415 Exam 1

global health

- health problems, issues, and concerns that transcend national boundaries ◦May be influenced by circumstances or experiences in other countries ◦Best addressed by cooperative actions and solutions

tertiary prevention

-Correction and prevention of deterioration of a disease state EX teaching insulin injections at home

population focused nursing

-Focuses on the entire population -Is based on assessment of the population's health status -Considers the broad determinants of health -Emphasizes all levels of prevention -Intervenes with communities, systems, individuals, and families

Discuss laws and regulations relevant to environmental health and how government agencies use them to address environmental issues.

-right to know (hazards communication standard) -FDA, dept of agriculture, EPA, dept of health

Describe the process of conducting a community assessment (6)

1-describe makeup and history of community 2-what matters to people in community 3-what matters to key stakeholders 4-evidence weather problem/goal is priority 5-barriers and resources to addressing issues 6-state priority issues

18th century

1.Characterized by industrial growth, living conditions not conducive to good health - cities overcrowded, water supplies inadequate, unsanitary

Earliest Civilizations

1.Earliest community health practices probably went unrecorded 2.Combination of archeological evidence and written history show evidence of community health practices

Mary Breckinridge

1925 •Frontier Nursing Services •Mountains of Eastern Kentucky •Improved maternal and infant health outcomes (mortality) •1st U.S. training for nurse midwives

Understand historical events that have influenced population health

19th cen London Colera outbreak, Breckenridge 1925 midwife program

Community

A group of people who have common characteristics ◦Can be defined by location, race, ethnicity, age, occupation, interest in particular problems or outcomes, or common bonds

What is a vector?

A vector is a living organism which transmits microscopic disease agents to susceptible hosts. mosquito.

What are waterborne disease outbreaks? Name some waterborne disease agents.

A waterborne disease outbreak (WBDO) is a water exposure in which at least two persons have been epidemiologically linked to recreational or drinking water by location, time, and illness. Agents include Legionella and Cryptosporidium parvum.

Leading Health Indicators

Access to Health Services Clinical Preventative Services Environmental Quality Injury and Violence Maternal, Infant, and Child Health Mental Health

governmental:state

All 50 states have their own state health departments Purpose: to promote, protect, and maintain the health and welfare of their citizens

1. What are the major sources of air pollutants?

Answer: (1) transportation, including privately owned motor vehicles; (2) electric power plants fueled by oil and coal; and (3) industry, primarily mills and refineries.

health

Can mean different things to different people A dynamic state or condition of the human organism that is multidimensional in nature, a resource for living, and results from a person's interactions with and adaptations to his or her environment

Name some common foodborne disease causative agents.

Common agents include norovirus, Salmonella, and Campylobacter.

world community health in 2000s

Communicable diseases Poor sanitation and unsafe drinking water Hunger Migration and health

What options do communities have for managing MSW?

Communities can focus on source reduction and recycling, including composting, and proper disposal of MSW that cannot be reused or recycled.

What planning activities can a community engage in to minimize the potential for and impact of disasters?

Communities must be prepared to respond to disasters in order to minimize the loss of lives, help the injured, and perhaps prevent further disruption or catastrophe. Through FEMA, the federal government provides programs, grants, and resources to help communities prepare. The American Red Cross also can aid in this effort.

What are criteria pollutants?

Criteria pollutants are the most pervasive air pollutants and those of greatest concern in the United States. They include sulfur dioxide, carbon monoxide, nitrogen oxides, ground-level ozone, respirable particulate matter, and lead.

. Discuss determinates of health and indicators of health and illness from a population perspective.

Determinants: policies and interventions, access to quality health care Indicators: access, violence/injury rates, maternal death rate, mental health, substance use, environmental quality

secondary prevention

Early detection and intervention Early diagnosis and treatment EX screening

primary prevention

Efforts to prevent an injury or illness from ever occurring. EX immunization

What are endocrine disruptors and why are they an environmental concern?

Endocrine disrupters are chemicals that interfere in some way with the body's endocrine (hormone) system. The relationship between endocrine disrupters and human diseases of the endocrine system is poorly understood and remains scientifically controversial.

Describe areas of environmental health, environmental health problems, and related human health risks.

