Unit 1
This describes the tension in public health between giving priority to individuals-individual autonomy-and promoting the good of groups or populations.
What is the Fundamental ethical dilemma of public health?
True or False? Public health preparedness utilizes the phases of emergency management when preparing for, responding to, and recovering from a public health emergency.
What is True?
What kind of vector picks up infectious agents on the outside of their bodies and transmits the agents to susceptible hosts through physical contact?
What is a mechanical vector?
True or False? Since mental illnesses are sometimes difficult to diagnose (due to overlap of symptoms) they are easy for epidemiologists to count/track.
What is False?
Explain a way we can reduce the prevalence of a food desert.
What is by encouraging developers to build affordable housing near existing grocery stores and markets, tax incentives for grocery stores to open in underserved communities, increased funding for public transport, etc.?
This strategy seeks root causes of disease and disability and addresses issues through prevention rather than treatment.
What is the Upstream metaphor?
"Using real-time data to identify and respond to acute outbreaks, emergencies, and other health hazards." is an example of which of the following 10 Essential Public Health Services:
a. “Investigate, diagnose, and address health hazards and root causes.”
b. "Create, champion, and implement policies, plans, and laws.”
c. “Improve and innovate through evaluation, research, and quality improvement.”
What is A. “Investigate, diagnose, and address health hazards and root causes.”?
What is the building up of a chemical in an organism’s tissues over its lifetime, as the organism continually takes in more than it excretes?
What is Bioaccumulation?
(Remember: Biomagnification is the process by which a chemical becomes more concentrated in the tissues of organisms at each higher level of the food chain within an ecosystem.)
These are the 6 criteria air pollutants:
Particulate Matter (PM2.5 and PM10)
Sulfur dioxide (SO2)
Carbon monoxide (CO)
Nitrogen dioxide (NO2)
Ozone (O3)
Lead (Pb)
For each of these 6 pollutants, EPA has established _____________ to protect public health.
What are National Ambient Air Quality Standards (NAAQS)?
Incomplete Medicaid Expansion (some states did not adopt the expansion, so the coverage gap remains) is an example of:
a. an ACA provision
b. an ACA regulation
c. a challenge with the ACA
What is C. a challenge with the ACA?
______________ describes a disease occurring within an area or community at all times (the constant presence of a disease in a geographic population)
What is endemic level?
_____________ is a framework that considers how individuals and their environment interact with each other, and it consists of levels that prevention efforts should strive to impact.
What is the Socio-Ecological Model?
Individual-Intrapersonal
Factors specific to the individual within the target population: age, education, income, knowledge, attitude, skills
Interpersonal
Individual’s closest circle (relationships): family, friends, peers, coaches, etc.
These people can shape the behaviors of the individuals in the target population.
Social support.
Organizational
Organizations, schools, workplaces
Community
Relationships between organizations, media, parks
Policy
Federal, state, and local policy/laws and regulations
Zoonotic diseases are infections that are spread between humans and animals. Give an example of how zoonotic diseases can be transmitted.
What is through Indirect contact (example: touching a contaminated surface such as a water dish, then touching your mouth), Food-borne (example: consuming infected meat or milk), or Direct contact (example: bites from an infected animal)?
These are intervention strategies designed for an entire population without regard to individual risk factors. Provides all members of a population with the information and skills necessary to prevent substance abuse.
What are universal prevention strategies?
Please explain the goal/reasoning behind implementing the sugar sweetened beverage (soda) tax.
What is to reduce the purchase and therefore the consumption of sugary drinks and lower population-wide risks of obesity and diabetes?
Also, generate revenue for public health programs:
Money collected from the tax often funds health promotion initiatives, school nutrition programs, or healthcare services.
Explain the difference between primary, secondary, and tertiary prevention.
What is...
Primary prevention: Prevent exposure to risk factors = reduce incidence
Secondary prevention: Early detection & management = minimize harm
Tertiary prevention: Treatment = minimize disability & mortality
List the 6 links in the Chain of Infection, and describe one of the links.
What is...
1. Infectious agent (pathogen): virus, bacterium, or parasite that causes the disease in humans
2. Reservoir: place where pathogen lives and multiplies
3. Portal of exit: where the pathogen leaves/exits the host or the reservoir
4. Method/Mode of Transmission: the way pathogen travels from one host to another, or from a reservoir to a new host
5. Portal of entry: where the pathogen enters the new host
6. Susceptible host: even if the pathogen enters, a new potential host may not be susceptible because that host has immunity to the pathogen
Explain what a half-life is.
What is the time it takes for a certain amount of a toxin to be reduced by half. This occurs as it breaks down in the environment?
Toxins can have many half-life's. This depends on the conditions of the environment:
In soil, the half-life of permethrin (a pesticide) is about 40 days, ranging from 11-113 days.
In the water column, the half-life of permethrin is 19-27 hours. If it sticks to sediment, it can last over a year.
Why is a half-life important?
The half-life can help estimate whether or not a pesticide tends to build up/persist in the environment/organisms.
The longer the biological half-life of a toxic substance, the greater the risk of chronic poisoning, even if environmental levels of the toxin are not very high.
