Study Guide for Test 1 Flashcards
(64 cards)
1
Q
Health
A
is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
2
Q
Public health
A
is the science and art of preventing disease, prolonging life, and promoting physical health and mental health and efficiency through
3
Q
Global health
A
is an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide.
4
Q
The Determinants of Health
A
- The interconnected factors that determine an individual’s health status
- Determinants include personal and inborn features, socioeconomic status, culture, environment, educational attainment, health behaviors, childhood development, access to care, and government policy
- Increasing attention is being paid to the social determinants of health
5
Q
Health status indicators are used for
A
- Finding which diseases people suffer from
- Determining the extent to which the disease causes death or disability
6
Q
WHO
A
leader in international health
7
Q
World Bank
A
Most questions will be categorized by regions by them. reduce poverty in developing countries
8
Q
OECD
A
improve economy of developed countries
9
Q
UNICEF
A
help mothers and children of developing countries
10
Q
Low-income
A
$1,035 or less
11
Q
Lower middle-income
A
$1,036 to $4,085
12
Q
Upper middle-income
A
$4,086 to $12,615
13
Q
High income
A
$12,616 or above
14
Q
Countries do not need to be high-income to enjoy good health status
A
True
15
Q
When considering health policy, one must ask
A
“if I only had $100 to spend, how should I spend it to achieve the maximum health gains for the key groups, at least cost?”
16
Q
Low-income countries should focus on
A
“…burying old people, instead of young people, making the transition as fast as possible, and doing so at least cost”
17
Q
DALYs
A
- The sum of years lost due to premature death and years lived with disability
- Indicates losses due to illness, disability and premature death in a population
- A health-gap measure
- The sum of years lost due to premature death (YLLs) and years lived with disability (YLDs). DALYs are also defined as years of healthy life lost
18
Q
The Burden of Deaths and Disease Within Low- and Middle-Income Countries
A
- Rural people will be less healthy
- Disadvantaged ethnic minorities will be less healthy
- Females will suffer from their weak social positions
- Poor people will be less healthy
- Uneducated people will be less healthy
19
Q
Majority of population growth will occur in:
A
- low- and middle-income countries
20
Q
Population of the world is
A
aging
21
Q
Health usually increases as
A
national income increases
22
Q
countries have achieved higher life expectancies because:
A
“best buys” such as nutrition, education, good hygiene, and low-cost services that have a high impact such as vaccination programs and TB control
23
Q
Equity:
A
“differences in health that are not only unnecessary and avoidable, but also unfair and unjust” —
24
Q
Inequality:
A
“differences in health status or in the distribution of health determinants between different population groups” —WHO
25
Equity is about
fairness
26
Equality is about
outcomes
27
Common Patterns:
| Less well-off people, with less social and political power, will generally have ...
worse health, poorer services, and less fairness and protection for financing health
28
Common Patterns:
| The less well-off groups will generally include...
- Women
- Indigenous people
- Ethnic and religious minorities
- Rural area residents
- Those working in the informal sector
- Less educated
- Other marginalized groups, such as LGBT
29
Most high-income countries spend
9–12% of GDP and have higher life expectancies
30
Most low-income countries spend
3–6% of GDP and have lower life expectancies
31
Important outliers, such as Sri Lanka and Cuba
spend relatively little, but achieve higher life expectancies
32
Public Expenditure:
expenditure by any level of government or government agency
33
Private Expenditure:
expenditure by sources other than the government such as non-governmental organizations or individuals
34
Out-of-Pocket Expenditure:
expenditure by individuals that is not covered or reimbursed by an insurance program
35
Cost-effectiveness analysis
- Compares the cost of an intervention with the amount of health that can be purchased with that investment
- Can help to set priorities among different ways of achieving a health goal
- Can be used to compare costs and gains of different health interventions
- Should not be the only factor in decisions
36
Selected Human Rights Issues : Human Rights and HIV/AIDS
1. Health condition that is stigmatized and discriminated against
2. Associated issues:
- Protecting the rights of people who are HIV-positive to employment, schooling, and participation in social activities
- Ensuring access to care
- Policies regarding testing
- Protection of confidentiality
37
Nazi Medical Experiments
