exam 3 planned responses
what do health promoters do?
-Conduct needs assessments -Identify health problems/develop problem statements utilizing "epi data" -Plan programs in a variety of settings: ~Community ~Schools (incl. colleges, universities) ~Worksites ~Hospitals, health care facilities ~Faith-based settings ~Military ~NGOs, not-for & for-profit organizations -Implement programs -Evaluate programs -Act as a resource -Advocate, "educate" policy makers, "testify" -Communicate - healthy, risky -Develop social marketing & communication campaigns -Write grants (to pay for all of the above) -Help people -Create health ed materials & curricula -Use computers & other technology - "informatics" -Conduct research - collect data (surveys, FGs, interviews, etc.) -...and a whole lot more!
Provide historical examples of occupational risk
-Paracelus: Miner's disease came from inhaling metal vapors; foundation for the field of chemotherapy -Plott: linked scrotal cancer and soot in chimney sweeps (happened when they leaned up against chimneys) -Radium girls: painted licked their brushes to pull it to.a point; women were in deathly danger -1950s shoe salesmen: used a fluoroscope to size feet to fit shoes, radiation high dose x rays of feet, repeated exposure 1940s modern day: occupations with higher risks (chemical industries, health care workers)
the road to zero 1918 flu pandemic healthcare-associated infections in the United States VIDEOS
-a texas resident had ebola --> increased lab testing, positive patients into treatment center, highlighted the need for strong public health systems before health outbreaks begin -In 1918, the flu killed more people than the us soldiers -shortage of nurses and doctors -CDC prepare for future outbreak -1 in 25 patients in a hospital are infected by medical care (lungs and surgery sites) -1 in 9 infected patients die
environmental factors for infectious disease
-altered environment (air conditioning) -changes in food production and handling (antibiotics in animals, fast food pesticides) -climate changes (global warming) -deforestation (effects on air quality) -ownership of exotic pets -global air travel and exotic journeys -Increased use of immunosuppressives/antibiotics -natural disasters --> power outage, broken water lines --> food grows bacteria
Food waste causes
-biggest contributor to landfills -rotting food --> methane --> potent greenhouse gas -foods have to measure up to standards -food that isn't sold to best buyer is dumped -If a price is not expected, it's cheaper to throw it away -40% of food processed is never eaten
Birth Outcomes Initiative
-effort by SC department of health and human services (SCDHHS), South Carolina hospital association, march of dimes, BCBS..... -works to improve the health outcomes for newborns not only in the Medicaid program but throughout the state's population methods -baby-friendly hospitals -Mother's milk bank -centeringpregnancy -vaginal birth initiative -reducing c-sections
STD trends in the united states
-high rates of chlamydia, gonorrhea, and syphilis -STD prevention challenges limited resources --> hard to identify and treat left untreated --> severe health outsomes people cannot get STD care -what can be done? STD screenings and timely treatment, state and local health departments could direct resources, talking openly about it, getting tested regularly, using condoms
explain conditions that increase the risk of infection
-host: behavior (sexual), having no vitamins and minerals, co-morbid conditions, age -environment: high population density, access to water, indoor air quality, food -agent: infectivity, pathogenicity
briefly explain why disease is an on-going concern
-most people have little or no immunity because they have no previous exposure to the virus or similar ones -healthy people can be at high risk for serious complications -mental health with stress and quarantines ??????????????//
Identify and briefly explain qualitative methods
-personal interviews --> group responses into categories to examine data and make conclusions -case studies: look at one particular instance and see what's going well/not well -systematic observation -participant observation -content analysis group techniques -focus groups -brain storming -community forum/meeting
american academy of pediatrics: child vaccination across America (website)
-routine childhood immunizations are vital to individual and society health -Immunization rates across the US vary -vaccinations are monitored constantly -public health concerns during covid have been causing lower vaccination rates
Explain exposure concepts
DOSE MAKES THE POISON -routes: absorption, injection, inhalation, ingestion, mucosal membranes -different toxic response arise from different routes of exposure, frequencies of exposure, and duration of exposure -highly variable from individual to individual -depends on life stage, gender, form and ability to be absorbed, metabolism -epi triad but replace agent with substance
what are HAIs and what are some examples
Healthcare associated infections -central line-associated bloodstream infections -catheter-associated urinary tract infections -ventilator-associated pneumonia -surgical site infections
SARS (severe acute respiratory syndrome)
Potentially life-threatening viral infection that usually starts with flulike symptoms. -STARTED IN CHINA
fungi
Primitive life-forms that feed on organic materials.
