NR 503/ NR503 Final Exam| 2026/2027 Update | Questions and Correct Answers | Complete Exam Material

1/ 22 NR 503/ NR503 Final Exam| 2026/2027 Update | Questions and Correct Answers | Complete Exam Material 2026/2027 | QUESTIONS & CORRECT ANSWERS | 100% VERIFIED STUDY MATERIAL Cultural Awareness :Self-examination of one's own prejudices and biases toward other cultures. An in- depth exploration of one's own cultural/ethnic background. Cultural competence in nursing consists of four principles. Care is designed for the specific client. Care is based on the uniqueness of the person's culture and includes cultural norms and values. Care includes self-employment strategies to facilitate client decision making to improve health behaviors. Care is provided with sensitivity and is based on the cultural uniqueness of clients. The APN may also use the Kleinman Explanatory Model of Illness (1978). Below are the questions that can be utilized. What do you call your problem? What do you think caused your problem? Why do you think it started when it did? What does your sickness do to you? What do you fear most about your sickness? What are the chief problems your sickness has caused you? What kind of treatment do you think you should receive? What is the most important result you hope to receive from the treatment? According to Giger and Davidhizer (2000), although cultures differ, they all have the same basic organizing factors that must be assessed in order to provide care for culturally diverse patients. These factors include communication (verbal and nonverbal); personal space; social organization; time perception; environmental control; and biological variations. The NCCC uses four major approaches to fulfill its Web-based technical assistance, (2) knowledge development and dissemination, mission, including (3) supporting a community of learners, and (4) collaboration and partnerships with diverse groups. Epidemiological Triad: host, agent, environment Genetics The study of individual genes and their impact on relatively rare single gene disorders is the probability of an event, such as illness, injury, or death. Gives no indication of how its magnitude compares with others The odds ratio closely approximates the relative risk if the disease is rare. Odds ratio and the relative risk are used to assess the strength of association between risk factor and outcome. How is Attributible risk used is used to make risk-based decisions for individuals. 2/ 22 Population-attributable risk measures are used to form public health decisions EGAPP: Evaluation of Genomic Applications in Practice and Prevention Genomic Applications in Practice and Prevention Network (established in 2009) is a collaborative initiative involving partners from across the public health sector working together to realize the promise of genomics in health care and disease prevention. GEDDI Genetics Early Disease Detection Intervention project (GEDDI) (established in 2009) developed a model strategy for using clinical, genetic, and family history information to reduce the risk of disease, death, and disability in affected individuals, family members, and populations. Human Genome Epidemiology Network (HuGENet) (established in 1998) helps translate genetic research findings into opportunities for preventive medicines and public health by advancing the synthesis, interpretation, and dissemination of population-based data on human genetic variation in health and disease. HuGENet reviews are systematic, peer-reviewed synopses of the epidemiologic aspects of human genes, including prevalence of allelic variants in different populations, population-based information on disease risk, evidence for gene-environment interaction and quantitative data on genetic tests and services carried out according to specific guidelines. NHANES III DC's Office of Public Health Genomics (established in 2002) formed a multidisciplinary working group with members from across CDC. It developed a proposal to measure the prevalence of selected genetic variants of public health significance in a representative sample of the U.S. population and to examine the association between the selected genetic variants and disease outcomes available in NHANES III data. The World Health Organization defines a pandemic as a global epidemic that spreads to more than one continent (WHO, 2009). One of the more recent pandemics that you might be familiar with is the H1N1 influenza outbreak of 2009. the occurrence of disease within persons in excess of what would normally be expected in a clearly defined community, location, or time of year. An outbreak may only last for a matter of days or weeks, but may last for years Quarantine the separation and restriction of the movement of people who were or are exposed to a contagious disease for a set period of time, to see whether they become ill is a term describing the changes that occur within virus's ribonucleic acid that changes the virus. Typically, these changes create seasonal changes or new strains of a