____ are portfolios of observations and data summarizing health priorities needs and resources and are key to establishing to establishing public health budgets
Community Health Assessments (CHA)
The National Center for Health Statistics (NCHS) is a division of the ____ and conducts ______
CDC; period surveys of representative samples of the population
National Health Interview Survey is conducted by DHHS _____ on _______ households
Every other year; 50,000
National Health and Nutrition Examination Survey (NHANES) is conducted ______ on ______. Involves ____
Every year; 5,000 individuals; full medical work up
in 2005-2006, ___% of American children's parents talked to a healthcare provider about a child's emotional or behavioral problems; __% were prescribed meds for mood disorders; __% for ADHD
15; 5; 89
Health Informatics info come from (5)
Clinical studies, standard databases, census (very detailed questions), DHHS, coroner reports.
T/F A comprehensive health information database exists
T/F Medical records are available to foreign hospitals to serve travelers
False- administrative costs are accrued when these records are gathered manually
Hospital Records contain ____(3)
Medical, family, diagnostic history
Almost all psychopharm medications prescribed to 4-17 yr olds is for ____ (more ___ than ____0
ADHD, males than females, older children than younger
For the treatment of ADHD, more children are treated with ___ than ____ and are most commonly treated in _____
meds than others; private practice or clinic, schools, general medical practice
Current treatment methods of ADHD may indicate these 3 anthropological conclusions (so what?)
Need for greater access to wider variety of mental health services, more research on non- medical/ combo treatments, community level assessments of quality and scope of school based/ other mental services (follow up studies needed for all)
Notification systems: WHO requires international reporting of ___ (3)
Yellow fever, cholera, plague
Notification Systems: Reporting is imperfect because there is no universal health care access or use, no universal reporting system, takes time
Notification Systems: CDC requires reporting of disease by ____ and _____ for more urgent conditions
mail/ internet; phone
Notification Systems: Chain of disease reporting (4)
Health care professional, local/ state public health agency, federal agency, news media
Notification Systems: : Task of Health care professional
(diagnosis),
Notification Systems: : Task of local/ state public health care agency
investigates source/ spread, communicates with CDC
Notification Systems: : Task of federal agency
disease control and public relations strategies, scientific research
Notification Systems: : Task of news media
Public notification
Commodity fetishism: Definition and relation to tomato scare
Marx- disconnect final product from its sources
Even though only canned tomatoes were affected, sales of all mexican produce went down, subtle xenophobia in news (masks accurate assessment of immigration policy and public health),
emphasizes need for political sensitivity when issuing press releases
T/F There is no reason for the lax monitoring of produce importation that exist today
False- economic incentives
Older age groups have higher rates of death by most causes except _____ (3)
injuries, suicide, homicide, HIV infection
The most common cause of death for children under 19 was _____ is ______
motor vehicle accidents (occupant or pedestrian); falls
4 important factors of interpreting public health info
Single study or meta- analysis, size of study, animal or human study, study of biological markers or actual disease
The DARC gene has been associated with ___ (2)
Decreased susceptibility to malaria, increased to HIV
___% of healthy people 2010 goals were accomplished, __% are moving in the right direction, __% moving in wrong direction
15; 44; 15
Poor perception of health status is inversely related to ____
Household income
T/F Income inequalities have increased since 1980
True
Morbidity/ Mortality from chronic disease is ____ higher in low- income citizens compared to high- income citizens
300%
Men are twice as likely to die from _____ and 4 times more likely to die from _____
unintentional injuries, fun accidents
Women have ___ as much depression as men
2x
People lacking higher education are ___ more likely to die from premature death than are people with some higher education; infant mortality rate is reduced by ___ if you graduate from college
200%
These factors are affected by race, income, education, sex (7)
morbidity/ mortality from chronic disease, life expectancy, death from unintentional injuries, gun accidents, premature death, depression, infant mortality
Total infant mortality is ___ but African American infant mortality is _____
decreasing, increasing (2x rate for white Americans)
T/F African Americans are both more likely to get chronic diseases and to die from them
True- heart disease, prostate cancer, HIV/AIDS
____ have highest diabetes, depression, suicide rate in world
African- Americans
__% of Americans live in rural areas (fewer than 2,500 residents) where injury related mortality is __% higher
25; 40- less likely to have healthcare visits, use seatbelts, be insured or exercise regularly
Gay men have significantly higher rates of ___ (4)
STDs, substance abuse, major depression, suicide (2-3 times rate of suicide)
Military personnel have higher rates of (3)
substance abuse , domestic abuse, suicide (veterans are 8x more likely to commit suicide)
T/F more women than men are discharged from the hospital following treatment for cardiovascular disease
____ make routine doctors visits more regularly, varies ____ among "8 America" classifications
Females, surprisingly little
According to 8 Americas study ____ and ____ seem have worse health conditions than comparable demos
males, poor Southern blacks
___ year difference in life expectancy between America 1 and 8 (Asians, High- Risk urban blacks)
21
Since 1980, life expectancy gap between sexes has _____ by ____%
increased, 0.5%
Top 3 contributers to disease burden
Smoking, alcohol use, overweight and obesity (these affect males more than women)
8 most cost- effective PH interventions
tobacco cessation counseling in young adults, anti-tobacco messaging for adolescents, screening elderly for vision impairments, counseling adolescents on alcohol abuse, screening adults for problem drinking, screening adults for colorectal cancer, screening young women for HPV (or providing vaccine), vaccinating older adults against pneumonia.
