| Definitions | Determinants | Interventions | Pearls & Peeves | Disparities |
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What is POPULATION HEALTH?
This term refers to the health outcomes of a group of individuals, and the distribution of such outcomes within a group.
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What is E?
Premature mortality: total number of deaths before life expectancy ie <77yo in US; determinants a-d are listed in order of most freq-least freq cause of premature death in US. Not listed: environmental exposures e.g. air/water quality, occupational hazards.
The following are determinants of health contributing to premature mortality in the US: a. behavioral patterns, b. genetics, c. social circumstances, d. medical care, e. all of the above?
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What is E?
Mail-in ballots, hospital or med school communication directors, collaborating with legal clinics all help!
Busy clinicians can improve health through
a. voting, b. writing an op-ed, c. speaking w local govt d. medical-legal partnerships, e. all of the above |
What is T?
Life expectancy is similar to less wealthy nations (e.g. Portugal, S. Korea) and is even worse when stratified by race (Life expectancy in US: up to 14y lower in Blacks than in Asians, depending on region of US)
T or F: Despite having the highest per capita income in the world, the US lags behind other nations in life expectancy at birth.
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What is TRUE?
By the most conservative estimates, being born in zip codes with lower education levels correlate to lower life expectancy at birth (69-77yrs in East SJ) compared to zip codes with higher life expectancy (85-104yrs in Monte Serreno.)
T or F:
Life expectancy at birth, depending on where someone was born in Santa Clara county, can vary as much as 8 yrs (ranging from 77 to 85 yrs, lower in East SJ, higher av life expectancy near Los Gatos) |
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What is HEALTH LITERACY?
This is the degree to which individuals have the capacity to understand basic health info in order to make health care decisions.
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What is D? Lack of access to care, delays in dx/tx, and medical errors cause 11% of premature deaths in the US.
MEDICAL CARE (i.e. errors/delays) is responsible for what proportion of premature death in the US?
a. 60% b. 40% c. 25% d. 10% e. 5% |
What is (any of the following:) teach-back method, using simple ratios (3/1000 vs 0.3%,) written/verbal/visual communication, in CA: living will documents written at 4th gr reading level preferred by all users
This is one example of leveraging patients' HEALTH LITERACY to improve communication (multiple possible answers; pls give one example.)
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What is a SOCIO-ECOLOGICAL model of health?
Other models include upstream-downstream (public health) or pyramid models of health.
This is a model (framework) of health that organizes determinants of health into indiv, community, and environmental levels or domains.
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What is FALSE?
In SC county, similar to many areas of the world, poverty does not predict lowest life expectancy at birth; education and life expectancy are more closely linked. In Alameda county, however, areas with highest poverty (30% under FPL) also have the lowest life expectancy at birth.
T or F:
In Santa Clara county, folk living in zip codes with HIGHER PROPORTIONS of POVERTY (%living under FPL) have the LOWEST LIFE EXPECTANCY at birth. |
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What is C?
This is the range of personal, social, economic, and environmental factors that influence health outcomes (pick one:) a. health disparity, b. health equity, c. determinant of health, d. built environment, e. health literacy
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What is the BUILT ENVIRONMENT?
lack of access to affordable, nutritious food; lack of transportation/walkable neighborhoods; poorly-lit areas unsafe for physical activity all influence health
This is an environmental-level determinant of health that influences behavior through man-made structures, e.g. food deserts, safe spaces for physical activity, violence
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What is SUPPORTIVE HOUSING?
Housing + co-located MH or SW or nursing support compared to usual discharge w case mgmt saves $ ($16K/housing unit in 2 studies) & saves lives
This is an intervention that has reduced LOS, ED use, and mortality compared to usual discharge to street of urban homeless individuals after hospitalization.
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What is E?
https://www.uwmedicine.org/coronavirus/protesting-safely
This is an example of a SAFER WAYS to protest: a. wearing masks, keeping safe distance, b. using signs/banners, not sharing signs, c. noisemakers or banging on signs vs. shouting/singing, d. use hand sanitizer, avoid drinking/eating, e. all of the above
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What is TRUE?
T or F:
Investigators can use geolocation to help map areas of highest gun shot firing, work w local health ctr and police dept to design exercise classes (biking, bball) inside parks in the high-gunshot-density zones |
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