types of agents
bacteria, viruses, fungi, protozoa, helminths
antigenic stability
condition of an individual who has been infected by a disease, and then remains immune to further infection in later life. -this is the case for most childhood diseases -greater chance for herd immunity
identify infectious diseases of ongoing concern
dengue yellow fever HIV/AIDS tuberculosis malaria influenze smallpox cholera leishmaniasis West Nile Virus plague
direct vs indirect transmission
direct: involves direct body surface contact and physical transfer of microorganism between an infected or colonized person to another person by touch indirect: involves contact between a person and a contaminated object. this is often a result of unclean hands contaminating an object or environment
define environmental health
the science and practice of preventing human injury and illness and promoting well-being by... 1. identifying and evaluating environmental sources and hazardous agents and... 2. limiting exposures to hazardous physical, chemical, and biological agents in air, water, soil, for, and other environmental media or settings that may adversely affect human health
Approaching PH problems from a systems perspective
the socio-ecological model has effective solutions to public health problems have to address micro and macro influences -public health problems are complex! they have factors that are inextricably linked with multiple, interacting parts, multiple "actors" environmental sustainability model -approaching problems from the recognition that there are multiple influences on environmental challenges -environment, social, and economics
explain the concept of toxicology
the study of the effects of poisons -oldest scientific discipline -application of science to important social, environmental, and public health issues -how poison produces a toxic effect -what are the same amount of exposure? DOSE MAKES THE POISON
community health investments yield results (video)
tobacco-free environments asthma initiative: addresses asthma disparities in boston -reduction in hospitalizations, ER visits community conversation about diabetes -reduced amputations schools offer better, healthier foods -better grades, healthy students = successful students wellness programs in workplaces -smoking cessation, encouraging healthier foods, policies to encourage healthy lifestyles well-maintained parks
articulate the difference between "infectious" and "communicable diseases"
infectious: disease caused by different classes of pathogenic organisms; commonly called germs -a disease producing agent, such as a virus or bacteria communicable: an infectious disease that may be passed from individual to individual all communicable diseases are infectious diseases, but not all infectious diseases are communicable (ex. infected cut, tetanus, Lyme disease)
WHO end TB strategy
vision: a world free of tuberculosis 1. political commitment and increased funding 2. improved, quality case detection 3. standardized, supervised treatment with patient support 4. effective drug supply and management system 5. proper monitoring and evaluation system to measure impact barriers to conquering TB: weak health systems, underlying determinants, lack of effective tools, continuous unmet funding needs
disease X
stands for the unknown -we should always be preparing for what is coming next -there is value in research and discovering anti-viral medications
health promotion
the combination of educational and environmental supports for actions and living conducive to health -MACO -broader than health education -purposeful, organized -Involves a planned approach/program/intervention at the macro level
Can you be forced into quarantine? article
