Population & Society Exam 2
-What are some of the barriers to providing treatment/prevention for HIV/AIDS worldwide?
-Treatment rates vary by country (lack of medical attention) -Not having political support or denial of disease -Financial barriers -Access to antiretroviral drugs (59% didn't have access in 2014)
-What are some examples of social determinants of health?
-Where you live (access to transportation) level of income (ability to afford insurance, healthy food) -Allostatic load (stress) hypertension/heart disease -Equality of schooling -Safe housing -Neighborhood -Cleanliness of food, air & water
-Why is population aging of potential concern for the sustainability of elderly support policies?
-because we aren't giving enough money tot social security to begin with... therefore if age keeps increasing we will not have enough funding -1/2 of adults 65 and older had incomes below twice the poverty thresholds & another 33% under the official measure -considers food & room needs, not childcare , different living areas, etc. -not enough money to have a great life over the poverty line, safety and quality of nursing homes is low, nutrition is poor etc - need to increase workforce, reduce benefits, shifting responsibilities to families to take care of their elders -population age is increasingly growing!!
-What is the American Community Survey? What did it replace in the US Census?
A survey that is distributed to 250,000 households each month, rather than just once every 10 years, and which will provide detailed information on American cities and towns annually that used to be available only on a decadal basis in the census long form.
-What are the (general) patterns in life expectancy worldwide today?
Rapid improvements in life expectancy except in some LDRs (men 25-->65, women 25-->70)
-What is life expectancy?
How long one lives. The age that an average person can expect to reach upon death
-What are some of the current concerns regarding population aging in Japan, and why is this issue particularly important in that country?
-1/4 of population is over 65 -causes problems with replacement and dependency ratios -in 2050 their older populations will grow to around 75% of their population making it even more problematic -they cannot be cared for and they don't have money to support themselves because they aren't working
-Who was John Snow and why was he important? What did he find, and how did this help control the spread of infectious diseases like cholera?
-Father of epidemiology. English physician and leader in the adoption of anesthesia and medical hygiene. Mapped cases of cholera in London to find that the contaminated water was coming from one specific well. -Removing the pump handle ended the epidemic and proved a turning point in understanding infectious diseases and helped create new waterways
-What was the role of medical technology in the improvement in mortality during the mortality transition in more developed countries? And how has this differed in less developed countries?
-Immunization of diseases, antiseptic surgery, antibiotics and insecticides, hormones, genetic engineering -Improving living standards and public health efforts were key LDR countries really depended on efforts, decreased mortality rate dramatically, however some counties did not have the resources; didn't have the same effect on MDRs
-How have antiretroviral drugs for AIDS contributed to higher prevalence rates for the disease?
-It is keeping HIV/AIDS patients alive longer instead of dying off; slows down progression-->prevalence higher
-Who was Jeanne Calment, and how long did she live?
-Oldest woman reported to have lived -She lived for 122 years and 146 days
-What were Vaupel and Olshansky's central arguments regarding the future of life expectancy improvements? Where did they differ? Where did they agree?
-Olshansky believes we are fast approaching a limit to how high average life expectancy can rise, all of the previous progress was due to decreases in infant mortality -Vaupel believes there is no limit and there is a linear relationship for it -Their bet: $150 that the first 150-year-old human was born before 2000. -Agreement: accurately predicting life expectancy is important for entitlement spending, savings, social services, pensions, healthcare resource allocations, general economic stability -->Gains will have to be made by prolonging age of the elderly, even though harder
-What are some of the potential limits to future increases in life expectancy?
-Senescence: physical condition of the body declines, person becomes more susceptible to disease. -"Wear and Tear" theory: Body's parts break down from use, like a machine. -Planned Obsolescence theory-->human body like a machine...meant to give out at a certain time so new ones can survive
-What are some pieces of evidence suggesting a social gradient in health in the US and in other countries?
-Social causation - SES causes health -Social drift/selection - Health causes SES "drift" - loss of job and wealth due to poor health (downward mobility) poor health may limit capital accumulation in the first place (preventing upward mobility). -Spurious relationship - SES-health association is due to some third factor
-What are some of the arguments for limitless life? Who is Aubrey De Gray, and what does he argue?
-There has been a steady linear increase of life expectancy overtime. History of life expectancy limitation predictions have been proven false. Declines in mortality are slowing and the next medical innovation could change everything. -Aubrey De Gray (the bearded guy from video) is an author and biomedical gerontologist. He believes medical technology may enable human beings alive today to live indefinitely (5,000 years or so).
-How did the type of diseases prevalent in the population (and the primary causes of mortality) shift during the mortality transition?
-before transition most deaths caused by communicable diseases )degenerative and man-made) -then more medical technology and information comes out and mortality rate decreases significantly -remaining deaths primarily come from chronic or non-communicable diseases (ex: People first died because of infectious diseases like small pox and then later onto noninfectious disease like lung cancer from smoking.)
What is the difference between de jure and de facto population counts? What is the concept of "usual residence" used in the United States and many other countries?
-de facto: individuals are recorded to the geological area where they were present at a specific time. -de jure: individuals are recorded by their place of residence -"usual residence"-the place where a person lives and sleeps most of the time
-What is the "Hispanic health paradox" in the United States?
