Community Health

Judiasm

"Kosher" diet-prohibit pork or gelatin and combo (beef w/dairy)., govern method of how to prepare certain foods (beef). During Passover, distinction between food that is specifically "Kosher for Passover" and just "kosher". Handwshing before eating is religiously significant. After patient has diet, burial must happen quickly and no autopsy (sometimes necessary thouhgh), family membe rmust accompany body in hospital, even to morgue, say prayers and read psalms, request that amputated limbs be available for burial.

family as a function of society

"What plans do we develop to increase h1n1 immunization rates families of lower income households?"

Socio-ecological model

-Basis for understanding health in populations and assuring conditions in which populations be healthy -public policy (state, national, local laws) -community (relationships between organizations) -organizational (organizations, social institutions) -interpersonal (families, friends, social) -individual (knowledge, attitude, skills) (top to bottom) For example, obesity: -public policy: regulations about school programs, what chemicals they put in our foods, bloomburg trying to ban soda in restaurants -community: access to healthy food, healthcare services, safety of outdoor spaces, community norms, school hours. Banning soda in local vending machines -organizational/institutional: Food options in cafeteria, wellness programs, gyms, if there are Dr. offices near by and access to healthcare -Interpersonal: you and others around you so CULTURAL factors, food choices, society and family views, caregiver behavioral, how much time your family has to cook (think of your family view), what foods you mostly eat based on your culture -Individual: obesity can be genetic, knowledge, attitude, behavioral about eating and exercise

upstream

-ecological model approach that focuses on eliminating the factors that increase risk to population's health -ecological model reflects a deeper understanding of role not only of physical environment but also of the conditions in the social environment creating poor health- SOCIAL ENVIONRMENT HAS INFLUENCE ON INDIVIDUAL (think of what's up on the ecological model) -Upstream interventions involve policy approaches that can affect large populations through regulation, increased access, or economic incentives. For example, increasing tobacco taxes is an effective method for controlling tobacco-related diseases (7). Midstream interventions occur within organizations. -POLICIES, PROGRAMS,

Barriers to developing cultural competence

-stereotyping -prejudice -racism -ethnocentrism -cultural imposition -cultural conflict -culture shock

Spiritual assessment model

1. Is spirituality or religion important to you? 2. Are their certain spiritual beliefs and practices that you find helpful in dealing with problems? Do you attend a church? Are there any spiritual concerns I can help you with?

Percent of US births to mothers born outside the country. Do illegal immigrants receive public benefits or health care?

20%. No

assessment, assurance, policy development

3 core functions of public health Assessment-investigate to see what ppl need (_Diagnose and investigate health problems and health hazards in the community, Assurance-assure that they get what they need (Link people to needed personal health services and ensure the provision of health care when otherwise unavailable assurance_______Ensure competent public and personal health care workforce) Policy development-make laws (_Inform, educate, and empower people about health issues policy_______Mobilize community partnerships and action to identify and solve health problems policy_______Enforce laws and regulations that protect health and ensure safety)

What percent of American adults are family caregivers? How old are they usually (caregivers) and how old are the ppl they are caring for?

30% American adults provide care for someone 50 or older adn they themselves are over 50

Maslow's Hierarchy of Needs

=physiological-shelter, food Shelter-Nemo and Marlin live in a sea anemone Food-shark tried to eat Dori and Marlin Sleep-Marlin sleep in goggles =safety-safety and security Make sure egg is protected (security) Hide in the ship for safety, turtle saves Dory and Marlin from jellyfish (safety) =love/belonging (family, friends-friendship with Dori, having fish family) =esteem (confidence, achievement, respect of others)-Achievement: such as finally finding Sydney, Australia Confidence: Gil helps Nemo find confidence and live on his own Need to be unique individual (has his own fin) =self-actualization (creativity, spontaneity, problem solving, lack of prejudice, acceptance of facts) Creativity-Gil uses creativity for escape plans Spontaneity-Dory lets go of whales tongue w/o thinking of consequences Acceptance-Marlin had to accept that Nemo can do stuff on his own

Healthy people 2030

A society in which all people achieve their full potential for health and well-being across the life-span. Mission-to promote and evaluate the nation's efforts to improve the nation's health and well-being of its people

