Community Health PDF

Community \- a group of people who share something in common and interact with one another, who may exhibit a commitment with one another and may share a geographic boundary\ - PRIMARY FOCUS OF COMMUNITY HEALTH Public Health Intervention Wheel: Levels of Practice \- Community\ - Individual\ - Sys...

Community \- a group of people who share something in common and interact with one another, who may exhibit a commitment with one another and may share a geographic boundary\ - PRIMARY FOCUS OF COMMUNITY HEALTH Public Health Intervention Wheel: Levels of Practice \- Community\ - Individual\ - System System/group Level of Practice Example community health nurse working with the state health department and federal vaccine program to coordinate a response to an outbreak of measles in a migrant population. Community/Population Level of Practice Example public health nurses working with area high schools to give each student a profile of his or her health to promote nutritional and physical activity lifestyle changes to improve the student\'s health. Individual Level of Practice Example nurse receives a referral to care for an individual with a diagnosed mental illness who would require regular monitoring of his medication compliance to prevent rehospitalization Core Functions of Public Health \- assessment\ - policy development\ - assurance of availability Primary Prevention \- prevention of problem before it occurs\ - immunization Secondary Prevention \- early detection and intervention\ - screening for an STD\ - for diseases that can be controlled Tertiary Prevention \- correction and prevention of deterioration of a disease state\ - teaching insulin administration at home What is the main focus of Public Health? PREVENTION What is the main focus of Medicine? disease management and diagnosis Childhood Obesity \- focus on a healthier lifestyle\ - reduce the rate the childhood obesity\ - education **AD** What causes more than half of Premature Deaths? behavior and environment reasons What has the greatest influence on Community Health? behavioral choices What are the 3 elements of the Epidemiology Triangle? \- agent\ - host\ - environment Epidemiology Triangle \- depends on the extent of the host\'s exposure to an agent, the strength or virulence of the agent, and the host\'s genetic or immunological susceptibility.\ - also depends on the environmental conditions existing at the time of exposure Web of Causation illustrates the complexity of relationships among causal variables Incidence Rate describe the occurrence of new cases of a disease or condition in a community over a period of time relative to the size of the population at risk for that disease or condition during that same time period. Prevalence Rate the number of all cases of a specific disease or condition in a population at a given point in time relative to the population at the same point in time Endemic Diseases that are always present in a population (e.g., colds and pneumonia) Epidemic Diseases that are not always present in a population but flare up on occasion (e.g., diphtheria and measles) Pandemic The existence of disease in a large proportion of the population: a global epidemic (e.g., human immunodeficiency virus, acquired immunodeficiency syndrome, and annual outbreaks of influenza type A) Chronic vs Acute (prevalence) chronic always has a higher prevalence than acute disease Passive Immunity \- natural contact with antibody\ - hep a \--) immunoglobin\ - through blood or plasma\ EXAMPLE: Infant born with temporary antibodies to measles. Temporary or through colostrum and breast milk Active Immunity \- Natural contact and infection with the antigen\ - acquiring measles Leading Cause of Preventable Death \- smoking\ - alcohol\ - lifestyle choices Herd Immunity those not immune to an infectious agent are protected if a certain proportion of the population has been vaccinated or is otherwise immune Primary Failure of Vaccines \- failure of a vaccine to stimulate any immune response\ - caused by improper storage that may render the vaccine ineffective, improper administration route, or exposure of a light-sensitive vaccine to light. ANA - Code of Ethics promotes social reform by focusing on health policy and legislation to positively affect accessibility, quality, and cost of health care. Social Justice \- Mission of Public Health\ - entitles all people to basic necessities such as adequate income and health protection and accepts collective burdens to make it possible. High Walk Ability Communities \- where people are able to walk to stores\ - tend to be healthier than those who drive to where they need to go Demographic Data \- Age, gender, race/ethnicity, socioeconomic status, education level\ - found in a census **AD** Windshield Survey \- driving through an area and making organized observations\ - nurse can gain an understanding of the environmental layout Shoe-Leather Survey walking through an area and making organized observations How do you know if your interventions worked? \- look at baseline data\ - must be objective measurable goals What is the problem with Healthy People 2020? too much emphasis on personal responsibility while ignoring social/environmental factors and changes How do you know that learning has occured? long