the population context copyright ©2008 by pearson education, inc. upper saddle river, new jersey...

The Population Context

Copyright ©2008 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.Community Health Nursing, 5/eMary Jo Clark

2CHAPTER

Health Promotion and Disease Prevention

Community Health Nursing, 5/eMary Jo Clark

Copyright ©2008 by Pearson Education, Inc.

Definition of Health

• Health: state of physical, mental, and social well-being and not merely absence of disease or infirmity (WHO, 1986)

• Updated WHO definition (2008)included characteristics, behaviors, and physical, social, and economic environment



Health-Illness Continuum

• Care in the acute care settings is usually directed to resolving immediate health problems.

• In the community, care focuses on maximizing individual potential for self-care. The client assumes responsibility for health care decisions and care provision, with the client’s ability to function the primary concern.



Health Promotion Versus Disease or Injury Prevention?

• Health promotion: activities to help individuals change their lifestyle to move toward a state of optimal health (a balance of physical, emotional, social, spiritual, and intellectual health)



Health Promotion Versus Disease or Injury Prevention?

• Disease prevention: activities undertaken to avoid the occurrence of a disease or injury and minimize the consequences. Intended to prevent future illness.

• Health protection: environmental or regulatory measures that confer protection on population groups



Community Characteristics

• Groups of people

• Share common interest

• Interact with one another

• Function collectively within defined social

structure



Defining Aspects

• Social system or institutions

• Identity

• Commitment

• Common norms and values



Defining Aspects

• Common history or interests

• Common symbols

• Social interactions

• Intentional action



Population Health

• Arose from limitations in individual-oriented care for improving the health of population groups

• Defined as highest possible level of health in the population

• Distribution of health among members of the population



Two Approaches to Population Health

• Descriptive approach– Focuses on the health status of a population– Utilizes specific summary indicators of health– Distribution of health indicators in that

population



Two Approaches to Population Health (continued)

• Analytic approach:– Broad factors influencing health– Identifies factors contributing to health

indicators– Direct interventions to improve health status



Characteristics of Healthy Communities

• Ability to foster dialogue among residents

• Promote community leadership

• Engage in action based on a shared vision

• Embrace diversity among residents



Characteristics of Healthy Communities (continued)

• Assess both needs and assets

• Link residents to community resources

• Foster a sense of responsibility and cohesion

• Change and adapt to changing circumstances

• Manage conflict effectively




• Safe transportation, schools, and neighborhoods

• Clean air and environment

• Well-equipped parks, open spaces, and organized recreation

• High-quality mixed income housing




• Well-stocked grocery stores with nutritious food offerings

• Clean streets that are easy to navigate

• Well-kept homes




• Organized multicultural community programs, social services, neighborhood councils, or other opportunities for participation in community life

• Available and accessible primary care(Robert Wood Johnson Foundation, 2009)



Population Health Trends

• Historical– Control of epidemics and communicable

diseases:• Sanitation• Quarantine

• Mid-1900s– Disease prevention

• Immunization• Personal behavior changes



Population Health Trends (continued)

• Present– Population health

• Social justice• Healthy environments• Access to resources needed for health



Three Levels of Population Health Care

• Primary prevention

• Secondary prevention

• Tertiary prevention



Primary Prevention

• Promote general optimal health and prevent illness

• Actions occur prior to illness or disease

• Increase resistance to illness

• Decrease or eliminate the causes of health problems

• Foster a healthy environment



Primary Prevention

• Generalized health promotion and specific

protection against disease.

• It precedes disease or dysfunction and is

applied to generally healthy individuals or

groups.



Examples

1. Health education about:– Accident and poisoning prevention– Standards of nutrition and of growth and

development for each stage of life– Exercise requirement– Stress management– Protection against occupational hazards



Examples Cont

2. Immunization

3. Risk assessment for specific disease

4. Family planning services and marriage counseling

5. Environmental sanitation and provision of adequate housing, recreation and work conditions



Secondary Prevention

• Early identification and treatment of existing health problems

• Actions take place after problem has occurred

• Screening, early diagnosis, and treatment

• Develop programs to diagnose and treat at community level



Secondary Prevention

• Emphasizes early detection of disease,

prompt intervention, and health

maintenance for individuals experiencing

health problems.

• It includes prevention of complications and

disabilities



Examples

1. Screening surveys and procedures of any type.

2. Encouraging regular medical and dental checkups

3. Teaching self-examination for breast and testicular cancer

4. Assessing the growth and development of children



Examples Cont

5. Nursing assessments and care provided in home, hospital, or other agency to prevent complications. for example– Maintaining skin integrity– Turning, positioning, and exercising clients– Ensuring adequate rest, food, and fluid intake– Promoting fecal and urinary elimination– Administering medical therapies such as

medications.



Tertiary Prevention

• Return client to highest level of function

• Prevent recurring health problems

• Prevent further deterioration of health; examples:– Maintenance health programs



Tertiary Prevention

• begins after an illness, when a defect or

disability is fixed, stabilized, or irreversible.

• Its focus is to help rehabilitate individuals

and restore them to an optimum level of

functioning within the constraints of the

disability.



Examples

• Referring a client who has had a colostomy to a support group

• Teaching a client who has diabetes to identify and prevent complications, or insulin administration at home.

• Referring a client with a spinal cord injury to a rehabilitation center to receive training that will maximize use of remaining abilities.



Resources

• Population Reference BureauThis database contains data on 136 population, health, and environment variables for more than 220 countries, 28 world regions and sub-regions, and the world as a whole.

• U.S. Agency for International Development's Global Health WebsiteUSAID programs in global health represent the commitment and determination of the US government to prevent suffering, save lives, and create a brighter future for families in the developing world.

the population context copyright ©2008 by pearson education, inc. upper saddle river, new jersey...

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