Exam 1

Causes of death vs. actual causes of death

- Causes: diseases of the heart, malignant neoplasms (cancers), chronic lower respiratory disease, cerebrovascular diseases (stroke), unintentional injuries (accidents), Alzheimer's disease, diabetes mellitus, nephritis/nephrotic syndrome/nephrosis, influenza and pneumonia, and intentional self-harm (suicide). - Actual causes: tobacco, poor diet and physical activity, alcohol consumption, microbial agents, toxic agents, motor vehicles, firearms, sexual behavior, and illicit drug use.

Earliest era (plagues and miasmas) to the modern era of Health Promotion.

- 18th century: characterized by industrial growth, overcrowded cities, unsanitary water supplies, unsafe/unhealthy workplaces; 1790 first US consensus; 1793 yellow fever epidemic in Philadelphia; 1796 Edward Jenner created vaccination to smallpox; 1798 Marine Hospital Service was formed to deal with disease that was occurring onboard water vessels; 1799 large cities like Boston, Philadelphia, New York, and Baltimore had municipal boards of health. - 19th century: living conditions still unsanitary, better agricultural methods led to improved nutrition; federal government's approach to health problems was laissez faire; health quackery thrived; 1854 John Snow stopped the cholera epidemic by discovering the source the water pump - predated the discovery that microorganisms can cause disease; predominant theory of disease at the time was miasmas theory: vapors, or miasmas, were the source of many diseases; 1850 Lemuel Shattuck created a health report that outlined the public health needs for the state of Massachusetts (marks beginning of public health era); 1862 Louis Pasteur's germ theory provided death blow to theory of spontaneous generation; 1876 Robert Koch developed criteria necessary to establish that a particular microbe causes a particular disease; 1856 in US first law prohibiting adulteration of milk, 1864 first sanitary survey, 1872 American Public Health Association was founded, 1878 Marine Hospital Service gained new powers, 1890 pasteurization of milk, 1891 meat inspection, 1895 and 1899 nurses were hired by industries and schools, 1895 septic tanks, 1900 Major Walter Reed announced yellow fever came from mosquitos. - 20th century: much growth and development; 1900-1920 Upton Sinclair's book The Jungle drew attention to unsafe working conditions and created the Pure Foods and Drugs Act of 1906; 1910 movements for healthier workplace conditions were well established; first national-level volunteer health agencies; 1918 first school of public health was established at Johns Hopkins University, and the birth of today's school health instruction; 1912 Marine Hospital Service became US Public Health Service; states got health departments; 1922 first professional preparation program for health education specialists at Columbia University by Thomas Wood; 1933 FDR New Deal provided funds for public health agencies; 1935 Social Security Act marked government's major involvement in social issues like health; 1937 National Cancer Institute; during WWII CDC was established; 1946-1960s rapid hospital construction; 1950 vaccine to prevent polio; Eisenhower's heart attack led his physician to suggest exercise and many people listened; 1965 Medicare and Medicaid were passed; 1977 CDC report said 48% of premature deaths were due to lifestyle and behavior; 1979 creation of Healthy People.

Know a few branches of the US Department of Health and Human Services and be able to identify the core responsibility area of these branches.

- CDC: primary federal agency for conducting and supporting public health activities in the US. - FDA: responsible for protecting the public health by assuring the safety, efficacy and security of human and veterinary drugs, biological products, medical devices, our nation's food supply, cosmetics, and products that emit radiation; advancing the public health by helping to speed innovations that make medicines more effective, safer, and more affordable and by helping the public get the accurate, science-based information they need to use medicines and foods to maintain and improve their health; regulating the manufacturing, marketing and distribution of tobacco products to protect the public health and to reduce tobacco use by minors; and ensuring the security of the food supply and by fostering development of medical products to respond to deliberate and naturally emerging public health threats. - NIH: seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.

Chronic vs. acute diseases, chain of infection, methods of disease transmission, and agents that cause infection.

