Community Health Chapters 6-10

Flashcards for exam #2

WSCC Model

A model focused on addressing the educational and health needs of children within the context of the school setting 

Community strengths can boost the role of the school in addressing child health and learning needs but also can be a reflection of areas of need in the community

Provides a shared framework and approach for schools and the community to work together to provide a systematic, integrated, and collaborative approach to health and learning   

The School Health Advisory Council

People from a school or school district and its community who work together to provide advice and aspects of the school program

Should include diverse representation

Primary Role: Provide coordination of the WSCC components

The school nurse

Can provide great leadership for the school health program

Has medical knowledge and formal training 

Has multiple responsibilities 

Often districts do not have resources to hire full time nurses  

The Teacher Role 

Heavy Responsibility in making sure the WSCC model works 

Often spend more working hours with children than parents do 

Have insight into the typical behaviors and challenges of students 

Health education teacher preparation standards

1. Possess functional health education knowledge

2. Assess needs and assets of learners, learning, and the learning community

3. Use needs assessment data, health education standards and principles of learning to plan cohesive, sequential lesson and units

4. Employ a variety of research based instructional strategies

5. Use multiple assessment methods

6. Demonstrate professionalism and ethical practices

The Need for School Health

1. An unhealthy child has a difficult time learning

2. Health and success in schools are interrelated

3. A school health program provides the integration of education and health

Three examples of people who would ideally be on a school health advisory board

1. School Nurse

2. Parent

3. Teacher

Who would not be ideal to be on school health advisory board

1. Local business owner

2. Parent of a child who does not attend school

Foundation of the school health program

1. School administration that supports the effort

2. A well-organized health advisory council

3. Written school health polices

School Health Polices

1. Steps for creating local health related polices include:

2. Build a policy development team 

3. Assess the environment 

4. Adopt the policy

5. Implement the policy

6. Measure and evaluate 

7. Communicate the results 

Policy development

1. Should be executed by the school health council

2. Should cover all facets of the school health system 

3. Gain approval from key stakeholders

Policy Implementation

1. Policy only effective if implemented 

2. Distribute polices to those affected 

3. Distribute with the memorandum of explanation

4. Place in faculty, staff, and student handbooks

5. Present them at groups meetings 

6. Hold a special meeting for explaining polices 

7. Place them in the school district communication

Policy Development resources

1.Action for healthy kids

2. School health index via CDC

3. ASCD school implementation tool

Monitoring Status of School Health Policy in the U.S.

1. CDC conducts a national survey to assess school health policies and practices 

2. Assess

3. School health polices

4. School health practices at the state, district, school, and classroom levels 

Administration and Organization

1. A WSCC model should be administered by a school health coordinator

2. Trained professional at the state, district, or school level who is responsible for managing, coordinating, planning, implementing, and evaluating school health policies, programs, and resources

School Health Services

• Health services provided by school health workers to appraise, protect, and promote health

• The School Nursing Practice Framework calls for student-centered nursing care focused on: 

  • key principles of care coordination, 

  • Leadership

  • quality improvement

  • community/public health with standards of practice as the foundation

Healthy School Environment

• By law, school districts are required to provide a safe school environment

• Physical environment

  • School building and its contents, the land on which the school is located, and the area surrounding it

• Social and emotional climate

  • Psychosocial elements of students’ educational experience

School Health Education

• The development, delivery, and evaluation of a planned curriculum

  • Priority health content

    • Alcohol and other drugs

    • Food and nutrition

    • Mental and emotional health

    • Personal health and wellness

    • Physical activity

    • Safety

    • Sexual health (abstinence and risk avoidance)

    • Tobacco

    • Violence prevention

Development of Health Education Curricula

• Scope – part of the curriculum that outlines what will be taught

• Sequence – part of the curriculum that states the order the content will be taught

