UTD Public Health Pt 2 – Flashcards
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Use examples to list the different modes of disease transmission
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1. Air-borne transmission 2. Contact transmission-direct and indirect 3. Vehicle transmission (Water, milk, food etc.) 4. Vector-transmission 5. Tran placental transmission
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Explain the "chain of transmission"
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infectious agent-disease causing agent reservoir- environment that pathogen needs to survive portal of exit- needed for pathogen to exit (ex:mucus, coughing, feces, blood, etc) mode of transmission-indirect or direct contact portal of entry- penetration, inhalation or ingestion; it all depends on how depth) susceptible host- how strong is the bodies immune system and rate of reproduction of pathogen Agent lives in a reservoir to survive, finds a portal of exit and mode of transmission to a portal of entry inside a susceptible host!
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List five examples of vector-borne diseases
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1.) Mosquito borne diseases (West Nile) 2.) tick borne diseases (Lyme disease) 3.) fleas, flies, lice and mites (yersinia pestis) 4.) Plasmodium Parasite(Malaria) 5.) Chikungunya
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Describe the global burden of malaria
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-Public health impact on fertility, population growth, savings, investments, worker productivity, absenteeism, premature mortality *Huge global impact on children, kills a child every 30 seconds, direct impact on demographics
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Explain the demographic impact of malaria
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Parents have "child survivor hypothesis" which means they have more kids to begin with because they know that some will die. This leads to overpopulation, lack of resources, etc in this demographic region. Population Inc. Leads to - less investment in education, limits womens employment options (always taking care of children), and affects economic health of country
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Describe the emergence and evolution of West Nile Virus in the United States
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NYC noted outbreak of encephalitis (brain swelling) in elderly.... Link between birds and elderly Birds- reservoir Insect- vector *Bird might have virus and mosquito gets it from bird but then passes it to humans Birds carried it across the united states, leading to local die offs in the crow and jay populations.
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Describe early methods used to prevent the spread of HIV
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condoms Screening blood supply (preventing donations from high risk groups) taking prevention pills for HIV prior to sexual activity
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And the Band Played On by Randy Shilts
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The beginning of the AIDS epidemic. Tensions run hot when stakes are high, people at first unwilling to admit the existence of the epidemic,
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Use the HIV testing process to explain the difference between sensitivity and specificity
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sensitivity- proportion of all people with disease who test positive (useful for ruling OUT a disease); is the test able to pick up the disease specificity- proportion of all people without a disease who test negative (useful for ruling IN a disease)
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Explain the following terms: positive predictive value and negative predictive value
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-positive predictive value- probability that a person who tests positive for a disease actually does have a disease -negative predictive value- probability that a person is disease free given a negative test result
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List the World Health Organization's 10 guidelines for disease screening
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1. The condition sought should be an important health problem. 2. There should be an accepted treatment for patients with recognized disease. 3. Facilities for diagnosis and treatment should be available. 4. There should be a recognizable latent or early symptomatic stage. 5. There should be a suitable test or examination. 6. The test should be acceptable to the population. 7. The natural history of the condition, including development from latent to declared disease, should be adequately understood. 8. There should be an agreed policy on whom to treat as patients. 9. The cost of case-finding (including diagnosis and treatment of patients diagnosed) should be economically balanced in relation to possible expenditure on medical care as a whole. 10. Case-finding should be a continuing process and not a "once and for all" project.
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Describe the epidemiology of mental illness in the developed world and the U.S
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-1 in 4 American adults suffer from a diagnosable mental disorder; mental illness is a large proportion of disability in developed countries and bigger than groups of illnesses including cancer ; heart disease -economic cost is $300 billion in US
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Explain how outbreaks of suicide are investigated
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-psychological autopsies = investigating death by trying to reconstruct their mental state and actions before death; interview people who were close to them -qualitative assessments- focus groups to gather data from key people in the Bhutanese committee to find out about culturally-appropriate questions and adapt surveys to fit the target culture -surveillance and screening through BRFSS, PRAMS, etc. (mostly behavioral health, addiction, and injury surveys)
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Describe how mental illnesses are influenced by environmental factors
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Stressful environments can precipitate mental illnesses (i.e. college campuses, Native American reservations, low SES communities) -environmental factors like lead in water supply can affect behavioral risk and brain development
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Explain the challenges inherent to mental health prevention strategies
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Stigma- people may fear "judgement" and how others perceive the fact that the patient has a mental illness, so they may not seek treatment; CULTURE is a HUGE FACTOR, so each culture has to be carefully studied and thoroughly understood; lots of factors may be involved, so prevention may not necessarily work due to noncompliance / victims feeling like surveyors don't understand their situation mental health conditions are infectious (EX: Bhutanese refugee suicides and their perception on the "Index of Happiness")
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Describe recent outbreaks of vaccine¬preventable diseases in Texas and the U.S.