Native American Spirituality

Call upon medical man/woman/shaman. Medicine person-also holy person bc they do all their healing with the creator's help and guidance. Many today will call upon modern medicine and traditional ceremonies

Family resiliency

Ability for family to cope with expected and unexpected stressors (example-someone in family gets in a car accident, family offers support, counseling, pt, communication)

Three ethical tenents of policy development

Achieve the public good-rooted in citizenship, sacrifice to others over self (citizenship and public service above entrepreneurship), what is ethical is also a good policy

2 ethical tenents of assurance

All persons should receive essential personal health services, providers of public health services are competent and available

Religious scientist (Christian)

Although they are free to seek medical care, many don't

What should you do for health risk appraisal (assessment)

Assessing for factors associated with an increased likelihood of an unhealthy event. like look at what they are eating and their family hx, are they are at risk for MI or stroke in future? how likely? (Age-(elderly-more at risk for stuff like dementia), biological health, envionrmental (does their job handle hazardous that can lead to cancer), behavioral risk

Health risk reduction based on what? How can they be reduced?

Based on the assumption that decreased risk (in number or magnitude) lowers probability of an undesired event. health risks can be reduced by numerous approaches

Sustainable development crisis

Blueprint to achieve better and more sustainable future for all, interconnecting goals and we should try to achieve each by 2030. Include no poverty, hunger, good health, education, gender equality, clean water and sainitation, affordable and clean energy, etc

Buddhism

Body is valuable instrument whose good health is indispensable for maximizing spiritual development. Medication is important to address and prevent illness

How to identify global health disparicies and cause and how public health people address this

By looking at life expectancies of different countries due to low and high income difference, addressed by fixing the underlying reason (poverty and other social reasons.) ex-ppl living in Africa have lower life expectancy than ppl in America. In order to prevent this, try to address poverty in that country

Jehova Witness

Can't reveive blood (RBC, WHC, Platelets, Plasma) via tfn, medication, food. Some blood fractions (albumin, immunoglob, hemophiliac preparatoins) are allowed, but patients are guided by their own conscience. Organ donation and transplants are allowed, but patients are guided by their own consience.

What is leading cause of death now-chronic disease or infectious? Causes?

Chronic diseases now are leading cause of death, link between lifestyle and health. Heredity and lifestyle/envionrment

Cultural competence in health care and 3 principles.

Combo of culturally congruent behaviors, practice attitude,s policies that allow nurses to use interpersonal communication, relationship skills, behavioral flexibility to work effectively in cross-cultural situations. -CLIENT CENTERED CARE: if they are from Morocco, you must do interventions specifically for that -INCORPORATE CULTURAL NORMS AND VALUES: incorporate their diet -SELF-EMPOWERMENT to facilitate client decision making and self-care management in health and illness situations: allow them to make decisions about diet

What is biggest barrier to achieving social justice?

Concept of market justice

Nursing diagnosis for families

Conflicting caregiver attitude, impaired family coping, risk for caregiver stress, impaired family process, risk for parent child attachment, family able to participate in care planning, family knowledge of disease

What do you consider when you assess someone's health

Context of health-if they have access to resources, finances, access to exercise, access to food

Spirituality is as aspect of what type of identity?

Cultural (like in Grey's anatomy, that girl who was from a certain culture and wanted a priest to be with her before a procedure)

Developing provider cultural competence: 3 strategies with 3 dementions

Culturally incompetent, culturally sensitive, culturally competent. Cognitive, affective, psychomotor

commnity-based

DIRECT ONE-ON-ONE CARE (cancer center nurse, giving someone epi pen, home health nurse) involves practice in certain setting, Involves the delivery of nursing care to individuals and families who are 'ill' ___based____Involves the delivery of acute and chronic care to individuals and families in a specific setting, hospice

Challenges for nurses working with families in community

Definition of family, transitions of care, uninsured, under insured, limited services, social and family policy challenges, families experiencing homelessness, intimate partner violence

Virtue ethics/moral character

Do the persons selected to develop, assess, disseminate community knowledge possess integrity?

