Lecture 21

Question 1

Cardiovascular Disease

Answer 1

Leading cause of mortality in the U.S (#1)

Question 2

How much death is attributed to heart disease and stroke?

Answer 2

40% according to the American Heart Association

Question 3

What are the two main processes by which blood vessels become damaged?

Answer 3

1. Atherosclerosis
2. Hypertension

Question 4

What are the three categories of cardiovascular disease?

Answer 4

1. Coronary Heart Disease
2. Cerebrovascular Disease (17.9 million deaths 32% of all deaths)
3. Peripheral Vascular Disease

Question 5

3/4ths of Cardiovascular deaths take place in low and middle-income countries

Answer 5

True

Question 6

1 in every 5 deaths are due to heart disease

Answer 6

True as of 2021 that is 695,000 deaths

Question 7

Heart Disease among ethnicity, race, and sex

Answer 7

Black (non-Hispanic) have the highest percentage of deaths by 22.6%

Question 8

Heart Disease Death Rates by geography

Answer 8

Most deaths are concentrated in the deep south

Question 9

CVD mortality among males and females

Answer 9

As of 2021 males had more deaths due to CVD compared to females.
Males: 490,000
Females: 440,000

Question 10

Framingham Heart Study (1948-2015)

Answer 10

A longitudinal cohort study that includes multi-generations of people.
Includes 3 generations of people

Question 11

Significance of Framingham Heart Study

Answer 11

Much of what we know about heart disease is attributed to this study

Question 12

Life’s Simple 7

Answer 12

1. Monitor BP
2. Exercise
3. Eat Healthy (U.S does worse at this)
4. BMI
5. No Smoking (U.S did well at this)
6. Monitor Blood Sugar
7. Cholesterol levels

Question 13

Life’s Essential 8 Factors

Answer 13

Health Behaviors
1. Adequate Sleep (new!)
2. Not smoking and vaping
3. Healthy Diet
4. Physical Activity

Health factors
1. BP
2. Blood lipids
3. Healthy Weight
4. Blood Sugar

Question 14

Social Determinants of Health

Answer 14

The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels, which are themselves influenced by policy choices. Responsible for health inequities, (unfair, avoidable differences in health status)

Question 15

Determinants of Health

Answer 15

1. Social and Economic Factors 40%
2. Health Behaviors 30%
3. Clinical Care 10%
4. Genes and Biology 10%
5. Physical Environment 10%

Question 16

Social Determinants as Fundamental Causes of Health

Answer 16

1. Influence multiple disease outcomes
2. Affects disease outcomes through multiple risk diseases
3. Involves access to resources that can be used to avoid risk or to minimize the consequences of disease once it occurs.
4. Associations are reproduced over time

Question 17

Domains of Social Factors

Answer 17

1. Economic Stability
2. Education
3. Health and health care
4. Neighborhood and Built environment
5. Social and community context

Question 18

Race

Answer 18

A social category referring to social groups, often sharing cultural heritage and ancestry, that are forged by oppressive systems of race relations, justified by ideology, in which one group benefits from dominating other groups, and defines itself and others through this domination and the possession of selective and arbitrary physical characteristics. (skin color)

Question 19

Ethnicity

Answer 19

Ethnicity, a construct originally intended to
discriminate between “innately” different
groups allegedly belonging to the same overall
“race” is now held by some to refer to groups
allegedly distinguishable on the basis of
“culture”; in practice, however, ethnicity”
cannot meaningfully be disentangled from
“race” in societies with inequitable race
relations, hence the construct “race/ethnicity

Question 20

Heckler Report

Answer 20

U.S Department of Health and Human Services (HHS) released the report of the Secretary’s Task Force on Black and Minority Health.
Documents the existence of health disparities among racial and ethnic minorities in the U.S. Led to creation of the Office of Minority Health. “A disgrace to our ideals and American medicine.”

Question 21

Heckler Report Landmarks

Answer 21

1. Office of Minority Health
2. CDC and Office of Minority Health and Health Disparities est
3. NIH est
4. Healthy People 2010
5. Patient Protection and ACA signed into law

Question 22

What are the goals of Healthy People 2010?

Answer 22

1. Increase quality and years of healthy life
2. Eliminate health disparities

Question 23

Black Health Outcome Statistics

Answer 23

Cancer rates same (30%)
CVD and Stroke (20% + 30%)
Cirrhosis (705 - 30%)
Diabetes (110% - 100%)
Homicide and Accidents (70% -10%)
Homicide Only (430% - 470%)
Infant Mortality (110%)

Question 24

Health People 2020

Answer 24

1. Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
2. Achieve health equity; eliminate disparities
3. Create social and physical environments that promote good health
4. Promote quality of life, healthy development, healthy behaviors across life stages

Question 25

Health Equity

Answer 25

The “attainment of the highest level of health for all people.” Require valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities.

Question 26

Healthy People 2030

Answer 26

Attain healthy, thriving lives and well-being free of preventable
disease, disability, injury, and premature death
* Eliminate health disparities, achieve health equity, and attain
health literacy to improve the health and well-being of all
* Create social, physical, and economic environments that
promote attaining the full potential for health and well-being
for all
* Promote healthy development, healthy behaviors, and well-
being across all life stages
* Engage leadership, key constituents, and the public across
multiple sectors to take action and design policies that improve
the health and well-being of all

Question 27

Race is the foundational framework for health outcomes

Answer 27

True

Question 28

Institutionalized Racism

Answer 28

Differential access to goods, services, and opportunities by race. It’s normalized, legalized, often manifests as inherited disadvantage (access to power and material conditions)

Question 29

Personally-mediated Racism

Answer 29

Prejudice: Differential assumptions about abilities, motives, and intentions of others according to race

Discrimination: Differential actions towards others according to their race. Lack of respect, suspicion, devaluation, scapegoating, and dehumanization.

Question 30

Internalized Racism

Answer 30

Acceptance by members of the stigmatized races of negative messages, about their own abilities and intrinsic worth.
Manifests as embracing “whiteness”, self devaluation, resignation, helplessness and hopelessness.

Question 31

Whitehall Study

Answer 31

designed to investigate
the complex
relationships among
income, work status,
psychosocial support,
health behaviors, and
resulting morbidity and
mortality

19,019 British Civil
Servants were recruited
from 1976-1970 aged

Question 32

Socioeconomic Position

Answer 32

an aggregate concept that includes both resource-based
and prestige-based measures, as linked to both childhood
and adult social class position
* Resource-based measures refer to material and social
resources and assets, including income, wealth, and
educational credentials; terms used to describe inadequate
resources include “poverty” and “deprivation”
* Prestige-based measures refer to individuals’ rank or status
in a social hierarchy, typically evaluated with reference to
people’s access to and consumption of goods, services, and
knowledge, as linked to their occupational prestige,
income, and educational level