PHLT 303: Exam 2
what is the definition of an urban area?
"a place and the adjacent densely settled surrounding territory that together comprise a minimum population of 50,000 people"
what is the definition of densely settled surrounding territory?
"one or more contiguous block having a population density of at least 1,000 people per square mile."
what is the average income of the rural poor?
$2 or less per day
Urbanicity
- is urban living -Measures are usually in contrast to non-urban living compared to urban area.
Tobacco Notes
-34 million adults smoke -secondhand smoking effects 58 million nonsmokers -tobacco is highly assocaited with cancer, cardiovascualr disease, COPD
What is a Public Health Assessment?
-A public health assessment goes beyond a risk assessment by including data on actual exposure in a community
What are the Health Impacts of the Built Environment?
-Addressed health hazards associated with crowded conditions -Recently addressing increased air pollution and reduced exercise on automobiles -Healthy Communities movement is addressing social implications
How can culture be used to understand inequality?
-Can be measured as differences between societies (reflecting differences in cultural consensus) -Or as differences between individuals and groups within a society (reflecting degrees of cultural consonance)
What are the roles of state public health agencies?
-Collecting vital statistics -Running a public health laboratory -Licensing health professionals =Administering nutrition program -Regulating health facilities -Drinking water regulation -Administration of the state Medicaid program -Office of the medical examiner
How can public health take the lead in mobilizing community partnerships to identify and solve health problems?
-Community bases Participatory Research (CBPR) -Community - Oriented Public Health (COPH)
What are the 6 Sequential steps of the COCP?
-Community definitions -Community characterizations -Prioritizations -Detailed assessment of the selected health problem -Intervention -Evaluation
Physical environment refers to?
-Consists of underlying community factors and mediating, proximate-level factors including -ex: housing, roads -community facotors -Proximate level factors:
How could we show the rural poor to increase their incomes?
-Empower with vocational skills development -Teach women how to sew and sell their handmade garments -Encourage cultural arts and crafts to generate incomes
How could bring the classroom to the village help?
-Engage all students -Enable hands on learning -Inspire critical thinking -Encourage classroom participation
What is the COCP (community-orienteed primary care model)
-Expand the delivery of health services from a focus on the individual to also include an additional focus on the needs of communities -To connect the common commitments of public health and medicine
Rural life is very labor intesntive, girls are expected to help with what the daily chores?
-Fetch water -Prepare meals -Clean -Care for family members
By empowering the next generation it it out goal to educatate to rural poor about?
-Good healthcare practices -How to improve incomes -The value of an education
What are the Multiple barriers to education?
-High cost of tuition; distance to schools -Rural girls are twice as likely as urban girls to be out of school. -54.4 million girls are out of school in the Sub Sahara; 9 million may never enter a classroom
What are the roles of local public health agencies?
-Immunizations -Communicable disease surveillance and initial investigation of outbreaks -Communicable disease control -Inspection and licensing of restaurants -Environmental health surveillance -Coordinating public health screening -Tobacco control -Public health preparedness and response to disasters
Why do rural areas serverly lack healthcare serivces?
-Most rural villages are located far from healthcare facilities -Expensive and unaffordable -Families usually resort to home remedied
Why do we care about increasing access to physcial avtivity facilities?
-Obesity -Diabetes -Heart disease -such as adding greenspaces for better health
Probelms with the United Nation conference in Cairo in 1994
-Opposition to contraception by Catholics and Muslims -Rich and poor countries blame each other -20-year Programme of Action (empowering women to choose to have fewer children)
example of community factors
-Population density -Land use patterns
Demonstrating awareness of a patient's culture can:
-Promote trust -Better health care -Lead to higher rates of acceptance of diagnoses -Improve treatment adherence
Is There a Process of Accreditation of Health Departments?
-Public Health Accreditation Board developed a voluntary accreditation process -Health departments that serve over 75% of the U.S. population are accredited or in the process of being reviewed for accreditation
Urbanization
-Refers to changes in the size, density and heterogeneity of cities over time -Related to movement of populations and resources from rural and suburban areas to urban areas and traditionally has been linked to industrialization -A process that involves the emergence and growth of cities
What is social captial?
