Community Health - Exam 1

Community Health

Health status of a defined group of people in geographic areas, and actions and conditions to promote, protect, and preserve health.

Public Health

Measures that help prevent morbidity, mortality, and disability in the public at large, such as via immunization, monitoring the food and water supply, and increasing preventive health practices.

Primary Health Care

refers to interventions that focus on the individual or family such as hand-washing, immunization, circumcision and use of condoms etc.

Secondary Health Care

refers to those activities which focus on the environment such as draining puddles of water near the house, clearing bushes and spraying insecticides to control vectors like mosquitoes.

Tertiary Heatlh Care

hand refers to those interventions that take place in a hospital setting such as intravenous rehydration or surgery.

Health Protection Era

Authority-bases control of individual and community behaviors. Religous and cultural practices; and prohibited behaviors. Quarantined for epidemics; sexual prohibitons to reduce disease transmission; dietary restrictions to reduce food-borne disease.
(Ant

Hygiene Movement Era

Focused on sanitary conditions; evironmental action on a community-wide basis distinct from health care.
Snow on Cholera; Semmelweis and puerple fever; collection of vital statistics as foundation for publich health and epidemiology.
(1840's-1870's)*

Contagion Control Era

Germ theory; demonstration of infectious origins of disease. Communicable disease control; vaccination. Linkage of bacteriology and immunology to form TB sanatoriums. (1880's-1940's)

Medical Care System Era

Integration of control of commicable diseases; modifications of risk factors; care of high risk populations and medicare. Hospitals; antibiotics; randomized clinical trials; risk factors; Surgeon General report on cigarette smoking.

Determinants

Underlying factors that influence the occurrence of disease and other health-related events. (Ex: Behavior, Infections, Genetics, Geography, Enviorment, Medical care, Socio-economic-cultural.) biggems

Geography

an influence and even the presence of disease based on where you live. Infectious diseases such as malaria, Chagas disease, schistosomiasis, and Lyme disease occur only in certain areas. Also local area conditons like radon levels.

Group Associations

Investigating factors known as "person" and "place" to find patterns or associations in the frequency of a disease. May suggest ideas or hypotheses about the cause (etiology) of a disease.

Individual Association

Can establish that a "cause" is associated with the "effect". Comparing people with the disease to people without. (Case-control/cross-sectional studies.)

Cohort Study

A type of epidemiologic study where a group of exposed individuals (individuals who have been exposed to the potential risk factor) and a group of non-exposed individuals are followed over time to determine the incidence of disease.

Randomized Clinical Trials

study where individuals are assigned to be exposed or not exposed to the poentetial "cause". Individuals with and without the potential "cause are followed over time to determine who develops the "effect". (Not ethical when the "cause" is already establis

A Grade

Must - A strong recommdendation.

B Grade

Should - In general, the intervention should be used unless there are good reasons or contraindications for not doing so.

C Grade

May - The use of judgement is often needed on an individual-by-individual basis. Individual recommendations depend on the specifics of an individual's situation, risk-taking attitudes, and values.

D Grade

Don't - There is enough evidence to recommend against using the intervention.

I Grade

Indeterminant, insufficient or I don't know - The evidence is inadequate to make a recommendation for or against the use of the intervention at the present time.

Primary Intervention

Intervention that includes activities to provide support, information and education to prevent a disease. (brochures, campaign adds, vaccines, etc)

Secondary Intervention

Intevention that includes recognizing health risks and taking action to stop them before they lead to actual illnesses. At risk groups.(Screenings; ie. cancer/blood pressure/prostate)

Tertiary Intervention

Occurs after the initial occurence of symptoms, but before irreversible disability. Aims to prevent irreversable consequences of the disease.

Implementation and Evaluation

P.E.R.I process; the cycle of identifying a problem, the causes, recommendations and implementation. Then evaluating an intervention as a whole and "recycling" the P.E.R.I process.