- Chronic disease: a disease or health condition that lasts longer than 3 months. - Acute disease: a disease that lasts 3 months or less. - Chain of infection: pathogen (1), human reservoir (2), portal of exit (3), transmission (4), portal of entry (5), establishment of disease in new host (6). - Modes of transmission: direct - immediate transfer of disease agent between infected and susceptible individuals (EX: kissing); indirect - disease transmission involving an intermediate step (EX: airborne). - Preventing transmission: 1. pasteurization, chlorination, antibiotics, antivirals, disinfectants. 2. isolation, surveillance, quarantine, drug treatment. 3. gowns, mask, condoms, hair nets, insect repellants. 4. isolation, hand washing, vector control, sanitary engineering, sneeze glass, sexual abstinence, safe sex. 5. masks, condoms, safety glasses, insect repellants. 6. immunization, health education, nutrition promotion, sexual abstinence. - Agents that cause infection: viruses, rickettsiae, bacteria, protozoa, fungi and yeasts, and nematoda (worms).

Historical Figures in Public Health

- Clara Barton: established American Red Cross in 1881. - Walter Reed: announced yellow fever was transmitted through mosquitos. - John Snow: stopped the spread of cholera in 1854 by discovery the source of the disease was the community water pump. - Louis Pasteur: 1862 germ theory provided death blow to spontaneous generation theory. - Robert Koch: 1876 established guidelines that a certain microbe is necessary to cause a certain disease. - Edward Jenner: 1796 successfully created a vaccination to smallpox.

Be able to name these different types of organizations

- Community health: the health status of a defined group of people and the actions and conditions to promote, protect, and preserve their health (EX: local health department). - Public health: what we as a society do collectively to assure the conditions in which people can be healthy (EX: Medicare/ Medicaid). - Quasi-governmental: receive funding from both public and private sources, and carry out functions expected of government agencies without government supervision (EX: American Red Cross). - Philanthropic: dispensing or receiving aid from funds set aside for humanitarian purposes (EX: boy/girl scouts). - Voluntary: contributions by people in the local community, endowments, bequests, and, in some instances, fee collected by the agency for its services are the primary source of revenue (EX: American Cancer Society). - Private: healthcare and medicine provided by entities other than the government (EX: Kaiser). - Non-profit: A corporation or an association that conducts business for the benefit of the general public without shareholders and without a profit motive (EX: American Medical Association). - Corporate health: programs designed to nurture wellness in workers, regardless of the work environment (EX: home health care).

Epidemiology and prevention and control of diseases vocab

- Endemic: a disease that occurs regularly in a population as a matter of course. - Epidemic: an unexpectedly large number of cases of an illness, specific health related behavior, or other health-related event in a particular population. - Pandemic: an outbreak of disease over a wide geographical area such as a continent. - Rate: the number of events that occur in a given population in a given period of time (natality=birth, morbidity=sickness, mortality=death) - Crude rate: a rate in which the denominator includes the total population. Crude death rate: the number of deaths (from all causes) per 1,000 in a population in a given period of time. Bruce birth rate: the number of live births per 1,000 in a population in a given period of time. - Attack rate: an incidence rate calculated for a particular population for a single disease outbreak and expressed as a percentage. - Incidence rate: the number of new health-related events or cases of a disease in a population exposed to that risk during a particular period of time, divided by the total number in that same population. - Prevalence rate: the number of new and old cases of a disease in a population in a given period of time, divided by the total number in that population. - Case-specific mortality rate: the death rate due to a particular disease. - Propionate mortality rate: the percentage of overall mortality in a population that is attributable to a particular cause. - Age-adjusted rate: used to make comparisons of relative risks across groups and over time when groups differ in age structure. - Specific rate: a rate that measures morbidity or mortality for a particular population or disease. - Years of potential life lost: the number of years lost when death occurs before the age of 65 or 75. - Disability-adjusted life years: a measure for the burden of disease that takes into account premature death and loss of healthy life resulting from disability.

What are the layers of the social ecological model?

- Individual (interpersonal): knowledge, attitudes, skills. - Interpersonal: family, friends, peers, social networks. - Institutional: where we learn, work, and worship. - Community: places we live, and relationships among organizations. - Societal/ Public Policy: rules, regulations, and laws that govern our society.

What are the factors that influence the health of a community?