Cultural skill

Effectively integrate cultural awareness and knowledge when conducting a cultural assessment and use data to meet client's needs

What contributes to morbidity and mortaility?

Environment so if they were rich/poor (ex-poor-not being able to eat enough, adding stress, more frequent infections

Nightingale Environmental Theory

Environment-ventillation, warm, light, noise, clean, nutrition Person-patient Health-"prevention of disease through use of fresh air, pure water, efficient drainage, cleanliness, light" Nursing-general nursing-health, educated in art and science of nursing with application of nursing process

Cultural awareness

Exam your own beliefs and values as they influence behavior. Understand that culture is an influencing factor between themselves and others, understand basis of their own behavior, recognize that health is expressed differently

Family diversity

Expression of the range of family types in a society, from nuclear through extended and reconstituted to single-parent. (such as having some parents same gender, other parents different gender, single, foster

Community-oriented

FOCUS ON AGGREGATE (HELP REDUCE RISK OF NEGATIVE CONSEQUENCES)-health promotion, disease prevention, epidemiology. INDIRECT CARE (reducing tobacco use, reducing communicable diseases, can be to certain group (infants, women, children-provide free/reduced cost to them))POPULATION!!!!! population, Requires greater cognizance of the connections of various factors with health, Occupational health nursing (looking at overall health of population), school based nursing (individualized but it's an overall plan to keep students safe)

Family systems Theory

Families are social systems so nurses can learn much from a systems approach. For example, if a man cuts off his parents, he will become more reliant on his spouse and own children. This can create tension and other problems in those relationships within the newly separated emotional system, because there will be more pressure on these relationships than what is typical. The system will change in complexity over time. There is constant change within the system due to stressors from the outside environment.

What do you need to look for during home assessment?

Family structure, natural or home environment, behavior in that environment. Identify barriers and supports for reaching family health promotion goals, culture, cleanliness and safety, clarify visit plan, consent form, support systems, vitals

world health organization

Global leadership in health, health research, set norms and standards, est ethical and ebp, conduct disease surveillance and monitor health trends

Family as context

Health and development of individual members-strength or stressor to family member. For example, is family able to drive you to appointments? or do they give you junk food when you already have an obesity problem? (individual foreground, family background)

Socio Ecologic perspectives on population health

Health behaviors of someoen influenced beyond individual (internal and external, society)-ex. decision of someone wearing a mask determined by individual opinion (if they want to stay safe/think it's government conspiracy), external determinants-what family/friends do. society-cdc recommendations. other example-getting fit: individual-if you want to, external-?, society-everyone wants to be healthy

CDC duties

Health promotion and protection, disease prevention, health emergencies, investigate outbreaks, injuries, workplace hazards, disabilities, environmental health threats, national surveillance system, standards for disease prevention during outbreak, repository for health statistics

What is your goal for families?

Helping individuals and families assume an active role in promoting their health care, access and control needed resources, decision-making and problem-solving abilities, ability to communicate in order to obtain needed resources (Someone in poor neighborhood who doesn't speak English has access to buying insulin and can afford it, community where someone speaks in same language for help, able to understand their condition and know if they need more medication (make decisions and solve problems)

What is average mother's age of first birth? Older or younger than it was before? Are more children born w/in or outside of marriage?

Increase, average is 25.4 years, increase number of children born outside of marriage.

Cohabitation increasing or decreasing? effects?

Increased. Potential for negative child well-being, parental separation 5 times more likely than for married couples, increase in unstable living situations (transitions), higher rate of poverty

National public health departmetns

Individual countries have their own national organizations that coordinate with W H O and work together to address health. (CDC in US)

Aggregation

Individual units brought together as whole/sum. Unit of analysis (level at which health care provider analyzes and reports data)F

Baha'i Faith

Individuals should seek the assistance of competent physicians for medical treatment (religion that is about all religions)

Cultural desire, can it be taught?

Intrinsic motivation to engage in previous elements-based on humanistic value of caring for individual, do it bc they wan to, canNOT be taught in the classroom

"Do not harm"

Is disseminating appropriate information about groups and populations morally necessary and sufficient?