term change in behavior What are two diseases that do not have a vaccine? \- syphilis\ - gonorrhea Health Belief Model Assumption the major determinant of preventive health behavior is disease avoidance. Affordable Care Act \- access to preventative care\ - allows child to be on parent\'s health care until 26\ - decrease out of pocket spending on health care\ - treats disease you already have Example of Community Program? healthy living program Disease Agent Factor \- nutrition deficiency\ - anemia\ - b12 deficiency What are not contraindications for vaccinations? \- multiple vaccinations\ - low grade fever Aggregates \- subgroups or subpopulations that have some common characteristics or concerns\ - ex: pregnant teens in a school district Immunization Guideline do the least invasive first! If two people come in both complaining of nausea and diarrhea that started at the same time\... expect e. coli Intrinsic Factors \- factors which are within the body\ - ethnicity, age, genetics, behavior Descriptive Epidemiology \- focuses on the amount and distribution of health and health problems within a population\ - describe the characteristics of both people who are protected from disease and those who have a disease\ - can then generate hypotheses about the cause of disease What should you look for with a case of ZIKA? look for stagnant water in the area What is the least modifiable factor? environment Where will you find the most information about a community? \- long term residents\ - leaders Aggregate Impact on Health \- increased population\ - increased population density\ - imbalanced human ecology (resulted in changes in cultural adaption) Florence Nightingale credited with establishing modern nursing Louis Pasteur \- theory of existence of germs\ - discovered immunizations and rabies vaccine Robert Koch discovered causative agent or cholera and the tubercle bacillus Joseph Lister surgical successes in wound care Health a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. Goals of Healthy People 2020 \- attain high quality and longer lives free of disease\ - achieve health equity, eliminate disparities and improve health of all groups\ - create social and physical environments that promote good health for all\ - promote quality of life, healthy development, and healthy behaviors Healthy People 2020 Twelve Leading Health Indicators Access to Health Services\ Clinical Preventative Services\ Environmental Quality\ Injury and Violence\ Maternal, Infant and Child Health\ Mental Health\ Nutrition, Physical Activity, and Obesity\ Oral Health\ Reproductive and Sexual Health\ Social\ Substance Abuse\ Tobacco Lilian Wald \- affected the health of the community by organizing the community, establishing school nursing, and taking impoverished mothers to testify in Washington, DC\ - started public health nursing tradition Mary Brewster established a district nursing service on the Lower East Side of New York City called the House on Henry Street with WALD. Pender: Health Promotion Model depicts the complex multidimensional factors with which people interact as they work to achieve optimum health. Theory of Reasoned Action attempts to predict a person\'s intention to perform or not to perform a certain behavior The Transtheoretical Model behavior change takes place over time, progressing through a sequence of stages. Epidemiology the study of the distribution and determinants of health and disease in human populations Analytic Epidemiology investigates the causes of disease by determining why a disease rate is lower in one population group than in another. Extrinsic Factors environmental factors Crude Rate \- summarize the occurrence of births (i.e., crude birth rate), mortality (i.e., crude death rates), or diseases (i.e., crude disease rates) in the general population.\ - The numerator is the number of events, and the denominator is the average population size Community Assessment Parameters \- Physical Environment\ - Recreation\ - Economics\ - Communication\ - Health and Social Service\ - Politics and Government\ - Safety and Transportation\ - Education Community Diagnosis \- health problem\ - people at risk\ - cause\ - evidence to support diagnosis Outbreak the sudden or violent start of something unwelcome Vaccinations a narrower term referring to the administration of a vaccine or toxoid to confer active immunity by stimulating the body to produce its own antibodies. Immunization a broad term used to describe a process by which active or passive immunity to an infectious disease is induced or amplified. Attenuated created by reducing the virulence of a pathogen, but still keeping it viable Live Attenuated Vaccines measles, mumps, rubella, oral polio, yellow fever, varicella, BCG, Oral typhoid Inactivated Vaccines influenza, polio, rabies, hep a, diphtheria, tetanus, hep b Modifiable Risk Factors smoking, leading a sedentary or active lifestyle, type and amount of food eaten, and the type of activities in which he or she engages Non-Modifiable Risk Factors genetic makeup, gender, age, and environmental exposures What vaccination is included in Medicare Shingles vaccine Obesity Education more successful with those with higher education and socioeconomical levels Environmental Racism low income communities exposed to hazards