Global Final
The Bismarck Model
'Sickness Funds' usually joint financed by employers and employees through payroll deductions - Everyone is covered, no associated profits Tight regulation gives government much of the cost-control of Beveridge systems
Partial Access
Americans can access health care services • Through their employers Under a government health care program • By buying insurance using private funds By paying for services privately By obtaining charity or subsidized care
Risk factor
An aspect of behavior or lifestyle, an environmental exposure, or a hereditary characteristic that is associated with an increase in a particular disease, injury, or other health condition.
Who discovered Bacteria?
Antony Leeuwenhoek 1670
Non-modifiable risk factor
Any risk that cannot be reduced or controlled by an intervention
Who discovered the bacteria that causes leprosy?
Armauer Hansen 1873
If a mother dies due to accidental or incidental causes, would this death be counted in a maternal mortality rate? a. Yes/True b. No/False
B
In measuring the "Global Burden of Disease" what composite indicator of health status is most commonly used? a. Life-expectancy at birth b. Disability adjusted life year c. Infant mortality rate d. Health-adjusted life expectancy
B
The Mandela Washington Fellowship Program was created under whose presidential administration? a. Trump administration b. Obama administration c. Bush administration d. Clinton administration
B
True or False. According to the readings, chronic obstructive lung diseases, lower respiratory infections, and diarrheal diseases (the 3rd, 4th, and 5th leading causes of death respectively in low- and middle-income countries) are not consequences of environmental factors. a. True b. False
B
True or False. The word "accident" implies predictability in the epidemiologic sense and amendable by prevention. a. True b. False
B
What is the leading cause of death among adolescents (ages 10 to 19 years)? a. Interpersonal violence b. Road Injury c. Self-harm d. HIV/AIDS
B
Which of the following is an example of improved water sources? a. Small bore sewers and sewer connection b. Borehole and swells c. Septic tank and ventilation-improved latrine d. All of the above
B
Which type of air pollution is attributed to respiratory symptoms, including coughing and shortness of breath? This type of air pollution commonly affects the very young and very old. a. Household air pollution b. Ambient air pollution c. Household and ambient air pollution d. None of the above
B
Types of Pathogens
Bacteria, virus, Fungus, and parasite
Tropical Zone
15 depress north and south of the equator, where the most infections disease are located examples malaria and TB
How many vaccines were there by 1900?
2 virus vaccines- smallpox and rabies and 3 bacterial vaccines- typhoid, cholera, and plague
How many fungi are pathogenic to humans?
300
According to the Global Burden of Disease Study 2010, which income level of countries account for a greater percentage of mental health related disability adjusted life years (DALYs)? a. High-income countries b. Low- and -middle income countries c. The percentage is equal between high-income countries and low-and-middle income countries d. None of the above
A
Approximately, what percentage of the US budget do we allocate to foreign aid, specifically international development and humanitarian assistance? a. 1% b. 24% c. 15% d. .001%
A
Based on the example from lecture, the horse is considered what component of the epidemiologic triad of disease? a. Agent b. Human c. Environment d. Vector
A
In the United States, which sex is more likely to commit suicide? a. Males b. Females c. Both
A
The government provides and finances healthcare through tax payments. Most hospitals and clinics are owned by the government; doctors are either government employees or independent contractors. This system tends to have low cost per capita and countries such as New Zealand and Scandinavia follow this health care system model. a. The Beveridge Model b. The Bismarck Model c. The National Health Insurance Model d. The Out-of-Pocket Model
A
This refers to the increase in the earth's average temperature that has been observed and the consequences that might be associated with this rise in temperature? a. Climate change b. Global warming c. Ozone depletion d. None of the above
A
True or False. According to the morality data from "death of despair"; higher education, specifically a 4-year college degree or more, appears to be a protective factor among Non-Hispanic white males and females. a. True b. False
A
True or False. Overall, mental health is a bigger global problem than either cancer or cardiovascular disease? a. True b. False
A
True or False. There is a greater burden of disease in low- and middle-income countries resulting from household air pollution compared to ambient air pollution. a. True b. False
A
When understanding injuries as non-random events, what is the best epidemiologic model? a. Utilizing the Hadden Model to investigate the interaction between host, agent, and environment through three temporal phases. b. Prayer and divine intervention c. Examine the probably of the injury occurring again d. None of the above
A
______ is characterized/ defined as "...the unilateral transfers of US resources by the US government to or for the benefit of foreign entities." a. US foreign aid b. Peace Corporations c. Both d. Neither
A
Which of the following examples would align with "Delay in decision to seek care" of the Three Delays Model? Choose all that apply. a. Status of women in the society b. Distance to healthcare facilities c. Inadequately trained and poorly motivated staff d. Poor experience with the healthcare system
