MLSC 2060 Public Health Exam I Study Guide (Spring 2025) PDF

MLSC 2060 Public Health - Spring 2025 Exam I study guide Tuesday; February 04, 2025; 3.30 pm. – 4.45 pm. (Virtual via D2L) Require LockDown Browser and Respondus Monitor Ame Liz Mari...

MLSC 2060 Public Health - Spring 2025 Exam I study guide Tuesday; February 04, 2025; 3.30 pm. – 4.45 pm. (Virtual via D2L) Require LockDown Browser and Respondus Monitor Ame Liz Mari THIS IS UPDATED!!!!!!!!!! Dr. Lodh – Introduction to Public Health 1. Similarities and differences between public health and medical care. Public Health: primary focus on population. -public service ethic, tempered by concerns for the individuals -emphasis on control and prevention health promotion for the whole community. -public health paradigm employs a spectrum of interventions aimed at the environment, human behavior, lifestyles and medical care. Medical Care: primary focus on individual -personal service ethics, conditioned by awareness of social responsibility. -emphasis on diagnosis and treatment, care for the whole patient. -medical paradigm places predominant emphasis on medical care. 2. Social justice aspect of public health. -Belief that access to health services and health itself are a fundamental right. -Government has an obligation to provide healthy conditions for citizens who are unwilling or unable to provide such conditions for themselves and to provide medical care for those who need it. 3. Factors impacting public health. 1. assessment -monitoring and investigating health problems 2. policy development -educating and empowering communities -developing policies and plans that support health 3. assurance -enforce laws and regulations -assures the quality and accessibility of health services -competent workforce -evaluate programs 4. Different public health approaches. Surveillance and research: what is the problem? risk factor identification: what is the cause? Intervention evaluation: what works? Implementation: how do you do it? Evaluate/assess the effectiveness of intervention: did it work? 5. Different levels of prevention in public health. Primary prevention: vaccinations, education, wearing seatbelts, smoking cessation programs Secondary prevention: checkups, mammograms, pap smear, colonoscopy Tertiary prevention: managing blood sugar for diabetics, cardiac rehab after a heart attack, physical therapy after a stroke, support groups. 6. Contribution to public health. Immunizations Motor Vehicle Safety Workplace Safety Control of Infectious Diseases Declines in Heart Disease and Stroke Safer and Healthier Foods Healthier Mothers and Babies Family Planning Fluoridation of Drinking Water Tobacco as a Health Hazard Dr. Klockow – Introduction to Epidemiology 1. Definition of Epidemiology and its related variables. The study of the distribution and determinates of health-related states in specific populations and the application of this study to control health problems. A major part of public health’s assessment function Investigates causes of diseases Identifies trends in disease occurrence Evaluates effectiveness of medical and public health interventions 2. Types of epidemiology. Descriptive: Used when little is known about the disease Rely on preexisting data Who, where, when  Generates hypotheses regarding associations as to the causes and risks factors of the disease Describes epidemiology by time place and person ▪ Time o Annual, seasonal, weekly, hourly, weekday vs weekend o Elapsed time since an exposure (epidemic curve) ▪ Place o Geographic variation o Urban/rural differences, neighborhood clusters o Location of work sites or schools or social event ▪ Person o Demographic factors (age, sex, marital status, and socioeconomic status) o Race/ethnicity o Behaviors o Environmental exposures Does NOT involve a comparison group Analytical: Used when insight about various aspects of disease is available Rely on development of new data Why? How? Used to test hypotheses about the casualty of associations ALWAYS involves a comparison group which provides baseline data to quantify the association between exposures and outcomes ▪ Experimental: o Epidemiologist have control over the circumstances from the beginning (ex. Randomized control trial) ▪ Observational: o Investigators do not intervene but merely seeks to observe and quantify the relationship between and exposure and a health outcome 3. Different types of epidemiological studies – basics and examples. Intervention, case-control, cohort, ecological, and cross-sectional. Observational Cohort- individuals defined according to exposure; followed for disease Case-control- individuals defined according to disease; exposures compared Experimental Intervention- individuals defined according to assigned exposure; followed for disease Ecological- populations defined according to exposure and disease at a single time Cross-sectional- individuals defined according to exposure and disease at a single time point Case reports/ case series- single individual or single group defined according to disease 4. Epidemiological triangle. Host, agent and environment 5. Ethical considerations for epidemiological studies. Ensuring informed consent, protecting participant privacy and confidentiality, minimizing potential harm, managing conflicts of interest, and selecting study populations equitably, while also considering the potential social impact of research findings and the responsibility to communities affected by the study topic. Example of a profoundly unethical study: Tuskegee experiment started in 1932 New rules – informed consent New rules – institutional review boards Cannot knowingly expose a participant to harm Cannot withhold known benefit to study subjects 6. Threats to the validity of Epidemiological studies. Chance: role of random variation in outcome measure(s) → largely determined by sample size → p value; power of the study and confidence interval Confounding variables: 3rd variable (causal) assoc. w/ both X and Y Bias: role of systematic error in outcome measure(s) →Selection bias - subjects not representative → Reporting/ recall bias - error(s) in subject data/ classification Dr. Lodh – Statistical Methods used in Public Health (formula will be provided) 1. Measures of central tendency. Mean: the average value of values in the set. - Add all the numbers and divide by how many numbers there is Median How many numbers+ 1 divided by 2= the number you will pick Ex) 9 numbers + 1= 10 divided by 2= 5… you will pick the 5th number in this case 12 Mode The number that appears the most, in this case, 11 2. Measures of disease frequency. -Prevalence: total cases (old+ new) - Risks: only new cases -Rates: percentage -Odds Odds: P/(N-P) 3. Measures of association. Risks ration and odds ratio RR= risk among exposed / risk among non-exposed OR= Odds that an exposed person develops the disease/odds that a non-exposed person develops the disease 4. Statistical inference. P value and confidence intervals P value - 5. Basics of all statistics as mentioned earlier and their calculation. 