virus 3/ 22 Phase 1—None of the current viruses circulating in animals have been reported to cause infection in humans. Phase 2—An animal-based influenza virus is known to have caused infection in humans and is considered a potential pandemic threat. Phase 3—An animal- or human-animal-based virus has caused some clusters of cases in people, but has not caused human-to-human transmission that is significant enough to cause community-level outbreaks. Phase 4—Human-to-human transmission of an animal or human-animal virus is causing community outbreaks and sustained disease. This is a significant shift in risk and any country with such an outbreak should consult with WHO. Phase 5—There is human-to-human spread of the virus in at least two countries. This phase means that pandemic is imminent and that community action and implementation of planned mitigation procedures is needed. Phase 6—This is the pandemic phase, characterized by outbreaks in more than one WHO defined region in addition to all Phase 5 criteria (WHO, 2009) Phase 1 None of the current viruses circulating in animals have been reported to cause infection in humans. Phase 2 An animal-based influenza virus is known to have caused infection in humans and is considered a potential pandemic threat. An animal- or human-animal-based virus has caused some clusters of cases in people, but has not caused human-to-human transmission that is significant enough to cause community-level outbreaks. Phase 4 Human-to-human transmission of an animal or human-animal virus is causing community outbreaks and sustained disease. This is a significant shift in risk and any country with such an outbreak should consult with WHO. There is human-to-human spread of the virus in at least two countries. This phase means that pandemic is imminent and that community action and implementation of planned mitigation procedures is needed. Phase 6 This is the pandemic phase, characterized by outbreaks in more than one WHO defined region in addition to all Phase 5 criteria (WHO, 2009). Category 1—case fatality ratio of less than 0.1% and fewer than 90,000 U.S. deaths Category 2—0.1%-0.5% case fatality ratio and 90,000-450,000 U.S. deaths Category 3- 0.5%—1% case fatality ratio and 450,000-900,000 U.S. deaths Category 4—1-2% case fatality ratio and 900,000-1.8 million U.S. deaths Category 5—greater than 2% case fatality ratio and more than 1.8 million U.S. deaths (CDC, 2014). SDG's - No poverty - Zero hunger - Good health and wellbeing - Quality education - Gender equality - Clean water and sanitation - Decent work and economic growth - Peace, justice and strong institutions The Sustainable Development Goals (SDGs), otherwise known as the Global Goals, are a universal call to action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity. 4/ 22 1945: charter of the United Nations; article calling for establishment of health agency with wide powers 1946: UN representatives created and ratified the constitution of WHO 1948: constitution went into force and WHO began work The World Health Organization (WHO) is a specialized agency of the United Nations that is concerned with international public health. It was established on 7 April 1948, and is headquartered in Geneva, Switzerland. The WHO played a leading role in the eradication of smallpox. Its current priorities include communicable diseases, in particular HIV/AIDS, Ebola, malaria and tuberculosis; as well as the mitigation of the effects of non-communicable diseases such as sexual and reproductive health, development, and aging; nutrition, food security and healthy eating; occupational health; substance abuse; and driving the development of reporting, publications, and networking. It falls to nurses and midwives, the most numerous and arguably most patient- centered component of the health workforce, to assume a leadership role in addressing planetary health. Leadership begins with educating ourselves, students, staff, patients, and communities. Engagement in political and policy processes are needed-and can take many forms. Even small measures may have impact. Local level sustainability and readiness is meaningful at one's university, hospital, and or health system levels. Learn Communicate Find common ground Health Outcomes defined as an end result that follows some kind of healthcare provision, treatment, or intervention and may describe a patient's condition or health status outcomes may be classified into categories by describing who is measured, such as individuals, aggregates, communities, populations, or organizations; by identifying the "what" or the type of outcome, such as care, patient, or performance-related outcomes determining the "when" or the time it takes to achieve an outcome, such as short-term, intermediate, or long-term outcomes Domain 1 DOMAIN 1: Capacity Strengthening Capacity strengthening is the broad sharing of knowledge, skills, and resources for enhancement of global public health programs, infrastructure, and workforce to address current and future global public health needs. 