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What are the 5 basic “determinants of health”
- 1. Biology/Genetics
- 2. Access
- 3. Social circumstances
- 4. Environment
- 5. Behavior
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Describe different ways that we can define “health”
(WHO vs authors in textbook)
WHO - a state of complete physical, mental, and social well-being
Authors - A dynamic state or condition of the human organism that is multidimensional and exist in varying degrees depending on the individual
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Identify ways that the definition of health “matters”(e.g. leads to planning)
- 1. Measures progress
- 2. Identify contributing factor
- 3. Assess outcomes
- 4. Monitor changes
- 5. Influence Behavior and Actions
- 6. Sets goals and standards
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What are important differences between personal and community health activities?
Personal Health - Actions or decisions affect individual and may be preventative or curable but seldomly affect the behavior of others
Community Health - Aimed at protection or improving health of a population or a communtiy
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What are some social factors that can influence patterns of health and disease?
- 1. Geography
- 2. Individual Behavior
- 3. Age
- 4. Gender
- 5. Ethnicity
- 6. SES
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How much life expectancy has changed since 1900?
- 1. Public Health Knowledge
- 2. Public Health Resources
- 3. Life expectancy rose
- 4. Overall death rate declined
- 5. Leading cause of death changed
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What was the leading causes of death in 1900?
Pnumonia or Influenza
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What is the major differences in leading causes of death (1900 vs. 2000).
1900 - Pneumonia or Influenza
2010 - Heart disease or Cancer
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Name 3 major achievements for public health in the U.S. past (100 years)
- 1. Flu vaccine 1942-1945
- 2. Antibiotic for Penicllin 1928-1940
- 2. Medicare/Medicaid established 1965
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What are the key differences (for funding, leadership, and setting priorities) between 3 types of organizations (governmental, quasi-governmental, and non-governmental).
- Non-Government - Funding by Private
- Government - Funding by Public
- Quasi-government - Funding by both public and private
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What is the hierarchy of organizations for tracking diseases and infections
- 1. WHO (World Health Organization)
- 2. DHHS (Department of Health & Human Services)
- 3. NYSDOH (NYS Department of Health)
- 4. NYCDHMH(NYC Department of Health & Mental Hygiene)
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Who is in charge or the Government sector of Health organizations?
Elected Officials
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Name the 11 departments within DHHS (Dept of Health and Human Services) with examples of their roles and
responsibilities.
- 1. AOA (Administration on Aging) - service adults +65
- 2. ACF (Admin for Children & Families - Family assistance;child support
- 3. AHQR (Agency Health Research & Quality)- Monitor helath care cost; enforce patient safety guidelines
- 4. ATSDR (Agency for Toxic Substances) - focus on Harzadous Waste
- 5. CDC (Center for Disease Control/Prevention) - Research epidemics and disease prevention
- 6. CMS (Centers for Medicare & Medicaid)
- 7. FDA Food & Drug Administration - Monitors & approves food safety, medical devices and drugs
- 8. HRSA - (Health Resources & Service Admin)
- Essential health care services of the low income uninsured population
- 9. IHS (Indian Health Services) Health services for "tribal lands"
- 10. NIH (National Institues of Health) - Focus on research and treatment outcomes
- 11. SAMHSA - Substance Abuse & Mental Health - Prevention and treatment of addiction and disorders
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What are the key functions of epidemiology?
- 1. Study populations not just individuals
- 2. Investigate outbreaks (epidemics)
- 3. Cause and factors
- 4. Keep illness and disease at a minimum
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Describe the importance of “rates” compared to just the number of cases
The number of people that are affected in a given population within a period of time divided by the entire population
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What is prevalence?
Old and New cases
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What is incidence
Only new cases
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What is "attack"?
The percentage of sick among those exposed
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Epidemic
Diseases that do not occur regularly
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Endemics
Disease the DO occur regularly especially in a given population. ex.- Malaria in Africa & Norway
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What is Analytical Studies?
Test the relationship between health problem and risk factor
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What is Descriptive studies?
Examines the data, demographic, SES of a population
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Communicable
Can be transferred from one individual to another. A Chain of infection
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Multi-communicable
Multi-Causation
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What are some ways in which diseases can be classified and categorized
- Mode of Transport - airborne, waterborne, STD
- Organ system affected - Heart or Lung
- Duration of illness - accute vs. chronic
- Causative agent - viral, bacterial, chemical, injury
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What is an accute illness and an example of some?