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Measles outbreak and Texas Megachurch At Center of Measles Outbreak
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Explain the concepts of herd immunity and cocooning
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herd immunity: Proportion of a population that needs to have immunity to a disease in order to prevent an outbreak in the community cocooning- vaccinating parents / family members against certain infectious diseases to try and prevent transmission to babies that are too young to get vaccinated
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Explain factors for the re¬emergence of vaccine¬ preventable diseases
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Vaccination levels significantly lower for American Indian and Alaska Native children compared with other children -Exclusion of Native Americans/ Alaskan Natives from vaccine trials= vaccines less effective for Native Americans/Alaskan Natives used -NMR Wakefield controversy = lower vaccination rates for general population
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Describe the demographics of American Indian and Alaska Native populations
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2.9-5.2 million people .9-1.7% in the US 566 recognized tribes
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Explain why death rates from H1N1 flu in 2009 were four times higher among American Indians and Alaska Natives
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already WEAK IMMUNE systems b/c of higher rates of underlying chronic illness like asthma and diabetes (everything goes untreated, so non-communicable diseases common); poverty, delayed access to healthcare, live far away from healthcare; low vaccination coverage
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Explain how sovereign nations work with federal, state and local public health agencies
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ribal public health departments -FEDERAL- Indian Health Service (IHS) is an agency within the Dept. of Health & Human Services that provides free federal health programs and services -Work with tribal immunization programs across US Mission -reduce incidence of VPDs (Vaccine preventable diseases) among American Indians and Alaska Natives
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Describe the epidemiology of TB globally and in the U.S.
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one of the MOST COMMON infectious diseases worldwide ? of people infected in the world including 4% of the US population are infected TB disease about 9 million people worldwide ~9582 cases in the US 10% of infected people end up having the disease
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Describe risk factors for TB
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HIV Alcoholism Crowded living conditions with poor ventilation Prison Increased cases in areas where public health broke down Being the close contact of someone suffering from TB disease
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ELISA
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first test that looks for HIV anti-bodies
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Describe the role of Directly Observed Therapy in the management of TB
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**Makes sure patients comply & take medication DOT is a way to prevent the development of MDR strains. MDR strains occur as a result of inconsistent use of antibiotics.
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Explain the difference between latent TB infection and TB disease
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Latent: TB lives within body but not causing illness, no symptoms, cannot spread to others TB Disease (TBD): person is sick with symptoms and can spread to others
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Describe the epidemiology of workplace injuries and fatalities in Texas and the U.S
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4,405 people died from workplace-injuries in the US in 2013 Deadliest Job- defined by total deaths per occupation per year 1st Loggers 2nd Fishers 3rd Pilots and aviation engineers Localized pockets 2013- Texas 12% more likely to get killed doing the same job than the national average Homicides = 13% workplace deaths (Taxi drivers have the highest rates) Other issues- Popcorn lung, black lung in mining
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Describe the roles of the National Institute for Occupational Safety and Health and the Occupational Safety and Health Administration
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OSHA- main federal agency that enforces health and safety legislation for work place; employment standards administration- observes wage and breaks; set standards for noise control and temperature NIOSH- **part of CDC specific for coal miners & traditional agricultural industries; develops recommendations for mine health and safety standards (lvl of coal dust and fires and floods) and study the health of coal miners
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Describe the epidemiology of coal worker's pneumoconiosis in the U.S.
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coal worker's pneumoconiosis (a.k.a black lung, PMF if severe)- caused by inhaling coal dust; symptoms are fatique, chest pain, weakness; rates increasing due to noncompliance of coal miners- very macho culture, longer shift days, & companies flout laws for productivity (esp in fracking)
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Explain how outbreaks of workplace¬related injuries or deaths are investigated
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NIOSH investigates the outbreak and makes suggestions, but compliance is up to the company; EX: using a system to detect changes in the lung of each miner periodically & recording data; can only push for enforcement of safety measures like wearing protective equipment, constantly check on if the company's infrastructure is safe for workers; possibly monetary incentive
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Describe the changing epidemiology of legal and illegal drug overdose deaths in Texas and the U.S.
