Remember the Titans
There are how many categories of SDOHs according to the WHO?
Five
Education Access and Quality
Health Care Access and Quality
Economic Stability
Social and Community Context
Neighborhood and Built Environment
A child going to their routine annual wellness check-up would be which tier of prevention?
Primary prevention
For primary think PCP. You see your PCP to prevent disease and illness.
Secondary is screening and tertiary is treatment
Which of the following are included in the social and community context category of SDOHs? (SATA)
Discrimination
Steady employment
Family cohesion
Social networks
Discrimination, family cohesion, and social networks
Steady employment would fall under economic stability
You find that your clients are exposed to secondhand smoke from a nearby factory. Which category of determinants best describes this exposure?
Education access and quality
Social and community context
Neighborhood and built environment
Neighborhood and built environment
*blank* is superficial criteria such as skin color, physical characteristics, and parentage while *blank* is a shared geographical origin, language or dialect, religious faith, folklore, food preferences, and culture.
Race and ethnicity
Changes to the physical environment, economic environment, and social environment are all examples of what level of interventions? (Hint: think a body of water)
Upstream approaches
Remember: upstream approaches are "big picture", community wide interventions whereas downstream approaches are focused on the individual's specific situation.
A male patient getting a PSA level drawn in response to c/o urinary retention would be which tier of prevention?
Secondary prevention
This lab test is done to screen for a potential problem and therefore is considered secondary prevention.
Your patient hasn't been taking her HTN meds due to cost concerns. Which would be the priority assessment to help address this barrier?
The patient's understanding of the need for medication
The patient's ability to access affordable medications
The patient's support system
The patient's ability to access affordable medications
While the other two choices may also play a role in why the patient isn't paying for their medications, the most direct and likely cause would be their inability to do so, making this the priority assessment of the choices given.
True or false: the prevalence of a disease is the total number of cases of that disease
True!
This is the term that refers to resources available to individuals and communities based on membership in social networks.
Social Capital
Poor health literacy falls under which category of SDOH?
Education Access and Quality
True or false: screenings such as blood glucose tests and mental health questionnaires are intended to Dx problems
False.
Screening tools are used for early detection of a disease/concern. They are intended to gather information which, based on the results, helps the provider look into potential problems to then provide a Dx.
This patient has been couch surfing at various friends' houses. This is what type of homelessness? (Hint: is not chronic, transitional or episodic)
Secondary homelessness. These are people who stay in a temporary form of housing because they have nowhere else to go (includes "couch surfing").
Primary: Living without adequate shelter, living in vehicles, surviving on the streets, staying in parks, or squatting in abandoned buildings
Tertiary: Renting single rooms on a long-term basis without security of a fixed or permanent residence
Which of the following approaches is a key factor in improving mental health outcomes?
Providing emergency services only during a crisis
Implementing community education programs to raise awareness about mental health
Scheduling 1:1 therapy for everyone in the community
Increasing the number of mental health facilities
Implementing community education programs to raise awareness about mental health. This is a measure that would have the greatest effect on outcomes of mental health patients.
Providing emergency services only during a crisis would only help those during an emergency, hence neglecting non-emergent care needs and is therefore not the best option for overall outcome improvement.
Scheduling 1:1 therapy for everyone in the community would not be a key factor, as this would include those without mental health concerns.
Increasing the number of mental health facilities may increase access to Tx but wouldn't be a key factor in improving health outcomes.
After reviewing healthcare facilities and transportation options in a rural community, you determine that many people don't have access to necessary care due to distance and limited transportation. This is an example of what?
Cultural competence
Health equity
SDOH
Health equality
SDOH
Cultural competence would be taking into consideration the cultural differences of the population you're serving. Health equity is when people get the amount of help that they need to fix the problem they have and health equality is when everyone gets the same amount of help regardless of their need (remember the picture with the boxes at the baseball game)
Which of the following should you prioritize to address the root cause of health disparities in the homeless population?
Host a job fair for homeless individuals to help them gain employment
Provide the homeless with hygiene kits
Advocate for policies that increase access to affordable healthcare and housing
Educate the community about homelessness
Advocate for policies that increase access to affordable healthcare and housing
The other options would be helpful to members of that population but would not address the root cause of their health disparities.
Which of the following are included in the neighborhood and built environment category of SDOHs? (SATA)
Safe housing
Air and water quality
Hospital accessibility
Availability of healthy food
Safe housing, air and water quality, and availability of healthy food
Hospital accessibility would fall under Health Care Access and Quality
These homeless people require shelter for a shorter period, are younger, and are more likely to experience homelessness because of a catastrophic event. (Hint: is not primary, secondary or tertiary)
Transitional homelessness.
Episodic homelessness - are also younger, are in and out of the shelter system, are more likely to be chronically unemployed, and have medical or mental health issues.
Chronic homelessness - more likely to require shelter on a long-term basis, chronically unemployed, older, and more apt to have physical or mental health issues.
This group owns the Healthy People 2030 Framework (bonus karma points if you get the full name exactly correct)
The Centers for Disease Control and Prevention (AKA the CDC)
Which factor is the greatest concern when creating an effective DC plan for a homeless patient?
Lack of awareness of available community assistance programs
Lack of consistent basic necessities such as food and shelter
Reliance on emergency services for routine care
Underestimating the importance of preventive healthcare
Lack of consistent basic necessities such as food and shelter
The other choices are also concerns, but they are not the greatest concern for the patient at DC.
Which would be considered downstream approaches to addressing homelessness (SATA)?
Develop job training programs to increase financial stability for the vulnerable
Offer free meals to people living in shelters
Provide emergency housing for people living on the street
Advocate for policies that provide renting assistance programs
Increase mental health treatment services for at risk populations
Offer free meals to people living in shelters and provide emergency housing for people living on the street. These interventions are aimed at helping the individual rather than a whole population/community.
The other options are upstream approaches, as they are "big picture" interventions that would help the whole homeless population.
Wanda is 15 weeks pregnant and routinely uses cocaine. Drug cessation is a form of which type of prevention for her baby?
Tertiary prevention
For tertiary think treatment. This would be a treatment for the baby to hopefully lesson the addiction Sx upon birth.
You are responding to a TB outbreak at a nursing home. Which of the following are appropriate measures to take to help stop the spread? (SATA)
Establish a contact tracing program
Educate the residents about prevention, Sx, and the importance of Tx
Encourage residents to self Dx and Tx Sx at home
Isolate residents with Sx
Encourage residents to share personal items to increase immunity
Establish a contact tracing program, educate the residents about prevention, Sx, and the importance of Tx and isolate residents with Sx.
The other choices would not be best practice for CD transmission prevention.
This group has functions such as promotion of health for all people worldwide, reducing inequalities between and within countries, supporting global health research initiatives, and provision of resources for disaster relief/emergency response.
The World Health Organization (AKA the Who)
The World Health Organization focuses on global health issues; the CDC is focused on health issues in the USA.
You notice that the health outcomes of a community are higher than expected given they are a low-income community. Which is the most likely cause?
Strong community networks
Access to advanced technology
Adequate health insurance coverage
Lack of medical conditions needing care
Strong community networks
The question asks for the most likely cause of the positive health outcomes, and given this is a low-income community it is not likely that they have adequate health insurance, better average health or access to advanced technology. This leaves only one choice left!