Exam #2 Flashcards
What are the health care functions of the government?
Regulator, purchaser of care, provider of health services, sponsor of applied research, demonstrations, and education and training programs for health care professionals
What is a centralized health department type?
operated by state health agency or state board of health, public health functions under state agency (5 states use this method)
What is decentralized health department?
operated by local gov, no board of health (used by 27 states)
What is mixed/shared health system?
operated under shared authority of state health agency, board of health, and local gov (used by 16 states)
What are the types of environmental exposures?
toxins, air pollution, water pollution
What are types of toxins?
lead, pesticides, mercury, solvents)
What are types of air pollution?
carbon monoxide, nitrogen dioxide
What are types of water pollution?
waste, run off chemicals added to soil
What are the steps of an environmental assessment?
An individual environmental exposure assessment
begins with time and place.
An assessment includes:
1. an exposure survey
2. a work history
3. an environmental history*
Ways to reduce environmental health risks?
Apply basic principles of disease prevention.
Prevention is a core goal in PHN.
Every nurse’s role in risk reduction
Shift to e-records to avoid paper
Recycle
Promote minimal packaging and green wrappers
Go fragrance free
Turn off equipment not used
Report dysfunctional plumbing
Promote local sustainable foods (organic)
Start a Green Team
Education
Create community
What are the levels of prevention for fires and burns?
Primary prevention: environmental measures in the home and behavioral changes
Secondary prevention: what to do in the event of a fire (for example, Stop, Drop, and Roll)
Tertiary prevention: improved treatment has led to a worldwide decline in fire-related mortality*
What are the levels of prevention for drowning?
Primary Prevention: barriers, supervision, learning to swim, life jacket
use, and no alcohol use*
Secondary Prevention: C P R
What groups are at greatest risk for unintentional injury?
young and impoverished
What is environmental justice? What are examples?
Certain environmental health risks
disproportionately affect poor people and people
of color in the United States.
More likely to live near a hazardous waste site
or an incinerator
More likely to have children who are lead
poisoned
More likely to have children with asthma
What is the role of the public health nurse in environmental health?
Preventing and helping improve environmental health in their community for the future. Having knowledge of the role of environment plays in health of individuals,families, and populations. Ability to assess health hazards and make referrals. Use of appropriate risk communication
strategies.Understand policies and legislation related to environmental health.
What are the roles of the state health department?
responsible for monitoring health status and enforcing
laws and regulations that protect and improve the public’s
health
Distribute federal and state funds to local public health
agencies to implement programs at the community level
Provide oversight and consultation for local public health
agencies
What are the roles of the local health department?
responsibilities vary depending
on the locality and are responsible for
implementing and enforcing local, state,
and federal public health codes and
ordinances and providing essential
public health programs to a community
Goal: to safeguard the public’s health
and to improve the community’s health
status
What are the roles of the federal health departments?
Providing direct service to some groups (military, veterans, federal prisoners, like VA hospital, Financing; pay for some health care services (Medicare, Medicaid), Information; collect and analyze health care data and status of citizens, Policy setting; make decisions about HC (HP 2030), Public Protection; clean air,water, food, safety of drugs
What is health equity?
Unlike health equality, which calls for equal treatment for all patients, health equity prioritizes treatment and care based on need. Equality does not always work in practice because some people need more support — or a different kind of support — than others
What are health disparities?
If a health outcome is seen to a greater or lesser extent between populations, there is disparity.”
What are examples of health disparities and how are they linked to SDOH?
Health disparities are linked to social determinants of health such as living conditions and socioeconomic status (income, education, and occupation).
What are ways to improve health disparities?
Improving access to high-quality education likely improves health. Early childhood interventions, such as early childhood education and parental support programs, have positive health impacts and help address economic disadvantage and health disparities.
What does health in all policies mean?
a collaborative approach to improving the health of all people by incorporating health considerations into decision-making across sectors and policy areas
What is public health policy?
government laws, regulations, and practices that promote the health and well-being of people in a community
What are entitlement programs?
gov benefits that certain qualified individuals are entitled to by law, regardless of need
Who is qualified for medicare?
