Population and Community Health

What term can be defined as the health of all people living in a given place (e.g. New York City, Texas, Rome)?

Population health

Population Health

Health of all people living in a given place (e.g. New York City, Texas, Rome)

What does population health also refer to as?

Differences in health (e.g. rich vs. poor)

What is population health the product of?

Causes operating at many levels "from cells to society" (e.g. affects the individuals because of things happening in society)

Population Health vs. Public Health

Population health provides an opportunity for health care systems to work together in order to improve the health outcomes of the communities they serve whereas public health works to protect and improve the health of communities through policy recommendations, health education, and research for disease detection and injury prevention

What do policy recommendations drive the delivery of?

Healthcare

What term can be defined as what a society does to collectively assure the conditions in which people can be healthy?

Public health

Public Health

What a society does to collectively assure the conditions in which people can be healthy

What term can be defined as the study of the distribution, frequencies, and determinants of disease, injury, and disability in human populations?

Epidemiology

Epidemiology

The study of the distribution, frequencies, and determinants of disease, injury, and disability in human populations

What term can be defined as the number of new cases of a disease, injury, or disability within a specific time frame (usually a year)?

Incidence

Incidence

Number of new cases of a disease, injury, or disability within a specific time frame (usually a year)

What term can be defined as the total number of cases of disease, injury, or disability in a community, city, state, or nation existing at a specific point in time?

Prevalence

Prevalence

Total number of cases of disease, injury, or disability in a community, city, state, or nation existing at a specific point in time

2 Types of Factors

1. Risk

2. Resiliency

Which type of factor increases an individual’s or population’s vulnerability to developing a disease or disability or sustaining an injury; risk or resiliency?

Risk factor

Risk Factors

Precursors that increase an individual's or population's vulnerability to developing a disease or disability or sustaining an injury (e.g. poor drinking water, air quality)

Which type of factor increases an individual’s or population’s resistance to developing a disease or disability or sustaining an injury; risk or resiliency?

Resiliency factor

Resiliency Factors

Precursors that appear to increase an individual's or population's resistance to developing a disease or disability or sustaining an injury

True or False: Risk and resiliency factors can be internal or external.

True

What can population health be described as from an occupational therapy perspective?

A collaborative and interdisciplinary approach

What 5 concepts makeup the occupational therapy perspective of population health?

1. Advocacy

2. Program development

3. Program implementation and evaluation

4. Policy revision and development

5. Occupational justice

Which concept of population health within the occupational therapy perspective accounts for the right of every individual to be able to meet basic needs and to have equal opportunities and life chances to reach toward their potential for engagement in diverse and meaningful occupations; advocacy, program development, program implementation and evaluation, policy revision and development, or occupational justice?

Occupational justice

Occupational Justice

Accounts for the right of every individual to be able to meet basic needs and to have equal opportunities and life chances to reach toward their potential for engagement in diverse and meaningful occupations

According to occupational justice, what do people have the right to participate in? What does this enable?

Right to participate in a range of occupations that enable them to flourish, fulfill their potential, and experience satisfaction in a manner consistent with their culture and beliefs

What is the difference between inequality, equality, equity, and justice?

Inequality: Unequal access to opportunities

Equality: Evenly distributed tools and assistance

Equity: Custom tools that identity and address inequality

Justice: Fixing the system to offer equal access to opportunities

What is essential for population health in occupational therapy?

Understanding how each work together

_____, _____, _____, and _____ are inseparable for population health in occupational therapy.

Doing, being, belonging, and becoming

What can the "doing" aspect of population health in occupational therapy be described as?

Everything of meaning that people do in their lives

Doing

Everything of meaning that people do in their lives

4 Features of Doing

1. Promotion of occupational well-being

2. Occupational balance

3. Balance lifestyle

4. Examining personal and community factors

What can the "being" aspect of population health in occupational therapy be described as?

People's essential nature that drives them to do things

Being

People's essential nature that drives them to do things

3 Features of Being

1. Shared myths (e.g. black cats are bad luck)

2. Shared values (e.g. working hard, spirituality)

3. Tolerance for different ways of "being" in this world

What can the "belonging" aspect of population health in occupational therapy be described as?

Being accepted by others and feeling secure in relationships and connected to a place

Belonging

Being accepted by others and feeling secure in relationships and connected to a place

What is an essential feature of belonging for population health in occupational therapy?

Group cohesion

Group Cohesion

Network of relationships holding a group together with collected occupations that create bonds and a sense of common identity/shared history

What can the "becoming" aspect of population health in occupational therapy be described as?

People's development over their lifetimes

Becoming

People's development over their lifetimes

2 Features of Becoming

1. Fulfilling occupational potential

2. Finding occupations which are fulfilling

What do fulfilling occupations allow an individual to gain?

Competence, challenging them at the same time

What are fulfilling occupations based on?

The opportunities afforded to a population according to societal properties

What term can be defined as a combination of individuals, their needs/desires, and the environment in which they reside, work, and play?

Community

Community

Combination of individuals, their needs/desires, and the environment in which they reside, work, and play

What term can be defined as the physical, emotional, social, and spiritual well-being of a group of people who are linked together in some way?

Community health

Community Health

The physical, emotional, social, and spiritual well-being of a group of people who are linked together in some way

What term can be defined as a state of flourishing?

