Podcast
Questions and Answers
Which of the following is NOT an example of an occupational investigation?
Which of the following is NOT an example of an occupational investigation?
Which of the following is NOT a step in the Four Step Risk Assessment process?
Which of the following is NOT a step in the Four Step Risk Assessment process?
What health effect is associated with benzene exposure?
What health effect is associated with benzene exposure?
What year was the Occupational Safety and Health Administration (OSHA) established?
What year was the Occupational Safety and Health Administration (OSHA) established?
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What is a key difference between an Occupational Investigation and a Public Health Assessment?
What is a key difference between an Occupational Investigation and a Public Health Assessment?
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What contaminant has been linked to ecological risk in the Great Lakes?
What contaminant has been linked to ecological risk in the Great Lakes?
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Which of the following statements is TRUE about Public Health Assessments?
Which of the following statements is TRUE about Public Health Assessments?
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What is the purpose of Ecological Risk Assessment?
What is the purpose of Ecological Risk Assessment?
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What is a key characteristic of Sentinel Monitoring?
What is a key characteristic of Sentinel Monitoring?
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Which of the following is NOT a principle outlined in the Nuremberg Code?
Which of the following is NOT a principle outlined in the Nuremberg Code?
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The Unfamiliarity Effect in risk perception is best illustrated by which of the following?
The Unfamiliarity Effect in risk perception is best illustrated by which of the following?
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What is the primary purpose of Syndromic Surveillance?
What is the primary purpose of Syndromic Surveillance?
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Which of the following is a key concern regarding data collected in Syndromic Surveillance?
Which of the following is a key concern regarding data collected in Syndromic Surveillance?
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Which of the following is NOT a key principle of the Belmont Report?
Which of the following is NOT a key principle of the Belmont Report?
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How does the Dread Effect contribute to the way people perceive risks?
How does the Dread Effect contribute to the way people perceive risks?
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What is the primary focus of Risk Assessment?
What is the primary focus of Risk Assessment?
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Which of the following is NOT a goal related to increasing social and community support?
Which of the following is NOT a goal related to increasing social and community support?
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Which of the following interventions is categorized as tertiary prevention?
Which of the following interventions is categorized as tertiary prevention?
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Which of the following is NOT an example of a vital statistic typically used in public health?
Which of the following is NOT an example of a vital statistic typically used in public health?
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Which type of public health data relies heavily on individual patient self-reporting for information?
Which type of public health data relies heavily on individual patient self-reporting for information?
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Which of the following is a key challenge associated with using surveys and sampling for collecting public health data?
Which of the following is a key challenge associated with using surveys and sampling for collecting public health data?
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The PERIE approach in public health focuses on understanding which critical aspects of an intervention?
The PERIE approach in public health focuses on understanding which critical aspects of an intervention?
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What is a common advantage of single case or small series data collection?
What is a common advantage of single case or small series data collection?
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Which of these groups are identified as struggling in school and less likely to graduate?
Which of these groups are identified as struggling in school and less likely to graduate?
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Which of the following domains is NOT considered a social determinant of health in Healthy People 2030?
Which of the following domains is NOT considered a social determinant of health in Healthy People 2030?
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Which of the following is an example of an intervention that aims to improve economic stability and potentially improve health outcomes?
Which of the following is an example of an intervention that aims to improve economic stability and potentially improve health outcomes?
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Which of the following is an example of an intervention aimed at improving the "Neighborhood and Built Environment" domain, as defined by Healthy People 2030, to promote health and safety?
Which of the following is an example of an intervention aimed at improving the "Neighborhood and Built Environment" domain, as defined by Healthy People 2030, to promote health and safety?
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What is the main goal of improving economic stability as a social determinant of health?
What is the main goal of improving economic stability as a social determinant of health?
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Which of the following best illustrates the concept of "bottleneck" within systems thinking in public health?
Which of the following best illustrates the concept of "bottleneck" within systems thinking in public health?
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Which of the following best illustrates the concept of a "leverage point" within systems thinking in public health?
Which of the following best illustrates the concept of a "leverage point" within systems thinking in public health?