-Refers to the features of social relationships or organizations that can facilitate collective action aimed at the improvement of society (ex:as aggies we have an extreme social capital) -sturcutal social captial -cognitive social capital
what are the approaches to address complex interactions between humans and physical environment?
-Risk assessment -Public Health assessment -Ecological assessment -Interaction analysis
How are we exposed to the physical environment?
-Skin -Respiratory tract -Alimentary or digestive tract -Genital-urinary tract
Physical environment refers to?
-The built environment -Contamination/pollution -geological and climate conditions
What is an altered envrionment?
-The result of added chemicals, radiation, and biological products
What are the goals and roles of governmental public health agencies?
-To prevent epidemics and the spread of diseases -To protect against environmental hazards -To prevent injuries -To promote and encourage healthy behaviors -To respond to disasters and assist communities in recovery -To ensure the quality and accessibility of health services
Rural areas lack what type of services?
-Water -Sanitation -Power -Transportation
Materialism
-associated with lesser satisfaction of human psychological needs and thus diminished well-being -Materialism seems to breed unhappiness, depression, anxiety, anger, isolation and alienation
Individualistics
-focus on "I" -values autonomy -make personal choices as right -emphasize on individual achienvements -lesser influence of group views and values
Collectivistic
-focus on "we" -promot relatedness and interdependence -family -values respect and obedience -emphasize on group goals and values
What are the 4-step risk assessment process?
-hazard identifications -dose response assessment -exposure assessment -risk characterization
what are three characteristics of Urbanizations?
-intensity -rate -durations of change
Social epidemiology defines culture as
-looks at "subcultures" or "differences" -ex: ethnic and racial
Examples of Nongov. organizations.
-red cross -doctors without Borders & Physicians for Social Responsibility -Advocacy groups -private organizations (american cancer society, american heart association) -CARE and Oxfam international -private foundations
what are three distinct concepts that different between an urban and rural envrionment?
-social environment -physical environment -resources instructor Shaped in turn by local, municipal, national, and global forces and trends
What 4 modifiable risk factors shared between these 4 noncommunicable diseases cardiovascular, diabetes, and cancer.
-tobacco use -unhealth diets -physcial inactivity -harmful use of alcohol
Earth's temp has risen by how much since the early 20th century?
1 degree fahrenheit
What are the three core functions?
1. Assesment 2.Policy development 3.Assurance
What are the 4 critieria for a screening program?
1. THE DISEASE PRODUCES SUBSTANTIAL DEATH AND/OR DISABILITY 2. early detection imporves outcomes 3. feasible testing strategy for screening 4. screening is acceptable in terms of harms, costs, and patient acceptance.
What are the three catagories of the physcial envrionment?
1. Unaltered environment: "Natural" 2. Altered environment: 3. Built environment:
what are the four depletion of global resources?
1. fresh water -unevenly distrubuted -small precentage is earths water is suitable for human use 2. fuel -deforestaion of land 3. arable land -amount of land under cultivations is declining 4. food from the sea -decline of fish and shellfish
what is some example of how does culture interacts with social determinants to moderate or amplify health?
1. health behaviors - social norms 2.social status -Culture may also interact with socio-economic status to moderate or amplify its health effects 3. Religion
What are the three main ways urban is viewed in the context of productions of health and diseases?
1. urban area 2.urbanicity 3.urbanization
_________% of the world's ______________ people live in sub-Saharan Africa ________ countries in Africa have literacy rates of 50% and below
27% of the world's illiterate people live in sub-Saharan Africa 7 countries in Africa have literacy rates of 50% and belo
____ out of 10 girls marry before the age of 18.
4 out of 10
Over _______ million people live in rural areas.
645
examples of Proximate level factors:
Air and water quality Dust Noise level Local climate Pestilence Physical safety and security
what are examples of the built envrionment?
Air quality Transport Housing/building Food access Clean water Green spaces
Although progress has been made in some countries, it is even and the agenda remains finished. True or false?
