Chapter 1 People's Health An Introduction
Health described by the WHO
"Health comprises complete physical and social well-being and is not merely the absence of disease."
is associated with both "mobilize community partnerships and action to identify and solve health problems" and "develop policies and plans that support individual and community health efforts."
"Policy Development"
population health is defined as:
"The health outcomes of a group of individuals, including the distribution of such outcomes within the group"An approach to health with a goal to improve the health of the entire population
Dental public health described by the American Association of Public Health Dentistry
"The science and art of preventing and controlling dental disease and promoting dental health through organized community efforts"
Public health described by the CDC
"The science of protecting and improving the health of families and communities through promotion of health lifestyles, research for disease and injury prevention, and detection and control of infectious diseases"
The ADA describes dental public health as
"that part of dentistry providing leadership and expertise in population-based dentistry, oral health surveillance, policy development, community-based disease prevention and health promotion, and the maintenance of the dental safety net."
Programs to treat dental disease can be conducted on a community_______or individual _______ level.
(public health) (private practice)
Healthy People 2020
-Provides a framework to address risk factors and determinants of health and the diseases and disorders that affect our communities -Oral health is included with objectives and guidance for reaching the new 10-year targets.
According to the Centers for Disease Control and Prevention (CDC), in 2013, about
1 in 5 American adults (17.8%) were current smokers; the rate was higher in men (20.5%) than in women (15.3%).
Every ______, the U.S. Department of Health and Human Services (DHHS) leverages scientific insights and lessons learned from the past decade along with new knowledge of current data, trends, and innovations.
10 years
Approximately______ Americans do not have access to fluoridated water.
100 million
The fourth iteration of Healthy People, Healthy People 2020, identified oral health as one of the
12 leading health indicators.
The DHHS has______operating divisions that are responsible for implementing programs to fulfill these goals.
13
The number of states that allow the public to have direct access to oral healthcare services of a dental hygienist in at least one practice setting rose from
28 states (2008) to 37 states (2014).
For children aged 2-11 years,
43% have dental caries in primary teeth, and 21% have caries in permanent teeth.
11. Knowledge about alleviating and possibly eliminating dental disease is not being applied, because of restraints and a lack of resources. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.
A
7. According to the report "Oral Health in America" (2000), oral health is essential to the general health and well-being of all Americans. Oral health can be achieved by all Americans. a. Both statements are true. b. Both statements are false. c. The first statement is true, the second statement is false. d. The first statement is false, the second statement is true.
A
8. Healthy People 2020 is published by the: a. Department of Health and Human Services (DHHS) b. National Research Council (NRC) c. Institute of Medicine (IOM) d. National Institutes of Health (NIH)
A
Healthy People 2020
A comprehensive set of disease prevention and health promotion objectives that contains an oral health focus area and oral health objectives
The ______ will have significant effects on health care, including dental care and dental public health. This will challenge the capacity of the current dental workforce and require innovative, effective, and efficient ways to increase the workforce so that the necessary dental care can be provided.
ACA
In 2004, the ______ became the first national oral health organization to propose a new oral health provider, the ADHP, in an attempt to reach underserved populations.
ADHA
10. Which of the following "Essential Public Health Services" is associated with the Core Public Health Function of "Policy Development"? a. Monitor health status to identify and solve community health problems. b. Mobilize community partnerships and action to identify and solve health problems. c. Enforce laws and regulations that protect health and ensure safety. d. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
B
12. An estimated __________ children and nonelderly adults will gain access to dental coverage by 2018 because of passage of the Affordable Care Act (ACA) in 2010. a. 1 to 10 million b. 11 to 24 million c. 21 to 30 million d. 31 to 44 million
B
13. How many states provided for direct Medicaid reimbursement of dental hygienists in 2014? a. 6 b. 16 c. 26 d. 36
B
15. Which of the following organizations proposed the Advanced Dental Hygiene Practitioner (ADHP) in an attempt to reach underserved populations? a. The American Dental Association (ADA) b. The American Dental Hygiene Association (ADHA) c. The American Dental Education Association (ADEA) d. The Association of State and Territorial Dental Directors (ASTDD)
B
3. About 1 in _____ American adults currently smoke. a. 3 b. 5 c. 7 d. 9
B
5. Which of the following agencies is primarily responsible for the federal government's role in participating in dental health-related activities? a. Department of Justice b. Department of Health and Human Services (DHHS) c. Department of Education d. Department of Labor
B
Healthy People 2020 consists of a list of health objectives for the nation, including oral health objectives, that are meant to be achieved by the year 2020. These objectives direct the agenda of government health programs and form the foundation for all other community health programs.