1.1 Design sustainable workforce development strategies for resource-limited settings. 1.2 Identify methods for assuring health program sustainability. 1.3 Assist host entity in assessing existing capacity. 1.4 Develop strategies that strengthen community capabilities for overcoming barriers to health and well-being. Domain 2 DOMAIN 2: Collaborating and Partnering Collaborating and partnering is the ability to select, recruit, and work with a diverse range of global health stakeholders to advance research, policy, and practice goals, and to foster open dialogue and effective communication. 2.1 Develop procedures for managing health partnerships. 2.2 Promote inclusion of representatives of diverse constituencies in partnerships. 2.3 Value commitment to building trust in partnerships. 2.4 Use diplomacy and conflict-resolution strategies with partners. 2.5 Communicate lessons learned to community partners and global constituencies. 2.6 Exhibit interpersonal communication skills that demonstrate respect for other perspectives and cultures. Domain 3 DOMAIN 3: Ethical Reasoning and Professional Practice Ethical reasoning and professional practice is the ability to identify and respond with integrity to ethical issues in diverse economic, political, and cultural contexts, and promote accountability for the impact of policy decisions on public health practice at local, national, and international levels. 3.1 Apply the fundamental principles of international standards for the protection of human subjects in diverse cultural settings. 3.2 Analyze ethical and professional issues that arise in responding to public health emergencies. 3.3 Explain the mechanisms used to hold international organizations accountable for public health practice standards. 3.4 Promote integrity in professional practice. 5/ 22 6/ 22 5.4 Develop proposals to secure donor and stakeholder support. 5.5 Plan evidence-based interventions to meet internationally established health targets. 5.6 Develop monitoring and evaluation frameworks to assess programs. 5.7 Utilize project management techniques throughout program planning, implementation, and evaluation. 5.8 Develop context-specific implementation strategies for scaling up best-practice interventions. Domain 6 DOMAIN 6: Sociocultural and Political Awareness Sociocultural and political awareness is the conceptual basis with which to work effectively within diverse cultural settings and across local, regional, national, and international political landscapes. 6.1 Describe the roles and relationships of the entities influencing global health. 6.2 Analyze the impact of transnational movements on population health. 6.3 Analyze context-specific policy-making processes that impact health. 6.4 Design health advocacy strategies. 6.5 Describe multiagency policy making in response to complex health emergencies 6.6Describe the interrelationship of foreign policy and health diplomacy. . 7/ 22 8/ 22 Domain 7 DOMAIN 7: Strategic Analysis Strategic analysis is the ability to use systems thinking to analyze a diverse range of complex and interrelated factors shaping health trends to formulate programs at the local, national, and international levels. 7.1 Conduct a situation analysis across a range of cultural, economic, and health contexts. 7.2 Identify the relationships among patterns of morbidity, mortality, and disability with demographic and other factors in shaping the circumstances of the population of a specified community, country, or region. 7.3 Implement a community health needs assessment. 7.4 Conduct comparative analyses of health systems. 7.5 Explain economic analyses drawn from socioeconomic and health data. 7.6 Design context-specific health interventions based on situation analysis. The WHO conceptual framework for social determinants of biology and genetics, individual behavior, social environment, physical environment, health identifies five multifactorial components of and health services. population health that impact health outcomes Activating a Disaster Assistance Response Team (DART) staffed by the CDC, in Monrovia, Liberia, and Guinea, to coordinate planning, operations, logistics, administrative issues, and interagency work •Saving more than 3 million lives with immunization programs •Reaching over 850,000 people with HIV-prevention education after establishing programs in 32 countries since 1987; training over 40,000 people to support HIV/AIDS programs in their own countries •Providing family planning to more than 50 million couples worldwide •Training 21,000 Honduran farm families to prevent soil erosion •Providing oral rehydration therapy in Bangladesh; saving tens of millions of lives worldwide with this program •Providing loans and operating costs to Bolivian Banco Solidario (BancoSol), which is the first self-sustaining commercial bank in Latin America to focus on microbusiness (small business loans averaging $200 each) 9/ 22 global Outbreak Alert and Response Network (GOARN), which initiates an international disease outbreak