Community Health Exam 1
What are the 8 principles of public health nursing?
1 The client or unit of care is the population. 2 The primary obligation is to achieve the greatest good for the greatest number of people or population as a whole. 3 The processes used by PHN's include working with the client as an equal partner. 4 PRIMARY prevention is the priority in selecting appropriate activities. 5 Public health nursing focuses on strategies that create healthy environmental, social, and economic conditions in which populations may thrive. 6 A PHN is obligated to actively identify and reach out to all who might benefit from a specific activity or service. 7 Use of available resources must be optimal to ensure the best overall improvement in the health of the population. 8 Collaboration with a variety of other professions, populations, organizations, and other stakeholder groups is the most effective way to promote and protect the health of the people.
Which of the following strategic directions is not included in the National Prevention Strategy? Building healthy and safe community efforts, Expanding hospital capacity Empowering people to make healthy choices Eliminating health disparities
2 Expanding hospital capacity- The prevention strategy is focused on prevention of disease rather than treatment of disease.
· Public health practice consists of which of the following functions? (SATA) Promotion of disease Promotion of health Preventing disease Addressing environmental safety and improvement
2, 3, and 4- Promotion of health, Preventing disease, & Addressing environmental safety and improvement- PH practice consists of preventing disease, prolonging life, promoting health, addressing environmental safety and improvement, and improving health for all citizens regardless of ethnicity, age, socioeconomic status, or gender.
Define aggregate, population, and community
Aggregate: individual units brought together into a whole or a sum of those individuals. In public health science, the term aggregate often refers to the unit of analysis, that is, the level at which the health-care provider analyzes and reports data. Population: larger group whose members may or may not interact with one another but share at least one characteristic such as age, gender, ethnicity, residence, or a shared health issue such as HIV/AIDS or breast cancer. The common denominator or shared characteristic may or may not be a shared geography or other link recognized by the individuals within that population. Community: group of individuals living within the same geographical area, such as a town or a neighborhood, or a group of individuals who share some other common denominator, such as ethnicity or religious orientation.
· The socioecological model uses which of the following: An upstream approach A midstream approach A downstream approach A model for examining causation of disease
An upstream approach- The socioecological model uses an upstream approach with a focus on the determinants of health and reflects a deeper understanding of the role not only of the physical environment but also of the conditions in the social environment creating poor health, referred to as an "upstream" approach.
What are 4 essential public health purposes/activities?
Conducting surveillance Responding to communicable disease outbreaks and disasters Evaluating evidence to make recommendations Set goals related to improvement of health
What are the main public health nursing roles and responsibilities?
Coordination, Consultation, and Leadership Advocacy Health Education and Health Promotion Regulatory Activities Ongoing Education and Practice Evaluation Professional Relationships and Collaboration
What is cultural context?
Cultural context: Aspects of life that affect the health of individuals, such as food preferences, gender roles, birthing practices, language, and spiritual beliefs, to name a few. A person's "luggage"- beliefs, habits, norms, customs, and rituals that are handed down from one generation to the next
Define diversity and culture
Diversity - groups and individuals are not all the same but differ in relation to culture, ethnicity, and race. Culture - the customary beliefs, social forms, and material traits of a racial, religious, or social group; also: the characteristic features of everyday existence (such as diversions or a way of life) shared by people in a place or time
How does poverty influence health? What is socioeconomic status, poverty threshhold, and poverty guidelines?
Economic factors are, perhaps, the most important ones influencing the health status of an individual or group. Socioeconomic status (SES): a composite measure of income, education, and occupation Poverty threshold: the standard of living below which a family lacks the goods and services commonly taken for granted by mainstream society Poverty guidelines: determining who is eligible for federal programs aimed at aiding those living in poverty
· True or False- overconsumption of alcohol is a high health risk for older adults
False
· True or false: A pharmacokinetic interaction between alcohol and a medication occurs because alcohol enhances the effects of the medication.