Both statements are true
14. Oral health professionals must continue to seek changes to move toward improved oral health of the public. Progress has not been made to meet the goals of dental public health. a. Both statements are true. b. Both statements are false. c. The first statement is true, the second statement is false. d. The first statement is false, the second statement is true.
C
2. Which of the following components of community oral health practice parallel diagnosis in private practice? a. Program planning b. Survey/assessment c. Analysis d. Community
C
9. The core functions of public health are assessment, policy development, and: a. outcome. b. benevolence. c. assurance. d. implementation.
C
REF: Government Agencies, p. 4 6. Which of the following federal governmental agencies is the primary federal agency for improving access to healthcare services for people who are uninsured, isolated, or medically vulnerable? a. Agency for Healthcare Research and Quality (AHRQ) b. Centers for Disease Control and Prevention (CDC) c. Health Resources and Services Administration (HRSA) d. Public Health Service (USPHS)
C
On the community level, the oral health professional focuses on the
Community as the patient rather than the individual The emphasis is on the individual as part of the community
______is the perfect example of a dental public health solution to the problem of dental decay.
Community water fluoridation
1. Dental public health is most likely to be used interchangeably with which of the following terms? a. Public health b. Population health c. Community health d. Community oral health
D
4. About __% of adults age 60 and older in the United States no longer have any natural teeth. a. 10 b. 15 c. 20 d. 25
D
Healthy People 2020 is a publication of the
DHHS.
Dental public health is concerned with:
Dental education of the public Applied research Administration of group dental care programs Prevention and control of dental disease on a community basis
_________ are comparable in the process of identifying and prioritizing problems.
Diagnosis and analysis
This is the definition provided by the Centers for Disease Control and Prevention (CDC)-
EDUCATION, HEALTH PROMOTION (ACTIVITIES, EVENTS, ETC) PROTECTING THE HEALTH OF ENTIRE POPULATIONS
Community oral health practice is unique in many respects:
Extends the role of the dental hygienist in private practice to include the people of the community as a whole
Government's Role in Public Health
Government agencies National initiatives Core functions of public health
This definition focuses on the implicit goal of improving health outcomes in the concept population health. EXAMPLE:
HEALTHY PEOPLE 2020
Examples of public health problems include:
HPV Smoking Newborns born with severe disorders Foodborne illnesses Parasitic diseases Chronic conditions
The______ improves access by strengthening the healthcare workforce, building healthy communities, and achieving health equity.
HRSA
The field of population health includes:
Health outcomes Patterns of health determinants and policies and interventions
American public health association is concerned with limiting health disparities by promoting
Healthcare equity, quality, and accessibility
Examples of solutions to public health problems that most persons are familiar with include:
Immunizations Tobacco cessation programs Fluoridation of drinking water Control of exposure to prevent disease Seat belts and air bags in cars to prevent injuries and mortality
SES is an important concept in public health:
It is the social standing or position of a person or group in a community or society on a social-economic scale. Measured by factors such as education, type of occupation, income, wealth, and place of residence. TEXTBOOK USES WATER FLUORIDATION AS EXAMPLE
These core functions were identified by the Institute of
Medicine (IOM) in 1988 and reinforced in an IOM report in 2003.
Overall, public health is concerned with protecting the health of our entire population including:
NEIGHBORHOODS, STATES, COUNTRIES, REGION OF WORLD DISEASE OUTBREAKS
Seven characteristics of public health solutions
Not hazardous to life or function Effective in reducing or preventing the targeted disease or condition Easily and efficiently implemented Potency maintained for a substantial time period Attainable regardless of socioeconomic status (SES) Effective immediately upon application Inexpensive and within the means of the community
This is the definition provided by the American Association of Public Health Dentistry:
ORGANIZED COMMUNITY EFFORTS
EDUCATE, EDUCATE -
POLICYMAKERS, PEERS, PATIENTS - NOT ELECTIVE CARE
Public health is concerned with:
Prevention Health education Recommending policies Administering services Conducting research Limiting health disparities
According to the American public health association, public health
Promotes and protects the health of people and the communities where they live, work, and play.
National oral health initiatives have the common goals of:
Promoting oral health Improving the quality of life Eliminating oral health disparities
Healthy People 2020
Reflects assessments of major risks to health and wellness, changing public health priorities, and emerging issues related to our nation's health preparedness and prevention
Goals for 2014-2018
Strengthen health care Advance scientific knowledge and innovation Advance the health, safety, and well-being of the American people Ensure efficiency, transparency, accountability, and effectiveness of DHHS programs
WHAT IS HEALTH?