alert, technical support, vaccines, drugs, specialists, and equipment, to prevent spread, such as the plague in India, in 1995, which had an economic cost of over $1.7 billion •Chemical Incident Alert and Response System (ChemiNet): initiates alerts of industrial accidents, chemical, water, sanitation, radionuclear or environmental health emergencies •Global network of national health systems •Global Polio Eradication Initiative Network (GPEIN) •Global Influenza Surveillance Network (GISN) •FluNet •H5N1 Avian flu tracking •XDR-TB drug-resistant tuberculosis tracking •Containment of 21st-century threats of bioterrorism (anthrax, etc.), SARS, and toxic chemical waste dumping, such as the 2006 illegal dumping of 500 tons of chemical waste in Abidjan, Cote d'Ivoire •WHO Foreign Policy and Global Health (FPGH) Initiative •Coordination of responses to natural disasters, with concomitant infectious diseases, malnutrition, mental illness, and displacement of large numbers of people Millenium Development Goals (MDGs) The UN's creation of eight goals for economic development and social progress in 2000. Members agreed to reach the goals by 2015. Eradicate extreme poverty and hunger. 2. Achieve universal primary education. 3. Promote gender equality and empower women. 4. Reduce child mortality. 5. Improve maternal health. 6. Combat HIV/AIDS, malaria, and other diseases. 7. Ensure environmental sustainability. 8. Develop a global partnership for development Clinical disease disease characterized by signs and symptoms disease that is not yet clinically apparent, but is destined to progress to clinical disease Subclinical disease disease that is not clinical apparent, not destined to become clinically apparent Pandemic excessive occurrence of disease present globally resistance of group of people to disease because large portion of population is immune 10/ 22 Epidemiology the science of public health Population Health Focuses on risk, data, demographics and outcomes Aggregate A defined population Community Composed of multiple aggregates Data Compiled information Prevalence Measures the existence of the disease Incidence Measures the appearance Surveillance Collection, Analysis, dissemination of data High Risk Increased chance of poor health outcome Morbidity Presence of illness in a population A dynamic, fluid, continuous process whereby an individual, system or healthcare agency find meaningful and useful care delivery strategies based in knowledge of the cultural heritage, beliefs, attitudes, and behavior of those to whom they tender care Specific practices that guide their actions and decisions of each person in a group based on their culture. Can be either learned or shared. A set of questions the advanced practice nurse can use in order to assess the culture of a patient and proposes that individuals have vastly different notions of health and disease. A measure that takes into account three interrelated dimensions: a persons income level, education level, and type of occupation. Some measures of socioeconomic status use only one dimension such as income. A higher burden of illness, injury, disability, or mortality experienced by one group in relation to another. ex. Socioeconomic, health, racial or ethnic 11/ 22 Neighborhoods and communities that have limited access to affordable fresh and nutritious food Things like poverty, education level, racism, income and poor housing that affect access to healthcare The goal that all people will have equal opportunity to healthcare access and quality of healthcare will be the same To create an environment that accommodates health practice and ritual from other cultures within a plan of care Degree To which an individual from one culture has given up the traits of that culture and adopted the traits of the dominant culture in which they now reside This social, economic, and political integration of a cultural group into main stream society to which it may have emigrated The study of all genes in the human genome as well as their interaction with other genes, the individuals environment, and the influence of cultural and psychosocial factors. Pharmacogenomics Medication efficacy, toxicity, and drug interaction based on genetic variations (World Health Organization) specialized agency of the United Nations that is concerned with international public health. The world health organization recognized that international collaboration could control infectious disease better than any single country. Sustainable Development Goals (SDGs) Goals resulting from a UN-led effort to end extreme poverty by focusing on 17 key indicators, the top five of which are no poverty, zero hunger, good health, quality education, and gender equality, with key benchmarks for 2030. Universal declaration of human rights All people have the right to a standard of living that guarantees health Community health needs assessment Assessing whether or not the region has the community resources that it needs. To analyze and identify the relationships among patterns