Determine risk of toxin
Determine risk of exposure to people, animals, plant, environment, etc.
Determine its ability to contaminate nearby environments/organisms
Explain what the risk factors for foodborne illness at the industry level are.
What are...
Farming-
Example: feeding corn instead of grass to cows; concentrated animal feeding operation (CAFOs), widespread antibiotic use in animals
Colonization-presence of a microorganism on/in a host, with growth and multiplication of the organism, but without interaction between host and organism
Example: E. coli in cows or Salmonella in poultry
Mass distribution- small problem can become huge
Cross-contamination – example: not wearing proper PPE (cross-contamination can explain why other types of foods end up implicated in foodborne illness outbreaks)
Please describe what the epidemiologic transition is.
What is as deaths from famine and infectious diseases (communicable) decreased, and life expectancy increased, the burden of disease has shifted to chronic, noncommunicable diseases such as diabetes, coronary heart disease, and stroke?
Name and describe each of the 3 core functions of public health.
What is assessment, policy development, and assurance?
1. Assessment: the diagnostic function
-Epidemiology: study of incidence, distribution, possible control of diseases
-Statistics: collection and analysis of data/information
2. Policy development: uses scientific knowledge to develop a strategic approach to improving the community’s health
-Biomedical sciences: prevention/control of diseases caused by infectious agents (microorganisms) (ex: AIDS)
-Social and behavioral sciences: behaviors like smoking that lead to diseases (e.g.,: heart disease)
-Environmental sciences: preventing the spread of disease through water, air, and food
3. Assurance: assuring that the services needed for the protection of public health in the community are available and accessible to everyone
-Health policy/management/administration
There are three areas of key challenges/barriers to achieving herd immunity, elimination, and eradication for vaccine-preventable diseases in the US. Describe each of these three areas.
What is access, hesitancy, and infrastructure?
Access: Cost/financial barrier, Insurance coverage, Location/distance to care, Underserved communities, Lifestyle/migration, Convenience/language barriers.
Main factor is hesitancy: Fear of vaccine safety, Lack of fear of diseases, Distrust, Fear of collateral effects, Misinformation, Lack of knowledge
Infrastructure: vaccine supply/storage, data sharing, state and local programs, disaster response, surveillance and outbreak response, outreach, education, etc.
Explain one of the control strategies for occupational injury/disease (elimination, substitution, engineering controls, administrative controls, PPE)
What is...
Elimination (most effective): physically remove the hazard.
Substitution: replace the hazard.
Engineering controls: isolate people from the hazard.
Administrative controls: change the way people work.
PPE (least effective): protect the worker with Personal Protective Equipment (PPE)
List the 7 steps in the Exposure Pathway and give an example of each.
What are...
Contaminant Source = where did the contaminant come from? Ex: industry, vehicle emissions, consumer practices, agriculture practices, wildfires, tanks, drums, contaminated debris, waste management, etc.
Release Mechanism = how was the contaminant released from the source into the environment? Ex: emissions, spills, leaks, direct discharge, volatilization, burning
Impacted Media = what environmental substance was the contaminant directly released to? Ex: air, soil, sediments, groundwater, surface water
Transport Mechanisms = how was the contaminant in the impacted media moved to other (the exposure) media? Ex: dispersal in air/wind & deposition, suspension (from ground to air), migration to subsurface soils or groundwater, volatilization, runoff, uptake into animals or plants, groundwater flow surface water transport, leaching (loss of materials into a liquid)
Exposure Media = what environmental substance was the contaminant transported to that an individual was ultimately exposed to? Ex: biota or water, surface or subsurface soil, indoor or outdoor air, groundwater, surface water, sediment
Route of Exposure = how did the contaminant come in contact with a receptor and how did it enter the body? Ex: Eating/drinking = ingestion, Breathing = inhalation, Skin = dermal contact
Receptor Population = what population has, will, or could potentially come in contact with the contaminant? Ex: Animals, Resident (adult and child), Commercial or industrial worker, Construction worker, Farmer, etc.
List the 5 factors in the Health Belief Model and give an example of a strategy for one of the factors.
What is...
(1) Perceived Susceptibility: the extent to which the individual feels vulnerable to the threat. Ex: personalized risk assessment, campaign, an online quiz, etc.
(2) Perceived Seriousness or Severity: the perceived severity of the threat. Ex: share stories about the real consequences of physical inactivity.
(3) Perceived Barriers: perceived barriers to taking action to reduce the risk. Ex: Address challenges and provide solutions such as workplace walking groups, more walkable neighborhoods, more parks, at-home workout videos, no/low cost exercise programs, etc.
(4) Perceived Benefits or Effectiveness: the perceived effectiveness of taking an action to prevent or minimize the problem. Ex: Highlight immediate, tangible benefits of physical activity-more energy, better mood, saving money on healthcare costs, less stress, etc.
Also.. (5) Self-Efficacy: the sense of having control over one’s life. Ex: Have easy programs and work up to goals gradually, peer support groups that teach exercise routines/skills, phone apps that track progress/achievements, etc.