question
WHO definition of health
answer
a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
question
PACES
answer
Populations
Action
Cooperation
Equity
Security
Action
Cooperation
Equity
Security
question
population (PACES)
answer
focus on greatest public health burden & affect large numbers of people (macro, deals with scale)
question
action (PACES)
answer
low-cost interventions (primary-tertiary levels)
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cooperation (PACES)
answer
global efforts across borders, share knowledge, tools, & resources
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equity (PACES)
answer
helping poor & addressing social, environmental, & health inequities
question
security (PACES)
answer
address health issues most likely to contribute to political/economic instability or conflict
question
PACES right v. left
answer
right: security (equal opportunity)
left: equity (equal outcomes)
left: equity (equal outcomes)
question
why is there no magic bullet for improving health?
answer
there is a diversity of contributors to disease, however this means interventions aimed at different contributors can improve health
question
Etiology
answer
study of the ROOT cause of disease
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intrinsic causes
answer
internal factors originating within organism
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extrinsic causes
answer
external factors originating outside of organism
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miasma
answer
pungent odors of poorly managed waste
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19th century approach to etiology
answer
epidemics spontaneously arose in areas with poor sanitation
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20th century approach to etiology
answer
pull back from looking at environment, recognize illness caused by infection & genes
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medicine
answer
treating individuals (micro)
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public health
answer
prevention among populations (macro)
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environmental health
answer
health and environmental exposures
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epidemiology
answer
disease among people
1. distribution
2. risk factors
3. interventions
1. distribution
2. risk factors
3. interventions
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biostatistics
answer
analyzing & interpreting health data
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health promotion
answer
actively working in communities to improve health
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areas of public health
answer
1. environmental
2. epidemiology
3. biostatistics
4. health promotion
2. epidemiology
3. biostatistics
4. health promotion
question
global health intervention
answer
strategic action to improve individual & population health status
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global health interventions also need
answer
social workers
spiritual advisors
sanitation workers
farmers
engineers
policy makers etc.
spiritual advisors
sanitation workers
farmers
engineers
policy makers etc.
question
is prevention or treatment cheaper?
answer
prevention cheaper
question
3 goals of prevention science
answer
1. choose correct population & issue
2. evaluate success to convince others it works
3. scale up from small to large
2. evaluate success to convince others it works
3. scale up from small to large
question
3 levels of prevention
answer
1. primary
2. secondary
3. tertiary
2. secondary
3. tertiary
question
primary prevention
answer
keep disease from occurring
-people with no disease
2 types: change behavior or environment
-people with no disease
2 types: change behavior or environment
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secondary prevention
answer
detect problems early
-people with asymptomatic disease
-people with asymptomatic disease
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tertiary prevention
answer
treatment and rehabilitation
-people with symptomatic disease
-people with symptomatic disease
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global health 100 years ago
answer
less health inequality
-2 leading causes death everywhere: infectious disease & malnutrition
-2 leading causes death everywhere: infectious disease & malnutrition
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20th century health transition
answer
transition among high income nations
-increase chronic disease (overnutrition)
-increase chronic disease (overnutrition)
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3 leading causes death U.S.
answer
-heart disease
-cancer
-stroke
-cancer
-stroke
question
what do health transitions show?
answer
-economic growth simultaneously creates massive inequality
-health is not determined
-health is not determined
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health transition
answer
a shift in the health status of a population that usually occurs in conjunction with socioeconomic development
question
8 examples health transitions
answer
1. fertility transition
2. demographic transition
3. obstetric transition
4. nutrition transition
5. risk transition
6. epidemiological transition
7. mortality transition
8. aging transition
2. demographic transition
3. obstetric transition
4. nutrition transition
5. risk transition
6. epidemiological transition
7. mortality transition
8. aging transition
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fertility transition
answer
decrease in birth rate
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demographic transition
answer
change in population size and structure (age)
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obstetric transition
answer
decrease maternal mortality
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nutrition transition
answer
increase (concern for obesity)
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risk transition
answer
exposure risk decreases, lifestyle risk increases (tobacco use, etc.)
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Epidemiologic Transition
answer
infectious disease decrease, chronic disease increase
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mortality transition
answer
Increase in NUMBER of people living to old age
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aging transition
answer
Increase in PERCENTAGE of population living to old age (structure pop.)
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2 types of inequality
answer
between-nation & within-nation
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Dual burden of disease
answer
middle-income countries must address both pre-transition and post-transition health problems (ex. undernourished & obese)
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2 goals of early international health initiatives
answer
1. prevent widespread outbreaks infectious disease
2. address threats to economic & political interests
2. address threats to economic & political interests
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Human Security
answer
the freedom from fear and want that results from having health, food, personal, environmental, economic, community, and political security
question
global health security
answer
protect populations from health & safety threats
question
Globalization
answer
process of nations becoming integrated and interdependent in multiple domains
question
globalization influences health transitions by
answer
-increasing access health technology
-encouraging urbanization
-changing social & cultural practices
-accelerating environmental changes
-encouraging urbanization
-changing social & cultural practices
-accelerating environmental changes
question
globalization & health transitions are both
answer
social processes
question
4 case study strategies
answer
1. rolling out medicine & technology
2. expanding access to health services
3. using targeted cash transfers to improve health
4. changing behavior population-wide to reduce risk
2. expanding access to health services
3. using targeted cash transfers to improve health
4. changing behavior population-wide to reduce risk
question
4 criteria for selecting cases
answer
1. importance (salience)
2. impact (causation)
3. scale
4. duration
2. impact (causation)
3. scale
4. duration
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