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HSCI 130- Final Exam Guide - Comprehensive Notes for the exam ( 57 pages long!)


Department
Health Sciences
Course Code
HSCI 130
Professor
Robert Hogg
Study Guide
Final

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SFU
HSCI 130
Final EXAM
STUDY GUIDE

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HSCI 130 - PUBLIC HEALTH NOTES
Lecture #1
— Public Health = to promote health and quality of life by preventing and controlling disease, injury and disability (CDC Mission Statement)
THE APPROACH TO PUBLIC HEALTH ACCORDING TO THE CDC:
Surveillance Risk Factor Identification Intervention Evaluation Implementation
What is the Problem ? ——————> What is the Cause? —————————> What Works? ———————> How do you do it?
PROBLEM ————————————————————————————————————————> RESPONSE
SOLVING HEALTH PROBLEMS IN 4 STEPS:
— 1) Data Collection = surveillance, determine time, place, and person
2) Assessment = interference
3) Hypothesis Testing = determine how and why
4) Action = intervention
5 CORE SCIENCES OF PUBLIC HEALTH
— 1) Prevention Effectiveness — 2) Surveillance — 3) Epidemiology — 4) Laboratory — 5) Informatics
SANITATION AND ENVIRONMENTAL HEALTH
500 BCE here's and Romans practice community sanitation measures
1840’s : The public health act of 1848 was established in the United Kingdom
1970’s: The Environmental Protection Agency was founded
PANDEMICS:
— Influenza: 500 million infected worldwide Polio: vaccine introduced in 1955; eradication initiative launched in 1988
HIV: 34 million living with HIV worldwide; 20% decline in new infections since 2001
PREPAREDNESS FOR DISASTER RESPONSE
— Biologic warfare: plague used as a weapon of war during the Siege of Kaffa
— September 2001: Public health surveillance conducted after 9/11 attacks
— Hurricane Katrina: emergency services, public health surveillance and disease treatment provided
PREVENTION THROUGH POLICY
— Book of Leviticus: the worlds first written health code
— Tobacco Laws: laws banning smoking in public spaces
— Obesity: food labeling and promotion of physical activity
ERAS OF PUBLIC HEALTH 1
— Health Protection (Antiquity - 1830’s): focus on authority-based control of individual and community behaviours. Action framework: religious
and cultural practices and prohibited behaviours. Notable events: quarantine epidemics, sexual prohibitions to reduce disease transmission, dietary
restrictions to reduce food-borne illness
— Hygiene Movement (1840’s-1970’s): focus on sanitary conditions as basis for improved health. Action Framework: Environmental action on a
community Wide basis distant from health care. Notable events: snow on cholera, collection of vital statistics as empirical foundation for public
health and epidemiology, Semmelweis and Puerperal fever.
ANCIENT GREEKS = (500-323 BC) focused on personal hygiene e.g. physical fitness such as the olympics. This was a NATURALISTIC concept
= disease caused by imbalance between man and his environment.
— HIPPOCRATES= was the father of western medicine. He proposed casual relationships (disease and climate, water, lifestyle and nutrition
caused disease). He coined the term EPIDEMIC (epis meaning “on”or “akin to” and demos meaning “people”)
ERAS OF PUBLIC HEALTH 2
— Contagion control (1880-1940’s): focus on germ theory: demonstration of infectious origins of disease. Action framework: communicate disease
control through environmental control, vaccination, sanatoriums, and outbreak investigation in general population. Notable event: Linkage of
epidemiology, bacteriology, and immunology to form TB sanatoriums; outbreak investigation e.g. Goldberger and pellagra
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— Filling holes in the medical care system (1950’s-mid 1980’s): focus on integration of control of communicable diseases, modification of risk
factors, and care of high-risk population as part of medical care. Action framework: public health system for control of specific communicable
diseases and care for vulnerable populations distinct from general healthcare system, beginning of integrated healthcare systems with integration of
preventative services into healthcare systems. Notable event: antibiotics, randomized controlled trials, concept of risk factors, surgeon general
reports of cigarette smoking, Framingham study on cardiovascular risks; health maintenance organizations and community health centers with
integration of preventative services into general healthcare
GROWTH IN SCIENTIFIC KNOWLEDGE
— Louis Pasteur: 1862: proposed that germs caused many diseases , 1888: established the first public health lab
— Robert Knoch: 1833: identified the vibrio that causes cholera, 20 years after Snow’s discovery, also discovered the tuberculosis bacterium.
Cholera = a public health approach = cholera, a fatal intestinal disease was rampant during the early 1800’s in London, causing death
to 10’s of thousands of people in the area. It was commonly though to be caused by bad air rotting from organic matter (sanitary matter- Edwin
Chadwick)
— John Snow: a physician, best known forces work tracing the source of the cholera outbreak and is considered the father of modern epidemiology.
Through continues research, Snow understood what interventions were required to: 1) stop exposure to the contaminated water supply on a larger
scale and 2) stop exposure to the entire supply of contaminated water in the area . His research convinced the British government that the source of
Cholera was water contaminated with sewage.
THE GREAT SANITARY AWAKENING = (1800’s-1900’s) = there was a growth in scientific knowledge and humanitarian ideals, an established
connection between poverty and disease, water supply and sewage removal, and monitored community health status. —->
— SANITATION REVOLUTION: Clean water and water treatment, Food inspections, Soaps, disinfectants and pharmaceuticals,
Personal hygiene (bathing), Public works departments: garbage collection, landfills, and street cleaning, Public health departments and regulation
ERAS OF PUBLIC HEALTH 3
— Health promotion/disease prevention (mid 1800’s-2000) = focused on individual behaviour and disease detection in vulnerable and general
populations. Action framework: clinical and population-oriented prevention with focus on individual control for decision making and multiple
intervention. Notable event: AIDS epidemic and need for multiple interventions to reduce risk, reductions in coronary heart disease through multiple
interventions.
— Population health (21st century): focus on coordination of public health and healthcare delivery based upon shared evidence-based systems
thinking. Action framework: evidence based recommendations and information management, focus on harms and costs as well as benefits of
interactions, globalization. Notable events: evidence based medicine and public health. information technology, new approaches to avoid medical
errors, antibiotic resistance, global collaboration e.g SARS, tobacco control, climate change
WHAT DETERMINES THE HEALTH OF A POPULATION : 1) genes and biology (5%), Health behaviours (15%), Medical Care, Social/
Societal (15%) characteristics, Total ecology (65%)
HEALTH IMPACT PYRAMID Great Public Health Achievements Canada vs. USA
Lifespan of Canadians increased by more than 30 years since early 19000s
— 25 of those years are attributable to advances in public health
— 9 of those were identified by the Centers of Disease Control in the US.
CDC also identified “Fluoridation of drinking water”
— 2 additional achievements that are particularity Canadian have been added:
“acting on the social determinants of health” and “universal policies”
10 Great achievements in Public Health 1900-1999
Vaccination, Motor-vehicle safety, Safer workplaces, Control of infectious
diseases, Decline in deaths from coronary heart disease and stroke, Safer and
healthier foods, Healthier mothers and babies, Family planning, Fluoridation of
drinking water, Recognition of tobacco use as health hazard
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