Competency

Knowledge development, analysis, dissemination-Are the persons assigned to develop community knowledge adequately prepared to collect data on groups and populations?

Which influences public dialogue about public health needs-social or market justice? Bateman's

Market

Population

Members may/may not interact but share at least one characteristic (age, gender, ethnicity, residence, shared health issues (aids)). May or may not be shared geography. Example-population of ppl with aids all across america, population of 50 years olds in america, population of boomers, population of dudes who play club penguin, population of diabetes patients in hospital (all are different ages, races, cultures but population is same bc they have one thing in common)

Do people in poor countries have more doctors or nurses?

More doctors, less nurses, care depends on doctors

How is parenting changing nowadays?

More nontraditional roles-blended households, single mothers, divorced mothers, single fathers, grandparents raising grandchildren

Did number of households increase or decrease since 1940? By how much?

Number of households tripled

Bateman's ethical principals

Patient's best interests, accordance with patient's wishes, keep patient informed, respond with diligene and competence, act impartially and offer frank, independent advice, maintain patient confidentiality -what they want and tell them what's going on

Largest growth of people demographic and why. Impact on healthcare?

People living alone. Higher life expectancy causes more single-person households. Healthcare: Delay seeking care, transportation for older singles, isolation from other family members who can help. Example-as life expectancy increased, older people live longer so more singles (widows?). Ex-elderly lady I work with who is single, no transportation, late seeking care bc family isn't around to see if they are safe, isolated from family

High physician-to-population ratio in some countries leads to what?

Physicians become expensive, nurse clinics seen as competition, physicians wield more political power

CDC goal

Premier health promotion, prevention, preparedness agency in us and global leader in public health

IPHC (pentecostal)

Relatively large numbers of people be allowed in the patient's room for prayer

Catholicism

Sacraments and blessings by priest before surgery or when there is a perceived risk of death. Called "Sacrament of the Sick"

Seventh Day Adventist

Saturday is seventh day-Sabbath

Cultural knowledge

Searching and obtaining sound educated understanding about culturally diverse groups, learning about client's worldview from emic (native) perspective

Ethnicity

Shared geographical feelign of peoplehood amount group of individuals relating to CULTURAL factors. nationality, geographic region, culture, ancestry, belief,s traditions, origin, language, dialect, religious faith, folklore, food, culture. There are cultural differences w/in the ethnicities. Don't stereotype. Equally influenced by: education, income, cross-cultural experiences. Ethnic group can have different culture groups (example: Native Americans are ethnic groups, have culture groups-Navajo which have their own language, culture; other groups.

Social justice vs market justice

Social Justice: setting a minimum bar of levels of income, basic housing, employment, education, & health care should be seen as fundamental RIGHTS (for the common good) Market Justice: emphasize individual responsibility, minimum obligation to the common good, & fundamental freedom to all individuals to be left alone, influences public dialogue about public health records

Islam

Specifically request diet in accordance with "Halal" food, but most op for vegetarian diet. Forbidden foods="Haraam", this can affect use of medications, especially drugs with porcine origins/have gelatin or alcohol. Prayers are 5 times a day but if they are hospitalized, advice should be encouraged from an imam. Washing-requiring runninggg water from tap or poured from pitcher, may request amputated limbs available for burial, request to whisper a proclamation of faith in ear right after birth and death, after death, family may request ot wash patient and position theri bed to face Mecca and head should rest on pillow, After death of client who is Muslim, a Muslim of the same gender must wahs and wrap the body. During Ramadan, must refrain from food and drink from dawn until sundown

Who decides on how to structure their local and state health departments?

