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Core Functions of Public Health
Assessment
Policy Development
Assurance
Assessment
systematic data collection, analysis, and monitoring of health problems and needs in a population
ex.) monitoring population’s health status
Policy Development
using scientific knowledge to develop comprehensive public health policies, support the health of a population through leadership and research
Assurance
assuring constituents that PH agencies provide services necessary to achieve agree-upon goals, making sure essential community- orientated health services are available
10 Essential Services (assessment)
assess and monitor population health
investigate, diagnose, and address health hazards and root causes
10 Essential Services (policy development)
communicate to inform and educate
strengthen, support, and mobilize communities, and partnerships
create, champion, and implement policies, plans, laws
utilize legal and regulatory actions
10 Essential Services (assurance)
enable equitable access
build a diverse and skilled workforce
improve, innovate, through evaluation, research, and quality improvement
build and maintain a strong organizational infrastructure for PH
Community
Population
collection of individuals who share one or more personal or environmental characteristics
Community Based
focus: health of individuals, families and groups within a community (client)
nursing activities: illness care
setting specific
Community Orientated
focus: health of community as a whole (client)
nursing activities: health care, surveillance, evaluation of communities collective health
8 Principle of PH Nursing
1.) client or unit of care is population
2.) achieve the greatest good for greatest number
3.) working with client as equal partner
4.) priority = primary prevention
5.) create healthy environmental, social, and economic conditions in which a pop. may thrive
6.) identify and reach out to all who might benefit from specific activity or service
7.) use of resources must be optimal to ensure best overall improvement in health of pop.
8.) collaboration with other professions, populations, organizations, and other stakeholder groups to promote and protect the health of the people
PH Nursing
practice of promoting and protecting the health of populations
Emerging Frameworks
upstream approach (socio-ecological)
downstream approach (conventional)
Upstream Approach
taking environmental and societal factors into consideration when examining an individuals health choices
Downstream Approach
only addresses biological and behavioral basis for disease
Lillian Wald
first PH nurse, founder of PH nursing
Mary Brewster
helped Wald establish Henry Street Settlement House and Visiting Nurse Service of NYC
Florence Nightingale
founder of modern nursing, improved care during Crimean War and in hospital
connected sanitation to disease
HP 2030
attain healthy, thriving lives and well being free of preventable disease, disability, injury, and premature death
Cultural Competency
attitudes, knowledge, and skills the health care provide quality care to culturally diverse population
Cultural Humility
understanding that awareness about one’s own culture and acknowledgement that we approach others as equals with respect for their beliefs and cultural norms
Social Determinants of Health
economic stability
education access and quality
health care access and quality
neighborhood and built environment
social and community context
Comprehensive Assessment
collection of data about population in a community
Population Focused Assessment
assessment of specific population that shares at least one similar experience
Setting Specific Assessment
treating the setting as a community
Problem Focused Assessment
looking at a specific problem, who is at risk and whats the issue
Health Impact Assessment
evaluate policies and projects on health, what is the effect of this on the people’s health
Rapid Needs Assessment
determines existing response capacity, what are the immediate needs
Program Planning
one of ten essential services and should be present in all communities and occurs when community partners express a joint recommendation for change
How to write a community diagnosis
1) risk for or actual (identifies the specific problem or risk
faced by the community)
- (2) among (the specific population that is affected by the problem or risk)
- (3) related to (identifies factors/strengths/weaknesses influencing the problem or risk)
Formative evaluation
feedback about the performance of the program during the development stage of the program (activities being implemented for the first time)
Summative evaluation
occurs at the end and evaluates the objectives and goal of the program
Process evaluation
how a program actually works
Community Health Assessment
identify the needs of the community
Community
group of individuals who share a common denominator
Community Client
the community is client only when the nursing focus is the collective or common good of the population NOT individual health
Epidemiology
study of distribution and determinants of disease/injury in human populations
process: outcome, distribution, influences
Descriptive Epi
who/what/when
Analytic Epi
how and why
Epi Triangle
agent, host, environment
Mortality
death rate
Morbidly
number or population of individuals experiencing similar
Attack Rates
proportion of people exposed to an agent who develop the disease
Secondary Attack Rates
new cases of diseases among the contacts of initial cases, only for fatal diseases and dont provide direct information about either level of existing disease in population or risk of contracting any particular disease
Prevalence
number of existing cases divided by total number of persons in the population
Incidence
number of new cases
Passive Surveillance
data collected based on individuals or institutions that report on health information voluntarily or by mandate
collecting and reporting the data to public health or gov agencies
Active Surveillance
deployment of PH professionals to identify cases of disease or health condition under surveillance
Web Causation
interrelationship of multiple factors interacting to effect the risk of disease
Development of disease depends on
host exposure to agent
virulence of agent
host immune susceptibility to agent
environment conditions existing at time of exposure
Levels of Prevention
primary
secondary
tertiary
Primary Prevention
prevent development of disease
Secondary Prevention
early detection and treatment
Tertiary Prevention
prevention of disability and premature death
Ecological Model
upstream approach
Upstream Approach
focuses on eliminating the factors that increase risk to a populations health
Downstream Approach
actions taken after disease or injury has occurred
Conventional Model
downstream approach: addresses biological and behavioral
Socio-Ecological Model
upstream approach: social relations, neighborhoods, and communities, institutions, social annd economic polices
Screenings (second prevention)
not a diagnostic and only indicates who may or may not have a disease or a risk factor for the disease
Educational Process
identify educational needs
established educational goals and objectives
select appropriate educational models
implement educational plans
evaluate educational process
Health impact pyramid factors
counseling + education
clinical interventions
long lasting protective interventions
changing context to make individuals default decisions healthy
socioeconomic factors
What part of health pyramid has the most impact?
socioeconomic factors
Which part of the health pyramid has the least impact?
counseling and education
Health Pyramid
impact of different types if PH interventions and improve health
Intervention Wheel
evidence based process, how to improve health of individuals, families, communities
population based intervention levels of care
Evidence Based Resources
reviews of published intervention evaluations or studies that have evidence of effectiveness, feasibility, reach, sustainability, and transferability
