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HLTH130 exam 3
Study Guide Material
30
Health Care
Undergraduate 2
11/12/2012

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Cards

Term
Sequence of Events leading up to Surgeon General's report on Tobacco
Definition
1961: National Commission on smoking called for by the American Cancer Society, the American Heart Association, the National Tuberculosis Association, and the American Public Health Association who addressed a letter to President John F. Kennedy.
1962: The Surgeon General (Terry) gathered a committee of experts to conduct a review of the scientific literature on “the smoking question”.
1962-1964: The committee reviewed more than 7,000 scientific articles with the help of over 150 consultants.
January 11, 1964: The Surgeon General issued the commission's report, choosing a Saturday to minimize the effect on the stock market and to maximize coverage in the Sunday papers.
Term
Major Victories Against Tobacco
Definition
1965, Congress required all cigarette packages distributed in the United States to carry a health warning.

Since 1970 this warning is made in the name of the Surgeon General
1969, cigarette advertising on television and radio was banned (effective September 1970.)
Term
Tobacco Master Settlement Agreement: November 1998
Definition
Between the four largest US tobacco companies--Big Tobacco--and the Attorneys General of 46 states
The states settled their Medicaid lawsuits against the tobacco industry for recovery of their tobacco-related health care costs, and also exempted the companies from private tort liability regarding harm caused by tobacco use.
The companies agreed to curtail or cease certain tobacco marketing practices, as well as to pay, in perpetuity, various annual payments to the states to compensate them for some of the medical costs of caring for persons with smoking-related illnesses.
The money also funds a new anti-smoking advocacy group, called the American Legacy Foundation, that is responsible for such campaigns as The Truth.
Term
Snow’s contribution to “evidence-based social action”
Definition
Epidemiologic legend has it that John Snow took socially responsible action and removed the handle from the contaminated Broad Street water pump. On the basis of the very best science then available, he took social action to remove a documented threat to the public health. He would have used the same approach to defeat Big Tobacco. This means that Snow would have worked to dismantle price supports, crop insurance, tax subsidies for advertising and lobbying, and the private purchase of public officials.
Term
3 factors that the “Future success of public health will be shaped by
Definition
• Realistic assessment of the magnitude and tactics of our enemy: Learn from the defeat, and even adopt some of Big Tobacco’s strategies. For example Big Tobacco only spent 40 million on their victory, clearly getting value for their money.
• The changing nature of the U.S. state: There is a shift from pluralist umpire to anti- leviathan occurring on the state level. The state seems to be losing the ability to protect Public Health.
• Rethinking our posture of scientific objectivity: To encompass the types of social action necessary to effectively modify the social determinants of health. Work with society rather than against it. Public health is inherently subjective
Term
what is meant by the term “Anti-Minotaur”
Definition
Facts and values cannot be separated in scientific research: There is a move within public health to divorce the results of scientific inquiry from subsequent social action: for some it is sufficient to conduct the research and publish the findings. But you cannot separate science from society, and society experiences subjectivity. It is impossible to separate value from science. Public health is not value free and objective (relates to exam 2)
Term
differences in the role of the FDA and the FTC
Definition
FTC has primary authority over food advertising’
FDA regulates food labeling.
Term
what is meant by the “New” Frontier- Tobacco
Definition
It is new because the law has already been used to in public health in accomplishments such as seatbelts, vaccinations, etc.. Obesity is “the newest targets of public health law.”
Term
how the law has been used to accomplish public health successes
Definition
New legislation, heightened regulatory enforcement, and litigation have combined to cause declining lead exposure, reduced rates of smoking, improvements in workplace and motor vehicle safety, and increased vaccination rates. increasing taxes and subsidies
Term
similarities and differences between tobacco control and obesity
Definition
Similarities:
the use of these products by children, who are vulnerable to advertising and whose eating habits persist over the life span.
Clinical Intervention-
4 As (ask, advise, assess, assist)
screening, pharmacotherapy, counseling
Educational strategies- primary prevention in schools, counter-marketing
Regulatory efforts- control access/sales, restrict advertising
Economics- increased costs, tax

Differences between unhealthy food and tobacco:
people cannot abstain from eating
high-calorie foods may be beneficial to some people and harmful to others
there is no food-related equivalent to harm from secondhand smoke
no one has shown that foods have physically addictive properties
Term
Regulatory targets and examples of approaches to obesity prevention through legislation (see article diagram)
Definition
Targets & Examples:

Food Environment:
Schools- Nutrition standards for lunch programs
Community- Taxation of non-nutritious foods, Subsidies for producers/buyers of nutritious foods, Expansion of FTC.

Physical Activity:
Schools-Physical-education requirements
Community-Funding for walking and bicycle trails

Insurance Coverage: Mandated coverage of weight loss treatments by private health plans.
Term
know what “open and obvious” means in relation to obesity
Definition
you have to prove a connection between fast-food to obesity to obesity related illnesses. This is really difficult to do.
You have to look at the ingredients, there usually isn’t anything particularly “harmful” individually (counter claims in the form of labeling)
You have to prove that the dangers are not obvious, that they are hidden or deceptive in order to have an argument
We hold individuals accountable for their decisions
Term
lawsuits of open and obvious
Definition
Must prove dangers not obvious but hidden or deceptive

Counter claims in form of labeling
Hold individuals accountable for their decisions
Even harder to prove with “Personal responsibility” rules in place because they immunize companies
Term
why advertising to children may be seen as deceptive
Definition
FTC sees advertising to young children as unfair and deceptive because they lack the cognitive ability to understand the bias inherent in advertising.