False: Pharmacokinetic interaction: Alcohol interferes with the body's ability to metabolize the medication. Pharmacodynamic interaction: Alcohol enhances the effects of the medication
What are the HealthyPeople 2020 infrastructure components?
Healthy people 2020 infrastructure components (required to meet the 10 essential public health services) Capable and qualified workforce Up-to-date data and information systems Public health agencies capable of assessing and responding to public health needs
What is the difference between aggregate/population and community?
In contrast to aggregates and population, individuals within the community recognize their membership in the community based on social interaction and establishment of ties to other members in the community, and often join collective decision making.
· An example of a downstream approach to population health promotion, protection, and risk reduction would be: Policies that require change at a community level Grocery stores removing all high-fat foods from their shelves Individuals being compliant with vaccinations Addressing environmental issues
Individuals being compliant with vaccinations- Downstream approach begins at and is focused on change at the individual level, such as individuals taking initiative to become compliant with required vaccines as part of prevention.
· Is taking prescribed medications one of the 10 keys to healthy aging?
No
How does culture impact nursing?
Nurses must have appreciation for cultures while acknowledging and understanding their own cultural view of the world to develop effective nursing interventions Respecting Culture and Diversity Within a Community Population-level interventions require the inclusion of community members as partners in the process.
What do public health nurses work to accomplish?
Nurses work to answer the "who, what, when, where, why, and how" of health problems within the context of populations. Public health nursing: practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences. Specialty practice within nursing and public health.
What is population health and population focused care?
Population health: develop interventions for individuals, populations, and communities, both locally and from a global perspective Population-focused care requires knowledge of epidemiology and biostatistics, to help identify priority health issues at the population level. Ultimately aims to improve the health of aggregates, populations, and communities.
What are the steps in developing a health education plan?
Steps in developing health education plan · Identify health education need · Assess the learner- literacy, culture, language, age, and learning style · Write a goal for the teaching · Write specific measurable objectives with learning domain in mind (cognitive, affective, and psychomotor) · Identify materials needed, appropriate environment, and length · Describe key lesson concepts · Write out procedure step by step · Have a plan for evaluation
What was created by the UN to address health equity?
The Universal Declaration of Human Rights, adopted by the General Assembly of the UN in 1948, continues to provide the underlying framework for equity in health at the World Health Organization (WHO) through national- and state-level approaches to improving health equity. WHO is the arm of the UN
What influences vulnerability at the population level?
The degree of vulnerability experienced by different populations is influenced by: -Social determinants of health including economic and environmental factors -Social capital -Health system determinants -Individual risk factors and population-level factors influence the vulnerability of at-risk groups
· The Aged Dependency ratio is: o The proportion of dependents (those aged 0 to 14 years plus those 65 years of age and older) per every 100 members of the population aged 15 to 64 o The ratio of the number of persons age 65 and older per every 100 members of the population aged 15 to 64 o The proportion of those on disability per every 100 members of the entire population o The proportion of dependents aged 0 to 14 years per every 100 members of the population aged 65 or older
The ratio of the number of persons age 65 and older per every 100 members of the population aged 15 to 64- answer 1 is the definition of the dependency ratio. Answer 3 and 4 are not standard epidemiological ratios
· According to W H O, the social gradient refers to a gradient in health that runs from top to bottom of: Education levels within a community The socioeconomic spectrum Prevalence of a disease in a community Income levels in a community
The socioeconomic spectrum- The World Health Organization (W H O) uses the term social gradient, which refers to "...a gradient in health that runs from top to bottom of the socioeconomic spectrum. This is a global phenomenon, seen in low-, middle-, and high-income countries. The social gradient in health means that health inequities affect everyone.
WHO created a new model that addressed what issues. What was created to assist with emergency response?