- Physical factors: - Geography: can be directly influenced by its altitude, latitude, longitude, and climate (EX: tropical countries have parasitic/infectious diseases, temperate climates increase obesity and heart disease). - Environment: quality is directly related to the quality of our stewardship of it (EX: depleting natural resources). - Community size: the larger the community, the greater its range of health problems and the greater its number of health resources (EX: larger communities have more health professionals and better health facilities). - Industrial development: can have either positive or negative effects on the health status of a community (EX: provides added resources for community health programs, but may bring pollution and occupational injuries). - Social and cultural factors: - Beliefs, traditions, and prejudices: Beliefs can influence policy maker's decisions like specific health behaviors and smoking; traditions influence types of food, restaurants, retail outlets, and services available in a community; prejudices can create violence and crimes. - Economy: reductions in health and social services (EX: economic downturn means less revenue, which means fewer contributions to charities, which means programs like welfare have to alter guidelines so not as many people are eligible)> - Politics: those in political office can improve or jeopardize the health of their community by the decision they make. - Religion: may limit type of medical treatment that can be received, or food that can be eaten. - Social norms: influence can be positive or negative and change over time (EX: smoking in 1940s-60s was socially acceptable, now in 21st century not acceptable). - Socioeconomic status: differences in individual and community level have independent effects on health (EX: poor people in inner cities live in worse environments with pollution, crime, and violence). - Community organization: the process by which community groups are helped to identify common problems or change targets, mobilize resources, and develop and implement strategies to reach their collective goals. - Planned action - Enrichment - Development - Building consensus - Politics - Individual behavior: contributes to health of the entire community. - Concerted effort of many to make a program work (EX: herd immunity: the resistance of a population to the spread of an infectious agent based on the immunity of a high proportion of individuals). - Sustainable action by many

What are the factors that affect the health of a community? Be prepared to analyze and discuss these factors in relation to a health problem that exists in your current community or your hometown.

- Physical factors: not enough walking paths, easy to drive because get places quicker. - Social and cultural factors: majority of people drive everywhere, most people get cars as soon as they turn 16, wealthier town so many parents buy their children cars. - Community organizing: nobody has ever brought up the issue of creating a walking community. - Individual behavior: someone has to be willing to start the process and others will follow.

Terms associated with control of disease

- Quarantine: limitation of freedom of movement of those who have been exposed to a disease and may be incubating it. - Isolation: the separation of infected persons from those who are susceptible. - Immunizations: protect against specific diseases.

Healthy People 2020

- Vision: a society in which all people live long, healthy lives. - Mission: strives to identify nationwide health improvement priorities; increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress; provide measurable objectives and goals that are applicable at the national, state, and local levels; engage multiple sectors to take action to strengthen policies and improve practices that are driven by the best available evidence and knowledge; and identify critical research, evaluation, and data collection needs. - Overarching goals: attain high-quality, longer lives free of preventable disease, disability, injury, and premature death; achieve health equality, eliminate disparities, and improve the health of all groups; create social and physical environments that promote good health for all; and promote quality of life, healthy development, and healthy behaviors across all life stages.

Public health 4 core functions

1. Assessment: assessment, monitoring, and surveillance of local health problems and needs, and of resources for dealing with them. 2. Policy development: policy development and leadership that fosters local involvement and a sense of ownership that emphasizes local needs and that advocates equitable distribution of public resources and complementary private activities commensurate with community needs. 3.mAssurance: assurance that high-quality services, including personal health services, needed for protection of public health in the community are available and accessible to all persons; that the community receives proper consideration in the allocation of federal, state and local resources for public health; and that the community is informed about how to obtain public health, including persona health services, or how to comply with public health requirements. 4. System Management.

What are the 5 goals or core functions of public health? How the public health system works and services are provided. Be able to give examples.

1. Prevent epidemics and the spread of disease: EX: flu immunization, wash hands, sick people stay home. 2. Advocate and encourage healthy behaviors: address top 3 killers - heart disease, cancer, stroke. Ex: pay attention to what is being brought into the community like fast food restaurants; tobacco education; Healthy People 2020 goals. 3. Protect against environmental hazards: drinking water, swimming/recreational bathing, lead abatement, waste management, food safety, hazardous materials, vector control (contracts through animals). 4. Respond to disasters: earthquakes, floods, fires, bioterrorism, send first responders to other countries with disasters. 5. Promote accessible, appropriate, and responsive health services to all: low income medical care (Medicaid), healthy families (low cost, comprehensive medical, vision, and dental insurance), and clinic services (family planning, immunizations, communicable disease screening).