Persons age 65+, certain disabled people, and people with end-stage renal disease.
What does medicare part A cover?
Hospital insurance
What does medicare part B cover?
medical insurance
What does medicare part C cover?
medicare advantage plans
What does medicare part D cover?
Prescription drugs
What is WIC and Who qualifies for WIC?
a special supplemental food program for women, infants, and children, sponsored by the USDA
Who qualifies for Medicaid?
Varies by state, aimed more towards vulnerable populations such as single parents with dependent children, aged, blind, and disabled populations. Covers 68 million people today.
What is Tenncare?
TN’s managed care medicaid program
What is CHIP?
The Children’s Health Insurance Program (CHIP) provides health coverage to eligible
children, through both Medicaid and separate CHIP programs. CHIP is administered by
states, according to federal requirements. The program is funded jointly by states and
the federal government.
How do we achieve health equity?
-We address the conditions in which people are born, grow, live, work, learn and age.
- These social determinants of health are shaped by the distribution of money, power and resources that include employment, housing, education, health care, public safety, and food access
What are 4 solutions to health disparities that should be focused on?
- Social determinants
- Collaboration and promotion of
community engagement. - Promoting sustainable and effective partnerships.
- Media outreach and communication of
research findings.
What are 8 ways to reduce health disparities?
- Increase cultural awareness and sensitivity
- Initiate cultural assessment of the individual, community, or population
- Promote training to develop culturally sensitive and empathetic communication skills
- Increase the diversity of the health-care staff
- Make sure patients receive equitable health-care services
- Be a patient advocate
- Always use a translator, as needed
- Recognize that nurses and other care providers can be discriminatory
What are evidence based interventions that can help reduce ACEs?
Home visiting
The Department of Health and Human Services launched the Home Visiting Evidence of Effectiveness (HomVEE) review to conduct a thorough and transparent review of early childhood home visiting models. HomVEE provides an assessment of the evidence of effectiveness for early childhood home visiting models that serve families with pregnant women and children from birth to kindergarten entry (that is, up through age 5).
What are considerations when working with vulnerable populations?
- Create a trusting environment.
- Show respect, compassion, and concern.
- Do not make assumptions.
- Coordinate services and providers.
- Advocate for accessible health care services.
- Focus on prevention.
- Know when to “walk beside” the client and when to encourage the client to “walk ahead.”
- Know what resources are available.
- Develop your own support network.
What is the MSDS?
A MSDS contains details of the hazards associated with a chemical, and gives information on its safe use.
What is an HMO and what does it include?
health maintenance organization. has lower deductible and premium, only covers in-network services, need a referral for specialists, no need to file claims (must choose PCP), lower cost
What is a PPO and what does it include?
Preferred Provider Organization. higher deductible and premium, can go out of network, no need for referrals for specialist, best for control and flexibility
What are the types of violence in an intimate relationship?
Physical violence
Sexual violence
Psychological/emotional violence
Threats of physical and/or sexual violence
What are the risk factors for violence against women?
Female gender, young age, being unmarried, being uninsured or on medical assistance, low income,
and having a history of maltreatment as a child
At-risk alcohol use
Low self-esteem, mental health problems, unemployment, or desire for power and control in
relationships
Residence in an area characterized by poverty and social disadvantage*
What are types of violence in the community?
Physical
When pain or harm results
Sexual
Lack of consent
Emotional
Neglect
Economic Maltreatment
Failure to provide for needs
What are the most common injuries?