-tensions between government enforcing rules and individual rights -the gov can force you into quarantine due to the Public Health Service Act: prevents the spread of communicable diseases into the US or between states -laws vary by state and even locally -seem somewhat voluntary but local county officials could be held liable -those who ignore the rule could face jail time (not ideal and counterproductive) -persuade people that it's for their own good -the government SHOULD provide medical service, money etc. because they don't -the US lacks the broad authority to impose a sweeping quarantine (no power for expansive measures) -1918 influenze pandemic...pandemics are extremely rate -Mary mallon "Typhoid Mary" infected 53 people with typhoid fever by being a cook
draw, label, and explain the "epi" triad for disease transmission
-the epi triangle is a model for infectious disease that explains how dynamic interaction between an agent, a host, and an environment spreads disease. host: person or living organism that can be infected by an infectious agent domain in which the disease-causing agent may exist, survive, or originate -acts as a reservoir that fosters survival environment: physical, biologic, social, economic components agent: a factor such as a microorganism, chemical substance, form of radiation...whose presence, excessive presence or relative absent is essential for the occurrence of disease -has infectivity
Following the Mercury Trail (video)
-there is a tight and surprising link between the ocean's health and ours; toxins at the bottom of the ocean food chain find their way into our bodies -"pinch a minnow, hurt a whale" -PCBs are fat soluble and have accumulated in dolphins --> get passed with mother's milk --> sold at street markets ecosystems can get better due to people's efforts to protect the ocean's pyramid, which translates to our own pyramid of life
birth control in developing nations
1 in 4 sexually active women who want to avoid pregnancy have an unmet need for contraception --> 82% of unintended pregnancies problems: 1. women die from pregnancy-related causes 2. abortion (which can be illegal --> unsafe abortions) 3. lack of economic and personal freedom (cannot pursue education and career as easily, family size) 4. poverty (lack of clean water, low health care spending, malnutrition, poor sanitation, poor or no primary health care services) who's at risk? 1. adolescents in poor countries (increased infant mortality, obstetric complications, less likely to provide good prenatal care) 2. old women (could suffer from anemia, malnutrition, damage to reproductive system often from previous births --> infant mortality) why birth control? 1. women can choose when they will become pregnant 2. women can control the timing of their pregnancies barriers 1. lack of information about were to obtain contraception 2. inability to afford contraceptives 3. inability to obtain contraceptives 4. cost/time to travel to clinic/pharmacy 5. religious or cultural oppression 6. lack of knowledge about methods 7. oppression from family
food waste solutions
1. Don't Waste Food S.C.: public and private sector campaign that offers information on food labels, composting for business and at home composting 2. French supermarket made "ugly" vegetables look good 3. donate to food banks for tax breaks 4. loaves and fibers and harvest hope are food banks that collaborate with state department of health and environmental control to aid in food recycling programs
assumptions of health promotion (tells why it's important to focus on)
1. Health status can be changed. 2. Disease occurrence can be understood -relative risk, dose response, biological plausibility 3. Prevention strategies can be developed for health problems. 4. Health is affected by multiple factors - not just lifestyle -socio-ecological model, outermost rings influence our behavior 5. Changes in micro & macro level behaviors and factors can positively affect health. 6. People & communities can assume responsibility for their health -empowering people and giving them the tools and context to change their own behaviors 7. Individual responsibility does not mean victim blaming 8. For permanent behavior change, people must be ready & motivated. -stages of change model
What efforts have been taken to reduce risk?