-despite having lower average levels of SES, latinos in the US often (but not always) have better health outcomes than everyone else -could be because we only let healthy and younger migrants over sick ones into the US
-Has the worldwide HIV/AIDS pandemic peaked in terms of incidence? In terms of prevalence? What's the difference? (HINT: Look at the quote from the UNAIDS 2010 report in the lecture about the AIDS epidemic for this question).
-in terms on incidence it peaked in the 1990s (new HIV infections) and this is falling now -in terms of prevalence... more people in the world are living with AIDS do to antiretroviral therapy that is causing them to live much longer
-What were the Whitehall studies? Where were they conducted, who was their study sample, and what did they find? Why was this important?
-investigated the social determinants of health, specifically w/ cardiovascular disease prevalence and mortality rates among British Male servants between 20-64 --> found a social gradient in health and mortality -->positive associatie present at every level (low, mid & high) -Whitehall II study has shown evidence that the way work is organized, the work climate, social influences outside of work, influences from early life, in addition to health behaviors all contribute to the social gradient in health --> inequalities in health cannot be divorced from inequalities in society --> to address the inequalities in health it is necessary to understand how social organization affects health and way to improve the conditions in which people work and live
-What does the AIDS pandemic look like worldwide today? What geographic areas (in general terms) have been hardest-hit by the disease?
-it has appeared to stabilize -the annual number of HIV infections has steadily decreases since 1990 -significant decrease in AIDS related deaths because of increases antiretroviral treatments -but with the rate of people getting infected has decreased, the number of people with it has increased because of less deaths and better treatment -Sub-Saharan Africa (Bostwana)
-What is the "double burden of disease," and where does it tend to be found (in general terms)?
-people dying from chronic diseases (diabetes, heart disease, cancer [non communicable]) as well as infectious diseases (diarrhea and malaria [communicable])When a place tends to have infectious and chronic diseases. Tend to be found in Latin America
-What are some other types of demographic data, in the US and elsewhere?
1. Vital Statistics or population registers (i.e.Database with each individual) 2. Sample Survey (esp. in developing countries) 3. Administrative Data (i.e. Social Security record, Visas, Medicare Record) 4. Historical data repurposed
- What are age- and sex-specific mortality rates, and why are they useful measures?
-they compare death rates between male and females at different ages -show who is going to die in the future and who will live a long life -shows future in fertility and mortality -also shows people who have died from AIDS/other diseases Mortality depending on age and sex helps determine age pyramids
-What are the three stages described by Omran in the Western model of the epidemiological transition?
1) Age of pestilence and famine Leading causes of death: respiratory diseases, diarrhea, smallpox, TB, and other diseases that took heaviest toll on the young; life expectancy at birth between 20 and 40 2) Age of receding pandemics Time of most rapid changes due to changes in sanitation and standards of living, life expectancy increased to about 50 3) Age of degenerative or human-made diseases Mortality stabilizes at a lower level.Major causes of death are heart disease, cancer, stroke.
-What's happened with Russian men's life expectancy recently? Why?
Declining because of the recession, social disruption, erosion of public health systems, and increase in drinking. Declines in life expectancy of 4.2 years between 1980-2000
-When did the US start conducting regular decennial censuses?
Has been conducted in years ending in "0" since 1790
-Who was Ryan White, and why was he important?
He had AIDS and he was shunned by classmates at his old town but at his new town, they were more informed about Ryan's condition before his arrival. Important because he was a teacher for kokomo about AIDS and gave lasting lessons about compassion, courage, and AIDS
-What is meant by a social gradient in health? Does it apply throughout the socioeconomic distribution, or just at particular levels?
How your SES class is positively correlated with your level of health. If you are low on the SES scale, then you are more likely to have health issues and be in bad health, whereas if you are higher up in SES, then you will have better health. It does apply to all socioeconomic distribution
-Why do decreases in infant mortality lead to the largest improvements in life expectancy?
If less babies die they are more likely to live a lot longer in the future making the life expectancy a lot higher.
-How was the way race is collected changed in the 2000 census?
In 2000, you were able to identify as more than one race. Before, you could only self-identify as a single race
-What is a life table, and how is it used? What are some uses beyond human life expectancy calculations?
It's an actuarial table showing the # of people who die at any given age, ("probability of death") from which life expectancy is calculated. Measures patterns in marriage, migration, school dropouts, labor force participation, fertility, and family planning (*You can also use them to estimate pension plans, cost of providing warranties)
-When were the first cases of AIDS discovered in the US?
June 1981
-What are Disability Adjusted Life Years (DALYs), and how and why are they used?
Measure of overall disease burden expressed as the number of years lost due to ill health, disability, or early death. They put more weight on additional years of health life lived at younger ages because they value younger lives more than older. -gives a total picture of morbidity and mortality impacts due to specific causes. -one DALY shows one year of healthy living lost, helps to distinguish diseases that cause early death opposed to those that do not kill but cause disability
-Does life expectancy have to be calculated from birth?
No
-What is oral rehydration therapy, and how has it been useful in declining mortality, particularly in developing countries?
