Community Exam 1 Learning Objectives PDF

Alyssa Carter January 2025 COMMUNITY EXAM 1 LEARNING OBJECTIVES Ch. 1: Community Overview 1. Explain the concepts of community health nursing, population, aggregate, and public health. -​ Community Health Nursing: focuses on understanding, identifying, and meeting the health...

Alyssa Carter January 2025 COMMUNITY EXAM 1 LEARNING OBJECTIVES Ch. 1: Community Overview 1. Explain the concepts of community health nursing, population, aggregate, and public health. -​ Community Health Nursing: focuses on understanding, identifying, and meeting the health needs of a community to improve its overall well-being. -​ Population: a group of people living in a specific area who may share some common traits but do not necessarily interact or feel connected. Example: Residents of a large city.; elderly population (individuals aged 65 and older); homeless population (individuals who do not have a permanent place to live.) -​ Aggregate: is a group of people who are viewed together as one unit. They are loosely connected and don't have strong ties with each other. ( Example: A crowd at a music festival. They are grouped together in one place for the event, but they don't necessarily know each other or have strong connections outside of the festival.) -​ Public Health: involves actions taken by society to create conditions that promote health and prevent disease in individuals and communities. -​ Public Health Nursing: a specialized nursing practice that is community-based and focuses on the health of populations rather than individual patients. 2. Define and identify different communities -​ For starters, a community is a group of people who interact with one another and share common interests—forming a sense of unity. -​ The different types of communities are… I.​ Geographic: defined by a physical location, such as a town or neighborhood; the key aspect of this type of community is the shared physical space, which creates a common ground for social interactions, services, and a sense of belonging among its residents. Example: People living in a small town might form a geographic community because they share the same schools, parks, and local businesses II.​ Common Interest: formed by people sharing similar interests or goals, regardless of location; this type of community is built around shared activities, values, or objectives, rather than geographic location. Example: Members of a book club, fans of a particular sports team, participants in a hobby group (like gardening or knitting), or professionals in a specific field (like a medical association) III.​ Community of Solution: a group that comes together to address a specific issue; unlike geographic or common interest communities, a community of solution is formed based on a common goal of finding solutions to shared challenges. The members may not live in the same area or share the same hobbies, but they unite around a particular cause or problem. Example: People from different regions might form a community of solutions to tackle environmental issues like climate change, or healthcare professionals might come together to develop strategies for improving public health. 3. Explain the difference between acute care nursing and public health nursing -​ Acute Care Nursing: Focuses on individual patient care, typically in hospitals or clinical settings, providing direct treatment for acute illnesses or injuries. Alyssa Carter January 2025 -​ Public Health Nursing: Focuses on population-level health, emphasizing disease prevention, health promotion, and community interventions. 4. Identify the three levels of prevention. -​ Primary Prevention: Prevents diseases before they occur. (Example: Vaccinations, promoting a healthy diet.) -​ Secondary Prevention: Detects and treats diseases in their early stages. (Example: Screenings like mammograms or blood pressure monitoring.) -​ Tertiary Prevention: Manages and improves quality of life for people with existing conditions. (Example: Stroke rehabilitation programs.) *Dr. Davies says that, as nurses, we primarily wanna focus on primary prevention. That doesn’t mean that we won’t end up doing the other 2, but it’s just that our concentration is on primary, because we want to prevent you from getting sick in the first place. *Dr. Davies said that this is GUARANTEED to be on the exam. And that some questions will be similar to that activity we did in class where you’ll be given a scenario and you have to identify the level of prevention. Alyssa Carter January 2025 5. Identify the eight characteristics of community/public health nursing. -​ Focus on the whole population as the primary client. -​ Aim to benefit the greatest number of people. -​ Work with clients as equal partners. -​ Prioritize disease prevention. -​ Improve social, environmental, and economic conditions for health. -​ Proactively reach out to those in need. -​ Use resources efficiently for the best health outcomes. -​ Collaborate with other professionals and organizations to enhance community health. Ch.2: Public Health Nursing 1. Identify the 3 core public health functions basic to community/public health nursing. I.​ Assessment: Systematically collects, analyzes, and disseminates/spreads info about the community’s health. Example: Conducting health surveys to identify the prevalence of chronic diseases and health risks in a community. This data helps public health officials understand the community's health status and needs. II.​ Policy Development: Creates public health policies and strategies based on data to address health concerns. Example; Developing policies to promote vaccination, implement smoking bans in public places, or improve access to healthy foods. Alyssa Carter January 2025 III.