Community Health 331

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Community Health
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the health status of a defined group of people and the actions and conditions to promote, protect, and preserve their health.
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Physical Factors affecting community health
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geography, community size, industrial development, and environment.
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Public Health
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actions that society takes collectively to ensure that the conditions in which people can be healthy can occur; the most inclusive term
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Community
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is a group of people who have common characteristics; can be defined by location, race, ethnicity, age, occupation, interest in particular problems or outcomes, or common bonds
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Community can be characterized by
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membership, common symbol systems, shared values and norms, mutual influence, shared needs and commitment to meeting them, shared emotional connection.
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10 Great Public Health Achievements
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1. Vaccination 2. Motor vehicle safety 3. safer workplaces 4. control of infectious diseases 5. decline of deaths from coronary heart disease and stroke 6. safer and healthier foods 7. healthier mothers and babies 8. family plannings 9. fluoridation of drinking water 10. recognition of tobacco use as a health hazzard
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population health
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health status of people who are not organized; have no identity as a group
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social and cultural factors
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– beliefs, traditions, and prejudices – economy – politics – religion – social norms – socioeconomic status
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community organizing
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a process through which communities are helped to identify common problems or goals, mobilize resources, and in other ways develop and implement strategies for reaching their goals they have collectively set
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The Eighteenth century 1796
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Dr. Edward Jenner successfully demonstrated the process of vaccination as a protection of smallpox
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The Eighteenth century 1790
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following the American Revolution, George W. ordered the first U.S. census for the purpose of the apportionment of representation in the House of Rep.
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The Nineteenth Century 1850
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Modern Era of Public Health begins- the era of public health that began in 1850 and continues today
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bacteriological period of public health
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the period of 1875-1900, during which the causes of many bacterial diseases were discovered
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Dr John Snow
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1854 predated the discovery that microorganisms can cause disease; a cholera epidemic struck London and he studied this epidemic and hypothesized that the disease was being caused by the drinking water in Broad st, pump.
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The Twentieth century
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leading cause of death was communicable diseases
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Health Resource Development Period (1900-1960)
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the yr if 1900-60 a time of great growth in health care facilities and providers
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Major events in the Twentieth Century
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-(1900-1920) reform phase of public health -(1910) the first International Congress on Occupational Disease was held in Chicago – the first national-level volunteer health agencies – public health nursing – (1920) prohibition – life expectancy rose in 1930 to 59.7 – The Great Depression and World War II (New Deal) – The Social Security Act of 1935 – The National Cancer Institute was formed 1937 – CDC
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Major events for the Early 2000s
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– the Affordable Care Act (ACA) – the 4 leading causes of death are heart disease, cancer, chronic lower respiratory diseases, and stroke – health care deliver is public health concern
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Examples of personal health activities
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choosing to ear wisely, regularly wearing a safety belt, and visiting the physician
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examples of community health
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activities maintenance of accurate birth and death records, protection of the food and water supply, and participating in fund drives for voluntary health organizations such as the American Lung Association
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The reform phase of public health
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was characterized by social movements to improve health conditions in cities and in the workplace
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natural disasters (conventional)
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are the results of the combination of the forces of natures; hurricane, flood, blizzard, tornado, earthquake, landslide
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human-made (technological disasters)
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result from either unintentional (spill of a toxic substance into the environment) or intentional (bioterrorism) human activites, often associated with the use or misuse of technology
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public health preparedness
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the ability of the public health system, community, and individuals to prevents, protect against, quickly respond to, and recover from health emergencies, particularly those in which scale, timing, or unpredictability threatens to overwhelms routine capabilities.
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medical preparedness
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the ability of the health care system to prevent, protect against, quickly respond to, and recover from health emergencies, particularly those whose scale, timing, or unpredictability threatens to overwhelm routine capabilities.
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What are the 4 factors that affect the health of a community?