Top Public Health Achievements of the 20th Century

1. Vaccination 2. Motor vehicle safety 3. Safer workplaces 4. Control of infectious diseases 5. Decline of deaths from coronary heart disease and stroke 6. Safer and healthier foods 7. Healthier mothers and babies 8. Family planning 9. Fluoridation of drinking water 10. Recognition of tobacco use as a health problem

The neonatal mortality period is death that occurs up to

28 days after birth.

A low-birth-weight infant is one that weighs less than

5.5 pounds at birth.

All children should be immunized at regular healthcare visits beginning at birth through age

6.

Communicable disease model

Agent must be present for the disease to occur, the host is any susceptible organism invaded by an infectious agent, and the environment includes all other factor (physical, biological, or social) that inhibit or promote or permit disease transmission.

An example of a community gatekeeper is

All of the above (politician, teacher, member of the clergy).

If you were to use the Social Ecological Model to propose a change that would benefit people in the community where you have lived what change would you propose and what actions could be taken at each level to promote the health of your community?

A change that I would promote in my community is having a more walk friendly environment. There are sidewalks for the most part all over town, but not necessarily everywhere, and not many people walk anywhere at all. Clayton, CA is a very small town that probably only takes 10 minutes to drive across the entire town. Everything in town is easily accessible to walking if we could just convince people to be more naturally active. The way I would implement this change of creating a more walk friendly community would first start at the personal level. I could hang fliers around town to provide people with more knowledge about the health benefits of just having moderate physical activity (like walking) 30 minutes a day. Then I would move to the interpersonal level and I could reach out to well respected members of the community to help me develop a network for people to get in contact with others who want to adopt walking as a new mode of transportation. This way individuals might be more likely to walk places if they have someone to do it with them. Then I would move to the institutional level and contact the local middle schools and high school to have assemblies to teach children about the benefits of walking instead of driving everywhere. Then I would move to the community level and try to host an event downtown where the entire community could get together and talk about how they could implement walking into their new daily regimen, and provide a time and place for people to create new relationships with other people who share their concern with staying healthy. In this stage I could also try to get a professional to come give a speech on the importance of physical activity to the entire town. Lastly, I would move to the Public Policy level where I could try to get the town to provide new sidewalks or trails to make sure that no matter where anyone would want to walk in town, there are safe paths for them to do so.

Title X was signed into law to provide

Family planning services and help to all who wanted them but could not afford them.

The secretary of Health and Human Services is

Appointed by the President.

Program goals

Are more encompassing than objectives.

If you were planning a social ecological intervention at the interpersonal level to address distracted driving among Cal Poly students which of the following would be the best choice?

Ask club officers, team captains, ASI President and board members, RAs serve serve as role models by publicly taking the pledge to not text or call while driving.

Healthy gestational weight gain - IOM guidelines resurgent diseases like whooping cough (Pertussis and Measles) and the link to anti-vaccination movement and the vaccine-autism myth.

Average women should gain 1 pound per week, but an overweight/obese woman should only gain 1/2 pound per week.

The underlying concept of the social ecological model is best reflected in which of the following statements?

Behavior is influenced by the interplay between personal, social, and environmental factors.

The national health survey that is a state-based telephone survey of the civilian, non institutional, adult population that seeks to ascertain the prevalence of high-risk behaviors is the

Behavioral Risk Factor Surveillance System.

Prior or existing programs that have not gone through critical research and evaluation studies and thus fall short of best practice criteria but nonetheless show promise in being effective are known as

Best experiences.

A study that seeks to compare those diagnosed with a disease with those who do not have the disease for prior exposure to specific risk factor is a

Case/control study.

Which agency maintains records, analyzes disease trends, and publishes epidemiological reports on all types of diseases?

Centers for Disease Control and Prevention (CDC).

For community organizing/building and health promotion programming efforts to be successful, people must

Change their behavior.

The process of determining the preferred number and spacing of children in one's family and choosing the appropriate means to achieve this preference defines

Family planning.

The leading modifiable cause of low-birth-weight during pregnancy is

Cigarette smoking.

In an effort to promote more daily physical activity in children you have been assisting the school board, PTA and the city council to develop initiatives that will encourage parents to allow their children to walk or bike to and from school. This is an example of influencing behavior at what level of the Social Ecological Model?

Community level.