WHO- creating a new model that addresses Globalization Increased prevalence of noncommunicable diseases Chronic communicable diseases Response to public health emergencies and disaster preparedness -Manmade and natural disasters -Created International Health Regulations (INH)- countries must increase ability of the WHO to respond to public health emergencies (disease outbreak or disasters)
· What age group has the highest rate of alcohol consumption?
o 20-40 year olds
· You are a home health nurse who has been assigned to take care of a 72-year-old patient. When you get to her house, you see there is trash everywhere, molding food out, and dirty plates and cups. The patient is unclean and has foul body odor. She tells her only caretaker, her brother, has been too busy at work to stop by. Who do you contact first?
o Adult protective services
What is ageism?
o Ageism: bias toward older adults based on stereotypes o Judging or categorizing people and not allowing them to be individuals with unique ways of living their lives o Assumptions can influence screening procedures, information exchanges, and treatment decisions o Manifested through patronizing language or dismissing symptoms as part of growing older
What is aging, indicators of age, and nursing goals?
o Aging: becoming chronologically and biologically older § Concept of more than counting years § State of mind o Indicators of age § Physical health § Psychological wellbeing § Socioeconomic factors § Functional abilities § Social relations o Nursing goals: modify physiological and psychological change to help people stay healthy, functional, and independent longer
What are the two types of alcohol-medication interactions, what are the effects of substance use on physical health?
o Alcohol and medication interactions § Pharmacokinetic interaction: alcohol interferes with body metabolism of medication § Pharmacodynamic interaction: alcohol enhances effect of the medication o Substance use and physical health § Increased risk for injury § Untreated thiamine deficiency- Wernicke-Korsakoff syndrome § Alcohol-related: cardiomyopathy, liver cirrhosis, pancreatitis, cancer, HTN, and psychological disorders
· What does the CAGE assessment screen for?
o Alcohol withdrawal and addiction assessment
· What is an example of a primary prevention intervention?
o All vaccines- administering an influenza vaccine
How prevalent is ADRD as a cause of death. What are prevention measures for this disease?
o Alzheimer's disease and related dementias (ADRD) § 6th leading cause of death for adults in the U.S. § 5th leading cause of death in persons over the age of 64 o Other dementia diagnoses: vascular dementia, mixed dementia, dementia with Lewy bodies (Parkinson's), and frontotemporal dementia o Prevention: § Primary- no interventions to prevent AD or cognitive decline § Secondary- screening programs and medication to slow progressing § Tertiary- active AD management and achieving optimal quality of life
· Name the 6 standards of practice for public health nursing
o Assessment o Population diagnosis and priorities o Outcomes identification o Planning o Implementation o Evaluation
What is the CAPABLE program?
o CAPABLE program: health-care services with home modifications and community services so older adults can remain in their homes § An occupational therapist (OT), a registered nurse (RN), and a handyman § Work with low-income older adults for five months on what they identify as their most important goals
What is the CDC healthy brain initiative. What are consequences for caregivers of patients with ADRD?
o CDC prevention health brain initiative- Advance cognitive health as a public health goal § Four domains with interventions against cognitive decline · Educate and empower · Develop policies and mobilize partnerships · Assure a competent workforce · Monitor and evaluate o Caregiving § Consequences to caregivers' health from long house, physical tasks, stress, and relentless responsibility § Health problems- hypertension, hyperinsulinemia, impaired immune system, and cardiovascular disease
· According to the CDC, the first leading cause of death in the United States is ___________
o Cardiovascular disease
What are biological theories of aging?
o Collection of cells and material subject to mechanical failure resulting from genes or harmful genes turning on o Accumulation of errors in protein synthesis leading to impaired cell function o Mutations from exposure to environmental radiation or chemicals damaging DNA o Free radical theory: more prone to damage from free radicals along with a lower level of protective free-radical scavengers (vitamin A, C, and niacin) o Cross-linkage or connective tissue theory: chemical reactions create strong bonds make collagen stiff and affect movement and elasticity o Physiological theory: programmed aging/biological clock where cells double a limited number of times before death
· Community collaboration is an important aspect of public health. What are examples of community collaboration?