of morbidity, mortality, and disability within the demographic and other factors shaping thecircumstances of the population of a specified community, country, or region. Practices, beliefs, values, norms (can be learned or shared) which guides the actions and decisions of each person in the group. Communication, personal space, social organization, time perception, environmental control, and biological variations 12/ 22 Broad understandings of illness, suffering and healing. Social roles and bureaucratic and economic context of health care services Micro-scale influences Face-to-face interaction at front-lines. Successful and failed communication efforts. incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-clinician dynamic and to developing mutually beneficial and advocacy partnerships with communities on behalf of individuals and defined populations obtaining a sound educational foundation concerning the various worldviews of different cultures. Obtaining knowledge regarding biological variations, disease, and health conditions and variations in drug metabolism. Ability to collect culturally relevant data regarding the client's health history and presenting problem and conduct a culturally sensitive assessment. Motivation of the provider to want to engage in the process of cultural competence, characteristics of compassion, authenticity, humility, openness, availability, and flexibility, commitment, and passion to caring regardless of conflict. 4 principles of cultural competence 1. Caring is designed for the specific client 2. Care is based in the uniqueness of the person's culture and includes cultural norms and values 3. Care includes self-employment strategies to facilitate client decisions making to improve health behaviors. 4. Care is provided with sensitivity and is based on the cultural uniqueness of clients. Cross Cultural Health Care Program Includes a plethora of materials to improve cultural competency among providers including training programs. Mobilizes individuals and groups to work and improve quality and elimination of health disparities Key private and public stakeholders who have agreed to work on major health priorities of patients and families, palliative and end of life care, care coordination, patient safety, and population of health Quality Alliance Steering Committee (QASC) Work to improve healthcare quality and costs Office of Minority Health and Health Disparities Resources used by APNs to obtain data that demonstrate how minority population compare with the US population as a whole. Aggregate of cultural practices, social influences, religious pursuits, and racial characteristics shaping the distinctive identity of community A biological designation whereby group members share features (skin color, bone structure, genetic traits, blood groupings). 13/ 22 Nationality Country of birth Genetic Evaluation Medical history, testing, counseling, next steps, family risk Pandemic Global epidemic of disease that spreads to more than one continent The occurrence of disease within persons in excess of what would normally be expected in a clearly defined community, location, and time of year. The separation and restrictions of the movement of people who were or are exposed to a contagious disease for a set period of time, to see whether they become ill. Isolation The separation of sick people with a contagious disease from those who are not ill. Epidemiological Triangle Explains causation Caustive Agent Those factors from which presence or absence cause disease Susceptible host Things such as she, gender, race, immune status, genetics Environment diverse elements such as water, food, neighborhood, pollution agreement between countries to create an environment at the national and global levels alike conductive to development and the elimination of poverty due to human activity, trigger global migration, and local relocation due to sea level rise. the health outcomes of a group of individuals, including the distribution of such outcomes within the group. I.e. seatbelt laws, no smoking areas, allergy free schools. the health protection when individuals participate in behaviors that enable then to react to actual or potential threats the gathering of information abut a patient's physiological, psychological, sociological, and spiritual status. 