When using criteria of causation, the criterion that addresses the issue of whether the association been reported in a variety of people, exposed in a variety of setting, and can have repeatable results by other researchers is

Consistency.

Be able to describe what epidemiologists do and what their efforts help us to understand in relation to health and disease.

Epidemiology is the study of the distribution and determinants of health-related states or events in specified populations. Epidemiologists study the occurrence of disease or other health-related conditions or events in defined populations. They help us evaluate everything from the effectiveness of vaccines to the possible causes of occupational illnesses and motor-vehicle deaths. They also evaluate the effectiveness of programs already in existence and plan to meet anticipated needs for personnel, equipment, or facilities.

True or false? A disease that lasts three months or less is a chronic disease.

False.

True or false? An unexpectedly large number of cases of an illness, specific health-related behavior, or other health-related event in a particular population defines a pandemic.

False.

True or false? Choosing to eat wisely, regularly wearing a safety belt, and visiting the physician are examples of community health activities.

False.

True or false? FMLA provides paid family leave for women and men after the birth of a child.

False.

True or false? Health education and health promotion are terms that can be used interchangeably.

False.

True or false? Mammography for breast cancer is an example of primary prevention.

False.

True or false? The center of multi causation disease model is behavioral choices.

False.

True or false? The number of years of healthy life expected, on average, in a given population is the disability-adjusted life years (DALYs).

False.

True or false? The process for people to gain mastery over their lives and the lives of their communities is social capital.

False.

True or false? Years of potential life lost (YPLL) is the single best way to prioritize prevention and control efforts.

False.

If those who initiate community organization are members of the community, then the movement is referred to as

Grass-roots.

How could you explain the concept of Health Related Quality of Life? Can you name some measures of general health status? How could you explain what is meant by the determinants of health? How could you explain what is meant by disparities in health?

HRQOL is a broad multidimensional concept that usually includes self-reported measures of physical and mental health. Some measures of general health status include life expectancy, healthy life expectancy, years of potential life lost, physically and mentally unhealthy days, self-assured health status, limitation of activity, and chronic disease prevalence. Determinants of health are all the factors that affect health outcomes. Disparities in health are all the variation in health between races and ethnicities.

Most voluntary health agencies exist at the

Local, state, and national levels.

The final steps in community organizing/building include

Looping back.

What you view as the most important public health concern today?

I believe the most important public health concern today is promoting physically active communities. By physically active I don't mean that people have to be involved in a sports team or do intense and rigorous workout for an hour and a half everyday. I mean just the daily activities people should be doing everyday like walking or biking instead of driving everywhere if possible, moving around and not just sitting behind a desk or on a couch all day, and just being active in your daily activities. The reason I see this as such an important concern in promoting health today is because studies have proven that just 30 minutes of moderate activity a day have been linked to positive health outcomes. Also in every blue zone throughout the entire world, in those specific communities, the members who live their are very active in their daily life. Whether it is walking everywhere, working in the garden, or just doing playing outside instead of watching tv, the people who live in these blue zones always get some sort of physical activity in their everyday actions, and these areas have been proven to live much longer and healthier lives than much of the rest of the world. Therefore, in order to address this public health concern, we as health professionals need to address this head on and start promoting physically active communities and inform people of the major benefits to moderate physical activity.

The evaluation that focuses on immediate observable effects of a program is

Impact evaluation.

What is the World Health Organization and what does it do?

Organization that works to improve overall health within the United Nation's system. Works with other countries to help facilitate getting their health programs up and running and support their health programs and help make sure they work effectively.

Infant and maternal mortality rates and risk factors. Disparity in maternal and infant mortality. Which populations are at higher risk? Benefits of prenatal care versus risks of lack of prenatal care. What are the leading causes of childhood morbidity and mortality?

Infant mortality rate in the US is about 7 per 1,000 live births. Maternal mortality rates are increasing due to stroke eclampsia and hemorrhage. Black women are 4 times more likely than white women to die from pregnancy complications. Non-hispanic black and hispanics between 18-19 are at the highest risk for maternal pregnancy-related deaths. Infants raised by a single parent have an increased risk of adverse birth outcomes, low birth weight, higher infant mortality, and are more likely to live in poverty. Single mothers usually have lower education, lower incomes, and greater dependence on welfare assistance. Infant's health depends on mother's health and her health behavior during pregnancy, mother's level of prenatal care, quality of delivery, infant's environment after birth, nutrition, and immunizations. Infant mortality is a measure of a nation's health. It has declined due to improved disease surveillance, advanced clinical care, improved access to health care, better nutrition, and increased education. Leading causes of infant death are congenital abnormalities, preterm/low birth weight, and SIDS. Childhood mortality is the most sever measure of health in children. It has declined in the past few decades. The leading cause of death in children is unintentional injuries, specifically motor vehicle related deaths. Childhood morbidity is caused by unintentional injuries, child maltreatment, and infectious diseases.