• Additional content of health education curricula

  • Learning objectives

  • Standards

  • Learning experiences 

  • Possible instructional resources

  • Methods for assessment

Name the different parts of a healthy school environment

1. Physical 

2. Emotional

3. Social

Sources of Health Education Curricula

• Sources

  • Many available from national specialists

  • Approved curricula from state departments of education or health

  • Health agencies and associations

  • In-house development

• National Health Education Standards

Other Components of  the WSCC

• Counseling, Psychological, and Social Services

• Physical Education and Physical Activity

• Nutrition Environment and Services

• Community Involvement

• Family Engagement

• Employee Wellness

Issues and Concerns of the
School Health Program

Lack of support for WSCC

School health curriculum challenges

School-based health centers

Violence in schools

Lack of Support for WSCC

Limited success in getting WSCC implemented across the country

Need supportive legislation

School Health Curriculum Challenges

Controversey: Strong opinions on various topics

Improper implementation: Often provided by people other than health education specialists, Barriers to school health education 

School based Health Centers

1. Provided in different ways; most common on school property

2. Four main delivery models: traditional, school-linked, mobile, telehealth

3. Seven core competencies used to guide the delivery of health care in a school setting

4. Cultural wars 

5. Funding challenges 

Introduction

1. Using age-related profiles helps identify risk and target interventions 

2. Infants < 1 year

3. Children 1-9 years

4. MIC encompasses health of women of childbearing age from pre pregnancy through pregnancy, labor and delivery, and the postpartum period, and the health of the child prior to birth through adolescence  

MIC health 1 of 4

1. MIC stats are important indicators of effectiveness of disease prevention and health promotion services in a community 

2. MIC mortality rates have been going down over the past 20 years, yet in 2022, we saw a three percent increase in infant mortality over 2021 and continues to face challenges 

3. Significant racial disparities  

Family and Reproductive Health 

1. Families are the primary unit in which infants and children are nurtured and supported regarding healthy development 

2. Various definitions of family 

3. Concept has changed over time; depends on social and cultural norms and values; may be conceptualized differently on an individual basis 

Research Indicators

1. Unmarried women more likely than married women to experience negitive birth outcomes 

2. Within marital status categories, women still heterogenous 

3. Unmarried women include single women and those cohabiting with the fther of their children 

4. Cohabiting women generally experience birth outcomes that fall between married and those who are single but not cohabiting  

Teenage Births 

1. Teenage childbearing generally seen as placing social and financial burden on family and community 

2. Teenage pregnancies more likely to result in serious health consequences for mother and baby

3. Adverse consequences do not end when the child is born 

4. Choice to become a parent affects the individual and community 

Family Planning

1. Determining the preferred number and spacing of children and choosing the appropriate means to accomplish it 

2. Community involvement in family planning and care includes governmental and nongovernmental organizations   

Unintended Pregnancies

1. About half of pregnancies in U.S are unintended

2. Unintended- unwanted

3. Unintended pregnancy associated with negative health behaviors- Delayed prenatal care, inadequate weight gain, smoking, alcohol use, and other drug use   

Title X: Family planning Act

1. Federal program that provides funds for family planning services for low income people

2. Aims to reduce unwanted pregnancy by providing contraceptive and other reproductive healthcare services to low-income families 

3. Supports 4,000+ family planning clinics in U.S

4. 2.6 million family planning users receive care at clinics funded by Title X 

5. Gag rule- enacted in 1984, alternately reversed and reinstated by subsequent administrations

6. The Affordable Care Act requires insurance plans to cover birth control without any out-of-pocket cost

Evaluating the success of community Health family planning programs

1. Clinics have improved MIC health indicators 

2. Have shown large reductions in unintended pregnancies, abortions, and births 

3. Publicly sub sized family planning clinics help postpone or avoid 2 million unplanned pregnancies that would result in:    

1,000,00 unintended births, 700,000 abortions

4. Each public health dollar spent saves taxpayers $4.83 in Medicaid expenditures    

What population does Title X provide services to?