Although progress has been made in some countries, it is UNEVEN and the agenda remains UNFINISHED.
intentional injuries
Brought on by purpose, whether the injury is self-inflicted or meant for others -bioterrorism -suicide
Key federal health agencies in the DHHS
CDC and STDSR NIH FDA HRSA AHRQ SAMHSA HIS
What does it mean to be between cultures?
Children often struggle with being 'between cultures'- balancing the 'old' and the 'new' They essentially belong to both, whereas their parents often belong predominantly to the 'old' culture
China, with __________% of the world's population, has become the ____________ emitter, with __________% of greenhouse gases
China, with 19.3% of the world's population, has become the leading emitter, with 26% of greenhouse gases
How could be break these barriers and teach the rural poor?
Community based programs: -Work with locals that speak the language -Include community members in program development -Use visuals and examples -bring the classroom to the village
cultural competence
Cultural competence describes the ability of systems to address problems in populations that have diverse values, beliefs and behaviors, including tailoring the solutions to meet the populations' social, cultural, and linguistic needs EX: doctors taking into consideration of your religious values before further medical attention
What Are the Roles of Federal Public Health Agencies?
Department of health and human services (HHS) is the central public health agency of the federal gov.
Policy Development
Developing evidence-based recommendations and other analyses of options to guide implementation 3. Inform, educate, and empower people about health issues 4. Mobilize community partnerships and action to identify and solve health problems 5. Develop policies and plans that support individual and community health efforts
What Other Government Agencies Are Involved in Health Issues?
EPA, OSHA, Department of Homeland and Security, Department of agriculture, Departments of Housing and Urban Development, Department of Energy
Anthropology defines culture as:
Eschews broad definition of "culture" -details of population patterning and distribution, individual and group differences, and culture as local knowledge and daily life -View culture as a system of meanings, collective influences that shape people's lives
Culture may be composed of:
Ethnicity Language Religion and spiritual beliefs Gender SES Age Sexual orientation Geographic origin Group history Educations Upbringing Life experience
What is an Ecological Risk Assessment?
Examines the impacts of contaminants on ecological systems -chemicals -raditation -altered crops, ect.
Adding together the relative risks of two exposures may provide a bad approximation of their effects. True or false?
FALSE Adding together the relative risks of two exposures may provide a GOOD approximation of their effects
Greater than 40% now lives in the cities. True or false
FALSE 50%
mortality from all causes increased by 54% between 1900 and 2010. True or false?
FALSE! mortality from all causes decreased 54% between 1900 and 2010.
Psychosocial factors are not a significant pathway by which inequality and other social determinants affect health. True of false?
FALSE! THEY ARE SIGNIFICANT
Culture is not learning and passing on between generations. True of false?
False culture is Learned and passed on through generations
Health professionals and patients are influenced by their _______________ cultures
Health professionals and patients are influenced by their respective cultures
Sociology defines culture as:
Individualization is a dominant theme
"Cultural consonance"
Is the extent to which individuals demonstrate in their own beliefs and behavior the cultural consensus (FOCUS ON HOW YOU CHOOSE TO PRACTICE FROM THE OVERALL CULTURE)
The speed of culture evolution varies and depends on...
It increases when a group migrates to and incorporates components of a new culture into their culture of origin
Social status __________________ and ____________________ might highlight the costs of being poor or of low social status by making money more important to social position and weakening social bonds and group identity.
Materialism and individualism might highlight the costs of being poor or of low social status by making money more important to social position and weakening social bonds and group identity
What is the Burden of Disease Due to the Physical Environment?