Targeting/marketing vulnerable populations
Misleading claims
Term
6 key components of environmental health as specified by DHHS
Definition
Acronym for studying: HOTWIG
Healthy Homes and Healthy Communities
Outdoor Air Quality
Toxics and Waste
Water Quality
Infrastructure and Surveillance
Global Environmental Health
Term
WHO’s 6 general focal areas for preventing disease through healthy environments.
Definition
Acronym for studying: OW (I have an) ACHE
Occupational Safety
Water
Air
Children’s Environmental Health
Healthy Settings
Environmental Health in Emergencies
Term
implications of water scarcity and poor water and air quality
Definition
1. Water scarcity forces people to rely on unsafe sources of drinking water which increases the risk of diarrheal diseases such as cholera, typhoid fever and dysentery.
2. Poor air quality can lead to lung diseases and breathing problems such as asthma, bronchitis, emphysema and ARI (acute respiratory infection).
3. Water scarcity forces people (mostly women/girls) to travel long, unsafe distances to get water. In addition to safety issues this also prevents the girls from being in school because they spend the entire day getting water.
Term
the five countries showcased in "Sick Around the World"
Definition
Great Britain, Taiwan, Germany, Japan, Switzerland
Term
The meaning of universal health care
Definition
1) everyone gets it
2) it is a natural right
3) there should be an aspect of government regulation so it is not completely socialized. Does not go with the free market.
4) nobody goes broke paying for it
Term
The three limits that T.R. Reid recommends for the U.S. health care system impose
Definition
1, Doctors and hospitals must accept a standard price set by the government
2. Insurance company must accept everyone and not make a profit on basic care
3.Everybody is mandated to buy health care and the govt pays for the poor
Term
Know the relationship between poverty and global health - that is, how poverty threatens homeland security (how poverty is tied to un/under-employment, implications of poverty/unemployment).
Definition
1. Poverty tied to un/under employment by: housing market collapse, foreclosure, business failures, economic downturn, outsourcing of jobs, low paying jobs (minimum wage is not enough to provide for a family of three.)
2. Implications of poverty: Drop out of work force, internalize sense of despair, externalize expression of hopelessness and vulnerability to illness, disease, crime, violence. Intergenerational “Transmission” of poverty, poor families get stuck in a viscious cycle.
3. Implications of unemployment: Sluggish economy, non-productive citizenry, necessitates spending on safety net programs, medicaid and unemployment rather than on economic growth and revitalization.
“…our homeland security is tied as much if not more to the fact that huge numbers of Americans are being left behind economically…”
Term
The needed investments to prevent poverty and promote global health.
Definition
1. Social goods such as healthcare, education, housing and child care.
2. Social policy such as job creation/job training/retraining, livable wage, safety nets and neighborhood revitalization.
Term
The 3 pillars that must be addressed to eradicate poverty and create global stability and peace.
Definition
1. Environmental Stewardship(protect the planet)
Population, the ultimate health issue
Need to promote sustainable growth/development
Demographic transition vs population explosion
Depletion of the world’s resources due to slash and burn philospohy as well as Urbanization and Industrialization.

2. Poverty Reduction
Connection(nexus) of poverty and security widely accepted by international community
Eradication of poverty is central to stability and peace

3.Educating the youth
it is an investment for our global future
engage youth in finding solutions to local and global problems
teach tolerance, celebrate diversity
Term
demographic transition
Definition
Because of the many successes of Public Health, people are living long ages. This means that as the death rates go down, the birth rates go down. If we did not have Demographic Transition, we would have population explosion. > Think of the baby boomers, low death rate but high birth rate
Term
Factors responsible for the high and rising cost of medical care
Definition
Many Americans have difficulty getting access to healthcare when they need it.
People who are uninsured postpone medical care and may go to the emergency room when the illness is advanced, and the cost of emergency room will now be beared by taxpayers.
Medicare cost rises because Congress is paying out more than it collects in premium
Medicaid fixed fees are so low that many doctors do not want to participate.
The aging population
New equipment that is being developed is very expensive.
American characteristic of suing when something goes wrong with malpractice
Term
Approaches to controlling medical costs
Definition
Imposition of price controls by Nixon 1971-74
limiting the spending on new facilities and technology
an incentive for hospitals that can limit patient stay
Term
“carrying capacity” of the earth
Definition
The limit of population size that the environment can support without being degraded.
Term
the global impact of population growth
Definition
Depletion of resources: water, arable land, and fuel
Climate Changes: destruction of ozone layer (global warming), changes in air composition, greenhouse effect.
Term
Health Equity:
Definition
A new international economic order that balances the needs of social and economic development of the whole global population, health equity, and the urgency of dealing with global warming.
Term
Environmental Change:
Definition
Has profound implications for the way of life of people globally and for all living organisms
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