Environmental health is air, water, food, and communities risk of toxicity from pollutants, global warming and climate change

19th century

Epidemic problems in major cities ◦London cholera epidemics and Dr. John Snow

public health nursing practice

Focus on community as a whole and the effect of community health status (resources) on the health of individuals, families, and groups

community health nursing practice

Focus on health of individuals, families, and groups and the effect on the health of the community as a whole

community-based nursing

Focus on individuals and families where they live, work, and go to school; care is setting-specific and the emphasis is on acute and chronic care.

nongovernmental: philanthropic

Fund programs and research on prevention, control, and treatment of many diseases Some have broad support, others very specific -Examples: Bill and Melinda Gates Foundation, Commonwealth Fund, Robert Wood Johnson Foundation, local Community Foundations

Nongovernmental health agencies

Funded by private donations or membership dues Arose due to unmet health need Operate free from governmental interference Meet specific IRS guidelines with tax status Many types Voluntary, professional, religious, social, philanthropic, corporate, service

What is hazardous waste? Can you give some examples?

Hazardous waste is solid waste with properties that make it dangerous or potentially harmful to human health or the environment and, therefore, requires special management and disposal. Examples include by-products of petroleum refining operations and instruments containing mercury.

What is hazardous waste? Can you give some examples? Answer: Hazardous waste is solid waste with properties that make it dangerous or potentially harmful to human health or the environment and, therefore, requires special management and disposal. Examples include by-products of petroleum refining operations and instruments containing mercury.

Hazardous waste is solid waste with properties that make it dangerous or potentially harmful to human health or the environment and, therefore, requires special management and disposal. Examples include by-products of petroleum refining operations and instruments containing mercury.

US community health in 2000s

Health care delivery (insurance) Environmental problems (pollution) Lifestyle diseases Communicable diseases (AIDS) Alcohol and other drug abuse Health disparities Disasters

How is lead detrimental to our health? Which segment of our population is at highest risk for lead poisoning?

Health problems from exposure to lead include anemia, birth defects, bone damage, depression of neurological and psychological functions, kidney damage, learning disabilities, miscarriages, and sterility. Young children are at greatest risk of lead poisoning.

Formulate community and aggregate diagnoses

Increased risk of ____(problem) among ____(population) related to ____(etiology/cause) as demonstrated by___(health indicators).

How would you interpret the relationships among population growth, the environment, and human health?

Increases in population size and per capita consumption result in an ever-increasing environmental impact. The ramifications of overpopulation include the prospects of global warming, acid rain, bulging landfills, depletion of the ozone layer, increasing crime rates, increasing vulnerability to epidemics and pandemics, smog, exhaustion and contamination of soils and groundwater, degradation of arable land, and growing international tensions. All of these impacts affect health.

What is ionizing radiation?

Ionizing radiation is high-energy radiation that can knock an electron out of orbit, creating an ion.

Why is it a health hazard? How can individuals lower their health risk?

It is a hazard because it can damage living cells and tissues. People can protect themselves from radiation by limiting exposure to ultraviolet (UV) radiation from the sun and through early diagnosis and treatment.

Florence Nightingale

Known for her work in improving conditions in military hospitals during the Crimean War (1853-1856) Concern for environmental determinants of health Emphasis on sanitation, community assessment, and analysis Focus on health promotion & disease prevention

How do excessive amounts of lead get into our environment?

Lead is naturally occurring and has been used in electric batteries, pipe, solder, paint and plastic pigments, and, until 1986, in leaded gasoline. Because of its past widespread use, lead can be found in soil, household dust, air, paint, old painted toys and furniture, and foods and liquids stored in lead crystal or lead-based porcelain.

What factors contribute to foodborne disease outbreaks?

Leading factors that contribute to FBDOs are inadequate cooking temperatures or improper holding temperatures for foods (especially for bacterial outbreaks); unsanitary conditions or practices at the point of service, such as failure to wash hands (norovirus outbreaks); or drinking raw (nonpasteurized) milk (bacterial outbreaks).

Describe two leaders in nursing who had a profound impact on addressing aggregate health.

Lilian Ward and Mary Brewster (House on Henry St, public health nurses) Florence Nightengale and Mary Brekenridge

nongovormental: professional health organizations

Made up of health professionals who have completed specialized training and have met standards of registration/certification or licensure for their fields -Examples: American Medical Association, American Public Health Association

What are the National Ambient Air Quality Standards?

National Ambient Air Quality Standards are standards created by the EPA for allowable concentration levels of outdoor air pollutants.

What is a natural disaster and what is a complex disaster?

Natural disasters are natural hazards that involve human injuries and deaths. Natural disasters may result in substantial loss of life and/or property. A complex disaster can result when a natural disaster further escalates an ongoing crisis, such as a civil war, or causesa technological disaster.

