Which exemplify clinical interventions (the level just above the middle of the health impact pyramid)? (Select all that apply.)
A) Administration of insulin injections for diabetes
B) Restrictions on smoking in public places
C) Community immunization programs
D) Instruction provided by a nurse regarding proper nutrition
E) Treatment of hypertension
Ans: A, E
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At the level just above the middle of the pyramid are clinical interventions such as treatment of hypertension, hyperlipidemia, and diabetes. At the second level from the bottom of the health impact pyramid are interventions that change the environment or options available so that making the choice for a healthy behavior is the "default" or easy choice whereas choosing a less healthy option would require a person to spend more time, effort, or money. Examples include food and drug safety, iodization of salt, elimination of trans fats in food, and restrictions on smoking in public places and work sites. Changing food manufacturing to eliminate trans fats, for example, will have a positive impact on the health of the entire population without people having to change their buying or eating habits and would be sustained over time. At the middle of the pyramid are community health interventions such as immunizations that have a long-term protective effect as well as periodic screenings such as colonoscopy. At the top of the pyramid are counseling and health education.
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