​ Assurance: Ensures that essential health services are available and accessible to the population Example: Ensuring that there are enough healthcare providers in underserved areas, offering free or low-cost health screenings, and implementing programs to ensure the public receives essential health services. *So, to summarize, basically: assessment gathers and analyzes health data, policy development creates strategies to address health issues, and assurance ensures that these strategies and services are implemented and accessible to the community. 2. Differentiate among seven different roles of the community/public health nurse. 1.​ Clinician – Provides direct patient care to individuals and communities Example → A nurse administering immunizations at the CVS Minute Clinic 2.​ Educator – Teaches individuals and groups about health promotion and disease prevention. Example → Conducting a workshop on healthy eating habits. 3.​ Advocate – Supports patients by ensuring they receive the necessary healthcare resources. Example → Helping a low-income family obtain health insurance. 4.​ Manager – Organizes and oversees health programs and services to improve efficiency. Example →: Managing a public health vaccination campaign. 5.​ Collaborator – Works with other healthcare professionals and organizations to improve community health. Example → Partnering with schools to implement mental health programs. 6.​ Leader – Guides and influences public health initiatives and nursing teams. Example → Leading a task force on maternal and child health. 7.​ Researcher – Conducts studies to collect data and improve public health practices. Example → Studying the effectiveness of a community health program to provide healthy lunches to kids. 3. Describe the essential services of public health -​ Monitor health status – Identify and solve community health problems. -​ Diagnose and investigate – Address health problems and hazards. -​ Inform, educate, and empower – Promote awareness about health issues. -​ Mobilize community partnerships – Work with organizations to address health concerns. -​ Develop policies and plans – Create strategies that support community health. -​ Enforce laws and regulations – Ensure health and safety compliance. -​ Link people to needed health services – Improve healthcare access. -​ Ensure a competent workforce – Maintain skilled healthcare professionals. -​ Evaluate health services – Assess the quality and accessibility of health programs. -​ Research for new solutions – Study health problems and implement innovative strategies. 4. Describe 7 settings in which a community/public health nurse might practice. 1.​ Home – Provides healthcare services in patients’ homes. Example → A home health nurse going to an elderly woman’s home to help her manage a chronic condition 2.​ Schools - Nurses work in educational settings to promote the health and well-being of students. Alyssa Carter January 2025 Example → They conduct health screenings, administer medications, provide health education, and address health issues that may affect learning. 3.​ Ambulatory Services - Nurses deliver care in outpatient settings, such as clinics or doctors' offices. Example → Perform health assessments, administer treatments, and provide education to prevent illness and manage conditions. 4.​ Occupational Health - Nurses focus on the health and safety of workers in various industries. Example → They conduct health screenings, provide injury care, and promote workplace wellness programs to prevent work-related illnesses and injuries. 5.​ Residential Institutions - Nurses provide care in long-term care facilities, such as nursing homes or assisted living centers. Example → They help residents manage chronic conditions, administer medications, and support the daily health needs of residents. 6.​ Faith Communities - Integrates health promotion within religious settings Example → They offer health education, screenings, and support for congregation members, often addressing spiritual and physical health together. 7.​ Community-At-Large - Nurses engage w/ broader community health initiatives, working with public health departments, non-profits, and community organizations. Example → They address population health issues, advocate for public health policies (i.e. Combatting food insecurity), and they promote health equity. Ch.5: Transcultural Nursing 1.​ Define and explain the concept of culture. -​ Culture is a shared system of beliefs, values, and behavioral expectations that provides a social structure for daily living. It defines roles, interactions, and community norms. (So, to explain this in simpler terms→ think of culture as a big guidebook that everyone in a group follows. It includes: a.) Beliefs: What the group thinks is true or important. b.) Values: What the group considers right or wrong, good or bad. c.) Behavioral Expectations: How people are expected to behave in different situations.) 2.​ Discuss the meaning of cultural diversity and its significance for community/public health nursing. -​ Cultural diversity refers to the presence of multiple cultures within a group or society. It includes different traditions, languages, beliefs, and behaviors. -​ The reason why it’s significant in public health nursing is because: it helps nurses understand and respect different health beliefs and practices, it improves patient trust and compliance with healthcare recommendations, and it reduces healthcare disparities by providing culturally competent care. 3.