Final Exam - Weeks 6 -12 Flashcards
Health Education Programs
Encourages positive informed changes in lifestyle behaviour
Empowers people by voluntarily changing actions to improve their health status
Prevents disease and disability
Support social and political actions to promote health and quality of life in families and communities
Learning Principles of Health Education
Use methods that stimulate a variety of senses
Involve the person actively in the process
Create a comfortable learning environment
Assess readiness of the learner
Provide relevant information i.e. does it meet the learner’s needs? Interests?
Teaching Strategies of Health Education
lecture, discussion, demonstration and practice, simulation, gaming, role-playing
Evaluation of teaching
written/oral testing, demonstrations, self-reports, self monitoring, post-program questionnaires/surveys, verbal/non verbal feedback
RNAO Best Practice Guidelines on Client-Centred Learning
Clients have the right to accessible information, tools and supports to actively participate in their own care
People create their own understandings by integrating their previous experiences /knowledge with new learning to deepen understanding
Learning is social and involves many (friends, family, professionals, community, etc. )
LEARNS Model (RNAO)
Describes the interactions between nurses and clients
Evidence based
Can be used in any setting
Focuses on adults over age 18
Does not require fluency in health literacy
LEARNS Model Acronym
L - listen to the client
E - establish a therapeutic relationship
A - Adope intentional approach to every learning encounter
R - reinforce health literacy
N - Name new knowledge via teach back
S - Strengthen self-management via links to community
Health Literacy definition
Defined as the ability to:
access
understand
evaluate
and communicate information as a way to promote, maintain and improve health
Social Learning theory
Bandura’s Self-efficacy Model
Self-efficacy refers to the belief that one is capable of performing a certain behaviour needed to influence one’s own health
Health Belief Model
An individual’s perceived state of health or risk of disease will influence the probability of making an appropriate plan of action
Developed to explain why individuals do or do not act in relation to their health
Considers the individuals:
1. Perceived susceptibility
2. Perceived severity
3. Perceived benefits
4. Perceived barriers
Clients are most likely to change behaviours when they value their health and the perceived benefits
transtheoretical Model of Change
pre-contemplation
contemplation
planning or preparing
action
maintenance
relapse
Digital Health
Access to the internet for health information is not equitable
Individuals with low income, limited education, living on Indigenous reserves or in rural and remote areas, and who are members of minority ethnic groups or recent immigrants may have limited access to the internet
Digital Divide
Digital Divide – refers to internet users and non-users resulting in information “haves” and “have-nots”
Occupational Health
The promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations (WHO, 1995)
Prevention/protection of risks, injury and disease caused by working conditions
Placing and maintaining workers in an occupational environment adapted to their physiological and psychological capabilities
Occupational health nursing
Occupational Health Nurses (OHNs) apply the practice of nursing in the workplace to specific populations of workers
OHNs are often part of a team
OHNs are the frontline health care and emergency responders
First aid; policy planning and prevention
Environmental factors in the workplace
chemical factors
physical factors
biological factors
psychological factors
ergonomic factors
Environmental Health the History
Link between health and environment has underpinned nursing practice since Nightingale (1859) stressed the importance of:
- good ventilation
- pure water
- efficient drainage
- cleanliness
- light
Modifying the environment promotes the reparative process
Environment can also stimulate, promote and sustain disease
Environmental Health Risks
Environmental threats:
- Climate change
- Pollution
- Resource depletion
- Marine degradation
- Population growth
25% of the global burden of disease is related to environmental risks
Children, older adults, Indigenous communities are vulnerable to environmental health inequities
Social Trends (environment)
Increasing urbanization and displacement of people = food and housing insecurity
Climate change has forced migration:
impact on Canada’s Indigenous communities
compounds colonization = loss of connection to the land, loss of identity, culture health and livelihood
Environmental Injustice
Pollution related – unsafe water
Indigenous persons most affected
Unsafe drinking water
Fishing –contamination of traditional foods
Occupational roles
- Neurotoxicants – pesticides impact brain development, prenatal exposure
- Cosmetic sector –fumes from cosmetic products –endocrine disruptors
Autism, sex organ anomalies in males
Occupational carcinogens
- arsenic, asbestos, benzene, cadmium, formaldehyde
- Asbestos accounts for 40% deaths 2o to occupational carcinogens
The Role of the CHN (environment)
Work for social and ecological justice
An ethical imperative to preserve the environment for future generations – join interdisciplinary lobby groups
Need to curb pollution, reduce greenhouse gases
Start by reflecting “ What can I do today?”