Governmental Health Agencies

Part of governmental structure -Federal, state, or local -Funded primarily by tax dollars -Managed by government officials -Authority over some geographic area -'[Exist at four levels International, national, state, local

What is a pest?

Pest refers to any organism (plant, animal, or microbe) that has an adverse effect on human interests.

What is a pesticide?

Pesticides are natural or synthetic chemicals that have been developed and manufactured for the purpose of killing pests.

What are pharmaceuticals and personal care products and why should we be concerned with them?

Pharmaceuticals and personal care products (PPCPs) are synthetic chemicals found in everyday consumer healthcare products and cosmetics. The risks posed by PPCPs to humans, aquatic life, and wildlife are essentially unknown, except for the increase in resistance of some pathogenic bacteria to antibiotic

What is the difference between point source and nonpoint source pollution? Which is the bigger problem? Why?

Point source pollution refers to a single identifiable source that discharges pollutants into the water, such as a pipe, ditch, or culvert. Nonpoint source pollution includes all pollution that occurs through the runoff, seepage, or falling of pollutants into the water. Nonpoint source pollution is a greater problem than point source pollution because it is often difficult to track the actual source of pollution and, therefore, to control it.

What is the difference between primary and secondary pollutants?

Primary pollutants emanate directly from their sources. Secondary pollutants are formed when primary pollutants react with each other or with other atmospheric components to form new harmful chemicals.

List the three levels of prevention and give examples of each.

Primary-vaccine Secondary-Screen Tertiary-insulin

What is radon and why is it dangerous?

Radon is the number one cause of lung cancer among nonsmokers and the second leading cause of lung cancer overall. This radioactive gas, which cannot be seen, smelled, or tasted, is responsible for about 21,000 lung cancer deaths every year.

20th century

Resources Development Period (1900-1960) - growth of healthcare facilities and providers a. The Reform Phase i. Social movements to improve health conditions in cities and workplaces ii. Birth of first national-level volunteer health agencies iii. Birth of public health nursing iv. First school of public health established

governmental: local

Responsibility of city or county governments ◦Jurisdiction often depends on size of population State mandated services provided locally ◦Restaurants, public buildings, and public transportation inspections; detection and reporting of certain diseases; collection of vital statistics

Quasi-governmental health agencies

Some official health responsibilities; operate more like voluntary health organizations -Operate independently of government supervision -Derive some funding and work from government -Examples: American Red Cross, National Academy of Sciences, National Science Foundation

What are some major kinds of indoor air pollutants?

Sources of indoor air pollution include building and insulation materials, biogenic pollutants, combustion by-products, home furnishings and cleaning agents, radon gas, and tobacco smoke. Asbestos is harmless if left intact.

What is the Air Quality Index?

The Air Quality Index (AQI) tells you how clean or polluted your air is, and what associated health effects might be of concern for you or sensitive people in your community.

What is a foodborne disease outbreak?

The CDC defines a foodborne disease outbreak (FBDO) as the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food.

What is the Clean Air Act?

The Clean Air Act (CAA) of 1963 provided the federal government with the authority to address interstate air pollution problems.

What are some of the local, state, and federal agencies that help protect our food?

The EPA regulates the registration and labeling of pesticides. The United States Department of Agriculture (USDA) inspects meat and dairy products. The U.S. Food and Drug Administration (FDA), ensures the safety of the remainder of our foods. The task of enforcing state regulations at the local level falls on registered environmental health specialists (REHSs). Hired by local health departments, REHSs inspect restaurants and other food-serving establishments (such as hospitals, nursing homes, churches, and schools), retail food outlets (grocery stores and supermarkets), temporary and seasonal points of food service (such as those at fairs and festivals), and food vending machines to ensure that environmental conditions favorable to the growth and development of pathogens do not exist.

What role does the Environmental Protection Agency (EPA) play in protecting the environment?

The Environmental Protection Agency (EPA) is the federal agency primarily responsible for setting, maintaining, and enforcing environmental standards. As such, it is empowered to regulate air quality and is authorized to levy fines against those who violate the standards. The EPA sets limits on how much of a pollutant can be in the air anywhere in the United States.

What role does the Federal Emergency Management Agency (FEMA) play in preparing for and responding to catastrophic events?

The Federal Emergency Management Agency (FEMA) leads efforts to prepare communities around the United States for all hazards and manages federal response and recovery efforts following any national incident, such as earthquake, fire, floods, tornado, landslide, tsunami, wildfires, and winter storms, as well as terrorism.