14/ 22 an end result that follows some kind of healthcare profession, treatment, or intervention and may describe a patient's condition or health status collected laws, regulations, and approaches taken to make a decision including a wide range of topics including health care reform, insurance reform with an eye to individuals who are not covered by an employer or a group, and the prevention and control of communicable diseases. practices with compassion and respect committed to patient, family, community, and population promoting, advocating, and protecting the rights, health, and safety of the patient. Fairness the state, condition, or quality of being fair or free of bias or injustice unexposed incidence incidence of new cases of disease in persons who were not exposed unexposed incidence equation number unexposed with disease / total number of unexposed risk of disease in one group versus another; risk of developing disease after exposure; 1 = no risk # exposed with disease/total of all exposed // # unexposed with disease/total all unexposed odds ratio measure of exposure and disease outcome commonly used in case control studies odds ratio equation R(exposed)/1-R(exposed) / R(unexposed)/1-R(unexposed) prevalence number of cases of a disease in a given time regardless of when it began prevalence equation (persons with disease / total pop) x1000 preventing initial development of disease; action taken to prevent development of a disease in person who is well, does not have disease early detection of existing disease to reduce severity and complications (or) identifying people in whom disease process has already begun, but who have not developed symptoms reducing impact of disease (or) preventing complications in those who have already developed signs and symptoms of an illness, have been diagnosed 15/ 22 T OR F: prevention and treatment of single specific False disease are exclusive activities that do not occur together when providing care to patient disease that is not yet clinically apparent, but is destined to progress to clinical disease subclinical disease disease that is not clinical apparent, not destined to become clinically apparent persistent (chronic) disease disease/symptoms that persist for years or for a lifetime latent disease infection with no active multiplication of agent pandemic excessive occurrence of disease present globally one medical advance associated with Black Death in incubation period for disease/infection was identified through isolation/quarantine of Europe in late 1300s travelers entering seaport of Italy. it was found that 30 days was not enough time to isolate patient to prevent transmission of disease to others; time period lengthened to 40 days surveillance in which available data on a reportable disease is used to make note of or observe disease current number of all affected persons with a specific disease present in a population at a specific time period two reasons that prevalence rate of a disease in a - cure of disease community could decrease - deaths of patients with disease unexposed incidence incidence of new cases of disease in persons who were not exposed unexposed incidence equation number unexposed with disease / total number of unexposed measure of risk; total number in population with disease divided by total number of population incidence of disease equation number with disease / total population risk of disease in one group versus another; risk of developing disease after exposure; 1 = no risk 16/ 22 # exposed with disease/total of all exposed // # unexposed with disease/total all unexposed odds ratio measure of exposure and disease outcome commonly used in case control studies odds ratio equation R(exposed)/1-R(exposed) / R(unexposed)/1-R(unexposed) prevalence number of cases of a disease in a given time regardless of when it began prevalence equation (persons with disease / total pop) x1000 difference in disease in those exposed and unexposed, calculated from prospective data; directly attributed to exposure (if exposure gone, disease gone) attributable risk equation R(exposed) - R(unexposed) crude birth rate number of live births per 1000 people in population crude birth rate equation (# of births/estimated mid-year population) x1000 the percentage of individuals who have specific disease and diet within specific time after diagnosis (# of persons dying from disease after diagnosis or set period / # of persons with disease) x1000 preventing initial development of disease; action taken to prevent development of a disease in person who is well, does not have disease early detection of existing disease to reduce severity and complications (or) identifying people in whom disease process has already begun, but who have not developed symptoms reducing impact of disease (or) preventing complications in those who have already developed signs and symptoms of an illness, have been diagnosed T OR F: prevention and treatment of single specific False disease are exclusive activities that do not occur together when providing care to patient 17/ 22 disease that is not yet clinically apparent, but is destined to progress to clinical disease subclinical disease disease that is not clinical apparent, not destined to become clinically apparent persistent (chronic) disease disease/symptoms that persist for years or for a lifetime pandemic excessive occurrence of disease present globally endemic habitual presence of disease within geographic area one medical advance associated with Black Death in incubation period for disease/infection was identified through isolation/quarantine of Europe in late 1300s travelers entering seaport of Italy. it was found that 30 days was not enough time to isolate patient to prevent transmission