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physical social and cultural community organization individual behaviors
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the period of social engineering 1960-1973
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saw the US government’s involvement in health insurance through Medicare and Medicaid
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The Health agenda
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Healthy People 2020
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governmental health agencies
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health agencies that are part of the governmental structure (federal, state, of local) and that are funded primarily by tax dollars. They are funded primarily by tax dollars and managed by government officials.
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WHO
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the most widely recognized international governmental health organization
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The most widely recognized international health organization today is the …
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WHO- April 7 is commemorated each year as World Health Day
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What is one of the WHO’s most noteworthy achievements?
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Helping to eradicate smallpox
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Top-down funding
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a method of funding in which funds are transmitted from federal or state government to the local level.
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In the US what is the primary national health agency
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the Department of health and Human Services (HHS)
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The HHS
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is the US government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. it is the largest department in the federal government
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Federal agencies that contribute to the betterments of our nation’s health
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the Department of Agriculture inspects meat and dairy products and coordinates the Women, Infants, and Children (WIC) food assistance program; the Environment Protection Agency (EPA) regulates hazardous wastes; the Department of Labor houses the Occupational Safety and Health Administration (OSHA), concerned with safety and health in the workplace; the Department of Commerce, includes the Bureau of the Census, the Department of Homeland Security (DHS) deals with terrorism withingthe US, and the HHS
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superfund legislation
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legislation enacted to deal with the cleanup of hazardous substances in the environment
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CDC
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the nation’s premiere health promotion, prevention, and preparedness agency and global leader in public health; maintains records, analyzes disease trend, and publishes epidemiological reports on all types of disease
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core functions of public health
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assessment, policy development, and assurance
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State Health agencies p48
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p48
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Local Health agencies
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p48
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quasi-governmental health organization
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organizations that have some responsibilities assigned by the government but operate more like voluntary agencies; also funded by private sources
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Examples of quasi-governmental health org.
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The American Red Cross, the National Science Foundation (NSF), and the National Academy of Sciences (NAS) p53
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Nongovernmental health agencies
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funded by private donations or, in some cases, by membership dues; operate free fro governmental interference as long as they meet internal Revenue Services guidelings
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Types of Nongovernmental Health Agencies
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Voluntary, professional, philanthropic, service, social, religious, and corporate
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Voluntary health agencies
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nonprofit organizations created by concerned citizens to deal with a health need not met by governmental health agencies; exist at 3 levels national, state, and local; funded by paid staff and volunteers p54
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Volunteering Agencies purpose
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to raise money to fund their programs, with the majority of the money going to fund research; to provide education both to professionals and to the public; to provide service to those individuals and families that are afflicted with the disease or health problem; and to advocate for beneficial policies, laws and regulations that affect the work of the agency and in turn the ppl they are tying to help
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professional health organizations
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made up of health professionals who have completed specialized education and training programs and have met the standards of registration, certification ,and/or licensure for their respective fields; mission is to promote high standards of professional practice for their specific profession, thereby improving the health of society by improving the people int he profession; funded by primarily by membership dues
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professional health org. ex
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the American Medical Association, the American Dental Association, the American Nursing Association, the American Public Health Association, the American Association for health education, and the society for public health education, Inc. p55
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philanthropic foundations
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an endowed institution that donates, money for the good of humankind; have money to give away, and therefore no effort is spent on fund-raising; can afford to fund long-term or innovative research projects, which might be too risky or expensive for voluntary or even government-funded agencies
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service, social, and religious org
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Have played a part in community health over the year
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corporate involvement in community health
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p58
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While a primary care physician is concerned with the course of disease in an individual patient, an epidemiologist is ..
