HTH 231 Howley Midterm
Road traffic deaths attributed to alcohol was most common in a. The United States b. Australia c. Germany d. The UK
United States
Generally speaking, which group has the best overall health in the U.S.?
recent latino immigrants
Risk factor model
-active -diet -smoke -sexual activity
What percentage of the adult homeless population are veterans
11%
The child poverty rate in norway is 3.4% France is 7.5% Hungary 8.8% and Greece 12.4%. What is it in the U.S.?
21.9%
What is the U.S. ranked in life expectancy?
42
What is U.S. ranked in life expectancy
43
Children living in poverty are how many times more likely to have poor health, compared with children living in high income households?
7x
Worldwide, _______ is implicated in 30% of violent injuries. a. Marijuana b. Heroin c. Methamphetamine d. Alcohol
Alcohol
In regards to firearms, which of the following statements is true? a. There are 89 civilian-owned firearms for every 100 Americans b. US civilians own four times the number of automatic and semi-automatic riddles owned by the US Army c. The US is home to approximately 35-50 percent of the world's civilian owned firearms d. All the above
All of the above
African American men in Harlem have a shorter life expectancy from age 5 than which of the following groups
All the above (japanese, bangladeshis, cubands, algerians living in paris)
What country has the highest life expectancy?
Monaco
How does chronic stress impact health
Suppress immune system, mental health, gain weight, hypertension, sleep, relationships, heart disease, cognitive ability, stroke, heart attack, more likely to smoke or drink
What country is an example of egalitarian society?
Switzerland
Who spends the most on health care?
U.S. -$7,960 per capita
Which of the following countries has the lowest smoking rate? a. Germany b. United Kingdom c. Japan d. United States
U.S. (high taxes, limited smoking areas, negative advertisement)
What is the best predictor of one's health?
Whether or not you are wealthy
Which White Hall Study studied women and men?
White Hall 2
what is the leading cause of homelessness among women?
domestic violence
The number new disease cases is:
incidence
What is it called when latino immigrants' health deteriorates after they've lived in the United States for a couple years?
latino paradox
The total number of people who have a disease is:
prevalence
Importance of infant mortality
reflects our health care, clean water, healthy pregnancies, advancements in hospital technology --> infant mortality 5.8/1000
Chronic stress increases the risk of all of the following except?
sickle cell anemia
What determinant of health is a park?
social determinant
What branch of epidemiology studies how social position and context influence human health?
social epidemiology
Which of the following does the U.S. do well
-adult vaccination -specialty care -screenings
List something the health care system does well?
-adult vaccinations -specialty care -screenings -critical care beds
US Healthcare system
-all other peer countries offer populations universal or near universal health insurance coverage
Seattle WA
-asthma was endemic -unsafe outside, unhealthy inside -houses rebuilt, new clinic, new library, community center, gardens -breath easy units -included community members on rebuilding -sidewalks, backyard, community socializing
What countries provide less health insurance than the U.S.?
-mexico, chile, turkey
Richmond CA
-unsafe -less produce -fast food -$1500 more to buy a car -poverty tax -only whites get loans shifted to only black and latino -low income disinvested community -chronic stress -violence -high asthma -low birth rates -heart disease -diabities -lower health expectancy
What is the greatest difference in life expectancy observed between U.S. countries?
15 years
What % of Americans are uninsured before the Affordable Care act?
17%
How much time do Americans spend watching TV?
2+ hours
What % of Americans are uninsured after the Affordable Care act?
9%
How does the U.S. smoking rates compare to those of other wealthy countries?
Below 25 (lowest smoking rates)
Shorter lives poorer health is written by:
National research council and institute of medicine
Blaming the victim for having a disease is a weakness of which model?
Risk Factor Model
Which of the following countries reported the lowest percentage of motorcyclists wearing a helmet? a. United States b. Australia c. Canada d. Switzerland
United States
What is the most important measure of a country's health status?
infant mortality
Where does the U.S. rank in life expectancy 50 years ago?
top 5
What did the white wall study observe?
British public servants -first one did male, second one studied both gender
The younger population in the U.S. has a ____ mortality rate and ______ life expectancy?
higher, shorter
What population did the white hall survey?
-British public servants
Strengths of U.S.
-Preventative screenings -high access to specialists -high concentration of critical care beds -Blood pressure and cholesterol levels check -attention to clinical detail -hospital discharge planning -wait times short -adult vaccinations -specified treatment targets -biomedical research -medical technology are
Weakness of U.S.
-Primary physician care - access to care -child vaccinations -prescription control -extra care people don't need -lack of electronic medical records -gragmented care across U.S. -Low/unequal concentration of PCPs -low availability of long care beds -no universal health insurance -most asthma admissions -only 50% get care needed -out of pocket expenses
What stories from Jim Taylor's life illustrate how wealth, power, and status translate into better health?
-breaks from stress, safe neighborhood
Provide an example of an upstream approach
-education programs -vaccinations -better food sources -side walks -public policy (no smoking)
What is the number one reason for bankruptcy in U.S. today
-health care -if uninsured and get sick can cost a lot, pay out of pocket even if have health insurance, if become unemployed lose health insurance
What stories from Coreys Anderson's life exemplify a high demand/low control job and stressful home situation?
