Community Health

What are the main characteristics of a public health issue?

Increased morbidity, increased mortality, decreased quality of life.

How do we measure public health issues?

Life expectancy from birth, age-adjusted mortality rates, condition-specific or age-specific mortality rates, self-reported health and functional status (quality of life).

What influences whether people are healthy or unhealthy?

Personal, social, economic, and environmental factors known as determinants of health.

What is the socio-ecological approach?

Identifying determinants of health and labeling them as micro (individual) or macro (societal) level.

What are examples of micro-level determinants?

Individual characteristics or behaviors (owning a gun), individual knowledge, skills, perceptions (safe storage, knowledge, feeling of need).

How do we establish contributory cause?

Cause is linked to effect, cause comes before effect (temporal sequence), changing the cause changes the effect.

What criteria help determine contributory cause in epidemiology?

Strength, dose-response, consistency, biological plausibility.

What are common data sources for public health issues and determinants?

Governmental agencies (US DHHS, CDC, NCHS, DHEC), medical/health records, claims data, literature reviews, cross-sectional surveys, cohort studies (e.g., Framingham study).

Why are statistics not always enough to understand determinants?

Individual and community assessments are needed to identify assets, barriers, and priorities; quantitative data alone may not reflect context or community values.

What is the difference between qualitative and quantitative data?

Qualitative: text-based, narrow, deep, inductive. Quantitative: numbers-based, broad, shallow, deductive.

What is the purpose of qualitative research?

To describe, understand, explain, and examine relationships in social phenomena.

What are some methods of collecting qualitative data?

Interviews, focus groups, case studies, community forums, systematic observation, participant observation, content analysis.

How is qualitative research used in public health?

Needs and assets assessments, understanding priority populations' knowledge/attitudes/beliefs, evaluating programs and prevention strategies.

What are the goals of public health prevention and promotion?

Prevention: protection. Promotion: prolonging safety in physical and social environments. Focus on populations.

What is the framework for health promotion?

A mediating strategy between people and their environments.

What is health promotion?

Combination of educational and environmental supports for actions conducive to health; purposeful, organized, macro-level interventions.

What are the assumptions of health promotion?

Health can be changed, disease understood, prevention strategies developed, multiple factors affect health, changes in behaviors/factors affect health, people and communities can assume responsibility, individual responsibility does not equal victim blaming, permanent behavior change requires readiness and motivation.

What is health education?

Learning experiences designed to facilitate voluntary actions conducive to health; usually embedded in promotion programs; micro-level focus.

What are common health education philosophies?

Behavior change, cognitive-based learning, decision-making and functioning.

What is the difference between health promotion and health education?

Health promotion: macro-level, targets environmental/social factors, involves involuntary choice. Health education: micro-level, targets individual knowledge/behaviors, relies on voluntary choice. Both are well-planned, multi-approach, target behavior, and focus on health and wellbeing.

What is a program in public health?

An intervention or planned set of activities designed to address a health problem; can be single event or series; targets group or individual.

What are macro-level interventions?

Interventions for populations, not directed at individuals; population-based.

What are micro-level interventions?

Interventions for individuals; person-based.

What is community-based health promotion?

Programs involving community members at all steps; aim to change behavior by influencing cultural norms and environmental supports; mobilize leadership, assets, and resources; comprehensive and long-term.

What are the levels of health promotion?

Individual: knowledge, skills, attitudes, self-efficacy. Interpersonal: social support, networks, norms. Institutional: organizational characteristics, rules, physical environment. Community: relationships among organizations and groups. Public policy: laws and policies at local, state, national levels.

What do health promoters do?

Conduct needs and asset assessments, identify health problems, plan programs using epidemiologic data, implement and evaluate programs, act as resources, advocate and educate policymakers, develop health communication campaigns, write grants, create materials and curricula, use technology, conduct research and collect data.