​ Describe the meaning and effects of ethnocentrism on community/public health nursing practice. -​ Ethnocentrism is the belief that one’s own culture is superior, which can lead to biases in nursing practice. Alyssa Carter January 2025 -​ Effects of Ethnocentrism on nursing practice are as follows… a)Can create communication barriers between nurses and patients from different backgrounds. b)May lead to misunderstandings and misinterpretations of patients' health beliefs and needs. c)Can result in lower-quality care and decreased patient trust in healthcare providers. 4.​ Identify five characteristics shared by all cultures. -​ “The main characteristics of culture are that: it’s learned from others, it’s an integrated system of customs and traits, it’s shared, it’s mostly tacit, and it’s dynamic” (Now, to put this into simpler terms → Culture is… a)​ Learned: We pick it up from the people around us. b.) Integrated: It combines different customs and traits. c.) Shared: It's something we have in common with others. d.) Mostly Unspoken: Many parts of it are understood without being directly taught. e. )Dynamic: It changes and evolves over time.) 5.​ Apply principles of transcultural nursing in community health nursing practice -​ In order to have effective and culturally competent care, you should do the following… a.) Avoid ethnocentric attitudes – Recognize that all cultures have valid health beliefs. b.) Bridge cultural differences – Adapt communication and care to respect cultural backgrounds. c) Develop knowledge and skills in serving multicultural clients – Learn about different cultural health practices. d) Respect culturally based family roles – Understand who makes healthcare decisions in different cultures. e ) Use culturally sensitive language – Communicate in a way that aligns with patients' cultural and linguistic preferences. f) Provide teaching materials in the client’s primary language – Ensure health information is accessible to all patients. Ch.12: Planning, Implementing, and Evaluating Community/Public Health Programs 1.​ Discuss the planning process -​ The community health planning process involves four key stages: I.​ Assessment - Collect and analyze data to pinpoint community health needs, what resources exist, and what resources are needed Example → Conducting surveys and reviewing health records to determine common health concerns. II.​ Analyze & Design - Collaborate with community members to pinpoint priority issues. Use evidence-based approaches to design interventions. Example → Identifying obesity as a key issue and designing a nutrition education program. III.​ Planning and Implementation - Create actionable strategies to address identified goals–making sure to involve stakeholder input and ensure that strategies are in alignment with what resources are available Example → Partnering with local grocery stores to promote healthy eating habits. IV.​ Evaluation - Continuously monitor and adjust the program to ensure effectiveness Example → Measuring the degree of changes in obesity rates after implementing the nutrition program. 2.​ Identify the different target populations -​ Target populations are divided into two categories: I.​ Primary Target Population – this is the main group that’s being directly affected by a program. Example → In a childhood obesity program, the primary population is children at risk of obesity. Alyssa Carter January 2025 II.​ Secondary Target Population – these are groups that influence or support the primary population. Example → Parents and schools play a role in shaping children's eating habits. 3.​ Differentiate goals and objectives -​ Goals – Broad, general statements that define the program’s direction Example → Increase public awareness about the importance of nutrition in DeKalb County.") ← with this statement, we know that the goal is that we wanna spread awareness about the importance of nutrition but we don’t go into the specifics of it. Therefore, it’s perfectly broad. -​ Objectives – Specific, measurable steps used to achieve goals; when coming up w/ the objectives, we use the SMART framework to help with that… -​ Specific: Clearly define what the program intends to achieve (i.e. with a general goal like "promote health," you should specify the action with something like→ "organize five community workshops on nutrition by the end of the quarter.") -​ Measurable: Quantify progress with metrics. (i.e. if the goal is to reduce smoking rates, measure progress by tracking the percentage decrease in smokers over six months.) -​ Achievable: Ensure objectives are realistic given available resources. (i.e. if the goal is to reduce obesity rates in a community, an achievable objective might be to provide free nutritional classes for 200 residents over six months) -​ Relevant: Align objectives with community needs and program goals. (i.e. if a community struggles with access to fresh produce, a relevant objective might be to establish partnerships with local farmers to create affordable farmers' markets in underserved neighborhoods.) -​ Timely: Set clear deadlines for completion (i.e. if the goal is to improve vaccination rates, a timely objective might be: "Increase vaccination rates by 15% in the target population by December 31, 2025.") -​ SMART Goal w/ all the pieces together: "By February 26, attendees will identify three healthy alternatives to fast food during a local health class." 4.​ Differentiate the two types of evaluation -​ Formative (Process) Evaluation – Conducted during the program to refine activities. Example → Checking participant feedback halfway through a nutrition class to adjust the approach. -​ Summative (Outcome) Evaluation – Conducted after program completion to assess effectiveness. Example → Measuring obesity rates before and after a year-long intervention and comparing the results to determine how well (or unwell) the year-long intervention did. 5.