Measuring the impact of the physical environment is difficult because there are many types of impacts and effects are often subtle
NON-COMMUNICABLE DISEASES _______________ disease Represent the majority of causes of death and disability in most _________________ countries WHO estimates that ______ million people per year die (71% of deaths) globally Chronic and mental health conditions account for 90% of $3.5 ________________ dollars spent on healthcare ________________ _____/10 adults in U.S. have 1 chronic condition while ________/10 have two or more
NON-COMMUNICABLE DISEASES Chronic disease Represent the majority of causes of death and disability in most developed countries WHO estimates that 41 million people per year die (71% of deaths) globally Chronic and mental heealth condistions account for 90% of $3.5 Trillion dollars spent on healthcare annually 6/10 adults in U.S. have 1 chronic conditions while 4/10 have two or more
Assessment
Obtaining data that defines the health of the population overall and specific groups within 1. Monitor health status to identify and solve community health problems 2. Diagnose and investigate
Unintentional injuries
Occur not on purpose -Motor vehicle collisions -Drowning -Falls -Fires
One way of thinking about cultures is whether they are primarily '_____________' or '-_________________'
One way of thinking about cultures is whether they are primarily 'collectivist' or 'individualist'
Over 61% of _____- _________ ___________ live in remote, rural areas.
Over 61% of Sub Saharan Africa live in remote, rural areas
Assurance
Oversight responsibility for ensuring key components of an effective health system 6. Enforce laws and regulations that protect health and ensure safety 7. Link people to needed personal services and ensure the provision of health care when otherwise unavailable 8. Ensure the provision of a competent public and personal healthcare workforce 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services
What is "The Population Bomb" and who wrote it?
Paul Ehrlich criticized DDT for being too effective in reducing death rates and thus contributing to "overpopulation."
Populations stabilization comes with _____________________ and _______________ viability.
Population stabilization comes with modernization and economic viability
what is the built envrionment?
Result of human construction ex: roads, housing, transportation, placees to eat, public spaces ect.
How Does Risk Assessment Address the Impacts of the Physical Environment?
Risk assessment attempts to evaluate the impact of environmental exposures one at a time -Measures the types and magnitudes of the impacts
What is Risk?
Risk assessment is a formal process that aims to measure the potential impact of known hazards -how great the chance that someone will be harmed by the hazard
Risk assessment aims to take into account the inherent danger of the exposure as well as?
Route Timing Quantity
Benefit of religion.
Social support Existential or spiritual meaning Sense of purpose Coherent belief system Moral code that religion provides
what are some negative effects of health?
Stress Depression Anxiety Isolation Insecurity Hostility Lack of control
Disease prevention storybooks (developed by public health students at Texas A&M) describe:
Symptoms Home treatment When it's time to see the doctor Myths & misconceptions
COST-EFFECTIVENESS COMBINES ISSUES OF BENEFITS AND HARMS WITH ISSUES OF FINANCIAL COSTS. True or false?
TRUE
Fewer that 1/10 adults in the US est enough fruits and veggies? True of false?
TRUE
Living in areas with walkable greenspaces has shown increased longevity among elderly urban residents (independent of their age, sex, martial status, and socioeconomic ) status. True or false?
TRUE
Urban can be definied as towns, cities, villages, municipal areas. Urban can be describe differently depending on where you live. True or false?
TRUE
***Perceptions and emotions influence health outcomes. True of false?
TRUE!! Ex: cultural factors --> psychosocial pathways --> psychological well-being --. Behavioral and psychological pathways --> physical health
The U.S. has _____% of the world's _________________ but contributes _________% of ___________________ gases
The U.S. has 5% of the world's population but contributes 16% of greenhouse gases
social environment
The collective norms and values shared by members with the interpersonal relationships and interactions hared among urban residents and communities can both harm and promote health -ex: people in the elevator -ex: social norms
What is the connection between culture and health?
The influence of culture affects: -Perceptions of health -Illness and death -Beliefs about causes of disease -Approaches to health promotio -How illness and pain are experienced and expressed - -Where patients seek help -The types of treatment patients prefer
what is the actual leading cause of preventable diseases. diability, and death in the US?
Tobacco
6/10 YOUNG PEOPLE AND 5/10 ADULTS CONSUME A SUGARY DRINK ON A GIVEN DAY. True of false
True
ADDITIONAL EPIDEMIOLOGICAL AND BIOLOGICAL RESEARCH IS NEEDED TO UNDERSTAND CAUSES OF NON-COMMUNICABLE DISEASES. True of false?