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Which of the following scenarios BEST exemplifies the concept of "systems thinking" in public health?
Which of the following scenarios BEST exemplifies the concept of "systems thinking" in public health?
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Which of the following is NOT an example of a potential "leverage point" for improving access to quality healthcare in the "Healthcare Access and Quality" social determinant of health?
Which of the following is NOT an example of a potential "leverage point" for improving access to quality healthcare in the "Healthcare Access and Quality" social determinant of health?
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Study Notes
Public Health Week 4
- The course covers Schneider Chapter 4-8
- Learning objectives include comparing determinants of disease, illustrating approaches to identify causes and assess intervention efficacy, interpreting intervention options, analyzing public health data, and differentiating how perceptions affect information interpretation.
- Learning objectives also include interpreting key principles of human research ethics, analyzing public health ethics, distinguishing between risk, public health, and ecological assessments, and analyzing the meaning of interactions and how these impact risk.
- Students will learn techniques to analyze systems thinking, interpret how systems thinking is different from reductionist thinking, characterize systems, and understand how to conduct systems analysis using systems diagrams
- Students need to know how to analyze the meaning of interactions between factors, how to illustrate and employ One Health, and how to analyze the uses of systems thinking in public health.
Social Determinants of Health
- Social determinants of health are non-medical factors influencing health outcomes.
- Five domains are Economic stability, Neighborhood and built environment, Education access and quality, Social and community context, and Healthcare access and quality.
Economic Stability
- One in ten people in the US live in poverty
- The goal is to reduce poverty through steady employment
- Many people struggle to find and keep reliable jobs.
- Employment programs, career counseling, and high-quality child care help more people find and keep jobs.
Neighborhood and Built Environment
- The goal is to create neighborhoods and environments that boost health and safety.
- Interventions and policies (local, state, federal) can reduce health and safety risks.
- Opportunities for walking and biking (sidewalks, bike lanes) support health and safety and increase quality of life.
Education Access and Quality
- The goal is to enhance educational opportunities and support children doing well in school.
- Higher education correlates with better health and longer lifespans.
- Children from low-income homes, children with disabilities, and those facing discrimination often struggle in school and are less likely to graduate high school or college.
- Difficulty with education leads to fewer, lower-paying job prospects.
Social and Community Context
- The goal is increasing social and community support.
- Positive interactions and relationships positively impact health and well-being.
- Building social support can help minimize challenges and dangers.
Health Care Access and Quality
- The goal is improving access to high-quality comprehensive healthcare services.
- One in ten people lack health insurance coverage.
- Strategies to increase insurance coverage are vital for everyone to access necessary care.
PERIE Approach
- This evidence-based public health approach is represented by a circular process that moves through the steps of problem, etiology, recommendations, implementation, and evaluation.
Interventions-When, Who, and How?
- Intervention timing is linked to the course of a disease (Primary: before onset, Secondary: after development but before irreversible disability, Tertiary: after initial symptoms but before irreversible disability).
- Interventions are targeted to individuals, groups, vulnerable populations, or the community as a whole.
- Implementation methods include education, motivating incentives, and regulatory measures.
Types of Public Health Data
- Single cases or small series of cases: Case reports regarding new, resistant, or spreading diseases (SARS, anthrax, mad cow disease).
- Vital statistics and reportable diseases: vital statistics (birth, marriage, divorce, death), and communicable and non-communicable diseases. Identifies leading causes of death and tracks diseases.
- Surveys and sampling: Disease registries, national surveys (NHANES) support population-level conclusions but require careful consideration for achieving complete data.
- Self-reporting: Monitors for patient side effects, helps identify uncommon events, and usually relies on patient compliance.
- Sentinel monitoring: Identifies the beginning of predicted outbreaks, requires intimate knowledge of disease patterns, and has a significant impact on detecting and understanding a predicted outbreak.
- Syndromic surveillance: Uses patterns in symptoms (OTC drug increases), helps detect unexpected outbreaks or bioterrorism. Provides an early warning, not a diagnosis
How Do Perceptions Affect Interpretation of Information?
