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Foundations Exam 3 COPY > Public Health > Flashcards

Public Health Flashcards

1
Q

IS NOT: Health care in the public sector
Health care at all (usually)

(Think in societal terms…)

A

Public Health

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2
Q
  • Assessment
  • Assurance
  • Policy Development
A

Key Roles for Public Health

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3
Q
  1. Monitor health status/Identify problems
  2. Dx & investigate problems/hazards
  3. Inform/educate/empower
  4. Mobilize Partnerships
  5. Develop policies & plans
A

Essential Services of Public Health (10)

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4
Q
  1. Enforce law & regulations
  2. Link to services & assure care
  3. Assure competent public health & healthcare workforce
  4. Evaluate effectiveness
  5. Research
A

Essential Services of Public Health (10)

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5
Q

What are Dr. Bob’s 3 “core” Public Health services?

A
  1. Environmental Health (sanitarians)
  2. Disease Control
  3. Health Education/Promotion
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6
Q

Who is in charge of Public Health? Who is NOT in charge?

A

State IN CHARGE

Feds NOT in charge

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7
Q

Who has authority on Public Health?

A

Local

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8
Q

What are the 7 ways to “build walls?”

A
  1. Isolate infected person
  2. Treat infected person
  3. Treat contacts
  4. Behavior change
  5. Immunizations
  6. Make environment more healthy to reduce transmission (sanitize)
  7. Make policies to reduce transmission (access to healthcare)
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9
Q

Overall, since 1900, have mortality rates increased or decreased for INFECTIOUS DISEASE?

A

Decreased

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10
Q

Overall, since 1900, have mortality rates increased, decreased, or remained steady for NON-INFECTIOUS CAUSES

A

Remained steady

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11
Q

Has mortality due to C. diff (drug resistant pathogen) increased or decreased? Why?

A

Increased, due to overuse of abx –> abx resistance

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12
Q

Has mortality due to VACCINE PREVENTABLE DISEASES increased or decreased?

A

Decreased

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13
Q

Has mortality due to STREP PNEUMONIAE increased or decreased?

A

Decreased

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14
Q

Has mortality due to HEP B increased or decreased?

A

Increased til 1995,

Decreased in 2000

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15
Q

Has mortality due to WEST NILE (vector born) increased or decreased? When did we first see cases of West Nile?

A

Mortality rates have varied, first appeared after 2000

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16
Q

Overall, since 1980, has mortality due to SPOTTED FEVERS increased or decreased?

A

Decreased

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17
Q

How many reportable “communicable diseases” are there in AZ?

A

Over 80 (roughly 89)

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18
Q

What are the top 3 communicable diseases in AZ?

A
  1. Chlamydia
  2. Gonorrhea
  3. Cocci (valley fever)
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19
Q

What are the other 6 most prevalent communicable diseases in AZ?

A
  1. MRSA
  2. Campylobacter
  3. Hep B (non-acute)
  4. Salmonellosis
  5. Syphilis (1st & 2nd degree)
  6. Strep Pneumoniae
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20
Q

What are the 3 communicable diseases that are transmitted sexually in order of their prevalence?

A
  1. Chlamydia
  2. Gonorrhea
  3. Syphilis (1 & 2)
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21
Q

Why have STD cases continued to surge in Maricopa & Pinal counties?

A
  1. Increase in population

2. People aren’t using condoms

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22
Q

What STD was at an all time high in 2016? And has had no change in rates since 2000?

A

Syphilis

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23
Q

Primary & Secondary syphilis account for what % of all syphilis cases?

A

over 40%

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24
Q

Which STD is a much “older” disease for males than females?

A

Syphilis

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25
Q

Since 2010, have new diagnosis of HIV increased or decreased?

A

Slightly increased

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26
Q

Since 2010, have new diagnosis of AIDS increased or decreased?

A

Significantly decreased

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27
Q

Since 2000, incidence rates for HIV have increased or decreased?

A

Remained stable

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28
Q

Dual infections of which 2 STDs are a growing problem in Maricopa County since 2011? What percent on average are duly infected?

A

HIV & Syphilis

33.2%

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29
Q

Which STD in Maricopa County is double the rate of cases in the US?

A

Congenital syphilis

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30
Q

What are the 4 sexual behavioral changes in high school students over the past 20 years?

A
  1. Increased condom usage
  2. Increased amount of abstinence
  3. Less students currently sexually active
  4. Decrease in “multiple partners”
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31
Q

What STD is 75% asymptomatic in women?
10-40% untreated–> PID
14% of PID hospitalized
15% PID –> infertility

A

Chlamydia

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32
Q

As of 2012, what was the average cost of a hospitalized PID case in AZ?

A

$19, 853

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33
Q

What 5 things could we prevent?

A
  1. PID (1900)
  2. Hospitalizations (270)
  3. Infertility (285)
  4. Ectopic Pregnancies (90)
  5. Chronic Pelvic Pain
34
Q

How much $ could we save by prevention of PID?

A

Over 5 million in hospital costs

PLUS, costs for chronic pain, ectopic pregnancies, and infertility tx

35
Q

What do we need in order to prevent complications from STDs?

A

Over 40,000 gonorrhea & chlamydia interviews & 60 investigators

36
Q

How many investigators do we currently have? And why?