Age adjusted rates of death due to HIV have _____ between ___ and _____
declined; 1987-2002
In 1985, ____ had highest death/ case rates due to HIV. Now ____ have highest rates. (____ and ___ have almost no deaths due to HIV)
White; Black (rates in blacks have gone up while rates in whites have gone down); Asian/ Pacific Islanders, American Indian/ Alaska Native
___% of AIDS cases are among black people though they make up __% of the population. (for whites __% of cases, __% of population)
50, 13; 30; 68
Top 3 methods of AIDS transmission for males
Male-to- male sexual contact (58%), injection drug use, high- risk hetero sex
Top 3 methods of AIDS transmission for females
High- risk hetero sex (71%), injection drug use, other (other is only 2%)
Percentage of HIV deaths that are of females has ____ by _____ from ___ to _____
increased, 200%, 1987-2003
Most females who die from AIDS from hetero contact are ____
Black (probably most in general given prevalence of this mode of transmission)
The _____ region of the U.S. has the highest rates of adults living with AIDS while the ____ region has the lowest.
South; Midwest
Proportional distribution of AIDS cases in the South have ____ between 1987 and 2003 while rates in the West, Northeast have ______. Cases in the Midwest have more or less stayed the same for that time period.
Increased; decreased
Most adolescents with AIDS are ____. The proportion of this group has ____ since 1981
Black, Increased from 50-64% (only 15% of population)
African American household income is ___% of white's, ___% of blacks live in poverty while ___% of whites do
62; 26, 9
__ of Extremely poor Americans are ____ with ____
women with no high school diploma
Trio of social suffering
Gender, Poverty, Biology
STDS acquisition is ____ more likely in male to female vaginal intercourse
2-5
STD coinfection increases risk of HIV contraction by ___ times
50x
NIMH Prevention trial (2)
Best study regarding STD programs in U.S., study of 37 STD clinics with "high- risk" African- American and Hispanic men and women
Procedures of NIMH Prevention Trial (3)
study of 37 STD clinics with "high- risk" African- American and Hispanic men and women; participants shows 1 hr video or seven weekly 90 minute risk reduction training sessions; focused on behavioral interventin and risk reduction through education, self- esteem building and situational negotiation skills
Results of NIMH Study
No change in unprotected sex acts/ month (reduction on low- end, slight increase on high- end of intervention group), increased condom use, slightly lower reduction in gonorrhea rates
____ are least likely to be insured, ____ most likely
Mexicans, those slightly above poverty line; whites, 200% or more of poverty line
T/F Uninsured are more likely to have undiagnosed high cholesterol/ blood pressure
Modes of Transportation
Modes of transmission (4)
Direct (airborne), Indirect (bloodborne, waterborne, airborne), transcutaneous, vertical (mother to child)
Transmission cycle (4)
Agent--> vector--> host--> environment
Three possible steps from vector to human host
Vector--> intermediary host--> human host
Insect transmission accounts for___ of all vector- borne disease transmission.
85%
Worldwide resurgence of vector borne diseases since ___ because of ___(2)
1970's; major environmental changes, low surveillance in tropics and subtropics
Factors influencing spread of vector- borne diseases (4)
Size of host population, density of agents in host population, environmental conditions such as temperature and humidity, levels of human resistance
Immunity vs. Resistance
Immunity: Resistance to infection from presence of antibodies or cells that act on a specific microorganism; Resistance- resistance to transmission or development of disease
