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study of a variety of racial and geographically differentiated groups comparing life expectancy; more than 21 years of difference between Asian-Americans and poor black |
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asymptomatic carrier; NY maid who spread typhoid to a number of families she worked for |
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disability-adjusted life year (YLD[LE-age])*i |
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the main assessment and epidemiological agency for the nation, directly serving the population as well as providing assistance to states and localities |
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federal agency that ensures the safety and nutritious value of the food supply; evaluates all new drugs, food additives, and colorings; and regulates medical devices, vaccines, diagnostic tests, animal drugs, and cosmetics |
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primary federal agency for biomedical research; provides grants to biomedical scientists at universities and research centers |
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when a person is carrying a strain of a disease that can no longer be treated effectively using a particular drug |
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a person's choice or ability to consistently take medication and comply with a treatment plan for a particular illness |
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fever and severe bleeding from various orifices; extremely lethal and usually quarantined, infects monkeys as well as humans
huge outbreak in 1976: 67% mortality rate and still unknown cause; quarantine after 11/17 hospital staff die & dozens of patients |
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bacterial disease from air conditioning that infected a lot of dudes in 1976 |
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treatment plan for malaria but not effective because difficult to set up and there are issues with adherence |
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multidrug-resistant tuberculosis; resurged as a co-morbidity with HIV and also propagated by people who don't adhere to their medication |
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directly-observed therapy; outreach workers travel to patients' homes, workplaces, street corners, park benches, etc. to make sure the patient is taking their medicine |
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believe they cause autism, SIDS (especially MMR); wealthy parents relying on "herd immunity," problematic because it discourages investment in the development of new vaccines |
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measles-mumps-rubella vaccine |
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US Department of Agriculture |
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the sense of having control over one's life |
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medium through which disease is transmitted |
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the organism from which a parasite receives its nutrition and/or shelter |
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the organism who contains and transmits the disease |
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a form of violence where some social structure or social institution purportedly harms people by preventing them from meeting their basic needs |
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when the vector picks up the infectious agent on the outside of its body and transmits it in a passive manner |
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vectors harbor pathogens within their bodies and deliver them to new hosts in an active manner, like through a bite |
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Surgeon General's Report of 1964 |
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"Smoking and Health": first authoritative statement from the federal government that smoking caused cancer and other life-threatening diseases, had a significant impact on the prevalence of smoking int he US which began to decline for the first time after 1964 |
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assumes people act in rational ways, public health approach to changing behavior would be to convince people that they are vulnerable, that the threat is severe, and that certain actions are effective prevention methods |
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model that envisions change as a process involving progress through a series of five stages: precontemplation, contemplation, preparation, action, and maintenance |
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Ecological Model of Health Behavior |
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describes five levels of influence, starting with intrapersonal and then four interpersonal factors (interpersonal, institutional, community, public policy) |
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a host that only harbors the parasite for a short period of time and then transfers it |
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insecticide in which malaria nets are soaked (but is a term that refers to a number of Western items) |
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basic, case-control study with an experimental and a control group |
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when a large number of people are tracked over time, subjects choose their own exposures |
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120,000 married female nurses since 1976 for factors associated with breast cancer; interviewed every 2 years; RR 1.5 if using oral contraceptives, 1.1-1.4 with regular alcohol consumption |
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relationships between variables distort the actual link between risk factors and disease |
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bias in the way you recruit participants for a study |
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bias on the part of the informant |
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4-generation study of heart disease and risk factors by NIH in Framingham, Mass.; has shown a relationship between HDL (good) cholesterol and heart disease, BMI and mortality |
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study of British civil servants, all had equal healthcare access but much higher levels of stress in lower grade employment ranks; social support and feeling of reward important; higher job security=less chronic stress response; dispelled myths that only CEOs get heart attacks |
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diagnostic and statistical manual of mental disorders; creates categories and definitions-how do these apply across cultures?? |
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General Health Questionnaire (GHQ-12) |
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basic survey of 12 questions used to assess mental health conditions |
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experiencing 2 diseases at once, often having one makes one more susceptible to the other |
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Four Filters of Mental Health |
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0. Population 1. Attention in Primary Care 2. Specialized Mental Health Services 3. Hospitalization 4. Psychiatric Inpatient |
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inpatient vs. outpatient care |
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inpatient care is very expensive and can also result in alienation and segregation (think Girl Interrupted); now outpatient pharmaceutical treatment and talk therapy are being emphasized |
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clinical care and medication; social support; job, housing, and family stability; gun control (and access); school and workplace surveillance |
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leading cause of death 15-34 and 1-24 in US and world; most common injury-cause of death worldwide; responsible for 50% of spinal cord injuries |
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studied British coal miners, found they had higher rates of cancer, first look at occupational health and safety issues |
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the level at which a substance has been proven to be harmful to health |
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Epidemiology of Accidents and injuries |
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5th leading cause of death and 4th leading cause of morbidity; falls make up 37% of these (elderly, pregnant, young) |
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studies in the 1980s showed continuous and acute exposure are both harmful; public sympathetic because affected were seen as "victims" |
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major danger for those under 5 years; inhalation/ingestion/water/in-utero; found in paint, toys, pipes, affects all income levels |
