aggregate
population subgroup in a community made up of people who share one or more common characteristics
census tract
population boundary that subdivides larger communities and is used expressly for data collection and population assessment by the US Bureau of the Census
community diagnosis
consists of four components:
identification of the health problem/risk
aggregate or community affected
etiological or casual statement
evidence or support for the diagnosis
community health
organized efforts for health at the community level through both government and private efforts, including private agencies supported by private funds, such as the American Heart Association or the Red Cross
community health nursing
the provision of nursing service to the community or population as a wholeñ
community of solution
individuals coming together because of a common problem
conservative scope of practice
framework that focuses its energies exclusively on intrapatient and nurse-patient factors
critical theoretical perspective
uses societal awareness to expose social inequalities that keep people from reaching their full potential
disease prevention
efforts to protect persons from disease and its consequences
district nursing
Stemmed from public health nursing and was developed in England. The community was separated into districts, each with a nurse and social worker who met the needs of those in the district. William Rathbone.
Edward Jenner
In 1796, he observed that people who worked around cattle were less likely to have small pox. He discovered that immunity to smallpox resulted from an inoculation with the cowpox virus.
Edwin Chadwick
Called attention to the consequences of unsanitary conditions in Liverpool in 1842 that resulted in health disparities that shortened the life span of the laboring class in particular.
Elizabethan Poor Laws
Exacted in England in 1601, held the church parishes responsible for providing relief for the poor. This law governed health care for the poor for more than two centuries and became a prototype for later US laws.
Flexner Report
Outlined, in 1910, the shortcomings of US medical schools that did not use the German model that promoted medical education on the principles of scientific discovery.
health
a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
health belief model (HBM)
theoretical approach based on the premise that it is the world of the perceiver that determines what one will do
health visiting
enlisted home visitors in Manchester in 1862 to distribute health information to the poor
health promotion
efforts or activities aimed at improving well-being
Healthy Cities and Healthy Communities
A movement whose purpose is to help community citizens bring about positive health changes in their communities; stresses that interconnectedness among people and among public and private sectors is essential for a communities to address causes of poor health.
House on Henry Street
Nurses Lillian Wald and Mary Brewster established this district nursing service on the Lower East Side of New York City in 1893.
Joseph Lister
Observed the healing processes of fractures. When the bone was broken, but the skin was not, he noted that recovery was uneventful. However, when both the bone and the skin were broken, fever, infection, and even death were frequent. He found that something outside the body entered the wound through the broken skin causing the infection. His surgical successes eventually improved when he soaked the dressings and instruments in mixtures of phenol and oil.
John Snow
Demonstrated that cholera was transmissible through contaminated water in 1845.
Lemuel Shattuck
A Boston bookseller and publisher with an interest in public health who organized the American Statistical Society in 1839 and issues a Census of Boston in 1845.
Lilian Wald
Early twentieth-century community health nurse and political activist who recognized the connections between health and social conditions. She was a driving force behind the federal government's development of the Children's Bureau in 1912.
Louis Pasteur
Proposed the existence of germs while experimenting with wine production in 1845.
macroscopic
Perspective that examines interfamily and intercommunity themes in health and illness. Delineates factors in the population that perpetuate the development of illness or foster the development of health.
metropolitan statistical areas
large metropolitan areas that consist of a central city with more than 50,000 people and include the associated suburban or adjacent counties, which yields a total metropolitan area with more than 100,000 people
microscopic
perspective that examines individual (and sometimes family) responses to health and illness
Milio's framework for prevention
outlines six propositions that relate the ability of an individual to improve healthful behavior to a society's ability to provide options for health choices that are both accessible and socially affirming
needs assessment
collection of data about a community's health status, concerns, and services they use or require
population
a group of people having common personal or environmental characteristics; can also refer to all of the people in a defined community
population-focused nursing
nursing practice that concentrates upon specific groups of people, focusing on health promotion and disease prevention, regardless of geographic location
primary prevention
Activities directed at preventing a problem before it occurs by altering susceptibility or reducing exposure for susceptible individuals. It consists of two elements: general health promotion and specific protection.
