| Risk factors | Concepts | Outcomes | Pearls & peeves | Interventions |
|---|---|---|---|---|
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What is TRUE?
Per the WHO and Nelson et al (Annals 2018) individual income less predictive of mortality than neighborhood income in a nationwide survey of US veterans
T or F:
"Your zip code may be more important to your health than your genetic code" |
What is population health?
Kindig & Stoddard 2003, aka everything that affects health outside the clinical encounter/hosp/clinic
This is the health outcomes of a group of individuals, and the distribution of such health outcomes within that group.
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What is c?
Each event, if >3wks, is more likely to result in successfully quitting, esp w strategies for triggers e.g. using redirection, cognitive behav methods. 1800NOBUTTS is a phone-based prog in California
Multiple Choice:
Most individuals will attempt to quit smoking this many times before successfully quitting. a. 1, b. 2, c. 7, d. 16, e. 27 |
What is "do you have access to a toilet or place to prepare day before the colo?"
At VA, can request 1d to hoptel stay prior to many procedures/appts if hardships (e.g. travel, homelessness)
This is important to ask before ordering a colo for a homeless person (hint: logistics)
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What is T?
Highest risk of overdose, CV, violence/suicide in first 14d after reentry vs. general Seattle pop (Binswager et al) Poor access to care/medicaid, MH/cognitive, behaviors likely contribute.
T or F
Former inmates have 13x higher odds of death in first 2wks of release from correctional system than the general population. VA has VJO (vets justice outreach) to help transition for court/parole/probation w case mgmt |
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What is True?
11% of US veterans are black, but represent 33% of homeless veterans. Structural factors (e.g. poverty, discrimination) likely contribute to poor health outcomes including homelessness, CA, CHD, and chronic dz deaths in Afr Am men (Bagget et al 2013).
T or F:
Due to structural barriers, African-American vets have 3x higher odds of being homeless than non-African-American veterans. |
What is T?
Behavior is one of 5 determinants of health, i.e. social, economic or other factors affecting health outcome; it encompasses obesity, smoking, substance use, violence/suicide.
T or F
Behavior accounted for 40% of premature mortality in the US (ie. all deaths before age 76) per McGinnis et al |
What is e?
Screening for these conditions will help reduce risk of homelessness:
a. social isolation, b. low back pain, c. SUD, d. bipolar, e. all of the above |
What is e?
Multiple choice:
When asking about discharge plans, this condition is considered homelessness: a. couch-surfing, b. living in a storage space, c. doubling-up (sharing housing w mult indiv) d. moving freq in last 2m, e. all of the above |
What is supportive housing? i.e. housing + case management, MH, or RN co-located at residence can reduce LOS/ED/mortality in multiple studies (NY, Chicago) among urban homeless populations compared to usual discharge.
This intervention has improved ED utilization, MH hospitalization, and mortality (in HIV+ populations) among chronically homeless indiv compared to usual discharge
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What is the degree to which individuals have the capacity to obtain, process, understand basic health info…needed to make… health care decisions?
Ratzan & Parker 2003
This is a definition of health literacy, which if lower can result in higher health care costs, lower quality of care, and higher mortality (English longitudinal study)
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What is (1 of any of the following:)
safe places for physical activity, food deserts (no grocery stores,) walkability (ability to get from place to place without a car, sidewalks, pedestrian areas,)
This is an example of the built environment, or man-made structures that impact behavior and exposures, which impact health outcomes.
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What is teach-back technique? EC: good examples?
Also acceptable: mult modes of communication (e.g. written, verbal, drawings) and use of ratios rather than %, advanced directives written for 4th gr reading level
Individuals with lower health literacy i.e. ability to understand health info to make decisions may have worse outcomes e.g. ED, re-admission, LOS. This intervention helps clarify communication without taking more time.
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What is c?
(-31415926 points for getting this wrong, haha)
This is how often you may let your friends in business/law school or at start-ups think they are suffering more than you:
a. always, b. sometimes, c. never |
What are (any 3:) SUD, Heart (e.g. DM/lipid), IPV, MH, Infxn (e.g. HCV, TB, HIV, STI GC/CT) E.C.: SHIMI
(ref: HC for homeless clinicians' network, 2011)
These are 3 examples (of 5) of which screening recommendations differ for homeless vs housed individuals. (hint: acronym rhymes w TIMI)
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What is ?
Your feedback helps us improve teaching/learning. Thanks for playing! This is a suggestion for improving how we teach Pop health in Jeopardy format (e.g. fewer bragging rights/shame/prizes?)
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