Term
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Definition
-prevent spread of disease and epidemics
-protect againts env hazards
-prevent injuries
-promote healthy behaviors, mental health
-assure quality of care |
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Term
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Definition
-assessment (identify problems, eval effectivness of health services)
-policy development (support, inform, educate, mobilize)
-assurance (assure a competent public health and person care workforce, enforce laws related to health and safety, link ppl to care when needed) |
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Term
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Definition
| on-the-ground neighborhood level work, focuses on needs of smaller group, usually employed by NGO, city, county |
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Term
| Public health nutritionist |
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Definition
| works at population level, manages policy/eval programs, usually employed by state, federal, county agency |
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Term
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Definition
| state of complete physical, mental, and social well-being, and not merely the absence of infirmity (WHO) |
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Term
| Public health and health care continuum |
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Definition
primary - risk, holistic med
secondary - onset, illness, holistic
teriary - treatment, diagnosis, rehabilitation, outcome, illness, tradition med, holistic med |
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Term
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Definition
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Term
| six leading causes of death in US |
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Definition
| heart disease, cancer, chronic lower resp disease, accidents, diabetes |
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Term
| social-ecological approach |
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Definition
| individual -> family -> community/neighborhood -> state/region -> society/policy -> national/international |
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Term
| Freudenberg - toward improving health promotion |
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Definition
-access to primary health care
-increase knowledge
-reduce risky behavior
-increase social support
-reduce stigma
-advovate health policies
-improve physical env
-meet basic needs
-create supportive env
-reduce income inequality |
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Term
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Definition
demos = people
graphein - to write
"study of growth, density, and vital statistics of human populations" |
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Term
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Definition
-data about nation's pop and economy
-began 1790, 4,000,000
-1850: more individuals counted as part of pop, 23,191,876
-1900: 45 stars, 76,000,000
-1920: 48 stars, 106,000,000
-1950: 48 stars, 152,000,000
-2010: 309,162,581 |
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Term
| which race expected to decrease over time? |
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Definition
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Term
| Current consensus collects? |
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Definition
-religion
-birth rate
-life expectancy
-immigration/migration
-infant mortality
-unemployment |
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Term
| dietary factors are association with ___ of the leading 10 causes of death |
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Definition
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Term
| Healthy ppl overarching goals |
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Definition
1) increase quality and years of healthy life
2) eliminate health disparities |
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Term
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Definition
-28 focus areas
-467 specific objectives
-10 leading health indicators |
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Term
| 10 major public health issues |
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Definition
1) PA
2) overwt obesity
3) tobacco
4) substance abuse
5) responsible sexual behavior
6) mental health
7) injury and violence
8) env quality
9) immunization
10) access to health care |
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Term
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Definition
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Term
| epidemiology from classic greek |
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Definition
-epi: among, upon
-demos: ppl
-logos: study of
"the study of what is among the ppl" |
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Term
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Definition
| study of the distribution and determinants of health-related states (disease) and their frequencies in human populations |
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Term
| father of modern epidemiology |
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Definition
| John snow - traced cholera deaths to the Broad Street pump in London in 1854 |
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Term
|
Definition
-population
-distribution
-determinants |
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Term
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Definition
1) select sample
2) observe
3) count cases
4) related cases to pop at risk
5) make comparisons
6) develop hypothesis
7) test hypothesis
8) draw scientific inferences
9) conduct experimental trials
10) intervene and evaluate |
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Term
| Bradford Hill's criteria for causation |
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Definition
1) temporal relationship
2) strength
3) dose-response relationship
4) consistency
5) plausibility
6) consideration of alternate explanations
7) experiment
8) specificity
9) coherence |
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Term
|
Definition
quantitative
-continuous
-disrete (integers)
-ordinal (generalized)
-categorical (groups)
nominal - quality
-categorical |
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Term
| nutr epi studies desinged to... |
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Definition
-generate hypothesis
-describe risk factors and health outcomes
-study causal linkages between risk factors and diseases |
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Term
| ecological or correlational |