6. Specific types of risk and rates. Mortality rate: o Number of deaths occurring in a specified population in each period o Crude mortality: death rate in an entire population o Cause specific mortality: the rate at which deaths occur for a specific cause Case-fatality rate: o Deaths due to the specific cause A divided by the number of cases from that specific cause A. # deaths due to disease A during specific time #cases of disease A during that time Dr. Martins – The Role of Ethics in Public Health 1. Bioethics and public health – relationship (themes), interdisciplinary nature. I couldn’t find this 2. UN Sustainable Developmental Goals (SDG). couldn’t find on pp. Got from google 1. No poverty 2. Zero hunger 3. Good health and well being 4. Quality education 5. Gender equality 6. Clean water and sanitation 7. Affordable and clean energy 8. Decent work and economic growth 9. Industry, innovation and infrastructure 10. Reduces inequalities 11. Sustainable cities and communities 12. Responsible consumption and production 13. Climate action 14. Life below water 15. Life on land 16. Peace, justice and strong institutions 17. Partnership for the goals  3. Ethical resources – principles and values, framework, health care specifics. Principles and values Principles and values influence the way that healthcare services are made available and accessible. These will define, especially at the national level, whether health care will be offered with universal access targeting coverage of the entire population, or whether health care will be a privilege that some individuals and groups can access based on their capacity to purchase these services. Studies and reports have suggested that public systems that focus on primary care and universal coverage have given better results in promoting health and well-being. Ethical framework - Autonomy - Beneficence - Non-maleficence - Justice - Situational awareness - Prudential reasoning - People-centered perspective - Biosocial approach - Local participation - Principle of vulnerability - Humility - Prudence/discernment Specific to the healthcare field 1. Clinical practices 2. Medical research 3. Public health 4. Ethical dilemmas – commodity vs. human rights, other aspects. Healthcare as a Commodity ▪ Commercialization of Health care ▪ Profit-driven ▪ High cost of services and medications ▪ Cost-sharing and imposing fees to the patient ▪ Individualistic market approach ▪ Privatization of all healthcare services and systems ▪ Minimal or no regulation of the health market ▪ Globalization of health market opportunities: dismantling public health system in low/middle-income countries  Healthcare a Human Right ▪ It is a communitarian approach, a Sense of societal solidarity ▪ Health care a social good; Substantive equality ▪ Public Participation; Inclusion and participation ▪ Inclusion And participation of the disadvantaged and vulnerable ▪ Intersectoral action – collaboration ▪ Universal health care coverage with fair distribution ▪ Primary care is central ▪ Access to essential medicines ▪ Shared Research and public access 5. Bioethics relevant to public health case studies. Bioethics: ethical reflection on the practices related to the sciences of life, vulnerable populations, and the social determinants for health and well-being Dr. Whitmore – The Role of Policy and Government in Public Health 1. Role of WHO (World Health Organization) Directing and coordinating authority for health within the UN system Established April 7, 1948 (World Health Day) Exists to promote communication and collaboration among nations on important matters of health The international headquarters is located in Geneva, Switzerland The organization is headed by the Director General who is appointed by the World Health Assembly Not all countries are represented, and recommendations for practice or policy within non-member countries cannot be enforced WHO Core Functions Provide leadership and engage in partnerships Shape the health research agenda Set norms and standards and promote and monitor their implementation Articulate ethical and evidence-based policy opinions Provide technical support to countries and build sustainable institutional capacity Monitor and assess health trends 2. Role of CDC. The nation′s premier health promotion, prevention, and preparedness agency Traditionally focused on infectious diseases but now includes chronic diseases, genetics, injury and violence, and environmental health Houses the National Center for Health Statistics  National authority for collecting, analyzing, and disseminating health data Publishes the Morbidity and Mortality Weekly Report (MMWR) 3. Role of United Nations (UN). Maintain international peace and security Protect human rights Deliver humanitarian aid Promote sustainable development Uphold international law 4. Role of different public health departments – state, federal, local. Role of health equity. State- state health agencies such as health departments and human service agencies Local- local public health agencies, often called local health departments Federal- federal health agencies such as DHHS and CDC Tribal and Territorial- Indian Health Service and others 5. Healthy People 2030 initiative Improves nations health Provides science-based objectives and targets Tracks data-driven outcomes to monitor progress overtime to motivate, guide and focus action Engages a network of multidisciplinary, multisectoral stakeholders at all levels Guides national research, program planning and policy efforts that drive action to promote health and prevent disease