Salutogenic effects of nature
Health-enhancing environments
Promotes:
- psychosocial well-being
- decrease CV mortality rates
- decreased cancer rates
“Shinrin-yoku” - making contact with and taking in the atmosphere of the forest (bathing in the forest)
MIOB Framework
recognize (warning signs, risk factors)
respond (SNCit conversation, risk assessment, safety planning, monitoring)
refer (policy, local expert, internal team)
report
What is Domestic Violence?
Domestic violence is any form of physical, sexual, emotional or psychological abuse, including financial control, stalking and harassment. It occurs between opposite- or same-sex intimate partners, who may or may not be married, common law, or living together. It can also continue to happen after a
a relationship has ended.
Patterns of Abusive Behaviour
Physical: slapping, choking, punching, threats
Sexual: threats, force used for sexual acts
Verbal: making degrading comments
Emotional: humiliation, inducing fear, threats to
children, pets
Economic: stealing/controlling money/possessions
Spiritual: using beliefs to manipulate / control
Stalking: persistent, unwanted following or watching,
use of electronic devices to monitor
Origins of understanding of domestic violence
Forty years of research
Initially understood as violence that only
happened to women
Referred to as battering, woman abuse,
coercive control, intimate partner violence,
intimate terrorism
Domestic Violence – 3 Types
Situational couple violence
most common / arguments escalate to violence
Coercive control
abusive partner controls and coerces
pattern of behaviour
Violent Resistance
victim of coercive control fights back
Coercive control / Woman Abuse
Highest risk cases (DVDRC)
Most serious injuries (Stats Can)
More likely to be reported to police (Stats Can)
Women almost exclusively victims of sexual
assault in relationships (Stats Can)
More likely to fear for their lives (Stats Can)
Domestic Violence Death Review
Committee 2012 Report
229 cases resulted in 328 deaths since 2002
Perpetrators:
- women (3%)
- men (97%)
Victims:
- 29 children (11%)
- 212 women (80%)
- 23 men (9%)
45% of cases are homicide - suicides
How Common is Domestic Violence at Work?
One third (33.6%) had experienced DV in their
lifetime
Female, transgender, and Aboriginal respondents,
those with disabilities, or a sexual orientation
other than heterosexual had higher rates
Rates consistent with other large Canadian
surveys
Pillars of the Canada Health Act
Federal funding continues for the provincial health insurance plans, provided the five criteria are met.
Health care must be:
Publicly administered
Comprehensive
Universal
Portable
Accessible
The Canada Health Act
Benefits
Ensures that Canadians have access to to health care regardless of their ability to pay or where they live
Defines health care as a right
Upholds values of social justice and equity
Drawbacks:
Covers only essential medical and hospital services – what are they??
Health promotion, disease and injury prevention, health protection, home health care not emphasized (i.e., cost may not be covered by shared prov/federal cost sharing)
Primary Health Care (PHC)
promotes healthy lifestyles as a pathway to disease and injury prevention
provides continuing care of chronic conditions and recognizes the importance of the broad determinants of health.