1. Experiments on euthanasia victims, prisoners of war, occupants of concentration camps
2. International Scientific Commission investigated and documented abuses after war
3. Questions over whether it is ethical to use data the Nazis generated
38
The Tuskegee Study
1. U.S. Public Health Service conducted a study on the natural history of syphilis in African American men
2. Study went on for 40 years
3. Subjects were never given treatment
4. Eventually led to regulations for the protection of human research subjects
39
The “Short-Course” AZT Trials
1. Trials of a “short-course” AZT regimen to prevent mother-to-child transmission of HIV
2. Opponents noted trials not permitted in high-income countries, where a more complex “076 regimen” was the standard of care
3. Debated ethical double standard
4. Studies remain controversial
40
The Nuremberg Code
1. First document to specify ethical principles that should guide physicians engaged in human research
2. “Voluntary consent of the human subject is absolutely essential”
3. Human subjects should only be involved in research if it is necessary for an important social good
4. Requires limits on and safeguards against risks to participants
41
The Declaration of Helsinki
1. World Medical Association
2. Developed ethical principles to guide physicians/non-physicians conducting biomedical research on humans
3. Most influential and most cited set of international research ethics guidelines
42
The Belmont Report
1. U.S. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research
2. Identified basic ethical principles
3. Developed research guidelines
43
6 Ethics of evaluating human subjects research
1. Social value
2. Scientific validity
3. Fair subject selection
4. Acceptable risk/benefit ratio
5. Informed consent
6. Respect for enrolled subjects
44
Principles for Distributing Scarce Resources
- Health maximization
- Equality
- Priority to the worst off
- Personal responsibility
45
Health Care Services Organized:
1. Health as a Right
2. Ownership of Facilities
3. Employment of Providers
4. Form of Insurance
5. Financing of Insurance
6. Country Examples
46
Health as a Right:
```
National Health Service:
Fundamental
National Health Insurance:
Fundamental
Pluralistic:
Health as a personal good
```
47
Ownership of Facilities
NHS: Overwhelmingly public
NHI: Vast majority public and private, not-for-profit.
Pluralistic: Public, private, for-profit, and private, not-for-profit
48
Employment of Providers
NHS: The health service and private
NHI: Largely private
Pluralistic: Largely Private
49
Form of Insurance
NHS: Overwhelmingly public insurance linked to the health service
NHI: Largely government single payers and firms working with government schemes
Pluralistic: Public insurance and private, for-profit and private, not-for-profit insurers, with substantial numbers lacking insurance
50
Financing of Insurance
NHS: Overwhelmingly tax-based
NHI: Some based on individual premiums; others based on employee and employer
51
Financing of Insurance
NHS: Overwhelmingly tax-based
NHI: Some based on individual premiums; others based on employee and employer payroll taxes; some are tax-based
Pluralistic: Taxes, employer and employee insurance contributions, individual purchase of insurance, and out-of-pocket
52
Country Examples
NHS: United Kingdom
NHI: France, Canada, Japan, Germany
Pluralistic: India, Nigeria, United States.
53
Levels of Care
Primary Care
Secondary Care
Tertiary Care
54
Primary Care
basic medical care such as obstetric care, childhood vaccination, and TB treatment
55
Secondary Care
specialist physicians and general hospitals
56
Tertiary Care
specialized hospitals generally located only in cities
57
Primary Health Care,
from Alma-Ata to the Present
1. First articulated in Declaration of Alma-Ata
2. Established health as a human right
3. Set the goal of “health for all” by 2000
58
Culture
“behavior and beliefs that are learned and shared”
59
Culture influences
family, social groups, individual growth, communication, religion, art, politics, and the economy
60
Culture is least influenced by
sanitation
61
The Diffusions of Innovations Model
- Communication promotes social change
- This model focuses on how people adopt a new product, perceived cost efficiency of the innovation,
- How easy it is to try the innovation,
- How the innovation fits with the culture and values of the people considering its adoption
62
Application of tools of commercial marketing to promote a behavior change
4 P's
1. Attractive product
2. Affordable price
3. Convenient places to buy the product
4. Persuasive promotion
63
Social Assessment:
“a process for assessing the social impacts of planned interventions or events and for developing strategies for the ongoing monitoring and management of those impacts”
64
Social Assessment is important to...
include "affected" communities
