Units 1 & 2

How has the focus of healthcare in the U.S. changed over time?

It has shifted from treating disease to focusing on health outcomes and prevention

What is the main goal of a community/public health nurse?

To preserve and promote the health of populations through prevention and health maintenance

Why is community health important?

It focuses on populations rather than individuals, improving overall public well-being

What is primary prevention?

Preventing disease before it occurs (e.g., immunizations, adequate housing, birthing classes)

What is secondary prevention?

Early detection of disease (e.g., screenings, pap smear, dental exams, HIV testing)

What is tertiary prevention?

Managing disease to prevent complications (e.g., teaching insulin use, home care, therapy)

What is the core ethical value in public health?

Social justice and collective responsibility

What is distributive justice?

Fair distribution of resources and healthcare

What are social determinants of health?

Non-medical factors that influence health (e.g., income, education, environment)

Name the 5 major SDOH categories.

• Economic stability

• Education

• Healthcare access

• Neighborhood/environment

• Social/community context

How does low socioeconomic status affect health?

It is linked to higher disease rates and mortality

What is the “digital divide”?

Lack of access to technology affecting health, education, and resources

What is a key reason the U.S. has poorer health outcomes than other countries?

Higher income inequality

What are health disparities?

Differences in health outcomes among populations due to social, economic, or environmental factors

What is upstream thinking?

Addressing root causes of health issues (policy, environment)

• EX": Improving school nutrition policies

What is downstream thinking?

Treating individual illness after it occurs

What are the 3 core functions?

• Assessment

• Policy development

• Assurance

What are examples of assessment core functions?

• Conducting community health surveys

• Monitoring health trends (e.g., disease rates, births)

• Investigating disease outbreaks

What are examples of Policy development core functions?

• Mobilizing community partnerships (e.g., to reduce obesity)

• Educating the public on health risks

• Developing regulations like smoke-free workplace laws.

What are examples of assurance core functions?

• Financial audits

• Compliance reviews with laws and standards

• IT security assessments

What does assessment involve?

Collecting and analyzing community health data

What major contribution did Florence Nightingale make to public health?

She improved hygiene practices and reduced infection rates

What shift occurred in disease patterns from the 20th to 21st century?

From infectious diseases to chronic diseases

What is the difference between a community and an aggregate?

A community is a larger group; an aggregate is a subgroup with shared characteristics

Why is focusing on populations important in nursing?

It improves overall health outcomes and prevents disease on a larger scale

What is health equity?

Fair and just access to health resources and opportunities

Name one barrier to achieving health equity.

Income inequality, racism, or lack of access to care

How does housing impact health?

Poor housing can lead to injuries, asthma, and mental health stress

How does transportation affect healthcare access?

Lack of transportation leads to missed appointments and delayed care

How does education influence health outcomes?

Higher education is linked to better health and lower mortality

What factors are used to measure SES?

Income, education, and occupation

How does SES relate to health disparities?

Lower SES is associated with worse health outcomes

What theory supports upstream thinking?

Milio’s framework and the Health Belief Model

What does “medicalization” mean?

Treating social issues as medical problems

What is a policy?

A plan of action to achieve a goal

What is public policy?

Government actions to improve public health (e.g., smoking bans)

What is regulation?

Rules enforced by agencies (e.g., reporting diseases)

What are the 3 branches of government?

Legislative, executive, judicial

What do federal agencies do?

Protect public safety and guide national health priorities

What does the CDC do?

Monitors and prevents disease

What does the FDA regulate?

Food, drugs, and medical products

What is NIH?

Research agency for health and medicine

What do state agencies do?

Monitor funding and track health data

What do local health departments do?

Provide services like immunizations, inspections, and disease tracking

What is the Affordable Care Act (ACA)?

A law to expand insurance coverage and reduce costs

What is cost containment?

Efforts to reduce healthcare spending

What caused changes in U.S. healthcare?

• Shift to chronic disease

• Aging population

• Technology growth

• Rising costs

Why should nurses be involved in policy?

They advocate for patients and influence healthcare decisions

Name ways nurses can influence policy

• Voting

• Lobbying

• Advocacy

• Holding office

What is a PAC?

Political Action Committee that influences legislation

What is the Nurse Reinvestment Act?

Supports nursing education, retention, and workforce development

What drives healthcare costs?

Chronic disease, technology, aging population

What is return on investment in healthcare?

Improving outcomes while reducing costs

What is the purpose of public health law?

To protect and promote community health

• EX: Reporting communicable disease

What did the Social Security Act establish?

Programs like Medicare and Medicaid

What is the purpose of HIPAA?

Protect patient privacy and health information

What did the Occupational Safety Act of 1970 create?

Workplace safety regulations (OSHA)

What is the federal government’s role in healthcare?

Set national priorities and provide funding

What is the state government’s role?

Distribute funds and monitor health data

What is the local government’s role?

Deliver direct public health services

What are HMOs and PPOs?

Managed care organizations that control healthcare costs.

What is case management?

Coordinating patient care to improve outcomes and reduce costs

How do policies help reduce disparities?

By improving access to care and addressing social determinants

• EX: Expanding Medicaid coverage

What is the goal of the Nurse Reinvestment Act?

Increase and support the nursing workforce

What role do nursing organizations play in policy?

Advocacy, lobbying, and influencing legislation

What does the ANA code of ethics say about community/public health?

Promotes social reform by focusing on health policy and legislation to positively affect accessibility, quality, and cost of health care.

Who is the mother of community/public health?

Lillian Wald

What is a market justice system?

A theory of resource allocation based on individualism, self-interest, and personal effort, where goods—particularly healthcare—are distributed according to a person's ability and willingness to pay.

What is Principlism?

A commonly used ethical approach in healthcare and biomedical sciences. It emphasizes four key ethical principles of autonomy, beneficence, non-maleficence, and justice

Utilitarian Principle

Seeks the ‘greatest good for the greatest number