Part one
what is health?
a state of complete physical, mental and social well-being and not merely the absence of disease/ infirmity
Millennium Developmental Goals (MDGs)
United Nations*** goals from all 191 states that agree to work together to achieve by 2015, Signed in 2000, targeting to reduce poverty, global inequalities, and promote health and social welfare of the world’s citizens
Florence Nightingale
Crimean War work on soldiers
Improved sanitation
Address environmental conditions that were affecting patient outcomes
She documented everything, including what worked in terms of nursing care, what didn’t work and how it affected mortality rates, used health data to influence decisions, improved standards for hospitals, and advocated for nursing education
Epidemiology
is a way of looking at the health of a population
It is important when looking at population dynamics (like comparing covid deaths/ country) to adjust for total population size of the country … will show true risk
Determinants include agents, causes, risk factors, and sources
Sources of Community Health Data
U.S. Census!! Collected every 10 years, most comprehensive source of data for the U.S.
Data is used to make planning decisions about community health
what does global health consist of?
can be affected by political unrest, wars, natural disasters, man made disasters, limited resources, poor infrastructure, international travel/ exposure, climate change, maternity health/nutrition, social determinants of health
***Alma Ata
conference in Russia sponsored by WHO for an international declaration for all governments to protect the health of all the people of the world. Defined the role and importance of primary healthcare
Jessie Sleet Scales
First African American Public Health nurse
Tackled TB in african american populations within NYC to reduce it from spreading
Attack Rate=
identifies the number of people at risk that became ill
(# persons that got food poisoning/ # persons that are the food) x 100
You can then use this number and compare it to other populations or illnesses
Descriptive
v.s. Analytic
5 W’s: what, who, where, when, why/how
Generate hypothesis!
analytic=
How? Why?
Identify associations between the particular disease and etiology (the cause)
Test the hypothesis! Use an appropriate comparison group
Social Determinants of Health include:
Economic stability
Environment/ Pollution
Education access and quality
Social and community context
Healthcare access and quality
Community oriented RN=
aggregates, communities at risk and those that are underserved, aim to improve health of entire community, program management, direct care to populations
Mary Breckinridge
Started frontier nursing services and introduce first nursing midwives in USA
Got nurses to go into rural areas via horseback to take care of patients
Instrumental in bringing public health to rural locations
Incidence rate=
(# new cases in the time period/ total population at risk) x a multiplier usually 100,000
Using a multiplier makes it easier to interpret, otherwise you have a bunch of fractions/ decimals
Endemic v.s Hyperendemic
Endemic
A disease or condition when there is a moderate ongoing occurrence in a given location
Chicken pox, measles
Hyperendemic
persistent/high levels of disease occurrence
Healthy People 2030-
global health workgroups goals on an international level. Is continuously changing. Addressing USA health but also global health
Community based RN=
focus on individuals and families, management of acute and chronic illness, 1-1 care, illness care
Nancy Milio
Developed mom and tot center that assesses community to see what they needed to support mother and babies
Set up a model and framework for community outreach
Behavior change in a large group of people can lead to social change
Prevalence Rate=
prevalence rate the number of people in a population who have a disease at a given time
(# of existing cases of the disease/ # of people total in the population) x 100,000
Influenced by number of new cases
Influenced by duration
Epidemic v.s. pandemic
Epidemic
Occurs when the rate of the disease exceeds the usual (endemic) level of the condition in defined population, includes multiple geographic regions
Yellow fever, small pox, west nile virus
Pandemic
Occurs when an epidemic occurs in multiple countries or continents
HIV, COVID-19
Public health nursing goals?
Promotion of health and prevention of disease and disability for all through creation of conditions in which people can be healthy.
Liilian Wald
Founder of public health nursing
Coined term “”public health nurse”
NYC girl told Lillian that doctor absoned mother during PPH because they couldn’t afford it, Lillian saved the mother and it changed her life
Founded Henry Street Settlement= provide healthcare and education to poor populations of NYC - still in existence, changed focus to address current needs of population
21st Century Factors that Influence Community Health
Health care reform
Demographics – immigrants, refugees, aging population
Globalization – positive, negative
Poverty and growing disparities
Violence, injuries, and social disintegration
Uses of Epidemiology - cause of death
1900: #1 Pneumonia and influenza
2019: #1 Heart disease
Host Defenses and immunity
Active
Natural from disease exposure
Acquired from a vaccination
Long term
Passive
Transplacental or via breast milk
Acquired via antitoxin or antibody
Short term
Herd
Immunity of a group/community