​ Discuss factors that influence behavior change -​ Behavior change is influenced by three key factors: a.) Predisposing Factors - Internal motivations such as beliefs, attitudes, and values Example → A teenager believes that drinking alcohol increases social acceptance, so they drink more b.)Reinforcing Factors – Social influences from family, peers, and societal norms. Example → A person continues smoking because their friends do it as a social activity. c.)Enabling Factors – External factors such as resources, accessibility, and policies Example → A low-income neighborhood with limited access to fresh produce encourages unhealthy eating habits. Alyssa Carter January 2025 Ch. 15: Community as a Client 1.​ Describe the three dimensions of a community as a client -​ A community is viewed as a client when public health interventions focus on improving the well-being of the population rather than just individual patients. -​ These are the 3 dimensions of a community as a client… I.​ Status – The physical, emotional, and social health of the community; physical status describes health indicators such as morbidity/mortality rates, disease prevalence, and healthcare access; emotional status describes mental health resources, stress levels, and emotional support systems; social describes community engagement, crime rates, and support networks. Example → Let’s say there’s a town called Happyfield. Happyfield ‘s local health department conducts regular health screenings and vaccination drives. They have a low incidence of chronic diseases like diabetes and hypertension due to active health education programs and readily available healthcare services. The town has several parks and walking trails, encouraging residents to stay physically active. So, overall we’d say that the community would have a healthier physical, emotional, and social status since the community puts things in place that promote good health in all areas. II.​ Structure – The availability of services, resources, and systems that support the community. Example → The number of hospitals, clinics, schools, and public services available. III.​ Process – The relationships and interactions among community members that contribute to community health. 2.​ Describe the characteristics of a healthy community. -​ A healthy community aligns with the Healthy People 2030 goals and has the following characteristics: ​ Promotes living free of preventable diseases and early death. ​ Eliminates health disparities and promotes health equity. ​ Provides social, physical, and economic environments that support well-being. ​ Encourages collaboration between public and private sectors for health improvement. ​ Supports healthy development and behavior across all life stages. ​ Engages community leaders and residents in decision-making for health improvement. 3.​ Describe the meaning of community as client. -​ The term "community as a client" refers to population-based interventions aimed at improving health outcomes for a group rather than focusing on individuals. This approach considers social determinants of health, environmental conditions, and public health policies affecting the entire community. Example → Addressing diabetes in a Hispanic community by improving access to healthy foods and culturally appropriate healthcare services. 4.​ Identify the different types of community assessment -​ There are five main types of community assessment: a.) Windshield Survey – observing the community while driving/walking through it to assess physical and social characteristics. Alyssa Carter January 2025 b.) Problem-Oriented Assessment – focuses on identifying specific health problems, understanding their root causes, and developing targeted interventions to resolve them (e.g., high diabetes rates). c.) Community-Subsystem Assessment - focuses on evaluating specific sectors within a community in order to understand how these individual parts function and contribute to the overall well-being and health of the community) d.) Comprehensive Assessment - A broad evaluation of all aspects of community life, including social, economic, and health-related factors; is an in-depth and all-encompassing evaluation that aims to gather detailed info about several diff. aspects of a community, organization, or individual's situation. It provides a holistic view by looking at multiple dimensions and factors—leading to a more thorough understanding of the subject e.) Community Assets Assessment - a process of identifying and evaluating the strengths, resources, and capabilities within a community. This type of assessment focuses on the positive aspects and available assets that can be leveraged to address the community’s needs, solve problems, and foster its development 5.​ Discuss methods of conducting a community health assessment. I.​ Surveys - Questionnaires to gather opinions on behaviors. II.​ Descriptive Epidemiologic Studies – Analyze health patterns and disease prevalence. III.​ Geographic Information System (GIS) Analysis – Map and visualize health trends in specific locations. IV.​ Community Forums – Gather public input through things like town hall meetings. V.​ Focus Groups - conduct small-group discussions to gain in-depth community insights. 6.​ Delineate five sources of community data. -​ Primary Data: this is data collected directly by researchers (e.g., surveys, observations, ). -​ Secondary Data: pre-existing data from government reports, health records, and statistics. -​ International Data: information from global health organizations. -​ National Data: country-wide statistics (e.g., U.S. Census Bureau, CDC reports). -​ Local Data : community-specific 7.​ Distinguish primary and secondary data -​ Primary Data is data collected directly whereas secondary data is data that you’ve gotten that’s already been collected. Ch. 7: ​Epidemiology 1.