Low-income people

What are some indicators of successful family planning programs?

Reductions in unintended pregnancies, abortions, and births

Abortion

1. Legal in early stages of pregnancy since 1973 (Roe v. Wade)

2. June 2022, Dobbs v. Jackson saw the federal right to abortion overturned, leaving legality up to individual status 

3. Majority of abortions

Unmarried women (87.3%)

Women-aged 20-29 (57%)

Rates highest among non-Hispanic Black women 

Pro-Life vs. Pro-choice

Maternal Health

1. Effect of pregnancy and childbirth on women important indicator of health 

2. Pregnancy and delivery can lead to serious health problems 

3. Maternal mortality and morbidity- Causes include poverty, limited education, and comorbidities 

Preconception and Prenatal Health Care

1. Preconception Care: Medical care provided to men and women to promote health prior to conception 

2. Prenatal health care: Medical care from time of conception until birth process 

3. Early and continuous preconception and prenatal care leads to btter pregnancy outcomes 

4. Less likely to give birth to a low-birth weight infant

Infant Health

1. Depends on many factors

2. Mother’s health and her health behavior prior and during pregnancy

3. Genetic characteristics

4. Mother’s level of prenatal care

5. Quality of delivery

6. Infant’s environment after birth

7. Nutrition

8. Immunizations

Infant Mortality 

1. Measure of a nation’s health

2. Decline in infant mortality due to

Economic growth

Improved sanitation

Advanced clinical care

Improved access to health care 

Better nutrition 

3. Leading causes of infant death: congenital abnormalities, preterm/low birth weight, SIDS

Improving infant health

1. Premature births 

2. Low birth weight 

3. Cigarette Smoking 

4. Alcohol and other drugs 

5. Breastfeeding 

6. Sudden infant death syndrome 

Child Health

1. Good health during the childhood years essential to child’s optimal development 

2. Medical home recommended 

What aspects of infant health most need improved

1. Premature Births 

2. Low Birth weight 

3. Maternal health impacts 

4. Sudden infant death syndrome

Child Mortality

1. Most serve measure of health in children 

2. Rates have generally declined in past few decades 

3. Unintentional injuries are leading cause of death in children 

4. Motor vehicle deaths, those not wearing seat belts 

Child Mortality 2 of 2

1. Unintentional Injuries- Leading cause of death among children, significant economic, emotional, and disabling impact 

2. Child maltreatment- Can have lifelong consequences 

3. Infectious diseases- Importance of immunization schedule   

Community programs for women, infants, and children

1. Federal government has a multitude of health programs housed in a variety of agencies to serve needs of nation’s children

2. Many are categorical programs 

3. Only available to people who fit into a group 

4. Many fall through the cracks  

Maternal and child Health bureau

1. Title V- Only federal legislation dedicated to promoting and improving health of mothers and children

2. Maternal and child health- Established in 1990 to administer Title V funding

Women, infants, and Children program

1. Designed to provide nutritional and health related goods and services to pregnant, postpartum, and breastfeeding women, infant up to 1 year of age, and children under age 5 

2. Sponsored by the USDA, established in 1974

3. Eligibility requirements 

4. 2023- 6.5 million participant  

Providing Health Insurance for women, infants, and children 

1. Children without insurance more likely to have necessary care delayed or receive no care for health problems 

2. Medicaid: Low-income individuals and families; single largest provider of health insurance for children in U.S

3. CHIP: Targets uninsured children whose families do not qualify for Medicaid    

Providing child care

1. Family and Medical Leave Act- Grants 12 work weeks of unpaid job-protected leave to men or women after birth of child, adoption or illness in immediate family 

2. Only affects businesses with 50+ employees

3. Cost of child care

4. Child care and Development Block Grant

Other Advocates for Children

1. Numerous groups advocate for children’s health and welfare

2. Children’s Defense Fund 

3. United Nations Children’s fund 

4. American Academy of Pediatrics

Adolescents and young adults (10-24)

