Health & Society Midterm

  1. 2 factors causing emergence of new epidemics
    • prescribing too many antibiotics --> diseases mutate a lot, so we have to keep coming up with new medicines for it
    • environmental changes --> flooding, changing weather patterns
  2. Who is John Snow? What was he known for?
    • father of epidemiology
    • british cholera epidemic - inspected water pumps to see what was causing the disease
  3. Outbreak Investigations (6 steps)
    • 1. establish case definition - specific set of people that fit the disease
    • 2. confirm suspected cases - asking questions related to case and try to figure out a reason for disease
    • 3. define population denominator - limit it to people within a radius
    • 4. review the literature - read about stuff relating to case
    • 5. exposure assessment - make sure affected people were contaminated b/c of possible site and not other sites
    • 6. generate plausible hypothesis
  4. Incidence vs. Prevalence
    • incidence = number of new cases / total population
    • prevalence = number of all cases / total population
  5. What does prevalence NOT include?
    doesn't count all the people who already died
  6. Prospective Studies vs. Retrospective Studies
    • prospective - begins at beginning and follows people over time
    • retrospective - begins today, look backwards to see what happened to people in the past
  7. The two types of epi studies?
    • descriptive studies --> describes the occurrence of the outcome, examining distribution of disease and observing basic features
    • analytic studies --> describes association between exposure and outcome, tests hypothesis about cause by studying how exposure relates to disease
  8. 3 types of descriptive studies?
    • case report studies - unusual findings
    • case series - multiple cases of findings
    • description epidemiology studies - population based cases with denominator, look at entire population that are exposed
  9. 2 types of analytic studies
    • observational
    • experimental
  10. 3 types of observational analytic studies?
    • case control studies --> determines and compares exposures, not outcomes
    • cohort studies --> compares incidence of outcome to see if exposure leads to the outcome (all have been exposed but you observe which ones get affected)
    • cross-sectional studies --> aka prevalence study, single period of observation (today), exposure and disease info is collected at the same time
    • randomized control trial studies --> planned experiment with group of people, 2 groups (1 is the control), designed to test how effective the intervention/clinical treatment is, completely randomized
  11. Triad for descriptive studies
    • person
    • place
    • time
  12. Triad for analytic studies
    • host - person that is affected
    • agent - factor that is essential for transmittance of disease
    • environment - factor that affects the agent
  13. Sensitivity
    ability of a test to correctly identify those who have the disease
  14. Specificity
    • the ability of a test to correctly identify those who do not have the disease
    • SpPin
  15. High sensitivity = ?
    few false negatives
  16. High specificity = ?
    few false positives
  17. When is it better to have test of specificity vs. test of sensitivity?
    • specificity - better to test if the treatment is harmful  (chemo for cancer)
    • sensitivity - better to have this test when you need to detect something early on (cancer)
  18. Problems with sensitivity and specificity? Sometimes so good that ___?
    • specificity - sometimes so good at finding negatives that it gives false negatives
    • sensitivity - sometimes so good at finding positives that it gives false positives
  19. Sensitivity formula
    true positive / (true positive + false negative)
  20. Specificity formula
    true negative / (true negative + false positive)
  21. False positive
    test indicates disease but there is actually no disease present
  22. False negative
    test indicated no disease there actually is a disease
  23. 4 Key features of health statistics
    • population based - usually a small sample of overall population
    • measure wide range of health indicators for a community (entire country or state or county)
    • collected/analyzed over a period of time (months, years, etc)
    • include different types of data - vital, morbidity, mortality, use & cost of health care
  24. Assessing quality of health data (5 things)
    • nature (source) of data
    • availability of data
    • validity and reliability of measures
    • completeness of population coverage
    • strengths & limitations of study design
  25. what do health statistics provide?
    key indicators about life and health in a particular region
  26. Reliability vs. Validity of data
    • reliability - consistent, meaning it is collected in the same way over multiple years
    • validity - accuracy
  27. A reliable measure is usually free from ____
    measurement error or bias
  28. Scale is valid if _______
    if it measures what it intends to measure without systematic error
  29. Completeness of the data
    representative of entire parent population
  30. Snowball sampling
    network effect, one person can go out and recruit other similar people
  31. Generalizability (external validity)
    ability to apply findings to a people that did not participate in a study
  32. Thoroughness
    care it take to identify all cases of a given disease
  33. How to find health statistics? (4 steps)
    • formulate the question
    • choose the best resources for the question
    • evaluate the results 
    • repeat as necessary
  34. What are the two types of diseases?
    • Infectious (communicable)
    • Chronic (non-communicable)
  35. What are infectious diseases?
    • communicable diseases
    • caused by pathogenic microorganisms (bacteria, viruses, parasites, fungi)
    • can be spread directly or indirectly
  36. What are the 2 types of infectious diseases?
    • emerging - newly identified, previously unknown infectious agents that cause public health problems either locally or internationally
    • re-emerging - known for some time, fell to low levels, and now showing upward trends in incidence or prevalence worldwide
  37. What is a chronic disease?
    • non-communicable
    • not passed from person to person
    • of long duration and generally slow progression
  38. 4 main types of chronic diseases?