​ Apply the epidemiologic triangle to public health problems. -​ The epidemiologic triangle consists of three components: a.) Host: The person or animal that gets the disease (influenced by age, sex, genetics, immune status, lifestyle, etc.). b.)Agent: The cause of the disease, which can be biological (bacteria, viruses), chemical (toxins, poisons), physical (trauma, radiation), or nutritional (deficiency/excess). c.)Environment: The conditions that allow the disease to spread (climate, living conditions, sanitation, food sources, etc.). Alyssa Carter January 2025 -​ Example: If we look at Malaria …. ​ Agent: Plasmodium parasite ​ Host: Humans ​ Environment: Warm, humid climate where mosquitoes thrive. *Also keep in mind vectors, which are organisms like mosquitoes and sand flies that can carry and transmit the disease from one host to another. So, pretty much, this is how it works with vectors… -​ The agent needs a host to infect. -​ The environment influences how easily the agent can spread (i.e. warm humid climates since that’s when mosquitoes are most rampant, people who spend more time outdoors, coming into contact w/ contaminated food or water, ) -​ Vectors can help transfer the agent from one host to another 2.​ Describe theories of causality in health and illness. -​ Chain of Causation: A linear sequence where one event leads directly to a specific health outcome. Example: Smoking → Lung damage → Lung cancer. -​ Web of Causation: Multiple interconnected factors contribute to health outcomes. Example: Heart disease is influenced by poor diet, genetics, lack of exercise, stress, and smoking. -​ Causation in Non-Infectious Diseases: Chronic conditions (e.g., diabetes) result from various lifestyle and genetic factors rather than a single infectious agent. 3.​ Describe basic epidemiology concepts -​ Epidemiology is the study of how diseases spread, their causes, and ways to prevent/control them. ​ Person-Place-Time Model -​ This helps analyze disease patterns -​ It contains/asks the following… a.) Person: Who is affected? (age, gender, health status). b.) Place: Where is the disease occurring? (geographic location, climate). c.) Time: When does the disease occur? (seasonal trends, annual patterns). ​ Chain of Transmission -​ Describes how infectious diseases spread from one person to another. It consists of six connected parts, like links in a chain: 1.​ Infectious Agent → this is the germ (like a virus or bacteria) that causes the disease. 2.​ Reservoirs → this is where the germ lives and multiplies. It could be in humans, animals, or the environment (like water or soil). 3.​ Portal of Exit → this is how the germ leaves its reservoir. For example, it can exit through the respiratory tract (when someone coughs or sneezes), blood, or other body fluids. 4.​ Means of Transmission → this is how the germ spreads from one person to another. It can be through direct contact (like touching), airborne droplets (from coughing or sneezing), or vectors (like mosquitoes). 5.​ Portal of Entry → this is how the germ enters a new person. It could be through the respiratory tract (breathing in droplets), broken skin, or mucous membranes (like the eyes or mouth). 6.​ Susceptible Host(s) → this is the person who can get infected. Some people are more at risk due to factors like a weakened immune system or not having immunity to the disease. ​ Modes of Transmission -​ This explains how diseases can be spread from one person to another through different ways: Alyssa Carter January 2025 1.​ Direct Transmission - this happens when an infected person has direct contact with a healthy person, like shaking hands, touching, or kissing. 2.​ Indirect Transmission - this occurs when a healthy person touches surfaces or objects that have been contaminated by an infected person, like doorknobs, utensils, or shared equipment. 3.​ Airborne Transmission - this happens when infectious agents, like viruses or bacteria, are carried through the air in tiny droplets and are inhaled by a healthy person. For example, coughing, sneezing, or talking can release these droplets. -​ Purpose of This → Understanding these modes of transmission helps in taking preventive measures, like washing hands, wearing masks, and avoiding close contact with infected individuals, to reduce the spread of diseases. Practice Question 1.​ A nurse is preparing an education program on disease transmission for employees at a local daycare facility. When discussing the epidemiological triangle, the nurse should include which of the following factors as agents? (Select all that apply.) a)​ Resource Availability b)​ Ethnicity c)​ Toxins d)​ Bacteria e)​ Altered Immunity RATIONALE: C and D are the answer because it talks about educating on agents and agents are the cause of diseases. So, Toxins and Bacteria are the only options that refer to things that cause disease. Ethnicity and Altered Immunity are characteristics that would describe the host. 4.​ Define immunity and differentiate forms of immunity -​ For starters, immunity describes someone’s ability to fend off a particular infectious disease causing agent -​ There are 4 main types of immunity… -​ Passive Immunity - this type of immunity is borrowed from another source and lasts for a short time. (i.e. babies receive antibodies from their mothers through the placenta and breast milk, giving them temporary protection.) -​ Active Immunity - this type of immunity develops when the body's immune system is exposed to an infection or a vaccine, causing the body to produce its own antibodies. This type of immunity is usually long-lasting. -​ Cross-Immunity - this occurs when immunity to one disease or pathogen provides protection against another similar disease. (i.e. if you are immune to cowpox, you are also protected against smallpox.) -​ Herd Immunity - this type of immunity occurs when a large portion of a community becomes immune to a disease, making its spread unlikely. This helps protect individuals who are not immune. -​ So to summarize these even more simply… 1.