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129 Cards in this Set
- Front
- Back
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What is the definition of Health? |
A dynamicstate or condition of the human organism that is multidimensional in nature, a resource for living, and results from a person’s interactions with and adaptations to his or her environment |
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What is the definition of Community? |
An open social system that is characterized by people in a place over time who have common characteristics and goals. |
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What is the definition of Public Health? |
Actions that society takes collectively to ensure the conditions in which people can be healthy. (Umbrella term) |
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What is the definition of Community Health? |
Health status of a defined group ofpeople and the actions and conditions to promote, protect, and preserve their health |
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What is Global Health? Give an example |
The health of populations in a global context. Example: Pandemic flu |
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What is Population Health? |
Refers to the health status of people who are not organized but are part of a population, such as men under 50, adolescents or prisoners. |
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What are the goals of public or community health? |
•1. Createan environment that promotes health •2.Promotion of healthy families and populations •3. Equitable distribution of health care to all •4. Prevention of physical and mental illnesses •5. Providethe greatest good for the greatest number •6. Educate others to be aware of their own responsibility for health |
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What are the physical factors that affect the health of a community? |
* Geography - climate or location can create conditions for tropical diseases or parasites * Environment - pollution or depleting natural resources * Community Size - greater the range of health problems and reduces resources * Industrial Development - can create more resources but cause pollution |
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What are the social and cultural factors that affect the health of a community? |
•Beliefs, traditions, and prejudices (like smoking) •Economy - an economic turndown can mean not enough money for welfare and healthcare •Politics - historically, democrats have been for government involvement in healthcare (not Rep.) •Religion - addresses issues such as abortion and premarital sex •Social norms - sign of the times, smoking was accepted in the 50's •Socioeconomic status - poorer populations health is more threatened such as lead paint risk |
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Why was the 18th Century unhealthy for the citizens? |
* Unclean water * Poor Sanitation * Unsafe workplaces, no child labor laws * Poor living conditions |
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Who was Dr. Jenner? |
He invented a vaccine against smallpox in 1796 |
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When was the first census taken and how often is it taken? |
* 1790 * Every 10 years |
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Why was the 19th Century better than the 18th Century? |
* Better agriculture led to improved nutrition * Many scientific discoveries improved conditions |
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What was the government's stance on public health in the 19th Century? |
Laissez Faire, i.e., did not interfere and had few regulations, which led to epidemic problems in major cities |
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What is the Shattuck Report? |
* Lemeul Shattuck, a legislator in MA, was appointed to study sanitary problems in MA in 1850. * He discovered high mortality rates among the poor and unsanitary conditions. * He developed public health * Was considered the American Advocate for environmental health. |
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Who is Dr. Snow? |
* A doctor in London investigated a water pump in 1854 and upon removing the handle, abated a cholera epidemic. By disabling the contaminated pump, people didn't drink that contaminated water |
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Who is Louis Pasteur? |
A scientist in France, discovered germs |
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Who is Robert Koch? |
Discovered that different microbes caused different diseases and started the "Bacteriological Period of Public Health" |
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What are the 20th Century achievements? |
* Vaccinations * Motor Vehicle Safety * Control of infectious diseases * Decline of deaths from Stroke and CHD * Healthier Moms and babies * Safer and healthier foods * Safer workplaces * Family Planning * Flouridation of drinking water * Recognition of tobacco as a health hazard |
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Who was Florence Nightingale? |
In 1854 when the Crimean War started she went with other nurses to the British hospital to help. She was disgusted by the conditions and cleaned and fought to make hygiene essential for the recovering. Started "Nurse's homes" |
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Who was Lilian Wald? |
An American Nurse, humanitarian and author who founded the NAACP. Known for contributions to human rights and founder of the American Community of Nursing |
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What year did Medicare and Medicaid become established and what's the difference between them? |
* 1965 * Medicare is more for over 65 population and / or those with renal disease * Medicaid is for those with low incomes, disabled, pregnant women, children, etc. |
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What are the 4 leading causes of death for the 2000's? |
* Heart Disease * Cancer * Chronic Respiratory Disease * Strokes |