Involves a broad range of health-care providers (CIHI, 2006)
Primary Care
service at the entry of the healthcare system
“responsible for coordinating the care of patients and integrating their care with the rest of the health system by enabling access to other healthcare providers and services”
Principles of Primary Health Care (5)
- Accessibility
Healthcare universally available regardless of geography - Public participation
Clients are actively encouraged to participate in decision-making for their own health and needs - Health promotion
Includes the spectrum from health enhancement to disease prevention - Appropriate technology
Appropriate modes of care are available - Intersectional cooperation
Need collaboration between national and local health goals, public policies, and planning of services
Primary Health Care Reform
Move towards a more integrated system to provide full spectrum of healthcare services at a community/neighbourhood level- upstream approach
Community Health Centers
Family Health Teams (FHTs)
Public health vs. home health
Public Health: services depend largely on provincial (or municipal) governance and delivery structures
Funding and infrastructure being eroded
Home Health: MHLTC funds homecare (HCCSS)
Medical, nursing, social & therapeutic treatment/assistance and ADL support
Fastest growing nursing care sector in Canada
Public Health Agency of Canada
Main Government of Canada agency responsible for public health in Canada
Led by Chief Public Health Officer – Dr. Theresa Tam
Mission is to protect the health of Canadians
Goal is to strengthen Canada’s capacity to protect and improve the health of Canadians and to help reduce pressures on the health-care system
Home Care Costs
No legislative mechanism to fund = a wide variation in services across Canada
All provinces offer basic home care services however:
- Variation in access to and variety of homecare services
- Individuals may have to copay or pay entirely for services they need
- There is significant inequity in funding of home care across Canada
Policy
A principle or protocol to guide decisions and achieve rational outcomes
A definite course or method of action selected from among alternatives and in light of given conditions to guide and determine present and future decisions (Merriam-Webster, 2013)
Health Policy
Building healthy public policy involves advocacy for any health, income, environmental or social policy that:
fosters greater equity
creates a setting for health
increases options/resources for health (Stamler & Yiu, 2012)
policy development can be regarded as an act of social justice
Steps to Health policy development
describe the problem
access readiness for policy development
develop goals, objectives, policy options
identify decision markers & influencers
Build support for a policy
write/revise policy
implement the policy
evaluate/monitor the policy
Policy, Politics and Power
CHNs work in a variety of settings where resources are finite
Policy: guides the work of CHNS and occurs within a political context
Politics: “is the use of relationship and power” to encourage stakeholders to influence policy and the allocation of scarce resources
Power is “ the ability to act so as to achieve a goal”
Health inequities occur…
When there is bad policies and politics
Despite our universal health care system there are still barriers to access for many i.e. immigrants, refugees , Indigenous peoples
This has resulted from poor social policies and programs, unfair economic conditions and bad politics
Policy and Political Competence
CHNs should be prepared to perform in the policy and political arenas
Need knowledge, skills and behaviors that support social justice
Advocating and influencing policy is critical for health care leadership
Nurses have traditionally not been politically active
Political Advocacy
What?
A process by an individual/group aimed at influencing public-policy and resource allocation within economic, political and social systems and institutions
An act of social justice
The vehicle for the profession to have a voice and effect change
Why?
Builds capacity
A moral imperative that changes the social conditions that contribute to poor health
What is the meaning of health policy, policy development and outcomes, and political action for my practice with families and communities ?
Seat at the table
Link with government agencies (via RNAO)
Engage politicians OR become one
Development external informal and formal links with industry, politics and media
Be proactive
Stay the course
Be realistic strategies and focused
Have strengths-based relationships
Collaboration and partnerships
What characterizes a disaster?
Disaster
- Sudden, unpredictable
Multiple causes
Natural (e.g., nature)
Social and economic crisis
Man-made (e.g., human error, school shootings)
Biological hazards
Infectious disease
Other?
Considered random killers
Affect all in the community!