- Dread effect: Information about visually frightening events or catastrophic events evokes higher concern than similar events that are less easily visualized.
- Unfamiliarity effect: Things familiar are less concerning than unfamiliar things even when the unfamiliar is just as or more hazardous to one's health.
- Uncontrollability effect: Risks perceived to be manageable have a lower emotional impact than those events that seem out of one's control.
Bioethical Principles
- Bioethics incorporates the principles of autonomy, liberty, privacy, and individual rights.
- Public health ethics focuses on societal protection, paternalism, and the common good.
- Ethical considerations involve these shared ethical commitments.
Nuremberg Trials
- Provided guidelines for ethical research
- Critiques concerning Nazi treatment and crimes lead to the establishment of the Nuremberg Code.
Tuskegee Syphilis Study
- Conducted in 1932
- Involved 600 African American men.
- Followed the natural progression of syphilis.
- Ethical concerns regarding the lack of treatment with readily available penicillin and the unequal treatment of the research participants.
Belmont Report
- Establishes principles for ethical human research.
- The requirements of respect for persons, beneficence, and justice guide the current approach to protection for research participants.
Risk Assessment
- Measures potential impact of known hazards (inherent danger).
- Qualitative and quantitative analyses quantify, define paths, and understand exposure timing.
- Examples include chimney sweeps' exposure to carbon residue and ship workers' experience with asbestos.
- Occupational Safety and Health Administration (OSHA) plays a significant role in these analyses and investigations.
Four-Step Risk Assessment
- Steps to analyze hazard identification, dose-response relationships, exposure assessment, and risk characterization.
Benzene
- Benzene is discussed as a case example within the context of the four-step risk assessment. Understanding the potential health effects, dose response relationships, exposure assessment, and risk characterization associated with benzene is important.
Public Health Assessment
- Public health assessment includes data regarding actual exposure in a specific community, taking into account the risks for large groups of individuals and the population at large.
- Data collection and completion of assessments can take many years or decades.
Ecological Risk Assessment
- Examines the effects of contaminants (chemical, radiative, and genetically altered) on ecological systems.
Mercury
- Mercury in the environment comes from industrial processes.
- Mercury can concentrate in fish and other aquatic life.
- Mercury can have detrimental effects on birds and humans.
Multiplicative Interactions
- Exposure to multiple hazards often result in greater health impacts than just the effects of each additive hazard.
- Radon and cigarette smoking are discussed as an example for this type of interaction.
Systems Diagrams
- Identify key factors in the system.
- Indicate the direction of influence and relationship between factors.
- Interpret the strength of influence by visual representation of the arrow thickness.
- Apply these principles to identify positive and negative feedback loops.
Systems Analysis
- Step 1: Identify the most important influences on the outcome of interest.
- Step 2: Establish the relative strength of each influence or intervention. Linear relationships are analyzed to better understand the relative importance of impacts
- Step 3: Analyze how the influences interact. Interactions may be additive or multiplicative. Look for relationships that affect the outcomes positively or negatively
- Step 4: Analyze the dynamic changes that result from the interactions and how they may create feedback loops in the system for both improvement and attenuation of goals
- Step 5: Identify bottlenecks
- Step 6: Identify leverage points. Bottlenecks in a system show where the system may be weakest or where actions to resolve the bottleneck will have the most significant impact Analyze both positive and negative feedback loops. Positive feedback loops provide accelerating growth or decay, while negative feedback loops attenuate impacts.
One Health
- Recognizes that human health is dependent on the health of animals and ecosystems.
- Advocates for systems thinking to understand connections for ecosystem, human, and animal health.
- Provides a framework for disease outbreaks and transmission and the potential for new and emerging contagions for treatment.
Learning Objectives (continued)
- The content includes discussion of risk assessment, public health assessment, ecological assessment, and one health frameworks.
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Description
This quiz covers the essential concepts from Schneider Chapters 4-8, focusing on determinants of disease and intervention efficacy. Students will analyze public health data, human research ethics, and systems thinking. Gain an understanding of risk assessments and the interactions affecting public health outcomes.