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Definition
-disease at pop level
-aggregate
-good to generate hypotheses
-quick and cheap |
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Term
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Definition
| = (pop exposed w/ outcome x pop exposed no outcome) / (pop unexposed w/ outcome x pop unexposed without outcome) |
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Term
| Odds ration ex. calculation |
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Definition
pop exposed with = 3
pop exposed w/out = 7
pop not exposed with = 1
pop not exposed w/out = 9
odds ration = (3x9)/(1x7) = 3.86 -> pop with 4 times as likely to get cancer as ppl in unexposed |
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Term
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Definition
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Term
| Health Professionals Follow-up study |
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Definition
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Term
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Definition
|
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Term
| 1982 Pelotas birth cohort |
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Definition
->99% of births in city that yr
-> 10 folow-ups to date
- still going strong |
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Term
|
Definition
-numerator: number of abc during a time period
-denominator: pop at risk, defined
-multiplier at end (usually 1,000) |
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Term
|
Definition
-measure a group free of disease
-incidence rate calcuatled by when proportion of pop has the disease
-counts NEW events |
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Term
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Definition
| -TOTAL number of cases at a given time (both new and old |
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Term
|
Definition
-1909: USDA Food Supply Series
-1930's: USDA Household Food Consumption survey
-1960's: "War on Poverty" to deal with chronic hunger and malnutr
-1970's: NHANES starts |
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Term
| National Health Interview Survey |
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Definition
-since 1957
-principal source of civilian pop
-tarcks national goals and identifies new areas of need
-data collected from representative sample of US
-via personal in-person interviews |
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Term
| Behavioral risk factor surveillance system |
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Definition
-CDC
-personal risk behavior stats
-knowledge, attitudes, behavior, diet and health
-state level collection
-YRBSS - in school youth, one 45 min class period |
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Term
| Nati'l college health risk behavior survey (NCHRBS) |
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Definition
-nationwide: 20.5% overwt
->40% females on a diet
-63% exercise
-7% take pills
-4% laxatives, bulimia episodes |
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Term
|
Definition
-US not an outlier with respect to how fast health care costs are rising
-costs rising steadily over time
-US spends more than 1/2 of health care dollars on hospital and physician services |
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Term
| How health care in US is financed |
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Definition
-workers contribute about 27% of total
-private insurance: 68.8% of americans
-public: 13.7% medicare, 12.4% medicaid, 3.5% military
-uninsured: 15.6% |
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Term
| most likely to be uninsured |
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Definition
| 18-24 -> 25-34 -> 35-54 -> 55-64 -> under 18 |
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Term
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Definition
-traditional fee-for-service plans
-group contract insurance
HMOs or PPOs |
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Term
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Definition
=health maintenance organization
-permiums rising but profits not |
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Term
| capitation (health insurance) |
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Definition
| predetermined fee paid per enrollee per month to participating health care provider |
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Term
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Definition
-joint state and federal
-low income, 65+, blind, ppl wiht disibilities
-hospital services, drs, some tests, some skilling nursing homes, home health, family planning, children checkups diagnosis treatment |
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Term
| where does prevention money savings come from |
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Definition
| -reduced hospital admissions and reduced complications requiring a dr visit |
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Term
| HOD affordable care act goals |
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Definition
-coverage for uninsured
-improve affordability and stability of insurance
-slow growth and health care costs |
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Term
| HOD -ACA opportunities and challenges |
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Definition
Opportunities
-increased utilization of preventive care
-reimbursement to RDs
-wellness incentives
-granst
-labeling
Challenges
-not specifically include RD
-no appropriations
-competitors |
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Term
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Definition
| drastic decrease between $0 GDP to $5,000 GDP, then levels out a bit |
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Term
| Relative risk of premature death, USA |
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Definition
| steady decrease as family income increases |
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Term
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Definition
prevalence: black > white > hispanic > asian
incidence highest in whites, deaht rates highest in blacks |
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Term
| Policy to change health care disparities |
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Definition
1) policies that affect ladder (education for all, min wage increases, income distribution)
2)policies that blunt adverse consequences of being at the lower end of the ladder (housing, food availability, affordable housing, traffic safety) |
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Term
|
Definition
-biological/chemical
-built
-social |