public health
organized efforts made through governmental agencies such as health departments, which are authorized by legislation, serve all people, and are supported by taxes
public health nursing
a synthesis of public health and nursing practice
Robert Koch
a nineteenth century scientist who discovered the causative agent for cholera and the tubercle bacillus (for tuberculosis)
sanitary revolution
a period in the nineteenth century when a link was established between microorganisms and infectious disease
secondary prevention
Early detection and prompt intervention during the period of early disease pathogenesis. It is implemented after a problem has begun, but before signs and symptoms appear and targets those populations who have risk factors.
self-care deficit theory
Theory based on the assumption that self-care needs and activities are the primary focus of nursing practice. Nursing is a response to a sick person's inability to administer self-care.
social system
interacting members making up various subsystems within the community which provide embers with socialization, role fulfillment, goal achievement, and support
stages in disease history
hunting and gathering stage
settled villages stage
preindustrial stage
industrial cities stage
present stage
tertiary prevention
Targets populations who have experienced disease or injury and focuses on limitation of disability and rehabilitation. Aims of tertiary prevention are: to keep health problems from getting rose, to reduce the effects of disease and injury, and to restore individuals to their optimal level of functioning.
theory
a set or system of concepts that provide a way of structuring or explaining phenomena
upstream thinking
orientation to viewing a problem which emphasizes variables that precede or play a role in the development of health problems
vital statistics
the official registration records of births, deaths, marriages, divorces, and adoptions
windshield survey
survey by driving through a community and making observations in an organized fashion
market justice
you get what you can afford
social justice
entitles all people to basic necessities (adequate income/health protection)
goal of Health People 2020
increase quality and years of health life
eliminate health disparities
Public Health Intervention Wheel
helps to identify and define public health interventions
is population based
has levels of practice (community/systems/individual and family)
endemic
diseases that are always present in a society (ex. colds/pneumonia)
epidemic
diseases that are not always present but flare up occasionally
pandemic
diseases in large proportion of the population (ex. HIV/AIDS)
Florence Nightingale
helped British soldiers in the Crimean War
concern for environmental determinants of health
established nursing education
emphasis on sanitation, community assessment, and analysis
use of graphically depicted stats and gathered census data
political advocate for population
modifiable risk factor
patient has control over the severity and can change their susceptibility of these (poor diet/obesity/sedentary lifestyle)
non-modifiable risk factor
patient has no control over the severity (gender/age/family history)
Public Health Core Functions
assessment
policy development
assurance
epidemiology
Provides broad understanding of the spread, transmission, and incidence of injury and disease. Relies on statistical evidence to determine the rate of spread of disease and the proportion of people effected.
person-place-time model
identifies all factors involved in health and determines which factors are more at risk
epidemiological triangle
states that disease is dependent on exposure of the host to the agent, strength of the agent, and environmental conditions at the time
descriptive epidemiology
focuses on the amount and distribution of health and health problems within a population; person-place-time model
analytic epidemiology
investigates the causes of disease by determining why a disease rate is lower in one population group than another (observational, cross sectional, retrospective, and prospective studies and environmental design)
observational studies (analytic epidemiology)
descriptive purposes
etiology of disease
cross-sectional studies (analytic epidemiology)
sometimes called prevalence or correlational studies
examine relationships between potential causal factors and disease at a specific time
retrospective studies (analytic epidemiology)
compare individuals with a particular condition or disease with those who do not have the disease
prospective studies (analytic epidemiology)
monitor a group of disease-free individuals to determine if and when disease occurs
experimental design (analytic epidemiology)
to test treatment and prevention strategies
also useful for investigating chronic disease prevention
health determinants
biology (genetics; family history; physical/mental health problems)
behaviors (response to individual stimuli/external conditions)
social environment (interactions/relationships in community)
physical environment (things smelled/seen/touched/heard/tasted)
policies/interventions
access to quality health care
stages of the natural history of disease
prepathogenesis period (primary prevention)
pathogenesis period (secondary and tertiary prevention)
screening
identify risk factors and diseases in the earliest stages
surveillance
ongoing collection of community health information