TOTAL PACKAGE - MIND, BODY, SOUL
______ essential public health services have been identified to represent the activities that all communities should undertake. Considered to be vital to achievement of healthy people in healthy communities
Ten
Dental public health:
The form of dental practice that serves the community as the patient rather than the individual
___________ for the community are similar.
Treatment planning and program planning
A public health solution is an
answer to a public health problem designed to solve the problem.
Challenges and successes of these new workforce initiatives have been reported to
assist other states in making the necessary changes to pursue new workforce models.
Dental disease persists as a public health problem that can be alleviated and possibly eliminated. The knowledge exists, but because of restraints and a lack of resources, this knowledge is not being applied toward the goal of freeing communities from dental disease.
both statements are true
For the nation to make significant progress toward this goal, the commitment of a
broad group of collaborative stakeholders is needed.
These public health solutions are concerned with health promotion and disease prevention. They address the problems of the
community at large and are effective measures that follow seven characteristics (guiding principles).
The patient's oral examination compares to the
community survey as a means of assessment.
The public pertains to the
community, state, or nation.
The purposes of the _________ are to protect and promote health, wellness, and the quality of life and to prevent disease, injury, disability, and death.
core public health functions
It is the responsibility of _______ to emphasize the connection of oral health to people's general health to the policymakers of our nation.
dental health professionals
Community oral health and_______ are often used synonymously.
dental public health
Practice of dentistry and dental hygiene is integral to
dental public health in the United States
Dental disease has been described as a
dental public health problem of universal prevalence that can be alleviated, and even prevented, with future public health measures.
In many cases the term community oral health is used interchangeably with the term
dental public health.
The DHHS has 11 operating divisions, including .
eight agencies in the Public Health Service and three human services agencies. Many of these federal agencies encompass oral health programs.
Almost 25% of adults experience some form of
facial pain.
**Alfred Fones -
father of dental hygiene
The Department of Health and Human Services (DHHS) has jurisdiction of the
federal government's role in participating in dental health-related activities
Dental public health is the
form of dental practice that serves the community as a patient rather than the individual.
Government agencies are
formal public health programs that fall under the aegis of the government.
The Healthy People initiative is in its
fourth version.
The HRSA works through various means, including
funding community and school-based health centers.
Both dentists and dental hygienists, with this goal in mind, have entered the field of public health by accepting employment within programs that include
health promotion, community disease prevention, and provision of dental care to selected groups of people.
community health was traditionally referred to the
health status of a defined group within the population and the actions and conditions that improve and protect the health of the community.
Community health has traditionally referred to the
health status of a defined group within the population and the actions and conditions that improve and protect the health of the community. .
The effectiveness of a public health solution is dependent on
how well it possesses these characteristics.
The public health problem, as perceived by the public, usually brings to mind
infectious diseases such as AIDS or the swine flu (H1N1), but the spectrum of problems is much more extensive than many realize.
Having an impact on oral health will require greater
interprofessional collaboration to address the multifactorial nature of oral diseases.
Health, public health, and dental public health are all
interrelated.
The increase in the number of people with Medicaid dental coverage combined with the further development of midlevel dental providers will
necessitate that more states implement policies to allow dental hygienists to be directly reimbursed by Medicaid.
About 25% of adults aged 60 and older
no longer have any natural teeth.
The ADHP is a midlevel oral healthcare practitioner based on the
nurse practitioner model
The goal of dental public health is
optimal oral health for all citizens and universal access to comprehensive dental care.
The community oral health steps _____steps conducted in the private practice
parallel
On the community level, the dental professional treats the community as a .
patient rather than as an individual.
Public health is
people's health
Both ___________are concerns within the programs developed by government agencies.
prevention and delivery of services
The components of community oral health practice parallel those in
private practice.
One major step in achieving this goal is to
reduce the health disparities among population groups.
Public health and community health are used synonymously in this text. Both refer to the effort that is organized by
society to protect, promote, and restore health and quality of life of the people.
The terms public health and community health are used
synonymously in the text
Whether an oral health program is at the national, state, or local level, the objectives should be
tied with the current national oral health objectives.
About 25% of adults age 60 and older no longer have any natural teeth and may experience
tooth decay in their remaining teeth at rates higher than children.
The government plays a vital role in public health.
true
Developing alliances with other healthcare professionals can influence oral health in
two ways.
Formal public health programs generally fall under the .
umbrella of the government
Dental disease is a dental public health problem of _______that can be alleviated, and even prevented, with future public health measures.
universal prevalence