A and D
Modifiable risk factor
A risk factor that can be reduced or controlled by intervention, thereby reducing the probability of disease
How is child mortality defined? A.The death of a child regardless of age per 1,000 live births B.The number of children under one year old who die per 1,000 live births C.The death of a child prior to their fifth birthday per 1,000 live births D.The number of deaths to infants under 28 days of age in a given year per 1,000 live births in that year
C
In 2008, what country had the highest rate of crashes per vehicle in the world? HINT: This country also reported having one crash every minute in 2011. a. China b. Libya c. India d. Brazil
C
In the United States, which segment of the population has the lowest life expectancy? a. White males b. Black males and females c. Black males d. White females
C
What is the epidemiologic transition? a. A shift in the pattern from noncommunicable disease to communicable disease b. A shift in mortality trend from high mortality to low mortality c. A shift in pattern of disease from infectious disease to chronic disease d. A shift in fertility trend from low fertility to high fertility
C
What segment of the population is disproportionally affected by environmental health issues because of their social and economic status in society? a. Elderly people b. Wealthy people c. Relatively poor people d. Children
C
Which of the following statements are correct? a. Intentional injury is a subset of injury for which there is no evidence of predetermined intent b. Examples of intentional injury include road injury, exposure to forces of nature, and fires c. Examples of unintentional injury are poisoning, drowning, and falls d. Unintentional injury is a subset of injury for which there is evidence of predetermined intent
C
Which of these are NOT one of the Millennium Development Goals? a. Reduce child mortality; improve maternal health b. Ensure environmental sustainability c. Make cities and human settlements inclusive, safe, resilient, and sustainable d. Eradicate extreme hunger and poverty and develop a global partnership for development
C
What countries use the National Health Insurance Model?
Canada, Taiwan, South Korea
What disease are caused by Fungi?
Candida, a yeast found in the human gut Cryptococcus neoformans can cause a very severe form of meningitis and meningo-encephalitis; most Cryptococcus live in the soil and rarely effect humans Athlete's foot Yeast infection
Quest for Quality
Definition and measurement are not clear- cut. - Increased pressure to develop quality standards - Demonstrate compliance
Neglected Tropical Disease
Diverse group of communicable (infectious) diseases that prevail in the tropics and subtropics in 149 countries
What factor(s) contributed to the spread of disease, especially infectious disease, throughout the world? a. Globalism b. Colonialism c. Urbanization d. A and C e. All of the above
E
Which populations are most vulnerable to the effects of climate change? a. Everyone will be affected b. Low-income women and children c. People living in low- and middle-income countries. d. Farmers e. Both B and C
E
Determinants of Health
Factors that contribute to the social patterning of health, disease, and illness
Who discovered tuberculosis bacillus and cholera vibrio?
Robert Koch 1882 and 1883
Viruses
Smaller than bacteria, 20-300 nanometers Require a host cell to reproduce Wide variety of shapes and structures
Disease Caused by viruses
Smallpox AIDS Influenza Mumps Ebola Rabies
Imperfect Market
The U.S. has a quasi-market where health care is partially managed by free markets.
High technology
The U.S. is a hotbed of research and innovation in new technology.
medical mycology
The study of pathogenic fungi
Free market
Providers do not collude to fix prices. Prices are set by the interaction of supply and demand. Inverse relationship between quantity of services demanded and price of services. Equilibrium is achieved without interference.
Preventive Care
Public Health Programs community programs personal lifestyle Primary care settings
Sex
biological
Co-morbidity
can also refer to a situation where diseases interact, meaning that when they exist together, one or both diseases are more severe or more likely to result in mortality.
Salmonella
can cause food poisoning, typhus
Streptococcus
can cause strep throat, pneumonia
Mycobacterium tuberculosis
causes tuberculosis
Gender
cultural
Acute care
hospitals
What did Edward Jenner do in 1796?
inoculated a 13 year old boy with cowpox, and demonstrated immunity to smallpox
Subacute care
outpatient surgical centers
Least safe abortions
performed 15% of the time Untrained personals using dangerous methods ( foreign objects and herbal concoctions)
Less Safe abortion
performed 30% of the time Performed by trained providers but through the use of unsafe methods or safe methods without appropriate information
Safe abortions
performed 55% of the time as those performed by trained healthcare providers with proper equipment, correct technique, and sanitary standards.
Chronic Care
primary care settings specialist provider clinics Home Health long-term care facilities self-care alternative medicine
What countries have the out-of-pocket Model?
rural regions of Africa, India, China, and South America
What happened in 1798?
the first smallpox vaccine was produced
What health care model is the U.S.?
We have elements of all four models here in the United States
non-communicable disease
are a group of diseases that share common risk factors, common causes, and determinants; THEREFORE, they share opportunities for prevention.