In conducting a school based childhood obesity program using an ecological approach, which level would be addressed by targeting the relationships between family members?

Interpersonal.

In planning an intervention using the social ecological model, which level would you be addressing by focusing on attitudes, beliefs, and knowledge.

Intrapersonal level.

Barriers to school health education include

Lack of time in the school year/day.

What is MCAH? Be able to define maternal, infant, and child health. How are maternal, infant, and child health indicators of the health of a society?

MCAH is healthy living and is promoted for mothers and their families through programs for reproductive health, family planning, pregnancy, birth defects, infants, children, teens, and human stem cell research. It encompasses the health of a women of childbearing age from pregnancy, labor and delivery, and the postpartum period, and the health of the child prior to birth through adolescence. Recently, adolescent health got added to this because more and more teenagers are becoming pregnant. Maternal, infant, and child health are indicators of the health of a society because they are indicators of the effectiveness of disease prevention and health promotion services in a community. If women who are giving birth are not pregnant, there is a higher chance of their children not being heathy, thus creating an unhealthy society. So we can look at the health of women and their children to predict the overall health of a community.

An infant death is the death of a child younger than

One year.

The majority of unintentional deaths in children are the result of

Motor vehicle crashes.

Which agency is a leading medical research center, and the federal focal point for medical research in the US?

National Institutes of Health (NIH).

One's race and age are examples of

Non-modifiable risk factors.

Coordinated School Health Program

Organized set of policies, procedures, and activities designed to protect, promote, and improve the health and well-being of students and staff. Administrative leadership is very important for the program to run efficiently. Nurses can be very helpful, but often schools don't have resources to hire full-time nurses. Teachers are very important because they often spend more time with children than their parents. Components of a CSHP include administration and organization, school health services, healthy school environment, school health education, counseling, psychological, and social services, physical education, school nutrition services, family/community involvement, and school-site health promotion for staff.

An outbreak of disease over a wide geographic region is a

Pandemic.

The capability of a communicable disease agent to cause disease in a susceptible host is

Pathogenicity.

Those served by family planning clinics funded by Title X are predominantly

Poor.

The number of new and old cases of a disease in a population in a given period of time, divided by the total number in that population is the

Prevalence rate.

A temporary group that is brought together for dealing with a specific problems is a

Task force.

What is prevention? What are the different levels of prevention?

Prevention is trying to keep any disease from spreading. - Primary prevention: we use this method before the person gets the disease; aims to prevent the disease from occurring. (EX: immunizations, anti-smoking campaigns, restaurant inspections, physical activity campaigns). - Secondary prevention: after the disease has occurred, but before the person notices that anything is wrong; attempts to detect disease at it incipient (beginning) stages (EX: cancer screening, blood pressure screening, tuberculosis skin tests, smoking cessation). - Tertiary prevention: targets the person who already knows he/she has the symptoms of the disease; wants to make people with the disease healthy again and able to do what they used to do; prevents damage and pain from the disease; prevents the disease from causing other problems (complications); slows down the disease (EX: treatments).

Health education and health promotion programs are examples of

Primary prevention.

Nongovernmental health agencies are funded primarily by

Private donations.

The mission of professional health organizations is to

Promote high standards of professional practice for their specific professions.

Be able to explain what is the purpose of the National School Lunch program. How is the program funded?

Purpose of the NSLP is to provide reduced/ free breakfasts, lunches, and snacks to children who are in families at or below the poverty level. The lunches provide nutritional food to children who may not have any other way of getting these types of foods because their parents just can't afford it. The program is funded through the government and schools get reimbursed for every meal that meats the reimbursement guidelines.

The number of events that occur in a given population in a given period of time is a

Rate.