o Community collaboration- organizations working together o Mental health advocacy group partners with professional therapy organization to provide free substance abuse counseling o The public health department working with school to provide vaccination Different church groups organizing food banks to feed the homeless
What are the 2 types of substance use in older adults?
o Early onset at-risk substance use: older adults who have a history of regular alcohol consumption abuse recommended limits or problem drug use that began early in their lives § Also called hardy survivors o Late onset at-risk substance use: substance use that began later in life often triggered by an even such as loss of a spouse or partner
· ____ refers to having shared geographic origin, language, dialect, religion faith food preferences and culture while ____ categorizes groups of people based on superficial criteria such as physical characteristics
o Ethnicity o Race
· True or false: The distinction between and an asylee and a refugee is that a person asking for refugee status is seeking to enter the United States, while an asylee is a person outside the United States applying for asylum.
o False, the opposite is true: The distinction between the two is that a person asking to receive refugee status is outside the United States and seeking to enter, while an asylee is a person already residing in the United States when applying for asylum.
· You are taking care of a patient with type 2 diabetes. He has been struggling financially and tells you he hasn't been able to afford his insulin. What concept does this scenario represent?
o Health inequity- idea that everyone should be able to live a life free of disease
· Life expectancy in America is the highest it's ever been in history. What are some factors that contribute to longer lifespan in individuals?
o Improved sanitation systems o Modern medicine o Improved maternal and child health services o Modern technology and equipment
· A nurse is working in a very diverse town where there are people of many different ethnicities. What is the best way for the nurse to improve her cultural competency?
o Increase her knowledge through online research
· This vulnerable population is at the greatest risk for experiencing modern slavery
o Migrant workers
· What type of organization is the CDC?
o National
What is a naturally occuring and continuing care retirement communities?
o Naturally occurring retirement community (NORC)- subsidized housing complex, condominiums, apartments, or single-family neighborhoods § Residential housing with support § Transportation for appointments and shopping § Individual assessment of those at risk, followed by referral and follow-up of service § Coordination of nonprofessional services o Continuing care retirement communities (CCRC) § Provide housing and health care across the continuum, from independent living, to assisted living, to skilled nursing care § Advantages: older adults can remain within the CCRC long-term § Disadvantages: costliness
· 63-year-old male has recently been diagnosed with stage 4 colon cancer. His physician estimates he will live 6 more months. What type of referral would you give to the family of the patient?
o Palliative care
· What level of homelessness is someone living in a car experiencing?
o Primary
What is involved in noncommunicable disease prevention in older adults?
o Primary prevention: reduction of behavior risk factors associated with obesity and hypertension § Improved nutrition § Increased physical activity § Social support o Secondary prevention: screening and early intervention § Screening for breast cancer, colorectal cancer, diabetes, lipid disorders, osteoporosis, cervical cancer, obesity, alcohol misuse, depression, blood pressure, and alcohol misuse o Tertiary prevention: chronic self-management model § Communicate with a health-care provider § Proper use of medication § Nutrition § Regular exercise § Disease specific activities- foot care for diabetics
What are the 3 psychosocial theories of aging and what are psychosocial variabls of aging and health?
o Psychosocial theories of aging § Disengagement: disengage from pursuits and roles they enjoyed in earlier life § Activity: those remaining active and engaged in life were observed to age more optimally § Continuity: people are consistent throughout their lives and personalities remain constant o Psychosocial variables of aging and health § Depression § Adverse life events § Optimism § Perceived stress
What are important aspects of emergency preparedness?
o Public health infrastructure, cultural considerations, and economy of a country are fundamental for capacity to prepare for and respond to emergencies Infrastructure provides capacity to prepare for and respond to acute and chronic threats and is foundation for planning, delivering, and evaluating public health
What is the purpose of the U.S. Office of Minority Health (OMH)?
o Purpose of a logic model specific to improving ethnic and minority health: -Provide policy makers and others concerned with health disparities a better appreciation of the issues. -Understand better the interrelationship of all the variables. -Provide a research format and direction for data input. -Give building blocks to the community stakeholders so they can contribute input and improve structure. -Improve the systematic planning of data collection, interventions, and evaluation.