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Term
| psychological factors of obesity |
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Definition
| stress, racism, anger, etc |
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Term
| Proximate causes of globesity |
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Definition
1) energy balance equation
2) genetic factors
3) dietary composition
4) PA level
5) feeding behavior
6) endocrine factors
7) inflammation
8) psychological factors
9) social and env factors |
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Term
|
Definition
=process of an individual organism growing organically
- develop course of humans distinct
- fat deposition in various stages of life matters |
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Term
| Programming and tracking (globesity) |
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Definition
-Programming - long term phenotypic effect of env factors acting during critical windows of develop (studies - pregnancy under nutr)
-tracking - stability of expressed phenotype |
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Term
| Economic costs of obesity |
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Definition
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Term
| who is most overwt and obese? |
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Definition
| lowest income and least educated |
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Term
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Definition
| -> increased productivity and efficiency -> increased food supply, decreased cost, and increased dependability |
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Term
| how many crops get subsidies? |
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Definition
-8
-corn, soybeans, wheat, cotton, rice... |
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Term
| food security at 3 levels |
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Definition
-household (access by all family at all times to enough food)
-community (prevention oriented to support develop of sustainable, community-based methods to improve access of poor to healthy foods)
-world: universal rt to food |
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Term
|
Definition
-49.1 million, including 16.7 m children
-nearly 25% lived in 'very low' food security
-situation got worse from 2007 to 2008 |
|
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Term
| which types of households are most impacted by food insecurity? |
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Definition
- poverty: below FPG 42.4%
- single mom: 37% (number 1 predictor of FI)
- hispanic: 27%
- black: 26% |
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Term
|
Definition
-1930s: fed started buying and distributing excess food commodities
-food stamp program (experimental)
-1946 National School Lunch Act (in WWII 70% of boys who grew up with poor nutr were rejected from the draft) |
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Term
|
Definition
-food stamps
-state determines details regarding distribution off food benefits and eligibility
-FNS provides funding |
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Term
| Child nutr reauthorization act |
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Definition
| -improve nutr service programs, promote healthy choices, ensure free/reduced price lunch benefits for those who qualify |
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Term
| National School lunch act |
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Definition
-generally implemented by state educational agency
-individual schools prepare, serve meals
-school districts receive a reimbursement for meals that meet USDA menu standards
-originated in 1946
-price established per lunch |
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Term
| national school lunch program participants |
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Definition
- 18 m children
-99% public schools participate
-not all children who are eligible participate |
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Term
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Definition
-1966 pilot program
-subsidizes with cash reimbursements and commodities
-not all students participated who qualified |
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Term
|
Definition
-USDA surplus commodities
-emergency food assistance program
-disaster feeding
-food distribution program on Indian reservations |
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Term
| Welfare reform: welfare to work |
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Definition
-personal responsibility and work opportunity reconciliation act of 1996
-work based system with a 5 yr limit on benefits (must work after 2 y program)
-includes temporary assistance, for needy families (TANF) program |
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Term
| Historical review of federal nutr guidelines |
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Definition
-1st guideline 1902
-1st 'buying' guide 1916 (5 food groups)
-1930s: 'buying' guide and costing, 12 food groups
-1940s: 7 groups
-1956 to 1970s: basic 4 groups
-1979: 5 groups
-1984 to 2005: 6 groups (pyramid)
-2005 to 2010: MyPyramid concept |
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Term
| until 1960s-1970s govt focus was on... |
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Definition
| getting enough calories; research in 1970s implicated chronic diseases with over-consumption of energy and fats |
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Term
|
Definition
-published 1943
-revised 10 times until 1989
-became DRIs in late '90s
-for guidelines designed to target the individual |
|
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Term
| potentially negative factors of RDAs |
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Definition
-sig and numerous changes over time in recommendations
-food, public, and env policies do not support a healthy eating env
-food industry always at table |
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Term
| most visible and accessible format for nutr education for the public? |
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Definition
nutrient info on food labels
-FDA, USDA, FTC all involved in regulations
-Nutr labeling and education act ('90, '93) |
|
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Term
| requirements for health claims on food labels |
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Definition
-comparison of nutr labels claims and messages for food products and dietary supplements
-health claim on a label: explicit and implied, supported by valid and substantial scientific evidence, identified by FDA |
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Term
