the disease-causing agent or have early symptoms of the disease by reducing number of exposures and catching early disease before it progresses allowing morbidity and mortality to be reduced
(reduce severity, disability or death by early detection and treatment)
evaluated by incidence of disease, mobidity
54
tertiary prevention
Reduce number of complications or deaths
in those who have disease and need treatment by reducing disease severity and increasing recovery
(reduce impairment and minimize suffering)
evaluated by prevalence, morbidity, & mortality
55
Pharmacist role in prevention
•Traditionally involved in
–Tertiary prevention for individuals
–Secondary prevent for individuals
•Can expand into
–Primary prevention for individuals or populations
–Tertiary or secondary prevention for populations
56
epidemiology
* A core public health discipline
* “the study of the distribution and determinants of health-related states or events in specified populations" and application of this study to control of health problems.”
* The basic science of public health
* Population-based study of disease occurrences
57
objectives of epidemiology
1. identify the etiology (cause) of disease
- risk factors
- disease transmission methods
2. Study natural history and prognosis of disease
- develop new intervention and treatment
3. Determine disease extent in community
- helps allocate resources
4. Evaluate preventative and therapeutic measures of healthcare delivery
5. provide foundation for public policy development to prevent disease
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epidemiologic term: endemic
normal occurrence of a condition in a specific population
| –Ex: malaria in Africa
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epidemiologic term: epidemic
greater than normal occurrence of a condition in a specific population or when a disease that is NOT usually found in the population appears (in a community or region)
–Often involve large geographic areas such as countries on one continent, but are not global
–Ex: North America has seasonal influenza epidemic about every 3 years; obesity in America
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epidemiologic term: pandemic
epidemic in multiple countries across multiple continents (widespread and affects a whole region, a continent or the world)
61
Incidence
```
# of NEW cases
–The proportion of NEW cases of disease occurring at a specified time and in a specified population (i.e. population at risk)
–How many people per year newly acquire this disease?
```
𝐼𝑛𝑐𝑖𝑑𝑒𝑛𝑐𝑒=𝑁𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑛𝑒𝑤 𝑐𝑎𝑠𝑒𝑠 / population x 100
62
Prevalence
TOTAL # of cases
-The proportion of EXISTING cases of disease or attribute in a total population at a given time
–How many people have this disease right now?
𝑃𝑟𝑒𝑣𝑎𝑙𝑒𝑛𝑐𝑒=𝑇𝑜𝑡𝑎𝑙 𝑛𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑒𝑥𝑖𝑠𝑡𝑖𝑛𝑔 𝑐𝑎𝑠𝑒𝑠 / Population x 100
63
Point Prevalence
of existing cases in a total population at a set point in time
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Period Prevalence
of existing cases in a total population during a given period of time
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Association
–A link or relationship between an agent (or a vector or vehicle carrying the agent) and disease
–Important to know the “strength” of association
–Ex.: ASA and Reye’s Syndrome
Association between exposure and illness
- Use control/comparison groups
- test hypothesis
66
Causation
–Look to identify what may cause disease
| –Exposure that leads to new cases of disease (Remove exposure and most cases do not occur)
67
community health
Efforts to modify the environment for improving the health of community residents
Based on beliefs:
A community can create surroundings that promote health and prevent disease
Local residents, including health professionals, can engage in actions that will improve the health of all residents of the community
68
community health focus
The health of the population
Health promotion and disease prevention
Creation of a healthy environment
The health of all residents
Using limited resources effectively to promote health
**Involves collaboration among residents
69
IPECP
(Interprofessional Education & Collaborative Practice)
When multiple health workers from different professional backgrounds work together with patients, families, carers, and communities to deliver the highest quality of care.