Can result in an emergency situation
Past Emergencies, London Ontario
1881 – The Victoria Steamship disaster (182 lives lost)
1898 – City Hall collapse (23 lives lost)
1937 – The Great London Flood (5 lives lost)
1973 – Oxford Park area – Gas explosion (27 injured, 10 houses exploded and burned, 40 houses damaged, 3,000 homes evacuated)
1980 – Hyde Park train derailment (explosion propane tank car, 300 people evacuated)
1984 – White Oaks area – Tornado (30 people injured, 600+ homes and businesses damaged)
1990 – Tornado, Komoka ($20 million damage)
1995 – Hyde Park train derailment (diesel spill, 25,000 gallons of liquid propane remained intact)
December, 2010 – Blizzard (100 + cm snow)
Risk Factors for Ontario
Largest most concentrated population in Canada with 7 million in GTA alone
High concentration of rail lines, major highways and airports
Largest nuclear jurisdiction in North America (20 large nuclear reactors)
50% of Canada’s chemical industry
Yearly floods and forest fires
More than 100 severe summer storms
Average of 14 tornadoes every year
Extensive aging infrastructure
High tech dependence
Derecho storm hits Southern Ontario and Quebec
May 21,2022. Derecho storm hits Southern Ontario and Quebec
Aderechois described as a widespread, long-lived, straight-line wind stormthat is associated with a fast-moving group of severe thunderstorms.On May 21, 2022, aderecho storm hit Southern Ontario and Quebec. One of the most impactful thunderstorms in Canadian history, it had winds up to 190km/h along with several tornadoes that caused widespread,extensive damage along a path that extended for 1,000 kilometres. Tragically, at least 11 persons lost their lives in this storm
Classifications of Emergencies
gradual
sudden
Risk assessment- emergencies
describes and quantifies the level of exposure to objects, substances etc
Risk management - emergencies
regulations, policies
risk communication - emergencies
distribution and presentation of risk assessment and risk management information to public
Disaster Response - Emergency management cycle
How is preparing for emergencies and disasters a health promoting practice?
Planning: Activities that are taken to build capacity and identify resources that may be used
Legislation
Public education
Chain of command
Role description
Mitigation: Activities that reduce or eliminate a hazard
Immunization programs
72 hour kits
Accessible counselling
Infrastructure renewal
Assessment:
Understand:
Impact
Priorities
Causes
Current safety status for those going in
Response:
Action
Triage
Treatment
Leverage of resources
Recovery
Repair:
Infrastructure
Physical impacts
Systems
Mental health impacts
Prevention and Mitigation for emergencies
Prevention entails avoiding a potential disaster.
An example here is a position statement by the Canadian Paediatric Society that outlines key steps that can prevent gun violence in schools,
Mitigation involves reducing the impact of a disaster.
Introducing vaccinations against certain infectious diseases can mitigate their impact.
Preparedness for emergency
Preparedness involves maximizing the efficiency of the emergency response through planning and preparation.
Preparedness –to be ready to respond to a disaster and manage its consequences through measures taken prior to an event, for example emergency response plans, mutual assistance agreements, resource inventories and training, public awareness activities, equipment and exercise programs.
Response for emergencies
With the emergency response, the immediate effects of the emergency are addressed.
With COVID, Canada and Ontario’s response involved mobilizing providers, coordinating services, acquiring supplies, ensuring tertiary centres are equipped, tracking cases, ensuring compliance with self-isolation measures.
Response –to act during or immediately before or after a disaster to manage its consequences through, for example, emergency public communication, search and rescue, emergency medical assistance and evacuation to minimize suffering and losses associated with disasters
Recovery for emergencies
Lastly, with recovery, communities return to an acceptable and normal condition
This is the longest phase that includes restoration of health, services, and infrastructure.
Recovery –to repair or restore conditions to an acceptable level through measures taken after a disaster, for example return of evacuees, trauma counseling, reconstruction, economic impact studies and financial assistance. There is a strong relationship between long-term sustainable recovery and prevention and mitigation of future disasters. Recovery programs provide a valuable opportunity to develop and implement measures to strengthen resilience, including by building back better. Recovery efforts should be conducted with a view towards disaster risk reduction
Disasters and impact on mental health
Guiding Principles
- No one who experiences a disaster is untouched by it
- Panic is rare
- Most people pull together and function during and after a disaster
- Mental health concerns exist in most aspects of preparedness, response and recovery
- Disaster stress and grief reactions are “normal responses to an abnormal situation”
Survivors respond to active, genuine interest and concern.