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What are the 4 levels of governmental health agencies? |
Funded by tax dollars * International * National * State * Local |
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What is the largest and most widely recognized international health agency? What is it's primary goal and most notable work? |
* WHO - World Health Organization, headquartered in Geneva Switzerland * Primary objective is for all people to attain the highest possible level of health * Most notable work is helping the eradication of smallpox |
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What is the US Primary national health agency? |
Dept. of Health and Human Services (HHS) |
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What is the purpose of state health agencies? |
* To promote, protect, and maintain the health and welfare of their citizens |
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What are the core functions of Public Health? |
* Assessment * Policy Development * Assurance |
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What are the 10 essential services of Public Health? |
* Monitor Health * Diagnose & Investigate * Inform, Educate & empower * Mobilize community partnerships * Develop policies * Enforce Laws * Link to or provide care * Assure competent workforce * Evaluate * Research (DRAMMED LIE) |
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What roles do state health departments play? |
* They can establish a link between federal and local health Agencies * Establish health regulations * Serve as conduits for federal funds aimed at local health departments * Have laboratory services available for local health departments |
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What are the state mandated services that are provided by local health departments? |
* Inspections of restaurants, public buildings and public transportation * Detection and reporting of certain diseases * Collection of vital statistics |
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What are the official duties of the Red Cross? |
* Provide relief to victims of natural disasters * Serve as liaison between members of armed forces and their families during emergencies |
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What are the non-governmental services provided by the Red Cross? |
* Blood Drives * Safety Services * Community Volunteer Services * International Services |
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Who is Clara Barton? |
She was a hospital nurse during the civil war who founded the Red Cross in 1881 |
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What is the focus of public health nursing? |
•Maternal health •School nursing •Industrial nursing •Child health nursing •Tuberculosis nursing •Rural health •Elderly •Adolescents •Low-income persons •Homeless persons |
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What are the external influences affecting a community? |
•Money •Facilities •Human services •Health information Legislation |
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What are the internal influences affecting a community? |
•Economy •Politics •Communication •Values |
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What are the steps of community assessment? |
Like nursing diagnosis •Assess •Diagnose •Plan •Implement •Evaluate |
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How would the area of a community be defined? |
•Urban or rural •Boundaries: Densely or sparsely populated, and general condition of the area (i.e., well or poorly maintained). |
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How would the demographics of a community be defined? |
•People,including sex (mixed or heavily skewed to one sex) • Ages (i.e., young, old, mix) • Homogenous or mixed cultural • Racial and ethnic characteristics |
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What would be examples of amenities and open spaces for a community? |
•Parks •Tennis courts •Swimming pools •Recreation areas •Movie theaters •Skating rinks •Sports arenas |
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How would you describe the transportation common to a community? |
•Public: Visible transportation such as buses, cabs, street cars, and subways. •Private: Cars, motorcycles, bikes, SUVs, and other vehicles, and the condition of the vehicles |
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How would you describe the safety a community? |
•Active or inactive neighborhoods •Retail areas •Pedestrians: People mingling, children playing •Presence of police, gangs, and homes fortified or not (i.e.,having safety bars on the windows) |
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What types of commercial buildings and areas are there in communities? |
•Type of retail stores •Shopping malls/Strip malls •Small neighborhood stores •Liquor stores •Check- cashing establishments •Grocery stores •Evidence of industry (i.e.,factories in use or abandoned) |
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What types of government offices are there in communities? |
•Town hall •Police station •Firestation •Court house •Human service Facilities |
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What types of health services are there in communities? |
•Drug stores •Public clinics •Private clinics •Hospitals, doctors’ offices •Counseling services •Drug and alcohol treatment facilities |
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What types of schools are there in communities? |
•Public elementary •Middle or high schools •Private schools •Colleges •Technical schools •(e.g.,industrial, auto mechanic, beauty schools) |
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What types of communication are there in communities? |
•Messages posted •Newspaper stands •Graffiti •Political signs |
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What kind of environments are there in communities? |
•Condition of: •Air •Water •Soil, noticeable smog or haze, and obvious pollutants |