Be able to list some of the more recent changes (last 10 years) to the School Lunch program and food policy on public school campuses in CA. Be able to explain what else you think could be done to improve healthy eating in the school setting and why you think your suggestions have merit.

Recently the IOM stated that they want to reduce the amount of sodium in children's diets. Currently a child's average daily intake of sodium is 2-3 times more than the DRI. The IOM recommends reducing sodium intake 22.7 % of the upper limit at breakfast. They have a 10 year goal with decreases every 2 years in order to allow food companies to change their products and to allow children's taste buds to adjust to liking food with less sodium in it. The IOM also stated that children need to start eating fruits and vegetables at every meal and need to transition to whole grains instead of processed whites or wheats. One thing I think can be changed about high school eating environment in particular is not allowing kids to go off campus ever during the school day. Kids will often leave at lunch and bring back massive amounts of fast food, but if all high schools implemented closed campuses and actually enforced this, it would greatly reduce the amount of access kids could have to unhealthy foods during the day.

The first step in the process of community organizing/community building is

Recognizing the issue.

Health screenings are important measures in

Secondary Prevention.

Relationships and structures within a community that promote cooperation for mutual benefit describes

Social capital.

The contributions of religious groups to community health have been

Substantial.

An example of a quasi-governmental health organization is

The American Red Cross.

What are the National Institutes of Health? What is "Healthy People" 2020?

The NIH works to discover new ways to improve health and save lives. The "NIH's mission is to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability." Their goals to accomplish this mission statement include developing creative techniques, finding new and improved research strategies, and applying their knowledge to improve health and save lives; using all resources available to prevent disease at any cost; never stop learning to improve medical knowledge to keep the public healthy and ensure the economic health of the Nation; and making sure to work under the highest level of responsibility, ethics, and accountability. Healthy People provides science-based, 10-year national objectives for improving the health of all Americans. For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to: encourage collaborations across communities and sectors, empower individuals toward making informed health decisions, and measure the impact of prevention activities.

True or false? In the chain of infection, a disease-producing agent leaves its reservoir though a portal of exit.

True.

True or false? In using a generic approach for community organizing, the first step in the process is recognizing the issue.

True.

True or false? Physical factors affecting community health include geography, community size, and industrial development.

True.

True or false? The early diagnosis and prompt treatment of diseases before the disease becomes advanced and disability becomes severe is secondary prevention.

True.

True or false? Those who control, both formally and informally, the political climate of the community are referred to as gatekeepers.

True.

True or false? Those who the health promotion is intended to serve are the priority population.

True.

The activities of philanthropic foundations are unique because

They have money to give away.

Be able to provide suggestions for approaches that would promote healthy eating, more physical activity and healthy school environments from the preschool - grade 12 levels.

To promote healthy eating, students should be taught in school at a very early age about the importance of eating healthy and all the positives that will accompany it. Schools should also provide more fruit and vegetable options and less processed foods so kids have an easier time choosing to eat healthy foods. To promote physical activity schools can put on competitions because kids at all ages are competitive and love competing against there friends to win, so this will give them an opportunity to be active.

True or false? Politics and religion are examples of social and cultural factors affecting community health.

True

True or false? A community is a group of people who have common characteristics.

True.

True or false? An endemic disease is one that occurs regularly in a population but does not occur at unexpectedly high levels.

True.

True or false? Community capacity is the characteristics of communities that affect their ability to identify, mobilize, and address social and public health problems.

True.

Raising money to fun their programs, providing education, providing services to those affected, and advocacy are the basic objectives of

Voluntary health agencies.

Childhood diseases and immunizations. Public health and nutrition programs to promote the health of mothers, infants, and children. Health insurance and health care programs for children. Be able to name some groups that advocate for the health and welfare of children.

Women, infants, and children (WIC) is a supplemental food program for women, infants, and children sponsored by USDA. CHIP is another organization to help women, infants, and children and it targets uninsured children whose families don't qualify for Medicaid. Title X is the only federal program dedicated solely to funding family planning and related reproductive healthcare services. It is designed to provide services to low-income women, and is the nation's major program to reduce unintended pregnancy. Other groups that advocate for children are the Children's Defense Fund (CDF), the United Nations Children's Fund (UNICEF), which is the only organization of the United Nations assigned exclusively to children, and the American Academy of Pediatrics (AAP).

The largest and most visible international health agency is the

World Health Organization.