​ Passive Immunity: Temporary protection from another source (e.g., maternal antibodies). 2.​ Active Immunity: Long-term protection from infection or vaccination. 3.​ Cross-Immunity: Immunity to one disease protects against another (e.g., cowpox provides protection against smallpox). 4.​ Herd Immunity: When a large portion of a community is immune, reducing disease spread. Alyssa Carter January 2025 5.​ Identify the 4 stages of a disease or health condition -​ This explains the progression of a disease from the point of exposure up to the part of recovery, disability, or death. There are 4 main stages (this is the summarized version)… Susceptibility: Before exposure; prevention measures are key. Subclinical Disease: After exposure but before symptoms appear (incubation period). Clinical Disease: Symptoms develop, and diagnosis/treatment occurs. Recovery, Disability, or Death: The disease resolves, leads to disability, or causes death. -​ Now, this is the more in-depth version… -​ Susceptibility - this is the stage before you're exposed to the disease. Primary prevention measures, like vaccinations and healthy lifestyle choices, are taken during this stage to prevent the disease from occurring. -​ Subclinical Disease - this stage occurs after exposure but before you start showing symptoms. It includes the incubation period, where the disease is developing in your body. Secondary prevention measures, like screenings and early treatment, are taken during this stage to detect and treat the disease early. -​ Clinical Disease - this stage begins when you start showing symptoms of the disease. Tertiary prevention measures, like medical treatments and rehabilitation, are taken during this stage to reduce the impact of the disease. -​ Recovery, Disability, Death - this is the final stage, where the outcome of the disease is determined. It can end in recovery, long-term disability, or death. Tertiary prevention continues to play a role in managing the long-term effects of the disease and improving the quality of life. ​ Practice Question 1.​ During which of the following stages would the community HN first expect to see signs of a disease via laboratory testing? A. Susceptibility stage B. Subclinical disease stage C. Clinical disease state D. Resolution stage *On the PowerPoint it says C, but when I looked it up I kept seeing B, so here are the explanations as to why it’s B… -​ Susceptibility stage (A): The answer wouldn’t be A, because at this stage no signs of disease are present yet because the individual has not been exposed to the pathogen. -​ Subclinical disease stage (B): After exposure, the disease is in the early stages, developing in the body without causing any noticeable symptoms. However, laboratory tests can still detect the presence of the disease during this stage. So, this would be the stage where the nurse would FIRST start to see signs of a disease via labs -​ Clinical disease stage (C): It wouldn’t be C, because by this stage, symptoms are apparent, and the disease is fully manifesting. While laboratory testing can confirm the diagnosis, the signs of the disease would already be visible without requiring lab tests and so this wouldn’t be the stage where the nurse would FIRST see it. -​ Resolution stage (D): At this point, the disease has run its course, and the individual is recovering or has recovered. Laboratory tests might show evidence of past infection, but they would not be the first indication of the disease. So, you would first expect to see signs of the disease via laboratory testing during the Subclinical disease stage (B) because this is when the disease can be detected before symptoms appear. Alyssa Carter January 2025 6.​ Demonstrate the ability to calculate epidemiological rates -​ Before we get into the calculation aspect of this, it’s important that you, first, understand the definitions of the terms that you’ll be asked to find (this is because, she may include questions where it’ll ask, for example, the crude mortality rate. And, so, you’d have to know what that is in order to know which of the values you should pick out to plug in) So, let’s get into it…. ​ Rates -​ Morbidity: this refers to the rate at which a disease occurs in a population. It tells us how many people are getting sick with a particular disease -​ Mortality: this is the rate of deaths in a population. There are different ways to measure this… 1.​ Crude Mortality Rate: the total # of deaths in a population w/o considering specific causes or age groups. 2.​ Cause-Specific Mortality Rate: the # of deaths due to a specific cause (like heart disease or cancer) in a population. 3.