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What is "Community Organizing"? |
A process where people who live in close proximity come together to organize and act for a shared interest (term coined by American Social workers in 1880's) |
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Describe Community Health Problems |
They can range from small, that are local and involve only a few people and are easy to fix, to large and complex that involve whole communities and require lots of resources and effort to solve. A good example is teaching a small group smoking cessation class to reducing smoking rates nationwide. |
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Why is there a need for organizing communities? |
Because the world has gotten smaller with hand held cell phones and world travel, the days are gone where everyone knows their neighbors. It takes specific skills to organize a community to act together for the greater good. |
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What are Rothman's 3 models of community organization? |
* Locality Development (wide variety should be involved to affect change) * Social Planning (involves people and outside planners) * Social Action (a disadvantaged segment needs resources) |
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What is grass roots organizing? |
organizing community groups are built from scratch and leadership is developed where none existed before |
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In gaining entry into the community, what do organizers need? |
* Cultural sensitivity * Cultural Competence * Cultural Humility |
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In gaining entry into the community, what do organizers need to know? |
* Who is causing problem and why * How problem has been addressed in past * Who supports & opposes idea of addressing problem * Who could provide more insight |
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In gaining entry into the community, who is the gatekeeper? |
•Those who control the political climate of the community, a representative •Example: Politician, leaders of activist groups, business &education leaders and clergy |
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To organize people, where is it best to start? |
By organizing those who already know about the issue and want to solve it. |
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In organizing people, who are the executive participants? |
* The core group of community members who are interested in seeing the problem solved * They will be the backbone of the workforce and do most of the work |
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In recruiting, what population should be targeted? |
Recruit people from the subpopulation that is most directly affected by the problem |
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What is a task force? |
A temporary group that is brought together for dealing with a specific problem |
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What is a coalition? |
Formal alliance of organizations that come together to work for a common goal |
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What is community building? |
•Strengths-based orientation •Identification, nurturing and celebration of community assets |
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What are the criteria to consider when selecting priority issue or problem? |
•Must be winnable •Must be simple and specific •Must unite members of organizing group •Should affect many people •Should be part of larger plan |
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When examining alternatives for solutions and intervention strategies, what terms are looked at? |
* Probable outcomes * Acceptability to the community * Probable long- and short-term effects * Costs of resources |
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What are the final 4 steps to solving a problem? |
* Implementing (by trying to use resources in the community - helps with success) * Evaluating (involves comparing long term outcomes to the goals that were set up earlier) * Maintaining (most difficult part - putting in place a long term plan to resolve the problem) * Looping Back (looking back at previous steps to rethink or rework before proceeding) |
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What is the generalized model for program planning? |
* Assessing needs * setting goals and objectives * developing an intervention * implementing the intervention * evaluating the results |
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What are the steps in assessing needs of the priority population? |
1. Determining purpose and scope of needs assessment (What is the goal?) 2. Gathering data (What are the true needs?) 3. Analyzing data (What problems were found?) 4. Identifying factors linked to health problem (What are the risks?) 5. Identifying program focus (What directly impacts the target?) 6. Validating prioritized need |
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In setting goals and objectives, how are the goals achieved? |
Portions of the programming process aredesigned to achieve the goals by meeting the objectives |
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Describe Goals set for a community. |
•Provide overall program direction •Are more general in nature •Usually take longer to complete •Do not have a deadline •Are usually not observed, but inferred •Often not measured in exact terms |
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Describe Objectives set for a community. |
•More precise than goals •Steps to achieve the program goals •The more complex a program, the more objectives needed •Composed of who, what, when, and how much |
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Describe interventions set for a community |
•Activities that will help the priority population meet the objectives and achieve the program goals •The program that the priority population will experience •May be several or a few activities |
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What are some intervention considerations? |
