Econ Exam 3

  1. Interdisciplinary agglomeration of health sciences that incorproate elements of social, political, environmental and behavioral health science.
    Public Health
  2. Public Health is summarized as
    • health promotion
    • disease prevention
    • Disease intervention activities in human populations
  3. 4 aspects of public health
    • social
    • political
    • environmental
    • behavioral
  4. IOM mission of public health
    fulfillment of society's interest in assuring conditions in which people can be healthy
  5. Primary Prevention
    • handwashing
    • vaccines
  6. Secondary prevention
    • early detection
    • screening
    • pharmacists providing drug review
  7. Tertiary prevention
    • cardiac rehabilitation
    • medications
  8. Principles and methods of epidemiology are defined as
    • study of the factors that determine the frequency, distribution and etiology of disease
    • applications of these studies to control health problems
  9. Epidemiologic Triangle
    • relative health/history of disease in a population
    • host
    • environment
    • agent
  10. Endemic
    habitual presence of a disease within a geographical area
  11. Epidemic
    • disease occurrence in a community or region
    • group of illness similar in nature
    • excess of normal expectancy
    • derived from a common/propagated source
  12. Pandemic
  13. HIV/AIDS is not only an _____ in the US but a ____.
    • Endemic
    • pandemic
  14. State public health
    state health department
  15. National public health
    • public health service
    • national center for health statistics
    • FDA
    • Center for disease control & prevention
    • NIH
  16. Areas which state and national public health programs focus
    • needs assesment
    • environmental health
    • mental health
    • tobacco
    • health literacy/communication
  17. Healthy people 2010 has ____ objectives for improving health
  18. Healthy people 2020 has ___ objectives for improving health
    over 1000
  19. Public health objectives fall into ____ focus areas
  20. One general goal of national health objectives is
    ensure safe and effective use of medical products
  21. methods of ensuring safe and effective use of medical products
    • monitoring adverse medical events
    • review of medications
    • info from prescribers and dispensers
    • pt counseling
  22. 4 aspects of patient counseling
    • information about taking medication
    • precautions
    • side effects
    • risk associated with treatment
  23. association of economic growth in child mortality
    • as the country develops, life expectancy increases then levels off
    • highly correleated to economic growth
  24. International organizations formulating health policy
    • United nations
    • world bank
    • WHO
    • WTO
  25. Public health issues
    • obesity/nutrition
    • smoking cessation
    • immunization
    • cleanliness
    • HIV/illegal drug use
    • cost/treatment of disease
  26. Two main types of epidemiology
    • descriptive
    • analytic
  27. Descriptive epidemiology
    • describes disease/exposure and may consist of calculating rates
    • studies of drug utilization
    • incidence and prevalence
    • no control groups
    • only generate hypothesis
  28. Analytic Epidemiology
    • compare an exposed group to a control group
    • usually designed as hypothesis testing
    • observational studies
    • experimental studies
  29. Observational studies
    • type of analytic epidemiology
    • case control studies
    • cohort studies
  30. Experimental studies
    • type of analytic epidemiology
    • clinical trials such as randomized clinical trials
  31. 5 core functions of epidemiology
    • describe occurrence of exposure to certain population
    • conduct disease surveillance/risks of potential disease
    • describe differences between populations
    • identify/quantify root causes of disease (analytic)
    • test interventions that may aid in identification or mitigation of disease
  32. Pharmacoepidemiology then can also be defined as
    study of utilization and effects of drugs in large numbers of people
  33. Pharmacovigilance
    • scientific and data gathering activities related to detection, assesment and understanding of adverse events
    • pharmacoepidemiologic studies
    • identify adverse events
    • understand nature, frequency and potential risk factors
  34. ADHD and electrocardiac disturbances
    short term direct effects
  35. zyprexa weight gain leading to CV disease
    indirect effects
  36. Viagra and nitrates
    drug-drug effects
  37. Use of vertain anti-diabetes agents in diabetics with kidney disease
    drug-disease interactions
  38. Pharmacovigilance helps to
    • detect
    • assess
    • understand
    • prevent
    • adverse effects
  39. Integrated administrative data is an option to
    post marketing surveillance studies
  40. occurrence of a disease can be measured using
    • counts
    • proportions
    • ratios
    • rates
  41. Rates show us
    how fast disease is occuring in a population
  42. Proportions show us
    what fraction of the population is affected
  43. Measures of morbidity
    • incidence
    • prevalence
  44. Measures of mortality
    • mortality rates
    • case fatality rate
  45. Incidence
    • the number of specific events occuring in a specified population/unit time
    • new cases of a disease
    • measure of risk
  46. calculation of incidence per 1000
    (# of new cases/# of population at risk) x 1000
  47. Incidence
    cumulative incidence/incidence proportion
  48. Prevalence
    • number of cases of a diease existing in a specified population and a given point in time