1. National institute of occupational safety and health (NIOSH) -do research to determine the safety doses -helps keep workers safe 2. Occupational Safety and Health Administration (OSHA) - overviews workers across the US -seeks comments on a potential standard to prevent workplace violence in healthcare and social assistance settings 3. National Toxicology Program (NTP) -what are toxicology concerns? what are people being exposed to? -external science oversight and review 4. current research areas (National Tox Program) -Endocrine disruptors
Identify important environmental figures in history
1. Rachel Carson: wrote silent spring, american writers, scientist -questioned pesticide practices; took on the industry -DDT impacted bird population and accumulated in the environment --> could impact human health -led to foundation of NEPA 2. Ramazzini -Italian doctor -linked hazards of dust, fumes, gases to lung disease in workers 3. Paul Ehrlich: German scientists developed staining procedures to see how toxicants affected living organisms -looked into job and health outcome relationships
identify determinants in the environment that influence health
1. air pollution (indoor and outdoors) 2. inadequate water, sanitation and hygiene 3. chemicals and biological agents 4. radiation 5. built environments
describe 3 methods for preventing infection at the community/population level
1. barrier protection: isolation, quarantine -Isolation: if person is actually sick -quarantine: person is possibly exposed 2. immunizations --> herd immunity (protecting a community against certain diseases by having a high % of the community's population immunized) 3. child and adult immunization schedules are easy to read 4. public health campaigns (tug on those emotions)
list and define 3 indirect routes of infectious disease transmission
1. food-borne (Salmonella) 2. water-borne (cholera) 3. air-borne (chickenpox, colds)
describe 3 methods for preventing infection at the personal/individual level
1. handwashing (well!) 2. PPE (personal protective equipment) includes masks, gloves, boots (agricultural settings), avoid touching nose 3. get vaccinated
explain health promotion by level
1. individual -KABSS (knowledge, attitudes, beliefs, skills, self-efficacy) -knowing PA requirements, MyPlate -only micro level behavior 2. interpersonal -social support systems, social networks, social norms -you want to eat healthy, but your roommates eat tons of junk food...it's hard! 3. institutional -organizational characteristics and their rules and regulations, physical characteristics -working conditions (ex. safeway) -stress-coping programs 4. community -relationships between organizations, groups, physical environment -ex soda city market supports local farmers -creating bike lanes, riverwalk parks 5. public policy -laws and policies at the local, state or national levels -zoning laws that are conducive to health
Identify public health issues associated with environmental determinants
1. ischemic heart disease 2. chronic respiratory diseases 3. cancers 4. unintentional injuries 5. respiratory infections 6. stroke 7. malaria
global health challenges
1. making healthcare fairer -the gap between the haves and have-notes is growing in terms of access to healthcare -health wealth gradient 2. expanding access to medicines -only available to 1/3 of the population 3. earning public trust -new use of social media can reach more people 4. stopping infectious diseases
list and define 3 direct routes of infectious disease transmission
1. skin-skin (Herpes) 2. mucous-mucous/sexual intercourse (STIs) 3. across placenta (Rubella; HIV)
malaria
A disease caused by mosquitoes implanting parasites in the blood. risk factors: social economic status, government's economy (supply and staff, purchasing drugs), geography (hot and moist), education (how to protect yourself) prevention strategies 1. nets, insecticides, distribution campaigns 2. intermittent preventative treatment -pregnant women -Infants 3. indoor residual spraying 4. rapid testing
tuberculosis
An infectious disease caused by bacterium that may affect almost all tissues of the body, especially the lungs -has to be ingested -latent TB and TB disease -top 10 cause of death worldwide -poverty is great risk factor because they can't afford treatment (6 month treatment) -If they miss some pills, don't comply with protocol, or can't finish the treatment...the drug-susceptible strains die, the MDR becomes lethal -drug resistance has been increasing globally -surge again due to HIV/AIDS epidemic in the 1980s -primary prevention: BCG vaccine (not required, recommended for health care workers, prevents serious complications), proper ventilation systems, abide by sanitation, raising awareness, follow ups -WHO's end TB strategy with DOTS core was a successful global effort.
Explain the difference between qualitative and quantitative methods/data
Both qualitative and quantitative data strive to describe, understand, explain, and examine relationships in social phenomena. qualitative data -text based -narrow, deep information -open-ended and exploratory -Interviews quantitative data -numbers based -broad, shallow information -deductive
identify priority infectious diseases which pose a PH threat
Disease X: prediction of next disease, there is value in research and discovering anti-viral medications -SARS (severe acute respiratory syndrome): zoonotic disease -Ebola virus -zika
explain the health impact pyramid
Framework that describes the public health impact at five different levels : 1. Socioeconomic factors -- lowest level • First to be addressed • Poverty, lack of education, lack of access to clean water or sanitation 2. Changing the context to make individuals default decisions healthy - second to lowest level • Interventions that change the environmental context to make healthy options the default choice, regardless of education, income, service provision, and other societal factors... [such that] individuals would have to expend significant energy not to benefit from them • Ex. food and drug safety, elimination of trans-fats in food 3. Long-lasting protective interventions - middle level • Community health interventions that have long-term protective effect as well as periodic screenings • Ex. Immunizations; colonoscopy 4. Clinical interventions - second to top level • Clinical interventions for treatment such as treatment for hyperlipidemia, hypertension, and diabetes 5. Education and Counseling - top level These interventions require the largest effort of individuals, and achieving sustained health behavior change is the exception rather than
Why do pandemics occur?