· The constructivism theory of learning believes people learn best from
o Reflecting on own experiences
· Local public health departments are responsible for many services in public health. They may differ from state to state but they must comply with certain federal mandates. What are the federal mandates they must follow?
o Reporting specific disease to the state department and the CDC Initiating quarantine during disease outbreaks
· What is the difference between health promotion and risk reduction?
o Risk reduction- lowering chance of getting disease- vaccination, PPE, condoms o Health promotion- helping someone live their best life
· Ages and stages is a questionnaire used by providers to check a child's development and asses for any delays what kind of level of prevention is this?
o Secondary
· You are a nurse caring for a 54 y/o male patient. He tells you he has been staying in different shelters and sometimes stays with his friends. What type of homelessness is this patient experiencing?
o Secondary
· You are caring for a patient who has issues managing his diabetes. He states his medications have not been working for him and he wants to manage his disease w/o medication. What is NOT an example of providing patient centered care? o Educating him on ways to manage his disease through diet and physical activity o Referring him to a specialist or endocrinologist o Telling him he needs to take his medication to stay healthy
o Telling him he needs to take his medication to stay healthy- Do not reinforce the importance of taking his medication- not actively listening to patient who stated that he does not want to take medications
· Prevalence pot indicates what?
o Total amount of current cases
· What level of prevention: Treating a patient with measles Treating an asthma patient
o Treating a patient with measles- tertiary Treating an asthma patient- teriary
What are the purposes of the UN sustainable development goals?
o UN Sustainable Development Goals: end poverty, protect the planet, and ensure prosperity for all § WHO sets global health goals and tracks attainment of these goals § Strategies for economic growth, education, health, social protection, and job opportunities Goal three of the SDG's: ensure healthy lives and promote well-being for all at all ages
· This organization is focus on health of the global population and is the public health arm of the United Nations?
o WHO
What steps have been taken towards the globalization of healthcare?
o WHO launched Nursing Now campaign to promote global health o UN Sustainable Development Goals: end poverty, protect the planet, and ensure prosperity for all o Improve access to vaccines for childhood illnesses- Cairo M/R Catch-Up campaign o Bill and Melinda Gates Foundation pay off Nigeria's debt to Japan for eradicating polio
What is the WHO Nursing Now campaign?
o WHO launched Nursing Now campaign to promote global health § Improve health globally by raising the profile and status of nurses worldwide - influencing policymakers and supporting nurses themselves to lead, learn, and build a global movement
· Are these health promotions or risk reduction- o Wearing PPE? o Conducting a vaccine outreach program? o Promoting use of condoms at STI clinic? o Implementing an exercise program at an elementary school?
o Wearing PPE? § Risk reduction o Conducting a vaccine outreach program? § Risk reduction o Promoting use of condoms at STI clinic? § Risk reduction o Implementing an exercise program at an elementary school? § Health promotion
· What is an example of using an upstream approach to improve health outcomes for a community?
o Working with local farms to provide healthier lunches to school-age children
· Which vaccines are recommended for older adults (over 65 years)?
o Zoster vaccine o Pneumococcal vaccine o Influenza vaccine
What are the CDC recommendations to achieve aging in place?
§ Affordable, accessible, and suitable housing options can allow older adults to age in place and remain in their community all their entire lives. § Housing that is convenient to community destinations can provide opportunities for physical activity and social interaction. § Communities with a safe and secure pedestrian environment, and near destinations such as libraries, stores, and places of worship, allow older adults to remain independent, active, and engaged. § Combined transportation and land-use planning that offers convenient, accessible alternatives to driving can help the older adults reach this goal of an active, healthy lifestyle.