A

19, because funding for the Maricopa Health Dept hasn’t increased since 2015

37
Q

How much would we need to invest to save over $5 million + associated morbidities?

A

Less than $2 million

38
Q

What percent of all MC infectious disease reports are investigated w/control measures implemented?

A

only 14%

39
Q

The US federal government on avg is getting $21 in funding. How much is Maricopa County getting?

A

$7

40
Q

Definition: a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection

A

Herd Immunity

41
Q

In 1963, a vaccine was introduced which made cases of this disease decrease significantly.

A

Measles

42
Q

Attendance, work, or household contacts of employees in which line of work caused 95% of infections of Hep A?

A

Daycare

43
Q

What year did the Hep A vaccine become required in Daycare?

A

1998

44
Q

What year was Hep A no longer associated with daycare?

A

1999

45
Q

What vaccine was licensed in 2005 for ages 10-64?

A

Tdap

46
Q

What was added to the “tetanus shot?”

A

Pertussis

47
Q

Which vaccine is super important for those close in contact w/ infants?

A

Tdap

48
Q

What should we do in order to “cocoon” newborns from infection?

A

Vaccinate others in the home BEFORE newborn arrives home from hospital

49
Q

Should we vaccinate pregnant moms w/ Tdap?

A

Yes, at the right time/every time

50
Q

Which disease has caused:

  • 25-50 million cases
  • infection rate 7-20%
  • 100-200 million days of illness
  • > 200,000 hospitalizations
  • on avg 24k deaths
  • cost $3-$5 billion
A

Influenza

51
Q

Who should be vaccinated for flu?

A

EVERYONE (over 6 months), & especially kids w/asthma

52
Q

In 1990, what percent of health care workers were immunized against flu?

A

10%

53
Q

In 1999, an outbreak of flu in a French hospital resulted in what?

A

Additional costs per pt of $3700 (total was $34,000)

54
Q

In 2000, an outbreak of flu in a NICU affected 19 infants (resulting in 1 death). Who caused this outbreak?

A

Health care workers suspected, bc/moms were not infected

55
Q

What is the most important outcome from health care worker flu vaccinations?

A

Reduction in patient mortality

56
Q

7%-26% of un-vaccinated health care professionals had serologic evidence of having influenza, what % could not recall having a febrile URI?

A

42%

57
Q

What is a widely held belief surrounding the flu vaccine?

A

“I’ll catch the flu from a flu shot”

58
Q

What was the ONE symptom shown in patient’s who received the flu vaccine compared to the placebo group?

A

Arm Soreness

59
Q

What age group are the vectors (main disseminators) of flu?

A

Children

60
Q

“Attack rates” of flu are highest in what age group?

A

Children

61
Q

“Viral shedding” is longer in adults or children?

A

Children! (>10 days)

Adults (only 6 days)

62
Q

How many days before sxs start does viral shedding begin in children?

A

6 days

63
Q

Which country performed a “mass vaccination of children” for flu? What was the result?

A

Japan in 1962. Reduced OVERALL deaths from PNA and Flu

64
Q

If 80% of school kids were vaccinated against flu, by what % would flu decrease for everyone else??

A

> 90%

65
Q

If we invested $7 million in vaccinating school kids against flu, how much could we save??

A

$140 million

66
Q

The leading causes of death are reported to be Heart Disease & Cancer. What are the ACTUAL causes of death?

A

Tobacco & Poor diet/lack of exercise

67
Q

In 1985, obesity in the U.S. was 10-14%.

In 2010, what’s the percent of obesity?

A

over 30%

68
Q

How many children are obese in Maricopa County?

A

1 in 7

69
Q

How many adults are obese in Maricopa County?

A

1 in 4

70
Q

In 2020, if obesity continues to rise, MC adults will spend how much more on health care?

A

$910 million

71
Q

In 2020, if obesity were to decline to the 1987 levels, MC adults will spend how much less on health care?

A

$945 million

72
Q

What is the difference in the cost of our 2 futures?

A

1.85 billion

73
Q

From 1900-1967, deaths from aquatically transmitted diseases decreased due to what 2 factors?

A
  • Water service

- Sewage service

74
Q

4 examples of behavior change

A
  1. Better diet
  2. Encourage kids to be more active
  3. Encourage biking/walking
  4. Warn against 2nd hand smoke
75
Q

4 examples of policy change

A
  1. Availability of health food
  2. Open school playgrounds
  3. Create bike paths/sidewalks
  4. Smoke free work places
76
Q

With policy, should we make big changes or small changes?

A

Start with small policy changes (like having recess before lunch vs. after lunch)

77
Q

If school campuses become smoke free, what is the result?

A

We will save 1 billion as students quit smoking

78
Q

If apartment complexes become smoke free, what is the result?

A

Save $$ on cleaning costs.

People will rent more because they like smoke free.

79
Q

Public health IS NOT:

A

Individual health care

80
Q

3 core functions of PH

A
  1. Environmental health
  2. Disease control
  3. Health education (prevention)
81
Q

Prevention has both HEALTH & FINANCIAL benefits, but what must we do first?

A

INVEST

82
Q

What type of policy are we going to make for prevention..?

A

“Small P”

Foundations Exam 3 COPY (4 decks)

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