Week 1 Population Health

PHN targeting SDOH

Social determinants of Health are the non-medical factors that influence health outcomes.

• They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies, and political systems

What is health?

A state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity

• The extent to which an individual or group is able, on the one hand, to realize aspirations and satisfy needs, and on the other hand, to change or cope with the environment. Health is therefore seen as a resource for everyday life, not the objective of living. It is a positive concept emphasizing social and personal resources, and physical capacities.

What is Public Health?

The art and science of 1) preventing disease, 2) prolonging life, and 3) promoting health through organized community efforts to benefit each citizen

• The mission of public health is social justice: it entitles all people to basic necessities such as adequate income and health protection, and accepts collective burdens to make it possible.

• Public health nursing is the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences.

  
  

Lilian Wald: Public Health Nursing Pioneer

The focus of public health nursing is to promote the health of all populations for the purpose of “social betterment”.

• In early 20th century established Henry Street Nursing Settlement in New York City

• Lilian Wald: first public health nurse, focusing on sanitation and nutrition among people in New York and she invented the term public health nursing.

  
  

  
  

Scope and Standards for PHN practice

Set forth by the American Nurses Association (ANA)

• The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation’s 4.2 million registered nurses through its constituent/state nurses associations and its organizational affiliates. (ANA, 2022)

• Public health nursing practice focuses on population health through continuous surveillance and assessment of multiple determinants of health with the intent to promote health and wellness, prevent disease, disability and premature death; and improve neighborhood quality of life. These population health priorities are addressed through identification, implementation, and evaluation of universal and targeted evidence-based programs and services that provide primary, secondary, and tertiary preventive interventions.

• Public health nursing practice emphasizes primary prevention with the goal of achieving health equity’ (American Nurses’ Association [ANA], 2013)

  
  

  
  

Elements/Scope of Practice of PHN

• A focus on the health needs of an entire population, including inequities and the unique needs of sub-populations

• Assessment of population health using a comprehensive, systematic approach

• Attention to multiple determinants of health

• An emphasis on primary prevention; and

• Application of interventions at all levels— individuals, families, communities, and the systems that impact their health

Core Functions of Public Health Nursing

1. Assessment: This function involves systematically collecting, analyzing, and sharing data about the health conditions, risks, and overall status of a population. Public health nurses use this information to monitor health trends, identify disparities, and pinpoint community needs through surveys, epidemiological data, and health screenings.

2. Policy development: This function uses the data gathered during assessment to create laws, programs, and evidence-based regulations that promote health and solve community problems. Public health nurses engage community members and collaborate with leaders to design policies that address local social, economic, and environmental health factors.

3. Assurance: This function makes certain that necessary health services, resources, and protections are actually accessible and delivered to the community. Public health nurses help fulfill this by providing direct care, enforcing health standards, monitoring compliance, and evaluating the effectiveness of interventions.

Uniqueness of PHN

Compared to other nursing specialties:

• Using analytic community assessment skills for health promotion

• Partnership with community stakeholders

• Partnership with sectors within and outside the health sector

• Upstream level focused

Council of Public Health Nursing Organizations

Key areas for PHN

• Racism

• Poverty-Social determinants of health (SDOH)

• Refugee health

• Emergency preparedness

• Environmental justice

• Population Health

• Violence

What is community?

Community: group or collection of individuals interacting in social units and sharing common interests, cultural values and goals.

• Geopolitical or phenomenological

• Aggregate: subgroups with common characteristics or concerns. (e.g. elderly, women, etc)

• Note: a member of the community can belong to many aggregates.

Community Health

Community health extends the realm of public health to include organized health efforts at the community level through both government and private efforts.

• Examples: American Heart Association, American Red Cross

Community as client

The community itself is the unit of care (i.e., the client)

• The goal is to improve collective health and well-being

  
  

Community as a setting/care environment

• Home care (acute & long term)

• Care/Case Management

• Primary care

• Health education

• School Nurses; OHN

• Health promotion

• Screening

• Wellness clinics

• Public health: immunizations

• Disease detectives (Communicable Disease)

• Home & Community Based Services

• Program administrators

• Quality Assurance

Prevention is key

Community and public health nursing are focused not only on returning to health, but on health promotion and prevention of disease or complications of disease.

What do we mean by population?

• Geographically defined population such as county, state, or country

• At-risk groups

What influences population health?

Community Health vs. Population Health