What are some recommendations to prevent substance use in older adults?
§ Data analysis of substance abuse in the elderly § Expanded literature review on substance abuse § Prevention, treatment, and management strategies for older adults § Monitor demographic shifts in older population § Long-term projection for health services for substance abuse Traumatic brain injury
What is the goal and barriers to aging in place?
· Aging in Place o Goal: Improvement of functioning, enhancement of quality of life while maintaining older adults in their homes o Barriers to aging in place § Finances for home modifications § Security § Community services
Who are agricultural migrant workers? What a risk factors migrants have for poor health outcomes? What are interventions and policies for migrant workers?
· Agricultural Migrant Workers in the U.S. ○ Not all agricultural migrant workers are immigrants. ● A migrant agricultural worker: employed in agricultural work of a seasonal or other temporary nature who is required to be absent overnight from his or her permanent place of residence · Risk factors for poorer health outcomes: ● Substandard housing ● Crowded living quarters ● Poor nutrition ● Exposure to pesticides ● Lack of access to health care* · Interventions and Policy for Migrant Workers ● The U.S. Immigration and Nationality Act (INA) protects immigrant and migrant workers from discrimination. ● The Affordable Care Act (ACA) does not directly benefit migrant workers, especially those who are undocumented.
· What is behaviorism? · What is cognitive theory?
· Behaviorism- Seeking knowledge that changes though patterns · Cognitive theory- Examining own personal motivations
Define behaviorism, cognitive/social learning, constuctivism, and humanism
· Behaviorism: classical condition- reward and punishment, behavior change achieved with environmental stimulus that results a response, focus only on observed behavior change and not mental activity · Cognitive/social learning: focus on inner mental activity, behavior, and environment interrelation, more rational, result of knowledge that changed thought patterns · Constructivism: reflects on our own experiences, builds knowledge within our own unique framework as we increase experience and knowledge · Humanism: uses feeling and relationships encouraging development of personal actions to fulfill one's potential and achieve self-actualization
What are the 3 determinants of vulnerability?
· Marginalization: A social process through which a person or group is on the periphery of society based on identity, associations, experiences, or environment ● Treat a person as though they are of little or no consequence or is unimportant · Discrimination: When one group gives unjust or prejudicial treatment to another group based on race, ethnicity, gender, socioeconomic status, or other group membership ● Individual discrimination ● Institutional discrimination: policies of dominant institutions intended to have harmful effect on minority group ● Structural discrimination: policies of dominant institutions are race/gender/ethnic neutral in intent but have harmful effect on minority groups · Stigma: Stigmatized individuals either possess, or are believed to possess, some attribute that is not valued in a particular social context
What are the public health standards of practice?
○ Assessment- collect data about health status of population ○ Population diagnosis and priorities ○ Outcomes identification for population goal ○ Planning ○ Implementation · Coordination of care · Health teaching · Health promotion · Consultation · Prescriptive authority & referrals · Regulatory activities- apply law, regulation, & policy ○ Evaluation of progress
What is cultural competency and cultural humility?
○ Cultural competency: attitudes, knowledge, and skills the health-care provider uses to provide quality care to culturally diverse populations. ○ Cultural humility: understanding awareness about one's own culture is an ongoing process, and acknowledgment that we must approach others as equals, with respect for their prevailing beliefs and cultural norms · Requires self- reflection on own viewpoints, experiences, attitudes, values, and beliefs to develop insight and knowledge required to provide care
What are social determinants of health and interventions to combat them?
○ Definition- factors within a community or defined location that affect individual health · Neighborhood and built environment · Social and community context · Economic stability · Health and healthcare · Education ○ Requires personal choices and government choices- shaped by distribution of money, power, and resources at all levels ○ Mostly responsible for health inequities ○ Interventions aimed at health promotion and protection
What is equity/health equity?
○ Equity is the underlying concept behind optimum health as a basic human right. ○ Health inequity: describes avoidable gaps in health outcomes.