The Scientific Method

The systematic collection of information that will be analyzed to generate insight into a phenomena. (5 Steps)

Research Question

Simply seeks to examine, explore or describe a phenomenon.

Hypothesis

An educated guess about what is expected to be found in the study.

Variable

Are anything that can effect or change the results of a study.

Operational Defintion

Identifies how a specific variable will be measured.

Bias

All samples of human subjects are biased due to those who are WILLING to participate.

Protecting Research Participants

Protecton from harm, distress and anonymity.

Archival Research

This research examines data already collected. In public health this usually involves examining medical records, census data and other knowledge databases.

Participant-Observer

People know that they are being observed;
this may influence their behavior. (ethnography)

Observer-Participant

People don't know they are being observed ("undercover").
Many consider this unethical (ethnography)

Cross-sectional Research

Data collected at one time only, therefore "cause and effect" can only be inferred (assumed, not proven)

Intervention Research

Comparing at least two groups, one of which received a newly designed treatment or intervention.

Control Group

In intervention research, this group recieves no treatment or intervention.

Comparison Group

In intervention research, this group receives a "standard" treatment, a lower dose of medicine, or "education".

Longitudinal Research

Long term research where participants are surveyed more than once at pre set time points.

Qualitative Research

Research that relies on what is seen in field or naturalistic settings more than on statistical data

Health Informatics

Methods for collecting, compiling, and presenting health information.

Daly

A measure of premature deaths and losses due to illnesses and disabilities in a population.

Hale

A measure of quality of life, the number of healthy years you are expected to live free from disease.

Categories of Hale

Mobility - ability to walk
Cognition - mental function
Self-care - activities of daily living including dressing, bathing,and use of toilet.
Pain - regular pain that limits function
Mood - alteration in mood that limits function
Sensory organ function - i

Global Burden of Disease

Presents data on Dalys in all regions of the world divided into:
Communicable diseases, noncommunicable diseases, and injuries.

Single case or small series

Case reports of one or a small number of cases.
Uses:
Alert to new disease or resistant disease, alter to potential spread.
Adv/Dis:
Useful for dramatic, unusual, and new conditions; requires alert clinicians and rapid ability to disseminate information.

Vital Statistics (and reportable diseases)

Statistics on birth, death, marriage, divorce; reporting of key communicable and specially-selected non-communicable diseases (elevated lead; child and spouse abuse) Required by law. delays in reporting, relies on institutions.

Dread Effect

Perception of an increase in the probability of occurrence of an event due to its ease of visualability and its feared consequences.

Unfamiliarity Effect

Perception of increased probability of an event due to an individual's absence of prior experience with the event

Norms

Risk taking attitude that is influenced by the notion that "everybody else is doing it".

Self-Efficacy

Risk taking attitude where our personal sense of control over a behavior/condition determines how we make our decisions.

Inform of Decision

A decision making approach in which a clinician is merely expected to inform the patient of what is planned.

Informed Consent

A decision making approach in which a clinician is expected to provide information and obtain agreement to proceed from the patient.

Shared Decision Making

A decision making approach in which a clinician is expected to directly or indirectly provide information and options for intervention to a patient and then rely on the patient to synthesize the information and make their own decision.

High Quality Website

Criteria like overall site quality, authors, information, relevance timeliness, links, and privacy are important when determining a (blank).

Socioeconomic factors

Social and economic characteristics like education, income, and occupation that influence an individual's ability to function or compete in society.

Precontemplation

The first phase of the stages of change model in which an individual has not yet considered changing their behavior.

Contemplation

The second phase of the stages of change model in which an individual is actively thinking about the benefits and barriers to change.

Preparation

The third phase of the stages of change model in which the individual is developing a plan of action.

Action

The fourth phase of the stages of change model in which the change in behavior takes place.

Maintenance

The fifth phase of the stages of change model in which the new behavior becomes a permanent part of an individual's life.

1866

NY State legislature passed a law creating the Metropolitan Board of Health, (considered the Birth of the NYC Department of Health.)