* Multiplicity (# of activities that make it up) * Dose (# of program units delivered - like # of commercials run or newspaper ads) * Best practices (Telling people about the research that shows what is best) * Best Experience (Tell the people that what you are trying to get them to do is better than what they have right now) * Best Processes (shows the best model for change) |
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What are some ways for implementing the intervention? |
* Implementation - carrying out the plan * Pilot test - trial run and fixing problems part way through * Phasing In - Implementation in steps |
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Describe the evaluation of the results |
* Determine the value or worth of an object of interest * Evaluation should occur during first steps of program development * Formative evaluation: validate during pilot * Summative evaluation * Impact evaluation: changes in awareness& knowledge & attitudes (Outcome evaluation: End results Ex: Improves morbidity and mortality = Better health) |
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Describe the steps to evaluation |
* Planning the evaluation * Collecting the data * Analyzing the data * Reporting the results * Applying the results |
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What is the definition of epidemiology |
study of distribution and determinants of health-related states or events in specified populations |
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What is an epidemic? |
An unexpectedly large number of cases of an illness, specific health-related behavior or event, in a particular population |
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What is the definition of endemic? |
when there is a moderate, ongoing occurrence in a location |
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What is the definition of pandemic? |
outbreak over wide geographic area (countries & continents) |
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What is the role of a community health nurse during an outbreak of disease? |
•Identify # cases •Recognize patterns of disease •Eliminate barriers to disease control •Provide education & counseling targeted at a disease condition or specific risk factor |
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What is the population at risk when it comes to disease outbreaks? |
Those susceptible to the condition |
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What is the definition of "case" when it comes to a disease outbreak? |
People that are afflicted or sick |
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In epidemiology, what is the definition of "rates"? |
# of events in a given population over a given period of time or given point in time such as birth, death and illness |
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How is the incident rate calculated? |
# New cases in a population at a specific time/ population total X 1000 (gives the per 1000 rate) |
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How is the prevalence rate calculated? |
# Existing cases in a population at a specific time/ population total X 1000 (gives the per 1000 rate) |
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What are incidence rates used for? |
•to study of acute diseases •Acute disease: lasts three months or less |
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What are prevalence rates used for? |
•for study of chronic diseases •Chronic disease: last longer than three months |
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What are crude rates? |
When the Denominator includes the total population Ex. Crude birth rate: # of live births in given year, divided by midyear population |
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What are age adjusted rates? |
Used to make comparisons of relative risks across groups and over time when groups differ in age structure |
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What is the case fatality rate? |
% of cases of a particular disease resulting in death |
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What is the proportionate mortality ratio? |
% of overall mortality in a population that is attributable to a particular cause |
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What is the attack rate? |
# of people exposed to a specific agent who get the disease / total number of people exposed |
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What are notifiable diseases? |
infectious diseases in which health officials request or require reporting (Ex. chicken pox, Tb, HIV, etc) |
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What does the US Census track? |
* Gathers data on race, age, income,employment, education, and other social indicators * taken every 10 years |
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What are the descriptive studies for a disease case? |
Who? - Case count followed by who is ill When? - time of onset (epi curves made) Where? - (Determine address and travel history) |
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What is an epi curve? |
Visual display of the onset of illness among cases associated with an outbreak |
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What can you learn from an epi curve? |
1. The outbreak's time trend (distribution of cases over time) 2. Outliers, that is, cases that stand apart from the overall pattern 3. General sense of the outbreak's magnitude 4. Inferences about the outbreak's pattern of spread 5.The most likely time period of exposure |
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What are observational studies? |
•Investigator observes natural course of events •Noting exposed vs. unexposed and disease |
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What two types of observational studies are there? |
*Case/control studies *Cohort studies |
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What are case control studies? |
Compares those with disease to those without, such as what they have in common |