An illness that last less than 3 months...Flu, common cold. Chickenpox, measles mumps, broken foot
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What is a chronic illness and an example of some?
An illness that last more than 3 months...Cancer, Heart disease, hypertension, diabetes
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Non-communicable disease
Cannot be transferred from one individual to another. ex- Cancer, diabetes, hypertension
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What is the order for "chain of infection"
- Portal Entry
- Pathogen
- Infection in Host
- Reservoir
- Portal Exit
- Transmission
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Describe ways that chain of infection can be “broken”
at different steps in the cycle
Pathogen>VACCINE>Non-Infection of Host
Exit Portal>Barrier(Condom)>Non-Entry Portal
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Match types of transmission (airborne, waterborne, direct, indirect) with definitions and examples.
- Waterborne - bacteria on contaminated material
- Airborne - Respiratory tract illness (bronchitus) (COPD)
- Vector-borne - Malaria, Yellow Fever, West Nile Virus
- Direct - Touching, sneezing, sexual contact
- Indirect - Wet surface or standing water
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Primary Prevention
Preventing the onset of illness or injury before the disease process begins
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Secondary Prevention
Management of the disease before the disease becomes advanced ex. screening, treatment
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Tertiary Prevention
Intervention after the disease has caused disability. ex- surgery and/or rehab
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Identify steps and sequence in general model for program planning
- 1. Assessing Needs
- 2. Setting Goals and Objectives
- 3. Developing an Intervention
- 4. Implementing the Intervention
- 5. Evaluation (progress and outcomes)
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Describe differences in 2 approaches for decision-making
1. Top-Down Approach - If the NYC department of health tells you what problems you have in your community.
2. Grass-Root Approach - you and your neighbors tells the NYC department of health what problems you want addressed
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Identify differences in resources and “building blocks (primary, secondary, potential)
- 1. Primary: in the neighborhood and in residents
- e.g. knowledge, skills, personal property
- 2. Secondary:in neighborhood, but controlled by outsiders
- e.g. schools, hospitals, real estate
3. Potential: outside the neighborhood, and controlled by outsiders..e.g. data, information, media, funding
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Identify definitions and match examples of goals vs. objectives.
- Goals: Long-term (take longer to achieve)
- More general in nature and scope
- Not easily measured (on their own)
- Objectives: Shorter-term
- More specific in scope
- Written to be more measureable (as steps)
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Identify different goals and methods in “health education” vs “health promotion.”
Health Education: Provide information/tools for behavior change....e.x. - Dangers of Smoking
Health Promotion: Change in policy or resources (services). Change harmful physical or social conditions
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Describe differences between process and outcome evaluation.
Process Evalution: Progress Notes
Outcome Evalution: Assessment after process is completed
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Identify definition and key elements of a “coordinated school health program” (CSHP).
An organized set of policies, procedures, and activities designed to protect and promote the health and well-being of students and staff (to promote learning).
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Identify the potential duties of a school nurse
- 1. Conduct health services
- 2. A Health school environment
- 3. Refer for Health conditions
- 4. Promote Policy
- 5. Screen and refer for health conditions
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Describe essential steps for implementing school health policies
- 1. Create written policies
- 2. Distribute to team members
- 3. Publish in school handbooks
- 4. Present at public meetings
- 5. Build awareness/support
- 6. Use press releases to:
- 1.Share and publish policies
- 2.Explain priorities
- 3.Notify public of changes
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Identify three types of school health services recommended by AAP
1)State Mandated: Verify immunization, Report infections, Health screenings
2) Assess “minor” health complaints:Administer required medications, Care for special needs
3) Emergency services:urgentcare
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Identify examples of physical school environment
- Physical Environment: Location/age of buildings
- Traffic patterns/transportation, Indoor air quality, Pest/rodent, management, Temperature
- control lighting, heating, acoustics
- Water supply/quality
- Sanitation and food services
- Playground safety
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Identify examples of pychosocial school environment
- Psycho-social:
- Attitudes of teachers and staff
- Behavior of teachers
- Interactions among students
- Feeling safety and secure
- Promoting learning
- Open communication
- Reducing anxiety and stress
- Awareness of rules/standards
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Identify recommended topics in a school “health
curriculum.”
- Mental and Emotional Health
- Injury Prevention
- Sexual heath
- Healthy eating
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Identify potential barriers to “comprehensive” school education
- Contraversial Topics
- Health and behavioral issues not seen in the past
- Lack of Resources
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