    • cardiovascular --> diseases of blood vessels of the heart (stroke, heart disease)
    • cancers --> severe health consequences, generally not very treatable
    • chronic respiratory diseases 
    • diabetes --> increased blood sugar levels
  39. Causes and 2 types of diabetes? & a third type?
    • due to a lack of insulting or an inability or body's tissues to respond properly to insulin
    • type 1 --> need for lifelong insulin therapy
    • type 2 --> related to insulin resistance, managed with diet and exercise
    • gestational diabetes --> develops during pregnancy
  40. disease vs. illness
    • disease - pathological changes within the body which are expressed in various physical signs and symptoms (symptoms during pregnancy)
    • illness - an individual's subjective interpretation and response to these signs and symptoms (ancestor coming & possessing body)
  41. What is culture?
    a system of thoughts and behaviors shared by a group of people
  42. cultural characteristics
    • communication
    • orientation to space & time
    • social organization
    • family structure
    • gender roles
    • religion 
    • social factors
    • stigmatization of illness
  43. Contested illness
    • where sufferers claim to have a specific disease that many physicians don't recognize or acknowledge as medical 
    • ex: chronic fatigue
  44. medicalization
    • when human problems or experiences become defined as medical problems
    • ex: madness, drug & alcohol problems, menopause, baldness
  45. What is a social construction?
    • a conceptual frame work that emphasizes the cultural and historical aspects of phenomena widely thought to be exclusively natural
    • AND
    • examines how individuals and policy groups contribute to producing perceived social reality and knowledge
  46. Long term trends in socioeconomic status & health
    • better sanitation, clean water, etc
    • diseases of affluence (CHD, stroke, obesity)
    • disease patterns are changing
  47. Inequity vs. inequality
    • inequity - unfair or unjust
    • inequality - unequal
  48. Fixed vs. fluid factors in health
    • fixed --> things that cannot be changed, genetic or biological differences
    • fluid --> things that can change and we don't have control over (age, income, where you live)
  49. What is social epidemiology?
    studies the social distribution and social determinants of health based on things like socioeconomic states, gender & ethnicity
  50. Problem with social epidemiology?
    doesn't take genetics or lifestyle into account
  51. Social ecological model
    factors that influence a person's health/choices
  52. Income vs. consumption vs. wealth
    • income --> the amount that can be spent/consumed within a given time
    • consumption --> amount of resources actually used within a given time
    • wealth --> total value of assets and liabilities at any point in time
  53. Intersectionality
    the study of overlapping or intersecting social identities and related systems of oppression, domination or discrimination
  54. Observation about immigrants and their health over time?
    first generation migrants are generally much healthier than their children (health gets worse over time) -- don't know why
  55. 2 examples of disparities in health care?
    • blacks have a higher rate of infant mortality than other racial groups
    • blacks go to the emergency room more than regular doctor's office
  56. Gender vs sex
    • gender --> socially constructed term referring to roles, behaviors, activities, and attributes that a given society considers appropriate for men & women
    • sex --> defined biologically & physiologically
  57. sexual orientation
    a person's emotional, sexual, and/or relational attraction to others
  58. MSM vs. WSW acronyms
    • msm = men who have sex with men
    • wsw = women who have sex with women
  59. gender identity
    person's internal sense of being  male, female, or something else
  60. heterosexism
    denying any non-heterosexual behavior
  61. transphobia
    fear/hatred of somebody because they are trans
  62. the higher your social integration, the _________
    higher your social construct
  63. when is environmental justice achieved?
    when everyone, regardless of race, culture, or income enjoys the same degree of protection from environmental and health hazards and equal access to the decision-making process to have a healthy environment in which to live, learn and work
  64. what are neglected tropical diseases?
    a medically diverse group of tropical infections which are especially common in low-income populations in developing regions of Africa, Asia and the Americas
  65. 3 types of disease prevention
    • primary - reducing the risk and avoiding problems before they start
    • secondary - taking action to stop risk behaviors before an actual illness
    • tertiary - treatment / rehabilitation after an illness
  66. Stages of change model is also known as?
    transtheoretical model
  67. Stages of Change Model (list 6 steps)
    • pre contemplation --> no intention to adopt change within next 6 months, unaware of their issues
    • contemplation --> acknowledges there is a problem, intends to make change within the next 6 months but not committed yet
    • preparation --> planning on making behavior change within the next month, may doubt their abilities but collects info
    • action --> now making changes to modify behaviors, this phase includes a lot of time, money and energy
    • maintenance --> sustain changes for 6 months or more, try to prevent relapse and avoid temptations
    • relapse --> going back to previous behavior, can happen at any stage throughout the cycle
Card Set
Health & Society Midterm
Midterm review (lectures 1-11)