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drug overdose = leading cause of injury death in the U.S. From 1999 to 2012, the rate of deaths from drug overdose in the U.S. increased 117% - 80% unintentional - 13% suicide attempts - 6.7% unknown intention (have to determine from biopsy after death) • 53% of drug overdose deaths in 2012 were caused by pharmaceutical drugs, not illicit drugs such as cocaine.
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List the laws that aim to prevent injury and death from drug overdose
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Prescription drug monitoring programs- track prescriptions (to prevent doctor shopping) Policies to reduce opiod over-prescriving (educate provider) -Harm-reduction strategies o Aprropriate prescribing o Access to treatment of substance misuse o Access to Naloxone o Encourage bystanders to call 911 when they see people overdosing on opiods o Good Samaritan Law -physical exam laws -tamper-resistant prescription forms -Pill mill (pain clinics, doctors make money off of just prescribing meds)
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Explain the role of doctors in managing the prescription painkiller epidemic
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Encourage providers to use prescription drug monitoring program before prescribing Proper prescribing: WHO analgesia ladder; must know if they are prescribing too much ; lower amounts accordingly
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Primary, secondary, and tertiary levels of painkiller addiction
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Primary- keeping healthy people healthy Educating to prevent addiction Secondary- early detection Blood pressure checks, detect addiction early Tertiary- targeting people who are already addicted Offering treatment, counseling
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Describe the demographics of the U.S. prison population
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-Americans = 5% of world's population but 25% of world's prisoners -South US has the most inmates, far north has the least -mostly black prisoners -205,000 women in prison in the US (black women double than white women) -more than 60% illiterate; education level is grade 6 = a cycle of poverty -HIV patients 2.5 times higher in prisons -2 million prisoners, highest incarceration rate in the world
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List three health conditions that disproportionately affect prisoners
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1) infectious diseases (HIV, Hep-C, botulism, coccidioidomycosis) 2) mental illness-(schizophrenia, depression) 3) addiction
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Explain the challenges of investigating a disease outbreak in a prison
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-dishonesty b/c inmates would not reveal the truth about their actions -lack of trust -outside investigators' accessibility to inmates is limited and difficult Ex) Inmates tried to get rid of the Broccoli
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Describe the controversy and evidence for condom distribution and needle exchange programs in prisons
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Against it: Sex and drugs are not allowed in prison, if allowed to start these programs then some people might view this as enabling them to to participate in illegal acts Favors it: If prisoners are going to do these things anyways then we should try and prevent diseases from spreading (Harm reduction strategy) -Prisoners are not allowed to have sex or have any substances (so why give condoms and needles?) -prisoners share needles b/c they don't have enough or they do it in secrecy; supporting exchange programs would be like supporting use of needles -needles could be used as weapons or it could increase drug use amongst inmates Drug use still occur no matter what....
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List five ways in which conflict and war impacts public health
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Death or injury, adverse effects on medical care and public health services (AHPs die or flee, clinics destroyed, lack of resources for care), damages the environment (water supply, sewage treatment), causes people to become refugees or homeless, human rights violations physically and emotionally, diversion of human and financial resources (federal spending to fund the war efforts), promotes violent behavior in society
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Describe the epidemiology of gun-related deaths and injury in the U.S.
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More heavily affects children, a child is killed or injured by a firearm every 30 minutes; among top 3 causes of death among youth, causes 2x as many deaths as cancer, 5x as many as heart disease, and 15x as many as infectious diseases; Approximately 7.4 people per day are killed unintentionally by a gun Gun violence is the number one cause of death for young African Americans between the ages of 10 and 19. Gun violence is the Number 2 cause of death for young Americans between the ages of 10 and 19.
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Describe the history of the Centers for Disease Control and Prevention in collecting and analyzing data about injuries and deaths from guns
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•Used to investigate gun violence •Bill was passed to stop CDC from using federal funds to study gun violence •Dickey Amendment was passed 1996
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Explain the role of public health in addressing domestic violence
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Like any public health problem public health wants to define the problem, identify risk and protective factors, suggest and assess prevention strategies and assure widespread adoption of working strategies •CDC Added question about intimate partner violence to BRFSS in 2008
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Describe the epidemiology of intimate partner violence in the U.S.
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Pregnant women especially at risk, more frequent in places w/ low socioeconomic status Actual statistics: ? 23.6% of women and 11.5% of men reported at least one lifetime episode of intimate-partner violence. ? In households with incomes under $15,000 per year, 35.5% of women and 20.7% of men suffered violence from an intimate partner.
