test 1 community

• Social determinants of health (SDOH) include nonmedical social structures, policies, and economic systems that affect health and quality-of-life outcomes
• Public health science brings together environmental science, epidemiology, biostatistics, biomedical sciences, and social and behavioral sciences
• Understanding negative and positive factors from both a population and individual perspective helps develop nursing interventions that incorporate the full continuum of health
• Public health is the science and art of preventing disease, prolonging life, and promoting health and efficiency through organized community effort
• 3 core functions of public health:

  • Assessment focuses on the systematic collection, analysis, and monitoring of health problems and needs
  • Policy development uses scientific knowledge to develop comprehensive public health policies
  • Assurance assures constituents that public health agencies provide services necessary to achieve agreed-upon goals
• Globalization leads to increased disparities between rich and poor, environmental degradation, and food security issues
• Key population health measure is life expectancy, defined as the average number of years a person born in a given country would live if the mortality rate by age remained constant in the future
• Upstream determinants of health include social relations, neighborhoods, communities, institutions, and social and economic policies
• Cultural competency is essential for health-care providers to provide quality care to culturally diverse populations
• Cultural humility is an ongoing understanding that we must approach others as equals, with respect for their prevailing beliefs and cultural norms
• Communities with fewer resources and inadequate infrastructure are at greater risk for disease
• Environment is a key factor contributing to morbidity and mortality, with poor sanitation and lack of potable water increasing the spread of communicable diseases
• Public health nursing focuses on promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences
• Public health nursing roles include coordination, consultation, leadership, advocacy, health education, health promotion, regulatory activities, ongoing education, practice evaluation, professional relationships, and collaboration
• Public health ethics include principles of autonomy, dignity, and rights of individuals, as well as the concept of social justice
• Global health:

  • Collaborative transnational research and action for promoting health for all
  • WHO classic definition of health: "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity"
  • Countries differentiated based on country-level income data: high-income countries (HICs), upper-middle-income countries (UMICs), lower-middle-income countries (LMICs), and low-income countries (LICs)
  • Growing disparity between lower groups (LICs and LMICs) and higher groups (HICs and UMICs)
• Public health organizations and management: global to local:

  • WHO's primary role is to direct and coordinate international health within the United Nations' system
  • WHO's areas of work include health systems, promoting health through the life course, NCD, CD, and corporate services
  • WHO expanded to include emergency response and disaster preparedness initiatives
  • Institution of International Health Regulations (IHRs) for disease outbreaks response
  • IHRs increase WHO's ability to respond to public health emergencies
• • Seventeen current SDGs with a target date of 2030 built on the MDGs that ended in 2015
  • Purpose of SDGs: "end poverty, protect the planet, and ensure prosperity for all"
• National health organizations:

  • Individual countries have their own national organizations dedicated to health promotion and protection
  • Coordinate with the WHO and work together to address threats to health
  • Provide infrastructure and oversight of population health
  • U.S. Constitution provides a two-layer public health system at federal and state levels
  • States required to provide protections to citizens after ratification of the 14th Amendment
• Centers for Disease Control and Prevention (CDC):

  • Mission: "protect America from health, safety, and security threats both foreign and in the U.S."
  • Scope includes prevention and control of CDs and NCDs, injuries, workplace hazards, disabilities, and environmental health threats
  • Conducts research, maintains national surveillance system, and responds to health emergencies
  • Collaborates with state and local health departments for disease and injury surveillance
  • Sets standards for disease prevention strategies and provides funding for public health surveillance and programming
• State public health departments:

  • Independently decide on structure of local and state health departments
  • Variations exist across states in organization and management of public health systems
  • Basic mandate is to protect the health of citizens in their jurisdiction
• Local public health departments:

  • Mandate to protect the health of citizens in their area
  • Perform activities like surveillance, outbreak investigation, quarantine, and reporting diseases to state health departments and the CDC
  • Help federal government track disease incidence and prevalence nationally
• Summary points:

  • Public health is a core component of nursing knowledge and competency
  • Nursing goal is to help people achieve optimal health by understanding health of populations and communities
  • Public health science aims to improve health from cellular to global level
  • Public health builds a healthy environment and responds to health threats
  • Public health nursing is a recognized specialty with specific scope and standards of practice
  • Formal structures exist from global to local levels to promote health and protect populations
• Introduction to optimizing population health:

  • Vision of Healthy People 2030: "a society in which all people achieve their full potential for health and well-being"
  • Mission: "to promote and evaluate the nation's efforts to improve health and well-being"
  • Shift from focus on older adults to entire population with emphasis on health equity, SDOH, and well-being
• Population health promotion, health protection, and risk reduction:

  • Social-ecological model of health includes physical and social environments in health promotion
  • Health promotion enables people to improve their health beyond individual behavior
  • Risk reduction actions aim to reduce adverse outcomes like using condoms for disease transmission prevention
  • Health protection increases individual's ability to protect against disease
• Health promotion:

  • Prevention interventions focus on behavioral change for biological and behavioral change at individual level
  • Ecological determinants of health include potable water, sanitation, climate action, and more
  • SDOH affect health and quality of life risks and outcomes
  • Ecological model expands health promotion beyond individual approach
• Health protection and risk reduction:

  • Promotes healthy lifestyle and environment
  • Interventions protect individuals from disease by reducing risk
  • Individuals adopt protective health activities
• Prevention frameworks:

  • Health prevention aims to prevent disease, injury, and slow disease progression
  • Public health policies, programs, and practices improve population health and reduce disease risk
  • Natural history of disease provides foundation for prevention frameworks
• Levels of prevention:

  • Primary prevention prevents disease development in healthy individuals
  • Secondary prevention detects and treats disease early to reduce morbidity and mortality
  • Tertiary prevention aims to prevent disability and premature death
• Primary prevention:

  • Focuses on promoting healthy behaviors and building ability to protect against disease
  • Includes vaccinations and health education
• Secondary prevention:

  • Involves early detection of problems in asymptomatic individuals with risk factors
  • Targets conditions not yet clinically apparent for earlier detection
• Tertiary prevention:

  • Focuses on reducing disability, promoting cure, and preventing death in diagnosed individuals
  • Includes medical, environmental, and psychosocial strategies
• Universal, selected, and indicated prevention models:

  • Useful for preventable diseases with known early signs
  • Limitations in adapting to diseases with complex risk factors
  • Includes clinical, behavioral, and environmental interventions
• Model divides the continuum of care into three parts: prevention, treatment, and maintenance
• Under prevention, there are three categories: universal, selected, and indicated
• Universal prevention intervention is applicable to the whole population and is not based on individual risk
• Strives to deter the onset of a health issue within the general population
• Often the intervention is passive, such as a media campaign
• Selective prevention interventions are aimed at a subset of the population that has an increased level of risk for developing disease
• Based on demographic variables such as age, gender, or race, or on genetic, environmental, or socioeconomic risk factors