    • measures burden of diease
  49. Prevalance per 1000 =
    (# of cases present/# of persons in the population) x 1000
  50. Prevalence measures_____ in the community.
    burdens of disease
  51. Incidence measures_____ in the community
    risk of disease
  52. Prevalence shows how many people in the community are ____.
  53. Incidence shows how many _____ are in the community at a specific time
    new cases
  54. P =
    • I x time
    • in a steady state situation
  55. Case fatality rates
    shows what percent of people diagnosed as having a certain disease die within a certain time after diagnosis
  56. Mortality rate
    shows death in an entire population
  57. case fatality rate
    shows death in people with that disease
  58. observational studies
    • case control studies
    • cohort studies
  59. Experimental studies
    randomized control trials
  60. 7 types of bias
    selection, referral, information, recall, reporting, temporal-precedence, wish
  61. common measures used in screening
    • sensitivity
    • specificity
    • positive predictive value
    • negative predictive value
  62. validity of a test is defined as the ability to of a test to...
    distinguish between who has a disease and who doesn't
  63. Two components of validity
    • sensitivity
    • specificity
  64. ability of a test to identify correctly those who have the disease
  65. The ability of a test to identify correctly those who do not have a disease
  66. Why is it important to know the validity of a test?
    • false positives result in the use of more expensive tests
    • burden to health care system
    • worries
  67. 5 Types of epidemiological studies
    • Randomized control trials
    • cohort studies
    • cross-sectional study
    • case control study
    • screening
  68. randomized clinical trials
    • experimental studies
    • assess efficacy of preventative and therapeutic measures
  69. Uses of randomized control trials
    • evaluating new drugs and treatments of disease
    • test new health/medical technology
    • assess new ways of organizing health services
  70. 3 types of observational studies
    • cohort studies
    • case control studies
    • cross sectional studies
  71. Studies in which subjects are selected with respect to the presence and absence of a characteristic suspected of being associated with a particular outcome
    cohort study
  72. cohort study is also known as
    a prospective study
  73. Studies in which subjects are selected on a basis of their status with respect to a given characteristic. Cases show the characteristic and controls do not
    • case control studies
    • odds ratio
  74. Cross sectional studies
    • also called prevalence study
    • exposure and outcomes are determined
    • snapshot of population at a point in time
  75. Case control study =
    retrospective study
  76. cohort study =
    • longitudinal study
    • perspective study
  77. prospective cohort study =
    • concurrent cohort study
    • concurrent prospective study
  78. retrospective cohort study =
    • historical cohort study
    • non concurrent prospective study
  79. Randomized trial =
    experimental study
  80. cross sectional study =
    prevalence study
  81. Measures of association
    • relative risk
    • odds ratio
    • rate ratio
  82. relative risk
    ratio of risk of an outcome among people exposed to a given factor vs. people not exposed
  83. relative risk is used to
    estimate the magnitude of an association between exposure and disease
  84. RR =
    Risk in exposed/risk in not exposed
  85. relative risk greater than 1 means
    suggests strong positive association
  86. Relative risk = 1
    • no association
    • less than 1 means exposed individuals have less risk of the outcome than non-exposed
  87. RR = 0
    strong negative association
  88. Odds ratio
    • ratio of the odds of occurrence of an event under certain circumstances vs. other circumstances
    • used mostly in case-control studies
  89. when is the odds ratio obtained a good approximation of the relative risk in a population?
    • cases are representative of all people with the disease
    • controls are representative of all people without the disease
    • when the disease being studied does not occur frequently
Card Set
Econ Exam 3
Public Health