Well-being

Well-Being

State of flourishing

5 Elements of Well-Being

1. Positive emotion

2. Engagement

3. Positive relationships

4. Meaning

5. Accomplishment

What is a fundamental process for achieving health and well-being by facilitating engagement, meaning, and accomplishment?

Occupation

What does the use of occupations decrease?

Risk factors

6 Risk Factors for Occupational Dysfunction

1. Occupational imbalance

2. Occupational deprivation

3. Occupational alienation

4. Occupational delay

5. Occupational interruption

6. Occupational disparities

Occupational Imbalance

A lack of balance or disproportion of occupation resulting in decreased well-being (e.g. occupational patterns that fail to meet an individual's physical and/or psychological needs resulting in stress and a negative impact on health)

Occupational Deprivation

Deprivation of occupational choice and diversity because of circumstances beyond the control of individuals or communities (e.g. poor health, disability, lack of transportation, isolation, homelessness)

Occupational Alienation

Sense of isolation, powerlessness, frustration, loss of control, and estrangement from society or self as a result of engagement in occupation that does not satisfy inner needs

What tasks may result in an experience of occupational alienation?

Tasks that are perceived as stressful, meaningless, or boring

Occupational Delay

Occupational development that does not follow the typical schedule for the acquisition of occupational skills and is associated with occupational performance deficits

Occupational Interruption

A temporary interference with occupational performance or participation as a result of a change in personal, social, or environmental factors

Occupational Disparities

Inequalities or differences in occupational patterns among populations that are often the result of occupational injustice

What does use of occupations increase?

Resiliency factors

7 Resiliency Factors for Occupational Performance

1. Occupational adaptation

2. Occupational coherence

3. Occupational continuity

4. Occupational competence

5. Occupational identity

6. Occupational orchestration

7. Occupational self-efficacy

Occupational Adaptation

The ability to adjust and respond to challenges and changes in circumstances that require modifications in occupational performance or participation

Occupational Coherence

Engagement in occupations that are integrated, consistent, and congruent with one's current and aspirational occupational roles

Occupational Continuity

Engagement in valued and meaningful occupations that provide a continuous sense of occupational identity throughout one's life

Occupational Competence

The degree to which one is able to sustain a pattern of occupational participation that reflects one's occupational identity

Occupational Identity

A composite sense of who one is and wishes to become as an occupational being generated from one's history of occupational participation

Occupational Orchestration

The capacity of individuals to enact their occupations on a daily basis to meet their own needs and the expectations of the many environments in which they are required to function

Occupational Self-Efficacy

The belief in one's capacity to perform occupations to meet one's own needs and the demands of the environment

What is the role of occupational therapy in community and population health?

Prevent and reduce incidence of illness or disease

Reduce health disparities (e.g. low income) among minorities

Enhance mental health, resiliency, and quality of life

Prevent secondary conditions and improve overall health

Promote healthy living practices with respect to cultures

3 Roles of Occupational Therapists in Community Health

1. Promote healthy lifestyles and identify risk factors

2. Infuse occupation into proven health promotion programs

3. Develop/implement occupation-based promotion programs

What should occupational therapists aim to promote for all clients, their families, communities, and populations?

Healthy lifestyles

What should occupational therapists aim to identify?

Risk factors (e.g. tobacco use, unhealthy diet, sedentary lifestyle, substance abuse)

What should occupational therapists not overlook in people living with disabilities?

Risk factors

What should occupational therapists aim to infuse occupations into?

Health promotion programs

How can occupational therapists aim to infuse occupations into health promotion programs?

By adapting already credible programs to assist people living with disabilities (e.g. meal preparation/nutrition in the rehabilitation kitchen at TIRR)

What should occupational therapists aim to develop and implement?

Occupation-based community and population health promotion programs that target people with and without disabilities

Community Centered Practice Framework

A process and an outcome of occupation-based, community centered practice

What does the community centered practice framework focus on?

Achievement of the community's occupational goals, enabling community participation

What are the 4 main components of the community centered practice framework?

1. Community identity (e.g. age, gender, ethnicity)

2. Community occupations (e.g. church, school)

3. Community resources and barriers

4. Participation enablement

Community Identity

Individuals, groups, organizations, and social networks that are members of the community

Is membership in the community fluid, changing over time; yes or no?

Yes

How can an individual's membership in the community change over time?

Geographic location

Climate

Natural and built environments

Population characteristics

Sociocultural elements

What does each member have that supports the community’s shared purpose and goals?

Specific roles

Community Occupations

Occupations important and meaningful to the community as a whole

What do community occupations provide?

Sense of meaning and purpose (e.g. identity, belonging)

What do community members participate in to move in the direction of the shared goal with everyone drawing on their own diverse skill sets, experiences, and expertise?

Co-occupations

What does the community resources and barriers component of the community centered practice framework find?

Factors that facilitate and inhibit community participation (e.g. social capital, policies, infrastructure)

What factor of community participation can be both a resource and a barrier?

Infrastructure

How is the participation enablement component of the community centered practice framework enforced?

Building and sustaining partnerships

Recruiting, educating, and supporting volunteers

Increasing community's public profile

Attracting members/funders

Negotiating and advocating to complete applications