When you have a new strain of bacteria that's not cyclic & is new to a different environment where antibiotics for the bacteria are not prevalent -when a novel influenza A virus emerges which is able to infect people easily and spread from person to person
Spillover: zika ebola and beyond
Zika -destroys fetal brain cells -doesn't cause severe symptoms in 18 year olds -microcephaly (triangular face, no forehead, prevents brain from developing properly -correlation between prenatal Zika virus infection and microcephaly and other brain abnormalities -west africans aren't isolated + high population density = diseases have opportunity spread -stopping is difficult b/c mosquitos are everywhere, and their eggs can last in water for over one year Ebola -those who prepared the dead for burial were more susceptible for it -traced back to eating a live antelope -"the tragedy of ebola is that it is spread through love" -cannot maintain blood circulation --> decreased blood pressure --> organ failure -scariest time in Lagos ways to prevent -alter male mosquitos to breed with females to kill all offspring -contact tracers
define program
a program is an intervention that is well-planned to address a risk factor -geared towards activities/experiences towards groups -many or single events (eating healthier?? cooking class, grocery store, longer weight loss program
virulence
ability to cause death
pathogenicity
ability to cause disease
infectivity
ability to infect
COVID data
age is a serious factor -Increase in hospitalization rates by age
live healthy south carolina
an ongoing collaborative process to improve the health of people and places across SC 1. community systems model -multi-sector groups can build collective will that leads to change at the policy and practice levels and results in improved health outcomes -health equity lens: addressing health inequities which are differences in health that are avoidable, unfair, and unjust, among different groups of people -policy, systems, environmental (PSE) changes: enhances policy and advocacy efforts supporting active living, healthy eating, and tobacco-free living -community health improvement plans and assessments -partnership development
vector
an organism that carries a parasite or pathogen from host to host; asymptomatic carriers of pathogens -mosquitoes, ticks
health education
any combination of learning experiences designed to facilitate voluntary actions (behavior) conducive to health -embedded into health promotion -one tool or strategy -focuses on individuals and micro level
zoonotic
diseases caused by infectious agents that can be transmitted between animals and humans
elimination
getting rid of a disease from a specific geographical area
eradication
getting rid of a disease from the entire planet
how is health promotion and education related?
health promotion and health education both focus on health, QoL, and wellbeing; however, health promotion seeks to empower individuals, families, groups and communities at the macro level to be effective, while health education focuses on individual, voluntary behaviors and decision making.
Ebola virus
hemorrhagic fever
routes of transmission
how infectious agents are spread
non-vector hosts
humans, other vertebrates, birds, bats
family planning in Bangladesh
problem: rapid population growth, poor nation, highly conservative and opposed to birth control for certain reasons what they did: 1. door-to-door campaigns to raise public awareness 2. free birth control to women result: infant mortality rates decreased -reduces maternal deaths and infant mortality -empowers women and enhances education -key factor in achieving gender equality and reducing poverty
immunogenicity
likelihood of triggering an immune system defense
protozoa
one-celled organisms that use other living things for food and a place to live
helminths
parasitic worms
briefly explain why disease considered a priority
when a disease has the potential to cause a major public health emergency and the absence of efficacious drugs and/or vaccines accelerated need for research
why are qualitative methods used?
you can't put a number on someone's lived experience. -systemic discovery --> generate knowledge about socio ecological models -much more detail in words, images, and non-verbal actions -gives "meaning" -ex. colonoscopy