​ Case-Specific Mortality Rate: the # of deaths among people with a specific disease or condition. -​ Birth Rates: this measures how many babies are born in a population over a specific period. It's usually expressed per 1,000 people per year. -​ Attack Rates: this is the rate at which a particular event, like an infectious disease outbreak, affects a population. It measures how many people get sick compared to the total number exposed to the event. -​ Here’s the summarized version of each… ​ Morbidity tells us how many people are getting sick. ​ Mortality tells us how many people are dying, and there’s different types of mortality: one for overall deaths(Crude), one for specific causes(Cause-Specific), and one for specific cases(Case-Specific) ​ Birth Rates measure how many babies are being born. ​ Attack Rates measure the impact of specific events like disease outbreaks. ​ Prevalence Rate -​ Tells us how common a particular characteristic or disease is in a population at a specific time. -​ Helps public health professionals understand how widespread a disease or characteristic is in a population at a specific point in time. oCalculating It -​ The formula for calculating the prevalence rate is… # 𝑜𝑓 𝑃𝑒𝑟𝑠𝑜𝑛𝑠 𝑤𝑖𝑡ℎ 𝑎 𝐶ℎ𝑎𝑟𝑎𝑐𝑡𝑒𝑟𝑖𝑠𝑡𝑖𝑐 ​ ​ Prevalence Rate = ( 𝑇𝑜𝑡𝑎𝑙 # 𝑖𝑛 𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 ) 𝑥10ⁿ ← That is pretty much gonna represent however many persons you’re asked to find the prevalence rate out of (i.e how many cases out of 1000 people, 10,000 people, 100,000 people, etc. It’ll usually indicate it in the problem out of how many. But sometimes it may write it as an 3 exponent of 10 so, for example, 10 would be the same as saying 10 x 10 x 10 = 1,000) -​ Prevalence is defined as: “The number of existing cases in the population at a specific time ÷ the total population, x10 ”ⁿ -​ Example: if you have 50 people with a disease in a population of 10,000, the prevalence rate would be.. 50 50,000 -​ 10,000 𝑥 1, 000 = 10,000 = 5 𝑐𝑎𝑠𝑒𝑠 𝑝𝑒𝑟 1, 000 -​ Here’s an Example: Alyssa Carter January 2025 -​ Result: The prevalence rate of diabetes in the town is 15 cases per 1,000 people. ​ Incidence Rate -​ The formula for this one is very similar to the one for prevalence, except it measures the amount of NEW cases in the population, rather than existing cases: -​ The number of new cases in the population at a specific time ÷ the total population x10ⁿ (or instead of 10ⁿ it would be however many people, so per 1,000 people or per 10,000 people, etc.) Example: A nurse is reviewing data on the rates of varicella zoster (chicken pox) for a county. If there were 416 new cases of Varicella in 1 yr. among a population of 32,000 people, what should the nurse record as the incidence rate per 1,000 people? # of new cases in the population / Total population at specific time X 1000 people = 416 / 32,000 x 1000 = 13 new cases per 1,000 people ​ Mortality Rates -​ Mortality rates provide information about the causes of death in a population. They help us understand how many people die from specific causes within a certain period. This is how it’s calculated 𝑁𝑈𝑚𝑏𝑒𝑟 𝑜𝑓 𝐷𝑒𝑎𝑡ℎ𝑠 𝑖𝑛 𝑎 𝐺𝑖𝑣𝑒𝑛 𝑇𝑖𝑚𝑒 𝑃𝑒𝑟𝑖𝑜𝑑 𝑀𝑜𝑟𝑡𝑎𝑙𝑖𝑡𝑦 𝑅𝑎𝑡𝑒 = ( 𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑎𝑡 𝑅𝑖𝑠𝑘 ) 𝑋 10ⁿ oTypes of Mortality Rates -​ Crude Death Rate: this is the overall number of deaths in a population without considering specific causes or age groups. (i.e. The total number of deaths in a city in one year.) -​ Cause-Specific Death Rate: this measures the number of deaths due to a specific cause, like heart disease or cancer.(i.e. The number of deaths from gun violence or heart disease in 1 yr..) -​ Infant-Mortality Rate: this measures the number of deaths of children under the age of 1 within a specific time period, usually per 1,000 live births. (i.e. The number of infants who die before their first birthday in a country in one year.) Alyssa Carter January 2025 ​ Infant Mortality Rate -​ The Infant Mortality Rate measures how many babies die before their first birthday in a specific area and time period. It helps us understand the health of a population and the effectiveness of healthcare for newborns. oHow It’s Calculated 1.​ Count the Number of Infant Deaths: this is the number of babies who die before reaching 1 yr. of age in a specific area during a specific time period (usually a year). 2.​ Count the Number of Live Births: this is the total number of babies born alive in the same area and time period. 3.​ Calculate the Rate: use the formula → 𝐼𝑀𝑅 = ( # 𝑜𝑓 𝐼𝑛𝑓𝑎𝑛𝑡 𝐷𝑒𝑎𝑡ℎ𝑠 # 𝑜𝑓 𝐿𝑖𝑣𝑒 𝐵𝑖𝑟𝑡ℎ𝑠 )x 1000 Example: In 2008, a state had 1,300 infant deaths and 150,000 live births. So, we would then do…. 𝐼𝑀𝑅 = ( 1,300 150,000 )𝑋 1, 000 = 8. 7 So, the infant mortality rate is 8.7 infant deaths per 1000 live births in 2008. ​ More Practice Questions 1.​ A nurse is determining the attack rate following an E.coli outbreak at a restaurant. If 84 people ate contaminated lettuce and 13 people developed an E.coli affection, what should the nurse conclude as the attack rate? # 𝑜𝑓 𝑃𝑒𝑜𝑝𝑙𝑒 𝐸𝑥𝑝𝑜𝑠𝑒𝑑 𝑎𝑛𝑑 𝑊ℎ𝑜 𝐷𝑒𝑣𝑒𝑙𝑜𝑝𝑒𝑑 𝑡ℎ𝑒 𝐷𝑖𝑠𝑒𝑎𝑠𝑒 Step 1: Use the formula → 𝑇𝑜𝑡𝑎𝑙 # 𝑜𝑓 𝑃𝑒𝑜𝑝𝑙𝑒 𝐸𝑥𝑝𝑜𝑠𝑒𝑑 𝑥 100 13 Step 2: Solve. → 84 = 0. 1547​ Step 3: Multiply by 100 to get the percentage → 0.1547 X 100 = 15.48 Step 4: Round → 15.48 = 15 (since 15.48 is closer to 15 than 16) -​ These are the problems that we did in class…. 2.​ Use the following numbers to calculate each of the subsequent problems: *For ease of calculation, assume that cases alive at the beginning of 1991 live for the entire year. Total estimated Springhill population in 1991: 452, 780 Total cases of AIDS in Springhill reported from 1981 - 1991: 850 Total new cases of AIDS reported in Springhill in 1991: 95 Total deaths from AIDS in Spring Hill from 1981 (first year reporting began) to 1990: 595 a.) 1991 annual incidence rate of AIDS per 100,000 population in Springhill, TX. 𝑇ℎ𝑒 𝑛𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑛𝑒𝑤 𝑐𝑎𝑠𝑒𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑎𝑡 𝑎 𝑠𝑝𝑒𝑐𝑖𝑓𝑖𝑐 𝑡𝑖𝑚𝑒 Step 1: Use the formula → 𝑇ℎ𝑒 𝑇𝑜𝑡𝑎𝑙 𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 95 Step 2: Solve. → 452,780 = 0. 0002098149 Step 3: Multiply answer by 100,000 → 0.0002098149 x 100,000 = 20.9814 → 21 new cases b.) December 31st, 1991 prevalence of AIDS per 100,000 population in Springhill, TX. Step 1: Looking at the numbers given, we need to determine the total number of cases, so we have to subtract total cases of AIDS from Total deaths of AIDS (cause those who died from AIDS wouldn’t be included in the current prevalence.) ​ ​ ​ 850(total cases) - 595 (deaths from AIDS) = 255 cases # 𝑜𝑓 𝑐𝑎𝑠𝑒𝑠 255 Step 2: Use the formula → 𝑇𝑜𝑡𝑎𝑙 𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 = 452,780 = 0. 