Infections Disease
are caused by pathogenic* microorganisms/agents, such as bacteria, viruses, parasites, or fungi; the diseases can be spread, directly or indirectly, from one person to another.
Zoonotic Disease
are infectious diseases of animals that can cause disease when transmitted to humans. They can be caused by bacteria, viruses, parasites, or fungi. Examples include hanta virus, trichinosis, rabies, and venomous snakebite
What are the 5 dimensions of performance?
- Quality - Access - Efficiency - Equity - Healthy Lives
What are the 10 basic characteristics of the U.S. Healthcare systems?
1. No central agency governs the system. 2. Access to health care services is selectively based on insurance coverage. 3. Health care is delivered under imperfect market conditions. 4. Third-party insurers act as intermediaries between the financing and delivery functions. 5. The existence of multiple payers makes the system cumbersome. 6. The balance of power among players prevents any single entity from dominating the system. 7. Legal risks influence practice behavior of physicians. 8. Development of new technology creates an automatic demand for its use. 9. New service settings have evolved along a continuum. 10.Quality is not accepted as an unachievable goal.
The National Health Insurance Model
Cost control through considerable market power Cost control through supply
"Transmission by insects that breed in water or bite near water" is which category of water-related infections? a. Waterborne b. Water-washed (or water- scarce) c. Water based d. Water-related insect vector
D
According to the chapter reading on child health, what is the number one leading causes of death for children under the age of 5 years in high income countries? a. Diarrheal diseases b. HIV/AIDs c. Malaria d. Preterm birth complications
D
Globally, which mental disorder is most prevalent? a. Anxiety disorder b. Bipolar disorder c. Schizophrenia d. Depression
D
This model consists of both private sector providers and government-run insurance programs that every citizen pays into. Cost is controlled through considerable market power and supply. Countries such as Canada, Taiwan, and South Korea follow this model. a. The Beveridge Model b. The Bismarck Model c. The Out-of-Pocket Model d. The National Health Insurance Model
D
Through the lens of an injury epidemiologist, which of these terms are correct? a. Car crash b. Car accident c. Car collision d. Both A and C e. All of the above
D
What was established from the Act of 1912? a. The Secretary of Labor Department b. The department of Health and Human Services c. Child labor laws d. US Children Bureau
D
Why is addressing global mental health issues challenging? a. Low-resource countries lack the availability of effective treatments b. Cultural issues surrounding mental health and therapeutic intervention c. There are many cures and prevention solutions available d. Both A and B e. All of the above
D
_______ can be define as the external physical, chemical, and microbiological exposures and processes that impinge upon individuals and groups and are beyond the immediate control of individuals. a. Community b. Atmosphere c. Social milieu d. Environment
D
What are the Determinants of Helath?
Genetics and biology, Helath behaviors, Health care, Physical environment, and socioeconomic environment
What countries use the Bismarck Model?
Germany, France, Belgium, the Netherlands, Japan, Switzerland, and some Latin American countries
What countries use the Beveridge Model?
Great Britain, Spain, most of Scandinavia, New Zealand, Hong Kong, Cuba
Continuum of Services
Health care is not confined to the hospital. Additional settings
The Beveridge Model
Healthcare provided and financed by government through tax payments.
Double Burden
It means that we are observing an emerging epidemic of chronic diseases AT THE SAME TIME AS we are working on the "unfinished agenda of infectious diseases" and problems related to maternal and infant health.
The Out-of-Pocket Model
If you can afford it, you get medical care - If you cannot, you may stay sick and/or die
Characteristics of a system
Interactivity of independent elements to form a complex whole Harmonious and orderly interaction Coordinated methods and procedures Operation for the purpose of a shared outcome, or outcomes
Disease caused by Bacteria
Leprosy (Hansen's Disease) Syphillis, Chlamidia Tetanus
Who proposed the germ theory?
Louis pasteur 1850 heated milk to kill bacterial pathogens
Bacteria
Microorganisms, typically 0.5-5 micrometers in length (much larger than a virus) Shapes include spheres, rods, and spirals Present in nearly all habitats Single-cell, but some group together or form chains Can be killed with antibiotics, bleach, soap/water
Why are women more susceptible to STD's?
More exposed mucosal surfaces Often, asymptomatic of disease Less likely to seek treatment
No central Agency
Most developed nations have national health care U.S. has mostly private financing and delivery. Private health care, hospitals, and physicians are independent of government.
Third-Party Insurers and Payers
Patient is first party. Provider is second party. Intermediary is third party
Primary Care
Physician's office or clinic Community Health Centers Self-care Alternative Medicine
What are the seven characteristics of the U.S. Healthcare system?
Political climate Economic development Technological progress Social and cultural values Physical environment Population characteristics (demographics, health trends) Global influences
Litigation Risks
Practitioners engage in defensive medicine.