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Department of Health and Human Services; encompasses the NIH, FDA, CDC, EPA, IHS |
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Indian Health Service; provides health care to Native Americans but significantly underfunded |
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years of potential life lost |
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opioids leading to much accidental poisoning death when followed by cocaine and heroin; overdiagnoses in the 1990s |
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leading cause of injury death in 8 states; RR increases when people own guns, precautions have been helpful, homicide rates are 2-4 times higher in the US than in other developed countries |
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traumatic brain injuries, more common in men, controversy in athletics about when to return because of increased repeat vulnerability |
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Occupational Safety and Health Administration: empowered to set standards, inspect workplaces, and impose penalties for workplace hazards |
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mineral valuable for its strength and fire resistance; affects lungs of miner; carcinogen |
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Occupational Health and Safety Act |
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empowered the federal government to set standards for workers' exposure to toxic substances |
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six common air pollutants known to be harmful to health: particulates, sulfur dioxide, carbon monoxide, nitrogen oxides, ozone, and lead |
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established strict air quality standards, set limits on major pollutants, and mandated reduction of automobile and factory emissions |
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main sources of air pollution |
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motor vehicles; industrial factories and power plants |
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tobacco smoke, other products of combustion, radon gas, consumer products (that release chemicals), formaldehyde, biological pollutants like bacteria and mold |
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atmospheric carbon dioxide allows sunlight to enter and traps heat, leading to warmer temperatures at the earth's surface |
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microbial pathogens, chemicals, deposition from the air or runoff from the land |
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set national goals that lakes and rivers should be "fishable" and "swimmable" and that all pollutant discharges should be eliminated; also assisted municipalities in building wastewater treatment facilities |
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required the EPA to set standards for local water systems and mandated that states enforce the standards; uniform guideliens were set for drinking-water treatment and regular monitoring and testing were required |
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parasitic disease of the gastro-intestinal system that causes diarrhea, carried by a protozoa and found in New York City's water due to substandard septic tanks |
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meeting standards and regulations set by PH organizations like the EPA |
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waste must be confined in a sealed area; take up a lot of space |
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approach to conservation and prevention of a disposal problem; biggest problem with recycling is that there is not a large market for recycled goods |
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a housing area in Niagara Falls, NY in which more than 200 different chemicals in an abandoned industrial dump began to circulate and wreak horrible effects on the health of the citizens, had to evacuate and it was considered a Federal Disaster Area |
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set national goals that lakes and rivers should be "fishable" and "swimmable" and that all pollutant discharges should be eliminated; also assisted municipalities in building wastewater treatment facilities |
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required the EPA to set standards for local water systems and mandated that states enforce the standards; uniform guideliens were set for drinking-water treatment and regular monitoring and testing were required |
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parasitic disease of the gastro-intestinal system that causes diarrhea, carried by a protozoa and found in New York City's water due to substandard septic tanks |
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meeting standards and regulations set by PH organizations like the EPA |
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waste must be confined in a sealed area; take up a lot of space |
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approach to conservation and prevention of a disposal problem; biggest problem with recycling is that there is not a large market for recycled goods |
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a housing area in Niagara Falls, NY in which more than 200 different chemicals in an abandoned industrial dump began to circulate and wreak horrible effects on the health of the citizens, had to evacuate and it was considered a Federal Disaster Area |
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deaths are increasingly concentrated in a relatively short age range at about the biological limit of life span |
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rates of chronic disease and disability concentrated in a relatively short age range at abou the biological limit of life span |
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Medicare, Medicaid, and the "Medi-gap" |
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medicare is the federal program that pays medical bills for the elderly, but as their numbers increase they can't cover as much; some employers purchase "Medigap" insurance policies to cover the rest, the poor elderly have Medicaid |
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examined geographic variations in end-of-life care and showed that a significant amount of Medicare spending is wasted; some are receiving too much care to little or negative effect |
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natural vs. manmade/technological disasters |
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natural disasters are predictable and affect specific vulnerable areas; manmade/tech are generally unpredictable (ex. industrial explosions, bridge collapses, radioactive release) |
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Office of Emergency Management; tried to coordinate rescue efforts during 9/11 but the building was severely damaged by the collapse of the north tower |
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APHA's list of problems most likely to occur in a disaster |
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sharing information, resource management, warnings should be issued by mass media, warnings should be consistent and specific, search and rescue operations should track casualties, mass media should warn of public health risks post-disaster, triage, casualty distribution, tracking patients and survivors, establishing methods of care, management of volunteers and donations, expect the unexpected |
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terrorism involving the intentional release or dissemination of biological agents |
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take a small blood sample to identify PKU, HIV, Tay-Sachs, CF |
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aims to analyze the whole of human DNA and make a map of all human genes; knowing genes can potentially provide benefits in preventing disease and better treatments |
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a single gene defect in which symptoms appear between the ages of 30 and 50. Over 10-20 years the disease progresses towards death with symptoms of involuntary movements, intellectual deterioration, and psychiatric disturbances; a test is available but most people choose not to know |
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infant mortality rate: number of infant deaths within the first year of life for every 1,000 live births |
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responsible for more infant deaths than are indicated; common in smokers, older/younger mothers |
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prevents cervical cancer, affects 50% of people who will ever have sex, some parents think it will encourage promiscuity |
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