Define ethnicity and race
○ Ethnicity: shared geographical origin, language or dialect, religious faith, folklore, food preferences, and culture. ○ Race: groups people based on superficial criteria such as skin color, physical characteristics, and parentage.
What is the public health intervention wheel and the components of it?
○ Illustrates how public health nurses improve the health of individuals, families, communities, and systems ○ Components · Population basis of interventions: focus of all interventions is population health · Levels of care ● Individual- focus on knowledge, attitude, practices, beliefs, and behavior ● Community- focus on norms, attitudes, practices, awareness, and behaviors ● Systems-level- focus on policy, laws, organization, and power structures · 17 public health interventions- including health education, screening, and case management
Define immigrant, lawful permanent resident alien, and illegal alien
○ Immigrant: emigrates from one country to take up permanent residence · Lawful, permanent resident alien: not a citizen but entered the country with a valid visa, obtained a work permit, and permission to stay indefinitely ● Alien admitted to the US as lawful permanent resident · Illegal alien: enters a country without proper permission with the intent of becoming a permanent resident ● Would be strictly defined as an immigrant but is not a permanent resident alien
What is the difference in IMR in the african and european region? Why does this difference exist?
○ In 2016, the infant mortality rate (IMR) for the World Health Organization (WHO) African Region was 52 per 1000 live births compared to 8 per 1,000 live births for the WHO European Region. · Poverty and lack of access to resources are important risk factors for infant death and help to explain the differences seen among racial groups with a higher percentage living in poverty.
Who are migrant workers and what are they at risk for?
○ Migrant workers: move from place-to-place following seasonal agricultural jobs · One who moves from place to place to obtain work, often in a country that is not his or her own · Increased risk of homelessness due to continually moving to find work and lack of stable housing · Increased risk for exploitation- limited social protection, inequalities in the labor market ● Increased risk for human trafficking and modern-day slavery ● Modern slavery: labor extracted through force, coercion, or threats ● In the U.S.: particular focus on sex trafficking, forced labor, bonded labor, child labor, and domestic servitude ● The Walk Free Foundation and the International Labor Organization developed the Global Slavery Index to address the gap in knowledge related to the extent of modern slavery.
What are the levels of homelessness and how does homelessness impact health?
○ Persons Experiencing Homelessness · One who lacks a fixed, regular, and adequate nighttime residence · One who lives in a supervised shelter or institution designed for temporary residence, or one who lives in a place that is not normally used as accommodation for people · Levels of Homelessness ● Primary homelessness: Living without adequate shelter, living in vehicles, surviving on the streets, staying in parks, or squatting in abandoned buildings ● Secondary homelessness: Staying in a temporary form of housing because the person has nowhere else to go ● Tertiary homelessness: renting single rooms on a long-term basis without security of a fixed or permanent residence · Homelessness and Health- adults experiencing homelessness are faced with: ● Excessive disease burden ● Shorter life expectancy ● Limited access to healthcare ● Consumption of significantly more health-care resources when they do finally receive care
What is a prevalence pot?
○ Prevalence pot depicts total number of cases of a disease in the population and takes into account duration and the incidence of the disease. · Helps identify health conditions that may have increased number of cases over time if development of new cases is not prevented · Helps identify where prevention efforts are needed ○ Prevalence = Total number of cases/Total population
What is health promotion?
○ Process of enabling people to increase control over, and to improve, their health ○ Focuses on a wide range of social and environmental interventions
Define refugee and asylee
○ Refugee: Outside home country and unable or unwilling to return due to persecution · Globally, refugees experience: food insecurity, poor sanitation, exposure to multiple communicable diseases, violence, and mental health issues with limited medical care. ● Many live in refugee camps, some for several years, with a major impact on their health and greater risk for a number of health issues. ● Children in refugee camps are at increased risk for stunted growth due to chronic malnutrition. ○ Asylee: Unable or unwilling to return to country of nationality because of persecution or a well-founded fear of persecution on account of race, religion, nationality, or membership in a particular social group of political opinion.