-in the hospital -worked a lot -violence in neighborhood
What is one way cities have made homelessness a crime?
-no loitering -no sleeping in public places -spikes on benches
What are the determinants of health?
-social (education, income, transportation, social norms, social support) -Physical environment (housing, homes, neighborhood, schools, toxic substances, aesthetic elements) -health services (access to health care and quality of health care) -individual behaviors (diet, physical activity, tobacco, alcohol) -biology and genetics (age, biological sex, family history of disease)
What is an example of an egalitarian society?
-switzerland -society that shares resources (public funded colleges, universal health care, paid sick leave)
2 Weaknesses
1. draw us into trying to change individual behavior as our key strategy for improving health (we are focused only on problem, harder to change individual behaviors) 2. Lend itself to blaming the victim of disease
Leading cause of death in U.S.
1. heart disease 2. cancer 3. chronic lower respiratory disease 4. accidents 5. strokes
How much does chronic illness cost the U.S. each year in lost work productivity?
1.1 trillion
The predominantly white neighborhoods in west Los Angles contain approximately 31.8 acres of park space per 1,000 residents. How many acres of park space exist per 1,000 residents in the predominantly Black and Lation neighborhood of south central Los Angles?
1.7 acres
How much of the homeless population are children?
1/4, a quarter
How many homeless people were there in Harrisonburg in 2014?
124
How many peer countries are there?
17 1. Australia 2. Austria 3. Canada 4. Denmark 5. France 6. Findland 7. Germany 8. Italy 9.Japan 10. Netherlands 11. Norway 12.Portugal 13. Switzerland 14. Sweden 15. Spain 16. United Kingdom 17. United States
How much does the U.S. spend per person on health care to the average of the other industrialized countries?
2.5x as much
On average, how does the number of hours that americans work each year compare to other OECD countries?
200 hours more
On average, how many more supermarkets are there in predominantly white neighborhoods compared to predominantly Black and Latino neighborhoods?
4x as many
The top 1% of American families owns more wealth than the bottom:
90%
Compared to the US, which of the following countries reported a higher percentage of drivers wearing seat belts (in the front seat)? a. Canada b. United Kingdom c. Sweden d. All the above
All of the above
Which 3 countries provide less health care coverage than the United States?
Chile Mexico Turkey
All of the following are things the U.S. does not do well except:
Critical care beds
Which country reported lower breastfeeding rates than the US? a. United Kingdom b. France c. Canada d. None of the above
France (Spain is other one, short maternity leave, frowned upon nursing in public, midwives)
What countries have a lower breastfeeding rate than the U.S.?
France and Spain
Social factors
Income and poverty Income inequality Education Employment Social mobility Household compositions Race and ethnic identification
The 5 levels of SEM are:
Intra/Inter personal, community, organization, public policy
Affordable care act
It is reformed, but not universal coverage, 9-10% still uninsured
What peer country has the highest life expectancy?
Japan
Who is the father of population health?
Jeffrey Rose
Father of epidemiology
John Snow
Who discovered the source of a cholera outbreak in London?
John Snow
Are of the following are examples of the upstream approach except:
Physical therapy
During the 20th century, U.S. life expectancy increased 30 years. Which of the following was the most important factor behind the increase?
Social reforms (like wage and labor laws, house codes, ect) and increased prosperity
Which of the following statements is true in regards to physical activity? a. US children among the most active compared to peer countries b. There is not enough evidence to compare physical activity of Americans with people in other countries c. US adults are among the least active compared to peer countries d. US adults over 50 are among the least active compared to peer countries
There is not enough evidence to compare physical activity of Americans with people in other countries
Of the following countries, unsafe sex practices were most common in a. United States b. France c. United Kingdom d. Canada
United States
What country has the lowest smoking rate?
United States
Which country consumes the most calories? a. Australia b. United States c. Japan d. Mexico
United States
___ is implicated implicated in 30% of violent crimes
alcohol
do poorer people have more chronic conditions or than infectious diseases?
chronic diseases
Host Agent
communicable diseases
A society that shares their resources is referred to as an
egalitarian society
_____ means everyone has the same resources
equality
___ means everyone gets what they need
equity
Is the gap between white and African American infant mortality rates is greater or less today than it was in 1950?
greater
What is the number one cause of bankruptcy in the U.S. today?
health care
What is the leading cause of death in the U.S.?
heart disease
What is the leading cause of death for African American men in Harlem?
homicide and violence
Are cities increasingly or decreasingly making homelessness a crime
increasingly
Midstream v upstream factor
midstream: free health clinic Upstream: universal health care
How many days of paid sick leave are U.S. workers guaranteed by law?
none
Ireland, Sweden, France, Spain, Portugal and the other western European nations all mandate by law paid holidays and vacations of four to six weeks. How many days of paid vacations are mandated by law in the United States?
none
what makes a peer country a peer country?
similar economic statuses
Chronic stress
the response to emotional pressure suffered for a prolonged period of time in which an individual perceives he or she has little or no control
Citizens of other industrialized countries have longer life expectancies and better health than we do because:
they are more egalitarian
T or F Can only remove a panhandler if they come into street, free speech, can do ordanses for certain intersections
true
Between 1980 and 2000, how did the life expectancy gap between the least deprived and most deprived countries in the U.S. change?
widened by 60%