of disease to others; time period lengthened to 40 days surveillance in which available data on a reportable disease is used to make note of or observe disease number of new cases of a disease, during a set period of time, in a specific population who is at risk for the disease current number of all affected persons with a specific disease present in a population at a specific time period two reasons that prevalence rate of a disease in a - cure of disease community could decrease - deaths of patients with disease eliminate effects of differences in age distributions of populations in comparing death rates exposed incidence incidence of new cases of disease in persons who were exposed exposed incidence equation number exposed with disease / total number exposed unexposed incidence incidence of new cases of disease in persons who were not exposed unexposed incidence equation number unexposed with disease / total number of unexposed 18/ 22 risk of disease in one group versus another; risk of developing disease after exposure; 1 = no risk # exposed with disease/total of all exposed // # unexposed with disease/total all unexposed odds ratio measure of exposure and disease outcome commonly used in case control studies odds ratio equation R(exposed)/1-R(exposed) / R(unexposed)/1-R(unexposed) prevalence number of cases of a disease in a given time regardless of when it began prevalence equation (persons with disease / total pop) x1000 attributable risk equation R(exposed) - R(unexposed) crude death rate the number of deaths per 1000 people in population crude death rate equation (# of deaths/estimated mid-year population) x1000 fetal death rate number of fetal deaths (20+ wk gestation) per 1000 live births fetal death rate equation (# of fetal deaths / # of live births+fetal deaths) x1000 usually an expression of a specific disease or can be all causes per 1000 people for a year annual mortality rate equation (# of deaths of all causes(or specific disease) / mid-yr population) x1000 preventing initial development of disease; action taken to prevent development of a disease in person who is well, does not have disease early detection of existing disease to reduce severity and complications (or) identifying people in whom disease process has already begun, but who have not developed symptoms 19/ 22 reducing impact of disease (or) preventing complications in those who have already developed signs and symptoms of an illness, have been diagnosed T OR F: prevention and treatment of single specific False disease are exclusive activities that do not occur together when providing care to patient in counting incidence and prevalence of disease it is not sufficient to count only clinically apparent cases, but those who are asymptomatic or exposed without infection disease that is not yet clinically apparent, but is destined to progress to clinical disease subclinical disease disease that is not clinical apparent, not destined to become clinically apparent persistent (chronic) disease disease/symptoms that persist for years or for a lifetime pandemic excessive occurrence of disease present globally common-vehicle exposure group of people are exposed to a substance/organism that causes common illness occurrence of disease in community/geographic area in excess of normal expectancy; Outbreak at a population level one medical advance associated with Black Death in incubation period for disease/infection was identified through isolation/quarantine of Europe in late 1300s travelers entering seaport of Italy. it was found that 30 days was not enough time to isolate patient to prevent transmission of disease to others; time period lengthened to 40 days when project staff carries out current surveillance of disease through active field visits surveillance in which available data on a reportable disease is used to make note of or observe disease current number of all affected persons with a specific disease present in a population at a specific time period two reasons that prevalence rate of a disease in a - cure of disease community could decrease - deaths of patients with disease Chronic Disease indicators Level of data: state, territory, select large metropolitan areas The Chronic Disease Indicators enable public health professionals and policy makers to retrieve state and selected metropolitan-level data for chronic diseases and risk factors. 