States. Different states implement protection of public health different ways

T/F: fertility rates differ by race and ethnicity

T

family structure

The legal and genetic relationships among relatives living in the same home; includes nuclear family, extended family, stepfamily, and so on. affected by relationships between them (divorced/married), intractions with others (foster system)

public health science

The scientific foundation of public health practice and brings together other sciences including environmental science, epidemiology, biostatistics, biomedical sciences, and the social and behavioral sciences. So, you might use statistics to see which group of people are most likely to get a certain disease, use epidemics to track a disease, knowing that health is within context of population, knowing how vaccines work, knowing how environment contributes to health, how sociology impacts care

True or false: Growing trend that children are being the role of caregivers, affecting their health and school performance

True

True or false: families represent more than a set of individuals, more than a sum of its individual members

True

African spirituality

Varies by tribe, traditional healers serve many roles like responsibility of traditional African religion and customs, educators about culture, counselors, social workers, psychologists

Hinduism

Vegetarian, fasting, washing-hands after meals

Healthy people 2030 vision and mission

Vision: Where we are headed-all people achieve their full potential for health and well-being across the lifespan. Mission: "Why we are here"-promote and evaluate nation's efforts to improve health and well-being of its people

Family Health

a dynamic changing relative state of well-being that includes the biological, psychological, sociological, cultural, and spiritual factors of the family system

Terms used to differentiate nations based on country-level income data:

high-income countries (H I C) Upper middle-income countries (U M I C) lower middle income countries (L M I C) low-income countries (L I C)

Culture

beliefs, social forms, traits of religious or social group ex.-russian culture has superstitions, etc. shared by people in place or time. North America, West, S, each have their own culture

Family-As-System Approach

both family members and family unit. When something happens to one member, rest of members affected, vise versa. "What changed between you and your spouse when you had your child's head injury? Someone lost job, how does this impact family?

Race

categorizes people based on superficial qualities (skin color, physical characteristics, parentage/origin, hair texture)-is BIOLOGICAL variation/genetic. Race differences-growth and development, skin color, enzymes, susceptibility to disease, lab test findings, same race may be different cultures (think of same race can have different religion)

downstream

ecological approach that represents actions taken after disease or injury has occurred. INFECTIOUS DISEASE, INJURY, HOSPITALIZATIONS

family functions

economic survival-provide money for family reproduction-make kids protection cultural heritage socialization of young-learns norms, values of society, personality from family, what is right/wrong and good/bad conferring status relationships health-takes care of family members who are sick

biological systems theory

environment changes kids over time

What do you need to have basic knowledge in to do public health population-based care? It consists of caring for who?

epidemiology, biostats, other sciences, to identify priority health-issues. Caring for populations, not just individuals, aggregations, communities. (ex.-stats on how many covid cases a specific area has, how many different kinds of people life there (age, race, gender, etc)

family as a client

family is primary focus, members are secondary. "How is family reacting to a member's diagnosis of heart disease?" "How does diagnosis of insulin-dependent diabetes affect your family?" "Will your need for medication at night be a problem for your family"

family as patient

family patterns and processes-take care of everyone in the family and not just the individual who is sick

Family development and life cycle theory

focuses on predicted stresses of families as they change and transition over time (think of switched at birth and how they encounter stressors and changed over time)

individual focused care

giving epi pen to someone

WHO working on new model that addresses what?

globalization, more noncommunicable diseases, chronic communicable diseases

Diversity

groups differ in age, race, religion

Community

individuals living in same geographical area (town, neighborhood) or group of individuals that share similar common denominator (ethnicity/religion) ex. church community that know each other., community of boomers who are in the same neighborhood/know each other, people who are in the same club at school

Family durability

intrafamilial system of support and structure that may extend beyond the walls of the household Example: The grandparents watch the children while the parents are at work. Adoption of children,living in the same home for many years,and parental roles do not demonstrate family durability. Which example best demonstrates family durability? A) Four generations of family have lived at the same address. B) Two of the couple's children were adopted because of infertility. C) The grandparents watch the children while the parents are at work. D) The mother works full time while the father stays home with the children. A: C

case finding vs surveillance vs outreach

locates individuals w/risk factors, connects with resources. surveillance-collect and interpret data. outreach-reach out to people, can do screenings (DM)

affects of cohabitation on children

parents separate a lot, poverty (think of Joe from you), drugs/alcohol,

system focus

policy development-helmet laws for bicycle safety

Determinants of health include

range of personal, social, economic, environmental factors (rich/poor and have access to health care, genetics, what you eat, how you were raised (what type of family). The earlier model was health promotion that focus on changing individual behavior to reduce risk (smoking cessation, healthy eating, increased exercise)

community focused

takign care of comunity