Makes the "triple aim" possible
- Better Health for population
- Better care for individuals
- Lower costs thru improvement
IPE+IPCP=IPECP
70
why IPECP is important
National health care organizations and employers are emphasizing the importance of a team-based approach to health care to:
Decrease medical errors
Allow for continuity of care
Improve quality of care
Cut healthcare costs
Results in better patient outcomes
71
Multidisciplinary
Multidisciplinary is handled independently and the patient’s problems are subdivided and treated separately. (not a good approach...team-based approach is preferred)
72
Interprofessionalism Education
| IPE
When two or more professions learn about, from, and with each other to enable effective collaboration & improve health outcome.
73
Interprofessional Collaborative Practice (IPCP)
When multiple health workers from different professional backgrounds work together with patients, families, careers[sic], and communities to deliver the highest quality of care.
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Interprofessional
The provision of health care by providers from different professions in a coordinated manner that addresses the needs of patients. Providers share mutual goods, resources, and responsibility for patient care
ongoing learning with, from, and about other professions to improve collaboration and the quality of care
75
Multiprofessional
ongoing learning for professions together
| professions learn together simultaneously
76
Healthy People 2020 program
Provides science-based, 10-year national goals for health promotion and disease prevention
Based upon assessable behaviors or activities that should lead to better population health outcomes
Managed by the US Dept. of Health and Human Services
77
Healthy People 2020 goals
Overarching Goals:
(Longer lives free of preventable disease, health equity, eliminate disparities, promote good health)
Long Version:
Attain high quality, longer lives free of preventable disease, disability, injury, and premature death
Achieve health equity, eliminate disparities, and improve the health of all groups
Create social and physical environments that promote good health for all
Promote quality of life, healthy development, and healthy behaviors across all life stages
78
Healthy People 2020
| 12 topic areas
access to health services
Clinical preventive services
Environmental quality
Injury and violence
Maternal, infant, and child health
Mental health
Nutrition, physical activity, and obesity
Oral health
Reproductive and sexual health
Social determinants
Substance abuse
Tobacco
79
Triple Aim
The best care for the whole population at the lowest cost!
- Better Health for population
- Better care for individuals
- Lower costs thru improvement
80
FEMA
Federal Emergency Management Agency:
-Rapid response to man-made and natural disasters
-Provides financial assistance
( to individuals and governments to rebuild homes, businesses, and public facilities
Trains firefighters and emergency medical professionals
Funds emergency planning throughout the US
Part of the Dept. of Homeland Security since 2003)
81
Strategic National Stockpile
Housed within the CDC
Contains large quantities of medicine and medical supplies to protect the American public in the event of a national public health emergency (e.g., terrorist attack, flu outbreak, or earthquake) severe enough to cause local supplies to run out.
82
pharmacist's’ role(s) in public health at local or state level
·Be aware of health boards and task forces
·Become involved in education and awareness programs
·Report unusual sales volumes for medications or patient complaints
·Be an advocate for local citizens and keep eyes open for issues
83
pharmacist's’ role(s) in public health at federal level
·Participate on task forces within professional organizations
·Serve on review panels or government committees
·Use national voluntary reporting systems
84
pharmacist's’ role(s) in public health at international level
·Participate in voluntary medical and humanitarian aid
·Raise awareness for international travelers of risks and prevention
·Donate money or supplies
85
How are Health Promotion and Disease Prevention Programs Designed?
* Identify community strengths and challenges
* Identify specific population to be served by the health program
* Choose a health focus for the program
* Develop goals and objectives
* Set a program timeline
* Determine staffing for program
* Create a work plan
* Develop an evaluation plan
* Establish a budget for the resources needed for your program
86
What are key components to a successful Health Promotion Program?
•Effective program planning with realistic goals and priorities
•Barriers to the success of the program addressed
•Culturally sensitive
•Timing
•Marketing
•Flexible
•Well trained staff
-Some staff should be part of the community served
-Continued skills development of staff
•Regular assessment and reporting of outcomes
•Buy-in from community, state and local authorities
87
Importance of public health
- decreases medical errors
- allows for continuity of care
- improves quality of care
- cuts healthcare costs
- results in better patient outcomes