Motor vehicle crashes, burns, drowning, falls, unintentional poisoning, self-directed violence
What are examples of impact of client change on human health?
increased temp, more extreme weather, rising sea levels, and increased CO2 levels
What does this climate change lead to?
severe weather, air pollution, changes in vector ecology, increased allergens, water quality impacts, water and food supply impacts, environmental degradation, and extreme heat
What does severe weather lead to?
injuries, fatalities, mental health impacts
What does air pollution lead to?
asthma, cardio diease
What does changes in vector ecology lead to?
malaria, dengue, encephalitis. hantavirus, Lyme disease, west nile virus
What does increasing allergens lead to?
respiratory allergies, asthma
What does water quality impacts lead to?
cholera and others i cant pronounce
What does water and food supply impacts lead to?
malnutrition, diarrheal disease
What does environmental degradation lead to?
forced migration, civil conflict, mental health impacts
What does extreme heat lead to?
heat related illness, death, cv failure
What is the epi triangle?
host, agent, environment
What is the interaction between environment and host?
Epidemiology determines who was exposed, when, where, and how
What is the interaction between and host and agent?
Epidemiology determines “What disease” lab identifies and or confirms agent
What is the interaction between agent and environment?
Environmental assessment determines: “why was the agent present in the environment in such a way the host could be exposed”
What are nurses role in advocacy?
Advocacy activities can include active in- volvement in policy such as providing testimony, writing letters, and meeting with your state and federal legislators.77 Nurses engage in advocacy on behalf of their patients every day; however, advocating for health policy has the potential to affect entire populations.
About how much do environmental factors make up the global burden of disease/deaths?
23,24%
What are the steps to an environmental risk assessment?
- Hazard identification
- Dose-response assessment
- exposure assessmet
- Risk characterization
What are the steps of the policy process?
Assessment of health status, Goals and objectives, and explicit evaluation criteria for policy planning
What does the assessment of health status entail?
social data, needs, resources
What does goals and objectives entail?
input from stakeholders
What does explicit evaluation criteria for policy planning entail?
effectiveness, efficiency, and equity
What is state health policy?
-Medicaid jointly financed by federal/state government
-States set own guidelines with mandated federal services
Establishment of predetermined criteria for health-care providers and facilities
Each state has an official state public health agency
-State-based public health agencies participate in the U.S. Centers for Disease Control and Prevention (C D C) Health Alert Network (H A N).
What is business/organization health policy?
- Develop policies for employees/customers
- Offer health insurance
- Paid sick leave
- Nutrition information provided by restaurants
- Smoke-free campus
- Not selling tobacco
- Not selling inhalants to minors
What is the health impact pyramid?
A 5-tier pyramid that describes the impact of different types of public health interventions and provides a framework to improve health.
-Interventions focusing on lower levels of the pyramid tend to be more effective because they reach broader segments of society and require less individual effort.
What are characteristics of vulnerable populations?
Heightened risk of adverse health outcomes
Higher mortality rates
Less access to health care; disparities in quality of care
Uninsured or underinsured
Lower life expectancy
Overall diminished quality of life
What are barriers to care?
Factors that impede access to mental health services, including structural barriers such as lack of provider availability, inconveniently located services, transportation difficulties, inability to pay and/or inadequate insurance coverage; individual barriers such as denial of problems or lack of trust in the system; and sociocultural barriers such as the stigma of psychopathology or mental illness.
Risk factors for violence?.
- history of being abused/exposure to violence
- Low self esteem
- fear/distrust of others
- poor self control
- inadequate social skills
- minimal social support/isolation
What is IPREPARE?
environmental exposure history outline
What are the parts of IPREPARE?
“I PREPARE” is a method of determining current and past environmental exposures
–> I: Investigate potential expostures
–> P: Present work: exposures, use of PPE, location of safety data sheets (SDS), hazardous materials brought home on clothing from work, trends
–> R: Residence: age of home, heating, recent remodeling, chemical storage, water
–> E: Environmental concerns: air, water, soil, industries in neighborhoods, waste site or landfill nearby
–> P: Past work: exposures, farm work, military, volunteer, seasonal, length of work
–> A: Activities: hobbies, activities, gardening, fishing, hunting, soldering, melting, burning, eating, pesticides, alternative medicines/healing
–> R: Referrals and Resources: Environmental Protection Agency, SDS, OSHA, local health dep
–> E: Educate: risk reduction, prevention, follow up