0005631874 Step 3: Multiply by 100,000 → 0.0005631874 x 100,000 = 56.31874 → 56 AIDS cases per 100,000 people c.) In the past year, there have been 10 deaths of infants under the age of 1 yr. and 300 live births in Spring Hill. What is the infant mortality rate for Springhill, TX? Alyssa Carter January 2025 # 𝑜𝑓 𝐼𝑛𝑓𝑎𝑛𝑡 𝐷𝑒𝑎𝑡ℎ𝑠 Step 1: Use the formula → 𝑇𝑜𝑡𝑎𝑙 # 𝑜𝑓 𝑙𝑖𝑣𝑒 𝑏𝑖𝑟𝑡ℎ𝑠 𝑥1, 000 10 Step 2: Solve → 300 = 0.033333333 x 1000 = 33.33 → 33 infant deaths per 1000 live births 3.​ In a Haitian city with a population of 359,451 people, 20,000 deaths occurred during the year ending in December 31, 2011. These included 10,000 deaths from cholera and 150,000 people who were sick with cholera. a.) What is the crude mortality rate for 2011? -​ As a reminder, the crude mortality rate is the number of deaths that occurred in a population w/o taking into account any specific causes or groups. Therefore, this is how we’d solve it… # 𝑜𝑓 𝐷𝑒𝑎𝑡ℎ𝑠 𝑖𝑛 𝑎 𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝐶𝑟𝑢𝑑𝑒 𝑀𝑜𝑟𝑡𝑎𝑙𝑖𝑡𝑦 = 𝑇𝑜𝑡𝑎𝑙 𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑥100, 000 20,000 359,451 = 0. 0556404072 𝑥100, 000 = 5, 564 𝑑𝑒𝑎𝑡ℎ𝑠 𝑝𝑒𝑟 100, 000 𝑝𝑒𝑜𝑝𝑙𝑒 b.) What was the cause-specific mortality rate from cholera in 2011? -​ If you recall, cause-specific mortality looks at deaths as a result of a specific cause. In this case, the cause was cholera. So, we'd solve it like this… 𝐷𝑒𝑎𝑡ℎ𝑠 𝑓𝑟𝑜𝑚 𝐶ℎ𝑜𝑙𝑒𝑟𝑎 Step 1: Use the formula → 𝑇𝑜𝑡𝑎𝑙 𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑥100, 000 10,000 Step 2: Set up and solve → 359,451 = 0. 0278202036x100,000=2,782 deaths per 100,000 people c.) What is the case fatality rate from cholera in 2011? -​ Case fatality describes how many people died out of those who’ve dev. a case of something. So… # 𝑜𝑓 𝑑𝑒𝑎𝑡ℎ𝑠 𝑓𝑟𝑜𝑚 𝑎 𝑑𝑖𝑠𝑒𝑎𝑠𝑒 Step 1: Use the formula → 𝑇𝑜𝑡𝑎𝑙 # 𝑜𝑓 𝑝𝑒𝑜𝑝𝑙𝑒 𝑤/ 𝑡ℎ𝑒 𝐷𝑖𝑠𝑒𝑎𝑠𝑒 𝑋100 10,000 Step 2: Solve → 150,000 𝑥100 = 0. 066666667𝑥100 = 6. 666666667 −> 6. 7% 𝑐ℎ𝑜𝑙𝑒𝑟𝑎 𝑐𝑎𝑠𝑒 𝑓𝑎𝑡𝑎𝑙𝑖𝑡𝑦 𝑟𝑎𝑡𝑒 *We mutliply by 100 since it needs to be a percentage. *Just one more note to keep in mind when doing problems like these—It’s not in this one specifically, but just in case it shows up in other ones—make sure you pay attention to the cause. For example, if it’s asking for the crude mortality rate for cervical cancer. Only factor in the population totals for women, because men don’t get cervical cancer, because they don’t have a cervix. So, yeah, just keep that in mind. *Make sure you look at the additional practice problems (the ones we didn’t do in class) cause then that statement I just typed above this one would make more sense and also it gives you exposure to more of the other rates to calculate that weren’t covered in the PowerPoints. 7.​ Identify sources of information for epidemiologic study ​ Analytic Epidemiology -​ Analytic epidemiology focuses on understanding the causes and effects of diseases by identifying associations between the disease and its possible causes. These are the main methods used: 1.​ Prevalence Studies: these studies measure how common a disease is within a specific population at a specific time. Example: A survey to find out how many people in a city have diabetes right now) 2.​ Case-Control Studies: these studies compare people who have a disease (cases) with people who do not have the disease (controls) to identify factors that may have contributed to the disease. Example: Comparing the lifestyles of people with lung cancer to those without lung cancer to see if smoking is a common factor. 3.​ Cohort Studies: these studies follow a group of people over time to see how different exposures (like smoking or diet) affect the development of diseases. Example: Tracking a group of non-smokers and smokers over 10 years to see who develops heart disease. Alyssa Carter January 2025 ​ Experimental Epidemiology -​ Experimental Epidemiology: This involves conducting experiments to study the effects of various factors on health outcomes. This can include clinical trials where researchers test new treatments or interventions to see if they work. ​ Epidemiologic Information -​ These are various sources of epidemiological information, which is important in order to understand how diseases affect different populations. Here are the key sources: -​ Vital Statistics - data on important life events like births, deaths, marriages, and divorces. -​ Census Data - population data collected through national censuses, which give a complete picture of the number of people living in a country. -​ Reportable Diseases - information on diseases that must be reported to health authorities so they can track and control outbreaks. -​ Disease Registries - databases that keep track of the occurrence and spread of specific diseases. -​ Surveillance Systems - ongoing collection and analysis of health data to monitor public health and detect any changes in disease patterns. -​ Environmental Monitoring - data on environmental factors, like air and water quality, that can impact health -​ National Center for Health Statistics and Health Surveys - surveys conducted to collect detailed health information from the population -​ Federal Public Health Agency Reports - reports from government health agencies that provide insights into health trends and issues. -​ Informal Observational Studies - studies based on observations rather than formal experiments, providing valuable insights into health behaviors and outcomes. -​ Scientific Studies - research studies conducted to investigate specific health-related questions and provide evidence-based findings. -​ Counts - simple tallies of health-related events or conditions, such as the number of flu cases in a season.