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69 Cards in this Set
- Front
- Back
fields of public health
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1. basic science
2. biostatistics 3. epidemiology 4. behavioral/social sciences 5. environmental health 6. health services administration |
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silent victories
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preventative measures, absence of problem shows success
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three goals of public health
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1. assessment
2. policy development 3. assurance |
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positive impacts of medicine
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immunology, obstetrics, emergency care, pharmaceuticals
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epilepsy in china
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-stigma associated with epilepsy, would be brought to family
-keeping them in house was response to protect them and you -mental health comorbidity |
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western biomedcine
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individual, clinical intervention, diagnose and treatment, emergency and surgery, technology
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public health
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population, community interventions, education and health promotion, government, prevention, policy
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screening
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who has the disease in a community
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crime and punishment
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a lot of problems in our society are treated as criminal when they're really public health problems
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medical markets
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incentive to develop products that have market advantage, even if they don't match with public health priorities
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placebo use
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know something can help them but intentionally denying it to them for purpose of experiment
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Gibbons v Ogden
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1824
states have police power |
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Queenside Hills Realty Co v Commissioner of Housing in the City of New york
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1946
states have extensive authority to protect public health and safety |
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Jacobson v Massachusetts
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1905
states can require and enforce vaccination if it's necessary for public health safety and common good -has upheld fluoridation of water, fortification of foods, seat belts, motorcycle helmets |
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Griswold v Connecticut
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1965
no state can pass law that infringes on person's right to privacy -led to medical sovereignty |
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Wisconsin v Yoder
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1972
lawful for parents to make decision on religious grounds -harm of violating freedom of religion was worse |
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Prince v Massachusetts
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1943
right to practice religion does not take importance over vaccination requirement |
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church of lukumi babalu v hialeah
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1993
were allowed to break animal slaughtering laws due to religions beliefs -public health has a lot to do with reach of state in regulating |
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Cox v New Hampshire
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1941
permits regulate where, when, and how you can demonstrate publicly so protest doesn't interfere with public health |
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Tick Wo v Hopkins
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due process- all citizens have a right to full and even treatment under the law, full and equal access of government initiatives
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Brown v Board of Education
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1954
separate but unequal was a violation of due process -medical professionals have a high autonomy in how they practice (can't limit what physicians do) |
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nuisance
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origins of government organized behavior has the aim of containing anything that spills over the boundaries of personal liberties
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phases of public health history
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1. general health promotion
2. the sanitary movement 3. bacteriological revolution 4. international public health |
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what can cause an epidemic
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demography, agriculture, climate, host population resistance
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leprosy
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-loss of neurofunctioning in extremities, flaking skin, not that dangerous
-poor have lower resistance -isolation recommended in bible -social death |
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smallpox symptoms
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-leads to blinding and scarification
-30% mortality rate, 80% for at risk groups |
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Plague
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-"black death"
-yersinia pestis transmits it from rats -destroyed crops, targeted Jewish people (lower death rates because of kosher laws and sexual restrictions) -cultural judgements |
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quarantine
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-40 day period
-developed in context of mercantilism -if anyone shows symptoms, go into isolation |
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problems with quarantine
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-conflict between property holders, businessmen, and government/ph
-incentive to evade public health law -put all groups of diseases in same place |
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impacts of epidemic era
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-vulnerable populations more affected than others
-recognize more than one country needed to control disease -origins of public health |
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new poor laws
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can't get governmental assistance if you are able bodied
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effects of new poor laws
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-incentivizes labor
-immigrants move into cities -welfare largely for women and children |
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results of industrialization
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-industry doesn't want high mortality of workers
-synergy between business and public heath -government wants to keep work force healthy |
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Chadwick
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-miasmist
-basic social reforms (clear water, street sanitation) as a way to control infectious disease and improve economy -link between poverty and disease |
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registration of births and deaths act