What is health protection/risk reduction?
○ Risk reduction refers to actions taken to reduce adverse outcomes · Encompasses more than biological protection and can involve removing risk from the environment or reducing the level of risk. ○ Health protection puts the emphasis on increasing the person's ability to protect against disease. · Involves biological protection such as the use of vaccines. ○ Health protection/risk reduction interventions protect the individual from disease by reducing risk.
What is the WHO, their goals, major functions, and definition of health?
○ The public health arm of the United Nations (UN)- direct and coordinate international health within the UN systems ○ Goal: to build a better, healthier future for people all over the world · WHO's goals ● Eradication of malaria ● Maternal-child health ● Malnutrition ● Communicable disease ● PH infrastructure ● Sanitation ● Environmental health ○ WHO's Major Functions · Global leadership in health · Health research · Set norms and standards for health · Establish ethical and evidenced-based policy · Provide technical support · Conduct disease surveillance and monitor health trends ○ WHO definition of health: state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity · Promote health through the life-course, NCD, CD, and corporate services
What are downstream and upstream approaches?
○ Upstream focuses on eliminating the factors that increase risk to a population's health- a macro approach · a population that is high risk for disease · Ecological determinants of health use an upstream approach · ex: one with a lot of children is high risk for the flu- promote vaccination ○ Downstream approach represents actions taken after disease or injury has occurred-a micro approach · Once disease has occurred- working to reduce further impact/disease/damage/infection and others
What is vulnerability, the impact on health, and vulnerable populations?
○ Vulnerability: the degree to which an individual, population or organization is unable to anticipate, cope with, resist and recover from the impact of disease and disasters · Vulnerability does not mean that an individual or group is "less than," but rather acknowledges the increased risk for adverse health outcomes and provides a means to address health inequity. ○ Vulnerable populations: based on race, ethnicity, age, gender, sexual orientation, history of incarceration, socioeconomic status, exposure to violence and war, and lack of a permanent residence
What is health education?
○ WHO definition: any combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes ○ Purpose: positively change behavior by increasing knowledge about health and disease ○ Health education involves teaching, encouraging, and giving confidence to people to take the necessary actions to improve health.
What is health literacy?
● Health Literacy ○ The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions ○ Shame and stigma around low health literacy is a major barrier to seeking care ○ Important to consider culture
What is health disparity?
● Health disparity: exists when a health outcome is seen to a greater or lesser extent between populations ○ Disparities exist at the global level and can be seen by comparing life expectancies of high and low-income countries · Public health shifted from focus on dramatic cases to focus on existing disparities and addressing underlying social determinants of health, such as poverty.
What are primary prevention interventions?
● Primary prevention interventions: prevent development of disease in someone who is currently healthy ○ Promote healthy behavior and build the ability of the population to protect themselves ○ Goal: reduce risk factors for a health problem
What are secondary prevention interventions?
● Secondary prevention interventions: early detection and treatment of disease reducing disease-associated morbidity and mortality ○ Screening can contribute to reduction of prevalence of a disease ○ Early detection allows for interventions to alter course of disease
What are tertiary prevention interventions?
● Tertiary prevention interventions: prevention of disability, premature death, and initiation of rehabilitation for those diagnosed ○ Interventions to prevent secondary complications related to disease ○ Use medical, environmental, and psychosocial strategies ○ Focus of most acute care setting nursing interventions ○ Health education for chronic disease self-management
What are the Universal Health Literacy Precautions and goals?
● Universal Health Literacy Precautions ○ Steps practices take when assuming all patients may have difficulty comprehending information ○ Providing patients with information both oral and written that is understandable and easily accessible to persons across all education levels. ○ Goals · Simplifying communication and confirming comprehension · Make healthcare system easier to navigate · Support patients' efforts to improve health