|
Definition
| one whose genome has been modified by technology |
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Term
|
Definition
| DNA produced using genetic engr: used to create transgenics |
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Term
|
Definition
| city-state, unit of gov and social organization |
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Term
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Definition
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Term
|
Definition
| method of decision making among groups, process by which rules and group behavior are established |
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Term
|
Definition
| a principle or rule (force of law) to guide decision making processes for purpose of guiding or controlling institutional/community/group behavior |
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Term
|
Definition
| generally supported by empirical evidence suggesting close links between members of government and certain classes in society |
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Term
|
Definition
| most domestic, routine policies on health, education, transport involve participation by members of pluralist society; large economic and political questions by elitists |
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Term
| 4 stages of policy making |
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Definition
1) problem identification, issue recognition
2) policy formulation
3) policy implementation
4) policy evaluation |
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Term
| types of food and nutr policy |
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Definition
-policy statement: dietary guidelines
-comprehensive action plans: HP 2010
-law: NLEA, FALCPA
-local policies: school food programs
-federal regulation: FDA governs nutrient fortification |
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Term
|
Definition
| in the 80s, in 1979 Surgeon general's report - to improve health by 1990 (15 areas, 226 specific objectives), led to HP 2000 |
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Term
| Policy process: case study |
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Definition
-2002: Surgeon General recommends nutrient info be available
-2004: FDA report 'Calories Count' - included pt of sale info on kcals
-2006: MEAL Act (extends NLEA of 1990) to chain restaurants
-2009: Eventual adoption |
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Term
|
Definition
| unique values, customs, language, history shared by a group; usually dynamic over space/time |
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Term
|
Definition
| the ability to increase one's understanding and appreciation of cultural diff and commonalities by developing oneself |
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Term
|
Definition
| recognition that cultural differences and similarities exist |
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Term
|
Definition
| exposure to influences from different culture/s, sometimes leading to changing norms |
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Term
|
Definition
| commonality (real or assumed) of heritage based on nationality, lanquage, physical appearance, shared territory, kinship, hx |
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Term
|
Definition
| categorization on basis of heritable characteristics; a genetically linked pop |
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Term
|
Definition
| perception that one's own values, beliefs, and practices are superior to those of another culture |
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Term
| Causes of health disparities |
|
Definition
- SES
- Lack of insurance
- culture
- access to, and utilization of, quality health care services
- discrimination/racism/stereotyping
- environment |
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Term
| how many main languages spoken in US? |
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Definition
| 21 (English, Spanish, Chienes, French, German....) |
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Term
| which period had most immigration into US |
|
Definition
| 1991-1999 (excluding 1901-1910), most from Central and South American, then Asia, then EU, then Africa |
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Term
|
Definition
| acceptance or promotion of multiple ethnic cultures, for practical reasons and b/c for the sake of diversity, applied to the demographic make-up of a specific place (Canada is most multi-cultural country) |
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Term
| cultural competence continuum |
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Definition
| destructiveness -> incapacity -> blindness -> pre-competence -> competence -> proficiency |
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Term
|
Definition
-Listen with sympathy, understanding
-explain your perceptions
-acknowledge, discuss diff, similarities
-recommendations, relevant, concise, practical
-negotiate agreement |
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Term
| Title VI of civil rights act of 1964 |
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Definition
| no person, on grounds of race, color, national origin, shall be excluded or discriminated against in context of program/activity from federal financial assistance |
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Term
| proximal factors (determinants) |
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Definition
| lifestyle, genetics (closer to the individual, some modifiable) |
|
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Term
| distal factors (determinants) |
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Definition
| neighborhood,policy (farther from the individual, some modifiable) |
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Term
| Innocenti Declaration: on the protection, promotion and support of BF |
|
Definition
| -lowers infant mortality, good for mom, baby, economical, decrease cancer risk for mom |
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Term
| WHO/UNICEF international cod of breastmilk substitutes |
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Definition
-bans all forms of promotion of bottle feeding
-establishes requirements for labeling
-applies to formula, baby juices and foods, and paraphenelia
-companies may not promote in hospitals, shops or to the public
-may not proved free or subsidized samples |
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Term
|
Definition
-optimize nutr status, immunity, well being
-prevent def
-prevent wt loss, esp lean mass
-reduce risk for comorbities
-maximize effectivness of drugs
-minimize health care costs |
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