What are the purposes of the Resource Conservation and Recovery Act (RCRA) and the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA)?

The Resource Conservation and Recovery Act of 1976 (RCRA) was the first comprehensive law to address the collection and disposal of both solid and hazardous wastes. RCRA also established a system for controlling hazardous waste from the time it is generated until its disposal and mandated strict controls over the treatment, storage, and disposal of hazardous waste. The Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), also known as the Superfund, created a tax on the chemical and petrochemical industries to clean up abandoned hazardous waste sites that might endanger human health and the environment.

How do communities ensure the quality of drinking water, and what steps do communities take to reduce the likelihood that their wastewater harms the environment?

The community employs multiple processes to ensure safe drinking water. Surface and waste water are treated. In many communities, water is fluoridated. Communities also utilize septic systems in unsewered areas.

What are the purposes of the Clean Water Act and the Safe Drinking Water Act?

The goal of the Clean Water Act (CWA) is to return the quality of surface waters to swimmable and fishable status. Under the Safe Drinking Water Act, the EPA sets national standards to limit the levels of contaminants in drinking water and oversees the states, localities, and water suppliers who implement those standards.

What types of refuse make up our municipal solid waste (MSW)?

There are nine major categories: paper, yard waste, food scraps, rubber and textiles, wood, metals, glass, plastics, and other.

How can we reduce our exposure to them(pollutants)?

To reduce airborne biogenic pollutants in their homes, people should clean up standing water, remove any wet or water-damaged materials from around the home, and, if they suspect a problem, have the home inspected by someone knowledgeable about indoor air pollution problems. To avoid volatile organic compounds (VOCs), when building or renovating a residence, use exterior-grade products that emit less formaldehyde. Increase ventilation in the home, use a dehumidifier and air conditioning to control humidity, and keep temperature at moderate levels in the home to reduce formaldehyde emissions

What types of pollutants threaten our water supply? Give an example of each type.

Water pollutants can be classified as biological or nonbiological. Biological pollutants include pathogens such as parasites, bacteria, viruses, and other undesirable living microorganisms. Nonbiological pollutants include chemicals, radioactive materials, and heat especially from energy plant cooling towers.

governmental: international

World Health Organization (WHO) most widely recognized international governmental health organization

public health

actions that society takes collectively to ensure that the conditions in which people can be healthy can occur; most inclusive term

Discuss community/public health nursing interventions as explained by the Intervention Wheel

advocacy, policy, outreach, screening, case management, counseling, community

Identify social, cultural, economic, and political factors that contribute to pollution and impact environmental problems

agriculture workers at risk for unintentional pesticide chemical exposure...spills/exposure to skin, unable to speak English to read labels, eat without washing

Describe the importance of air, water, and food quality as a determinant of health

air pollutants are significant health issue, mostly from cars (carbon monoxide, nitrogen dioxide)

Identify sources of information about a community's health

census data, vital data (births, deaths), CDC, national center for health

Explain the difference between public/community health nursing practice and community-based nursing practice.

community based is focused on where individual/family lives, works, school...care setting is specific

governmental: national

e -ach nation has department or agency within its government responsible for protection of health and welfare of its citizens U.S. primary national health agency: Department of Health and Human Services (HHS) -dept of agriculture, EPA, OSHA, DHS(homeland)

population health

health outcomes of a group of individuals, including the distribution of such outcomes within the group

community health

health status of a defined group of people and the actions and conditions to promote, protect, and preserve their health

How much MSW do we generate per person per year?

in 2013, we produced a daily average of 4.4 pounds of MSW per person

Develop an understanding of the risk assessment and risk management role of nurses

known chemical? route of entry? 1. home-build? lead? radon? 2.combustion-gas?wood stove? fireplace? 3.gas-dryer?stove?vented? 4.water-well?lead pipes? contaminated? 5.smoke-detectors?

Explain the difference between target organisms and nontarget organisms and give examples.

the pest organism against which the pesticide is applied to is referred to as the target pest or target organism. An example is an insect. All other organisms in the environment that may also be affected are called nontarget organisms

What is a vectorborne disease? Can you give some examples of each?

vectorborne disease is a disease that is transmitted through a microscopic disease agent by a vector. An example of a vectorborne disease is Lyme Disease.

healthy people 2030 goals

◦Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. ◦Achieve health equity, eliminate disparities, and improve the health of all groups - by addressing the root cause of health problems ◦Create social and physical environments that promote good health for all. ◦Promote quality of life, healthy development, and healthy behaviors across all life stages.