True
AS A PUBLIC HEALTH PRACTITIONER, WE TYPICALLY ENCOURAGE EXISTING INTERVENTIONS THAT HAVE BEEN PROVEN TO WORK AND HAVE BEEN TESTED. (EVIDENCE-BASED PROGRAMS) True or false?
True
Collaboration needs to be an everyday effort and not just a requirement for emergencies or epidemics. True of false?
True
Countries already substantially urbanized usually richer, with better health infrastructure and conditions for better health. True or false?
True
Global statistics on urban may be based on population density or specific urban features. True or false?
True
Lack of education causes millions of preventable deaths and life altering diseases of children. True of false?
True
More rapidly urbanizing countries found mainly in low- and middle-income countries. True or false?
True
Often public health assessments are very controversial. True or false?
True
Public health agencies must coordinate local, state, federal, and global public health agencies into one unified effort? True or false?
True
Urbanization is not dependent on the definition of urban per se, but on the dynamics of agglomeration (coming together) of individuals. True or false?
True
What is the purpose of screening?
USED TO DETECT DISEASES AT AN EARLY STAGE. THE GOAL IS TO DETECT THE DISEASE EARLY TO IMPROVE TREATMENT OUTCOMES.
Urbanicity may also be defined as "_________________ _______________" in a dataset.
Urbanicity may also be defined as "percent urban" in a dataset.
How is the all-hazards approach keeping the population safe?
Using actual exposure systems, communication systems, evacuations, and an organized healthcare response
Psychology defines culture as:
Views a broader approach to culture: individualism and collectivism remain a major research theme -Psychologists characterize culture as loose,tight,vertical, or horizontal that shape culture
what is an exmaple of a global health organization/agency?
WHO
Multiple risk factors reduction
a stategy to intervene simultaneously on a series of risk factors, all of whick contribute to a particular outcome -most effetive when there are constellations, or groups of risk factors that cluster in definable groups of people or a single individual
Research is found where in the core public health functions?
all of them 10. Research for new insights and innovative solutions to health problems
What is the definition of Hazard?
anything that can cause harm
What is the difference between binge drinking and heavy drinking?
binge drinking: 4 or more (women, 5 or more (men) Heavy drinking: more than 8 (women) more than 15 (men)
The greenhouse eeffect is from ???
burning fossil fuels
What is perhaps the most threatening effect of population growth?
climate change
Cultural traditions in rural areas encourage __________ marriage.
early
Diabetes is not a non-communicable disease. True of false
false
Higher levels of social capital associated with negative health outcomes. True or false?
false Higher levels of social capital associated with POSITIVE health outcomes
It is not important to train local women to be our educators; so that knowledge can be shared and lives can be saved. True or false?
false! it is important
What is an Interaction Analysis Approach to Environmental Diseases?
implies that to understand and control the impacts of environmental exposures, it is necessary to take into account the effect of two or more exposures
How can public health agencies partner with health care to improve the response to health problems?
improve -evidence-based thinking -Cost-effectiveness -Providing quality services to the entire population -eliminating health disparities -Computerized and confidential data systems -COCP
What is a multiplicative interaction?
interactions between exposures that lead to an impact much greater than this estimat
Culture
is a pattern of ideas, customs and behaviors shared by a particular people or society. that is contantly evolving.
How does the altered envrionment impacts the entire ecosystem?
it leaves long-term and mostly irreversible consequences
What are Municipal structures:?
law enforcement which are shaped by national and international policies (legislation and cross border agreements)
______________ was nature's way of controlling the population growth.
malaria
1. urban area
particular in an urban area
Cognitive social capital
refers to the quality of those relationships
Structural social capital
refersto the quantity of relationships -the number of relationships
What is the definition of urban?
territory, population, and housing units within specific size and density parameters
what is the meaning of Non-urban?
those that are outside those parameters
Culture is dynamic and evovling. True of false?
true
Culture is often identified 'symbolically', through language, dress, music and behaviors. True of false?
true
Culture is shared among those who agree on the way they name and understand reality. True of false?
true
Publich health assessment addresses not just the risks in a specific location, but also the risks to large numbers of individuals and often to the population as a whole? True or false?
true
there are no innternational plan for improvement has been reached? True or false
true