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1836
-first act on national level in the world to make census taking and statistics of births, deaths, etc. -promoting idea of epidemiology |
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core elements of sanitary idea
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-disease, socioeconomic status, and urban environment closely interlinked
-poor people are more sick -urban planning and engineering |
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modern public health
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-General Board of Health created 1848
-social epidemiology (studies on tenements) -rise of epidemiological research |
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National Board of Health
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-established after reconstruction, first national level department of health
-charged with compiling national statistics and advising government |
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DHSS
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in charge of medicaid and medicare
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National Institute of Health (NIH)
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responsible for funding research
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imagined community
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you have something more in common with someone in california than someone in cuba or puerto rico
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Leewenhoek
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invented 500 microscopic lenses, pioneered microscope
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Pasteur
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-did experiments with changing temperature of food/drinks, found way to kill bacteria without cooking it (pasteurization)
-promoted microbiology -funded by food/drink businesses |
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Lister
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-found it was more common to get disease once hospitalized than not
-experimented with putting alcohol in wounds -created Listerine |
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Koch
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-developed water filtration system to remove cholera (Egypt and India)
-work with microbiology lead to new tensions between medicine and public health |
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Koch's Postulates
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1. microorganisms are found in abundance in diseased organisms
2. they can be isolated from the organism, grown in culture, and reintroduced into health organisms 3. disease-causing microorganisms can be found in asymptomatic individuals |
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von Pettenkofer
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-miasmist
-engaged in bet with Koch about cause of cholera, ate poop, got sick but survived -commit suicide because miasma belief caused deaths |
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effects of bacteriological revolution
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-start focusing on containing transmission and distribution of microorganisms
-public health now concerned with social reform and biomedicine |
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yellow fever
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"black vomit"
-major outbreaks due to increasing population, deforestation -white man's burden in tropics -led to antagonism between settler and indigenous populations |
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neurostemia
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-men got depressed when they came back from tropics
-indicated men took on too much pressure from deal with indigenous people |
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Finlay
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-clinical trial with soldiers, one group exposed to mosquitoes, other group not
-determined mosquito was vector, led to interventions -was it ethical? |
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syphilis
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-primary, secondary, and tertiary stages
-penicillin is treatment |
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rationales for Tuskegee
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-people weren't getting care anyway
-free check ups -never repeated opportunity -men were clinical material, not sick people -get money for funeral |
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IRB
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-certify there is no ethical danger for subjects
-ensure participants have given informed consent -can be controversial |
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smallpox
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-fully eradicated
-variola minor, major, and vaccinae (cowpox) -basis for discoveries that lead to contemporary technologies of vaccination -killed many people in americas |
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Jenner
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studied milk maids, developed variolation process
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advantages of smallpox
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-no animal reservoir
-little/no latency period -no asymptomatic carriers -clinical technological advances |
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eradication timeline
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lasted 20 years
South America/Africa, then India, then Bangladesh |
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surveillance
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monitoring population for health conditions and changes
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baseline
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specific set of data about population that can be used as base for measuring potential change
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prevalence
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distribution in a population (proportion of people affected)
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incidence
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new cases, is disease-specific and age-specific
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Morbidity and Mortality Weekly Report
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-weekly baseline updates
-articles about new findings and updates -creates a summary perspective and management/treatment of disease -creates recommendations |
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NHIS
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wide sampling of population, basic data on health, how government monitors health of population
-50,000 people, annually |
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NHANES
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very detailed questions on health behavior, how health behavior is monitored, public data
-5000 individuals, every year |
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BRFSS
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-tells us about behavioral risk factors (suicide, homicide, gang violence, self harm, etc)
-rolling telephone survey |
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disease notification
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health practitioners take data on patients and report it to CDC
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outbreak investigation
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-has to be as specific as possible
-systematic case finding -interventions for control |
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sensitivity
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true positives/(true positives + false negatives)
-if person actually does have disease, likelihood a test/screening will show they do have disease |