ORT is therapy used to treat children with excessive diahrrea. It is a liquid solution of electrolytes and water that helps lessen the amount of stool and prevents dehydration. It helps to rehydrate the body.
-What did WWII have to do with penicillin?
Penicillin was first used in WWII which helped reduce the number of deaths and amputees
-How has population aging in MDCs and LDCs differed in terms of the timing, pace, and level of socioeconomic development? What are some of the potential implications of these differences?
Population aging has been increasing more rapidly in LDC, making it harder for them to deal with population growth, aging policies, etc. It affects low SES classes in LDCs moreso than MDCs. MDC population has been growing for a longer time period, making them more well-adjusted and prepared for the effects of a growing elderly population.
-What role did public health advances play in the mortality decline in more developed countries over time? What are some examples of public health advances that helped reduce mortality?
Reduced # of sanitation related illnesses and improved nutrition Ex: Removal of waste in rivers, building of covered sewers, purification of drinking water (removed cholera and waterborne dieases)
-What was the "epidemiological transition"?
Reduction in risk of dying in infancy and childhood from infectious diseases and higher risk of dying from "degenerative" or "Chronic" diseases later in life. Transition related to improved, social, economic, and health conditions associated with modernization/development
-What do we mean by social determinants of health?
The complex, integrated, and overlapping social structures and economic systems that are responsible for most health inequities (ex: economic policies, development agendas, social norms and policies, political systems)
-What has happened to life expectancy in the United States and other Western, industrialized countries over time? When were the largest improvements made? What about in less developed countries?
The past century shows a steady increase of 15-20 years in life expectancy. The largest span of improvement was only two years. In less developed countries, the increase in life expectancy was much more rapid than more developed countries due to an increase of public health medicine. The largest increase was from the 1950s-1970s.
-What is morbidity, and why is it important to study? How does morbidity differ from mortality?
The prevailing condition of disease in a population, where disease includes both disability and illness -Importance: Disease is universally disliked. Close relationship between morbidity and population processes (including mortality as well as fertility and migration) Differ from mortality - mortality is death rate. Morbidity refers to the state of being diseased or unhealthy within a population
-Where does the United States rank in terms of infant mortality among industrialized countries? What are some possible explanations for this?
US lags behind many other MDRS; many preterm births but unclear why. Disparities not just with other countries but within US by race/ethnicity
-Why is the Census mandated in the Constitution?
Used for reapportioning House of Representatives seats; determining voting district boundaries; allocation of government services; conducted every 10 years
-Where do Vaupel and Olshansky agree future improvements in mortality will need to come from to extend life significantly? How is this different from the improvements in mortality seen in the 20th century?
Vaupel and Olshansky both agree that we need to improve mortality among the elderly instead among the young. Much of the previous progress was due to decreases in infant mortality.
-What is the difference between incidence and prevalence? Why might you be interested in one over the other? In the sink diagram we discussed in class, what does the water coming in from the faucet represent? How about the level of water in the sink at a particular moment? And what about the water going out through the drain?
Water in the sink represents existing cases of disease (prevalence). The water being added into the sink is considered the new cases of the same disease (incidence). When the water leaves the sink through the drain it doesn't necessarily mean mortality, it can also mean there is some sort of recovery because there may be a cure and it can also mean that the person with the disease left the community. When prevalence is high it may indicate that the incidence is high, or it lasts for a long time or even both. When prevalence is low it indicates that incidence is low, or there is a short duration (cure or death) or even both. Incidence--> new cases, frequency of cases over a given time Prevalence-->total cases Water from faucet-->incidence Level of water--> prevalence Out the drain--> cured or dead
-What are some of the causal mechanisms through which socioeconomic status might affect health?
behavioral factors: smoking, obesity pyschological factors: depression, low self efficacy access to medical care: higher socioeconomic status=better access to medical care and more likely to get treatment and help in health related problems housing/environment: better education (higher socioeconomic status) --> better health early life conditions: lower socioeconomic status (poorer countries) --> less health across the board -people with lower socioeconomic status have a greater chance of getting heart disease, HIV/AIDS, breast and cervical cancers (due to behavioral, psychological, access to medical care, housing, environment, early life conditions, etc)
-What is infant mortality and why is it so important to demographers? What has happened to infant mortality over time?
definition: number of deaths during the first year of life per 1000 births (important to measure populations health) -there were major improvements over time with infant mortality and life expectancy is longer -in past due to lack of nutrition, poor health knowledge and practices, hygiene and not-so-great medical developments -now we have vaccinations, oral rehydration therapy, etc.
-What are some of the implications of longer life expectancies for things like retirement and social security? Are the potential effects equal across all groups in society?
retirement--> the age is going to have to increase to keep enough people working to support the non eligible workers... peeps can no longer retire at age 65... retirement age needs to rise as our life expectancy rises... this means there will be a large decline of the population of prime working age... creates substantial pressures on public finances and reduces the living standards social security--> becoming increasingly more difficult to support our elders... as age rises we will have to support them for longer years (and we can't even sufficiently support our older nation now) ***more so a problem with elders receiving no other form of money or income because it is barely enough to survive