20/ 22 Interactive atlas of heart disease and stroke Level of data: national, state, territory, county The Interactive Atlas of Heart Disease and Stroke enables online county-level mapping of heart disease and stroke by race/ethnicity, gender, and age group. Maps can show social and economic factors and health services for the United States, specific states, or territories. National Center for HIV/AID, viral hepatitis, STD, and TB Level of data: national, state, select territories The Atlas provides interactive maps, graphs, tables, and figures showing geographic patterns and time trends of the reported occurrence of the following diseases: HIV, AIDS, viral hepatitis, tuberculosis, chlamydia, gonorrhea, and primary and secondary syphilis. The data are based on nationally notifiable infectious diseases in the United States and can be used to examine disparities. National Environmental Public Health tracking network Level of data: national, state, county The Tracking Network is a system of integrated health, exposure, and hazard information and data from a variety of national, state, and city sources. Maps, tables, and charts with data about environmental indicators (e.g., particulate matter in the air) are available. Social Vulnerability Index Level of data: census tract The Social Vulnerability Index uses U.S. census variables at tract level to help local officials identify communities that may need support in preparing for hazards, or recovering from disaster. Social vulnerability refers to the resilience of communities when confronted by external stresses on human health, stresses such as natural or human-caused disasters, or disease outbreaks. Reducing social vulnerability can decrease both human suffering and economic loss. Vulnerable populations footprint tool Level of data: state, county, city, census tract The Vulnerable Populations Footprint Tool creates maps and reports that identify geographic areas with high poverty rates and low education levels—two key social determinant indicators of population health. Thresholds for target areas are adjustable, allowing the tool to be used in geographic areas where regional rates may be higher or lower than the national average. Norms rules and expectations by which a society guides the behavior of its members the ideas, beliefs, and attitudes about what is important that help guide the way you live Social standing or class of an individual or group. Measured as a combination of education, income, and occupation A category of people who experience relative disadvantages as compared to members of a dominant social group because of their physical or cultural characteristics Aspects of society and the social environment that impact on health, such as poverty, early life experiences, social networks and support. Housing, education, access to public transportation, safe water, food, built environment justice in terms of the distribution of wealth, opportunities, and privileges within a society. Data sources that assess determinants of health Chronic disease indicators, interactive atlas of heart disease and stroke, national center for HIV/AIDS, viral hepatitis, STD, and TB prevention atlas, National environmental public health tracking tool, The social vulnerability index, vulnerable populations foot print tool 21/ 22 closely approximates relative risk if the disease is rare. Used with relative risk to assess strength of association between risk factor and outcome. Percentage of disease incidence that would be eliminated if the risk factor were removed. Used to form public health decisions. The purpose is to determine individuals with greater than average genetic contribution to disease. DNA testing, family hx. Ex. cancer, diabetes, or cardiovascular disease Genetic epidemiology the link of epidemiology and genetics how genetic variations affect medication efficacy, toxicity, and drug interaction outside of the drugs themselves components of risk assessment Family Hx, DNA testing Genetics Nondiscrimination Act (GINA) Enacted in 2008, is a federal law that protects individuals from genetic discrimination in health insurance and employment. Pandemic a global epidemic of disease that spreads to more than 1 continent the occurrence of disease within persons in excess of what would normally be expected in a clearly defined community, location or time of year. An outbreak may only last for a matter of days or weeks but may last for years. the separation of and restriction of the movement of people who were or are exposed to a contagious disease for a set period of time to see whether they will become ill. the use of epidemiology to assess the short and long term adverse health effects of disasters and to predict consequences of future disasters. It brings together various topic areas of epidemiology including acute and communicable disease, environmental health, occupational health, chronic disease, injury, mental health and behavioral health Primary goal is to direct international health within the United Nations system and to lead partners in global health responses Universal call to action to end poverty, protect the planet, and ensure that all people enjoy peace and prosperity SDG's list - No poverty - Zero hunger - Good health and wellbeing - Quality education - Gender equality - Clean water and sanitation - Decent work and economic growth - Peace, justice and strong institutions 1/ 1 Cardiovascular and respiratory effects, Drowning, injury, GI illness, wound/ blood infections, vector-born illness, malnutrition, poverty, distress, grief, behavioral and social health consequence due to increasing temperatures, extreme weather, desertification, and flooding