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concerned with the course of disease in a population; population medicine
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how many who when where
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epidemiology
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the study of the distribution and determinants of health-related states or events in specified populations; is is a health activity
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epidemic
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an unexpectedly large number of cases of an illness, specific health-related behavior, or other health-related event in a particular population
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endemic disease
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a disease that occurs regularly in a population as a matter of course
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epidemiologist
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on who practices epidemiology
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pandemic
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an outbreak of disease over a wide geographical area such as a continent
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epizootics
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is an outbreak of disease in animals and spread to human populations
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cases
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people afflicted with a disease
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rate
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the number of events that occur in a given population in a given period of time
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natality (birth) rate
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the number of live births divided by the total population
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morbidity rate
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the rate of illness in a population
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mortality (fatality) rate
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the number of deaths in a population divided by the total population
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population at risk
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those in the population who are susceptible to a particular disease or condition
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incidence rate
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the number of new health-related events or cases of a disease in a population exposed to that risk during a particular period of time, divided by the total number in that same population
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acute rate
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a disease that lasts three months or less
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prevalence rate
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the number of new and old cases of a disease in a population in a given period of time, divided by the total number in that population
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chronic disease
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a disease or health condition that lasts longer than 3 months
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attack rate
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an incidence rate calculated for a particular population for a single disease outbreak as a percentage
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crude rate
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a rate in which the denominator includes the total population
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crude birth rate
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the number of live births per 1000 in a population in a given period of time
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crude death rate
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the number of deaths from all causes per 1000 in a population in a given period of time
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age-adjusted rate
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rate used to make comparison of relative risks across groups and over time when groups differ in age structure
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specific rate
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a rate that measures morbidity or mortality for particular populations or diseases
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cause-specific mortality rate (CSMR)
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the death rate due to a particular disease
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What continues to be the single most reliable indicator of a population’s health status
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mortality statistics
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life expectancy
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the average number of years a person from a specific cohort is protected to live from a given point in time
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Years of potential life lost (YPLL)
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the number of years lost when death occurs before the age of 65 and 75
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disability-adjusted life years (DALYs)
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a measure for the burden of disease that takes into account premature death and loss of healthy life resulting from disability
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health-adjusted life expectancy (HALE)
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the number of years of healthy life expected, an average, in a given population
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vital statistics
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statistical summaries of records of major life events such as births, deaths, marriages, divorces, and infant deaths
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National Health Interview Survey
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conducted by the NCHS and ask ppl numerous questions about their health
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National health and Nutrition Examination Survey
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to assess the health and nutritional status of the general US population; most authoritative source of standardized clinical, physical, and physiological data on the American ppl; use mobile examinations
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Behavioral Risk Factor Surveillance System
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a state-based telephone survey of the civilian, non-institutional, adult population conducted by the Behavioral Surveillance Branch, a division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion at CDC
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Youth risk behavior surveillance system
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monitors six categories of priority health-risk behaviors among youth and young adults, including behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and STDs; unhealthy dietary behaviors; and physical inactivity1
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national health care survey
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comprises nine different national surveys that gather information on the nation’s health care system
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descriptive studies
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an epidemiological study that describes an epidemic with respect to person, place, and time
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epidemic curve
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a graphic display of the cases of disease according to the time or date of onset of symptoms
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point source epidemic curve
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an epidemic curve depicting a distribution of cases that all can be traced to a single source of exposure
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incubation period
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the period between exposure to a disease and the onset of symptoms
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propagated epidemic curve
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an epidemic curve depicting a distribution of cases traceable to multiple sources of exposure
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analytic study
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an epidemiological study aimed at testing hypotheses
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risk factors
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factors that increase the probability of disease, injury, or death
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observational study
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an analytic, epidemiological study n which the investigator observes the natural course of events, noting exposed and unexposed subjects and disease development
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case/control study
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a study that seeks to compare those diagnosed with a disease with those who do not have the disease for prior exposure to specific risk factors
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cohort study
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an epidemiological study in which a cohort is classified by exposure to one or more specific risk factors and observed to determine the rates at which disease develops in each class
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cohort
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a group of ppl who share some important demographic characteristic (year of birth, for ex.)
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odds ratio
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a probability statement about the association between a particular disease and a specific risk factor, resulting from a case/controls tudy
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relative risk
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a statement of the relationship between the risk of acquiring a disease when a specific risk factor is present and the risk of acquiring that same disease when the risk factor absent
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experimental (interventional) studies
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analytic studies in which the investigator allocates exposure or intervention and follows development of disease
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placebo
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a blank treatment

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