phlt 303 exam #1

environmental, social, and economic (can also include political and religious)

come up with interventions to address health issues

- health protection
- hygiene movement
- contagion control
- medical care
- health promotion
- population health

- authority based control and behaviors
- religious and cultural practices
- quarantines for epidemics
- didn't know what caused disease yet

- Sanitary conditions as basis for improved health
- miasma theory (bad air caused disease)
- John Snow on cholera

- germ theory (where disease originated)
- vaccinations
- sanatoriums
- Goldberger and pellagra
- communicable disease control through environmental control

- medicare and medicaid
- not every disease came from germs
- preventative measures to prevent disease
- integrated healthcare system
- antibiotics
- control trials
- framingham heart study

- individual behavior and how they relate to risk factors
- AIDS epidemic
- reduction in coronary heart disease through interventions
- disease detection in vulnerable populations

- changed from being based on individuals to based on communities and lifecycle
- antibiotic resistance
- global collaboration
- climate change
- full life cycle approach to improving community health

- Stresses collaboration
- utilizes evidence based approach
- analyzes determinants of health and disease

healthcare systems, traditional public health, and social policy

- health issues
- populations
- society-wide health concerns
- vulnerable groups

- physical health
- mental health
- medical interventions
- could add: faith, corporation, emotional health

- communicable diseases
- infectious diseases
- impacts of climate change
- toxic exposures
- transportation safety
- costs of health care

thinking about thinking
- higher order thinking

a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

yes

improve health and reduce inequities

public health, social science, behavioral science

religion, SES, culture

education, income, occupation

the characteristics and knowledge of a group of people, which can include language, religion, cuisine, social habits, music, and arts

the belief and worship of a superhuman or controlling power, especially a personal God or ghosts

- use of contraceptives, alcohol consumption
- christian scientists reject medical care
- attitudes towards abortion
- role of prayer as intervention

the complex, integrated, and overlapping social structures and economic systems that are responsible for most health inequities

- social status
- social support or alienation
- food
- housing
- education
- work
- stress
- transportation
- place
- access to health services

to identify macrosocial processes that influence population health can provide opportunities for interventions that influence the population distribution of risk and improve the health of whole populations

They contribute to a wide variety of disease rooted in lifestyle, environmental, and social factors

a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantages amongst different groups

- coronary heart disease
- colorectal cancer screening

- HIV
- influenze vaccination

- air pollution
- motor vehicle crashes

Reduces the problem to one potential "cause" and one potential "effect"

reductionist

equires not only an explanation of multiple influences and their interaction at one point in time using a static approach, but also encourages us to look at how these factors change over time

an interacting group of items forming a unified whole

working to analyze the pieces and understanding how they fit together

- Identify the key influences or interventions on an outcome of a disease
- Indicate the relative strength of the impact of each of the influences or interventions
- Identify how these influences or interventions interact

- Identify the dynamic changes that may occur in a system by identifying the feedback loops that occur in the system
- Identify bottlenecks that limit the effectiveness of the system
- Identify leverage points that provide opportunities to greatly improve outcomes

- show which it operates (which way the arrow points)
- Indicate whether the factor operates to reinforce or increase another factor outcome (+) or operates to dampen or decrease another factor/outcome (-)
- Indicate the strength or magnitude of the impact with the width of the arrow used

one factor reinforces another to magnify its impact

one factor reinforces another factor, which dampens yet another factor

- help incorporate interactions between factors and between diseases
- Identify bottlenecks and leverage points
- Develop ideas for multiple simultaneous interventions and look at processes as a whole to plan short and long term intervention strategies

cause of disease

the occurrence together of two or more diseases that interact to magnify the occurrence and/or burden of disease

- Some diseases predispose to other diseases
- Patterns of risk factors/symptoms that tend to occur together

a point at which events are slowed, presenting obstacles to the success of an intervention

a point in the system in which successful interventions produce better than expected outcomes

an intervention that occurs before the onset of disease
ex: controlling BP/cholesterol

early detection of disease or risk factors and intervention during an asymptomatic phase
ex: drug treatment that happens early in an MI

an intervention that occurs after the initial occurrence of symptoms but before irreversible disability occurs
ex: placement of defibrillators where large groups of people are

efforts to see the entire processes rather than pieces of the pie have become key to planning interventions

the collaborative effort of multiple disciplines working locally and nationally and globally to obtain optimal health for people, animals, and our environment

- human animal interactions
- ecosystem health/physical environment
- microbiological influences on health and disease

- Global movement of populations
- Agricultural changes and changes in food distribution
- Ecological changes in land and resource use
- Climate change

- Reduced BP
- Reduced cholesterol and triglycerides
- Reduced feelings of loneliness
- Increased opportunities for exercise, outdoor activities, and socialization

- Toxoplasmosis
- Cat-scratch disease
- Toxocariasis
- Monkeypox

describes the impact of falling childhood death rates and extended life spans on the size and the age distribution of populations

implies that as social and economic development occurs, different types of diseases become prominent

moving from a poorly balanced diet lacking nutrients to a diet of highly processed foods

- resource allocation
- social services
- physical environment
- social environment
- population heterogeneity

Communities have different access to goods and services

Local access to health care, emergency and security services, good educational opportunities and social support systems more likely to lead to good health

Physical conditions, which are affected by local, state or federal policies, such as zoning laws as well as by human behaviors and actions such as vandalism

Shape our interactions, out beliefs and our behaviors

those with low socio-economic position cannot access the resources that benefit more affluent people

- infrastructure resources
- employment
- income growth

Underinvestment in: - national health and social services
- environmental infrastructure

- Part time employment may create stress
- Poor work environment may affect health

- Dependable employment means people can access health care
- Sudden decline in wealth means compromised health care

- global trade
- income distribution
- population movement
- global governance
- community and technology

Unequal distribution of goods and services could lead to unbalanced trade and inequities among nations

Spread culture, technologies, disease

International policies may affect national health strategies

Enhanced communication affect population health through dispersions of ideas, knowledge, and technology

Political economic systems, socioeconomic development, population health

socialist

no

- slavery
- workers rights
- retirement

- poverty
- unemployment
- persecution
- internal civil strife
- change in government
- natural disasters

- perceived employment prospects
- reunite with family
- expectation of better economic or political situation
- freedom persecution
- safe haven from disasters

- pre-migration
- peri-migration
- post-migration

- begins prior to point of departure
- Individuals have formed beliefs about health, illness, disease, treatment, and expectations of care that they will carry with them to their intended destinations

- period from the individual's voluntary or involuntary departure to his or her arrival at the destination
- individuals will be affected by the conditions that they confront and the experiences that they undergo during this process

- when the individual arrives at the location where he or she is put to work
- stresses of new country

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