Adolescence generally regarded as puberty to maturity  

Adults (25-64)

1. Years between 10 and 64 some of the most productive years of people’s lives

2. Most enjoy the best health of their lives 

3. Shape health through lifestyle and health behavior for later years 

Adolescents and young adults

1. Represent the future of the nation

2. Adolescence is difficult stage, period of transition from childhood to adulthood 

3. Young adults complete physical growth; experience significant changes 

4. Many health beliefs, aptitudes, and behaviors are adopted and challenged     

Demography 1 of 2

1. Number of adolescents and young adults 

In 2020, around 1/5 of U.S population

In 2019, 51% of adolescents were non-Hispanic White 

2. Living arrangements 

In 2023, 27.5% lived in single-parent families 

Variations by race and ethnicity 

Demography part 2 of 2

1. Employment status and healthcare access

2. Participation in labor force has remained fairly constant in recent decades 

3. Disparities by race and ethnicity 

4. Employment status has impact on access to health insurance, health care  

Morality part 1 of 2

1. Significant decline in death rates over past several decades, mostly due to advances in medicine and to injury and disease prevention 

2. Male mortality rate much higher than female 

3. Most threats stem from behavior rather than disease 

4. Unintentional injuries, suicide, homicide 

5. Significant racial disparities among race and leading causes of death  

Morbidity 1 of 2

Communicable diseases

Meale’s immunizations important 

Sexually transmitted diseases 

This age group acquires nearly half of all new STDs in the U.S 

Some effects can last a lifetime 

Leading causes of death for young adults and adolescent’s populations

Unintentional injury, suicide, and homicide

Health Behaviors of High school students

• Unintentional injuries

• Violence

• Tobacco use

• Alcohol and other drugs

• Sexual behaviors—unintended pregnancies and STDs

• Physical activity and sedentary behaviors

• Overweight and weight control

Health Assessments of College Students

• National College Health Assessment III – examines wide range of health behaviors 

• Monitoring the Future – examines drug behaviors and related attitudes

Health Behaviors of College Students

• Unintentional injuries

• Tobacco and marijuana use

• Alcohol and other drugs

• Sexual behaviors—unintended pregnancies and STDs

Protective Factors

• Protective factors: Individual or environmental characteristics and conditions that promote the health and emotional well-being of children and adolescents

  • Examples: School connectedness, community service

Community Health Strategies

• Four major factors: physical factors, community organizing, individual behavior, and social and cultural factors

  • Two factors needing special attention are social and cultural factors and community organizing

• Alcohol use a main problem

Adults

• Ages 25–64

• Represent more than half of U.S. population

• Size expected to remain stable, but proportion will become smaller

Health Profile (1 of 3)

• Mortality

  • Mainly from chronic diseases

  • Many associated with unhealthy behaviors and poor lifestyle choices

  • Lifestyle improvements and public health advances have led to decline in death rate for adults

Cancer

• Number one cause of death for adults ages 45–54 and 55–64 

  • Males: Prostate, lung, and colorectal

  • Females: Breast, lung, and colorectal

Cardiovascular Diseases

• Age-adjusted mortality rates have dropped

  • Mainly due to public health efforts related to smoking cessation, increased physical activity, and nutrition

Health Behaviors

• Risk factors for chronic disease

  • Most significant for adults: Smoking, lack of exercise, poor nutrition, BMI, alcohol

• Awareness and screening of certain conditions

  • Hypertension, diabetes, cholesterol, cancer

Community Health Strategies

• Role of individual behavior, social factors, environmental factors, and previous influences on their health across lifespan

• Primary, secondary, and tertiary prevention efforts for adults

  • Primary: Exercise and nutrition programs

  • Secondary: Self- and clinical screenings to identify and control disease processes

  • Tertiary: Medication compliance