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What are cohort studies? |
Measures * Cohort * Odds ratio * Relative Risk |
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What is a cohort? |
group of people who share important demographic characteristic, is classified by exposure to one or more risk factors and observed to determine rate of disease development |
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What is odds ratio? |
measure between exposure & outcome |
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What is relative risk? |
A ratio of probabilities. It compares the incidence or risk of an event among those with a specific exposure with those who were not exposed. (ex: myocardial infarctions in those who smoke cigarettes compared with those who do not) |
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What is the infectivity of a communicable disease? |
Ability of a biological agent to enterand grow in the host |
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What is the agent of a communicable disease? |
cause of disease or health problem |
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What is the pathogenicity of a communicable disease? |
capability of a communicable agent to cause disease in a susceptible host |
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How is disease spread from person to person? |
* Airborne - inhaled * Blood borne - needles * Direct skin to skin * Insect-borne - mosquitos |
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How can disease spread in general? |
* Food-borne (contaminated food) * Water-borne (contaminated water) * Person to person (blood/fluids, air, skin, insects) * Zoonotic (animals to humans) |
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What is a pathogen? |
Disease causing agent |
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What is a reservoir? |
favorable environment for infectious agent to live and grow (human, animal, etc.) |
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What is a portal of exit? |
path by which agent leaves host (blood,respiratory system, digestive system, skin etc.) |
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What is "Mode of transmission"? |
how pathogens passed from reservoir to next host |
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What is "Portal of entry"? |
where agent enters susceptible host (blood, respiratory or digestive system, etc.) |
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What is a new host? |
susceptible to new infection being established |
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What is direct vs. indirect transmission? |
* Direct is immediate transfer of disease by touching in some way * Indirect involves an intermediate step such as air, insect, fomite |
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What are the five "F's" of transmission/ |
* Food * Flies * Fomite * Finger * Fluid |
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What is a fomite? |
Objects that are likely to transmit bacteria that can transmit infection such as a doorknob |
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What is the nurse's role in breaking the cycle of disease? |
•ID all factors influencing the spread of the disease. • Break the chain of transmission to control the spread of the disease. •Put the plan into action. •Evaluate the success in prevention of the spread of the disease. •Report and follow up. • Then the nurse evaluates successes and failures and bases follow-up on the evaluation information. |
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What is the nation's leading causes of death? |
* Heart Disease * Stroke * Cancer |
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What is the criteria used to judge the importance of a disease to a community? |
* # of people who will die from the disease * leading causes of death * # of years of potential life lost * economic costs associated with the disease (drugs and alcohol) |
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What is primary, secondary and tertiary prevention? |
* Primary - before being sick (vaccines, hand-washing) * Secondary - early diagnosis and prompt treatment (mammograms, screenings, Tb tests) * Tertiary - aimed at prevention from getting worse (rehabilitation, re-education, diet, etc.) |
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What would be examples of primary prevention of communicable diseases at the community level? |
* Chlorinating water supply * Inspecting restaurants * Immunization programs * Vector control (mosquito spraying) * Solid waste disposal * "Just say No" programs |
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What would be examples of secondary prevention of communicable diseases at the community level? |
* Trying to control or limit the extent of an outbreak * Isolation (isolation of those who are ill) * quarantine (Isolation of those that COULD be ill) * disinfection |
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What would be examples of tertiary prevention of communicable diseases at the community level? |
* Preventing recurrence * Removal, embalming, burial of dead * Reapplication of primary and secondary measures |
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What would be examples of primary prevention of non-communicable diseases at the community level? |
* Adequate food and energy supplies * efficient community services * opportunities for education * employment * housing |
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What would be examples of secondary prevention of non-communicable diseases at the community level? |
* Provision of mass screenings for chronic diseases * case-finding measures * provision of adequate health personnel equipment, and facilities |
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What would be examples of tertiary prevention of non-communicable diseases at the community level? |
* Adequate emergency medical personnel and services * Hospitals * Surgeons * Nurses * Ambulance services |