Disaster mental health assistance is often more practical than psychological in nature (offering a phone, distributing coffee, listening, encouraging, reassuring, comforting).
Disaster relief assistance may be confusing to disaster survivors. They may experience frustration, anger, and feelings of helplessness related to disaster assistance programs and may reject disaster assistance of all types.
Nursing Role – Psychological First Aid (emergencies)
Disasters have an impact on entire communities
Psychological impact on people can be great and long term but there are things we can do pre-event to mitigate
Role: Provide services
Awareness of legislation
Emergencies Act
Emergency Preparedness Act
Knowledge of role of the ICN and CNA
Why are (should?) nurses be involved?
Morbidity and mortality increase brought on by emergency/disaster
Public safety
Populations at risk in an emergency/disaster situation
Vulnerable groups
Children
Elderly
Those living in poverty
People living with mental and physical health challenges/disabilities
Other?
Inter-sectoral Approach for Emergencies
All health professions
Government - local, regional, national, international - e.g.,
Volunteer agencies – e.g., Red Cross
Ethical dilemmas:Managing limited resources in life and death situations
To whom is a duty owed?
How do we enforce limitations on individual rights?
Curfew; quarantine; evacuation?
What duty of communication/warning is owed the public?
What is the duty of the media in disseminating messages about risk?
What is culture?
Culture is learned, shared, and changes.
It encompasses all aspects of our lives: what we have learned to value, represents our assumptions about how to perceive, think, and behave in acceptable, appropriate, and meaningful ways
Culture is embedded in everyday life
Culture is shared and relational
Culture is largely implicit
Culture is fluid and dynamic
Culture intersects with other social constructs ( race , gender, ethnicity, class, language and disability)
Diversity
Refers to variety and differences of attributes among, between, and within groups
Includes characteristics and constructs such as race, gender, language, sexual orientation, and visible and invisible disabilities
As CHNs we must use an anti-oppression, anti-racism framework for practice
Race
Race refers to any group of people who share the same physical characteristics
An artificial way to categorize people
Racial profiling occurs when generalizations are made about certain groups
Racism
“The systematic practice of denying people access to rights, representation, or resources based on racial differences”
Includes more than solely the action of individuals
A system of discrimination involving social institutions
Canadian History (Culture/Race)
1834 - slavery abolition act
1876 - indian act
1885 - Chinese immigration tax
1910 - immigration act section
1911 - order in council Oklahoma black farmers
1923 - Chinese immigration act
WW2 (1939-1945) - Japanese Canadian internment
1996 - Last residential school
Cultural imposition
health personnel imposing their beliefs practices and values on other cultures, because they believe that theirs are superior.
Cultural competence
integrates the knowledge, attitude, and skill in order for a nurse to plan effective and appropriate interventions
Cultural safety
requires us to shift our gaze onto the culture of health care, and how practices, policies and research approaches can themselves perpetuate marginalizing conditions and inequities
Cultural Safety- Example
Studies on cancer screening behaviour among women in Canada reveal that South Asian immigrant women are less likely to have a mammogram or a pap-smear
Cultural Humility
Cultural humility – life-long process and a personal commitment to understand one’s biases through education and self-reflection
Indigenous Colonialism
Land purchased by government and Indigenous peoples relegated to living on reserves
Settlers brought disease i.e. Smallpox, TB and measles
Settlers depleted buffalo and beaver that had sustained communities
Resulted in malnutrition, starvation and death
Policies of assimilation resulted in loss of language and culture
Residental Schools
Process of education/religion and cultural degradation
Parents legally required to send children to residential schools
Failure to do so meant incarceration
Physical and emotional abuse in the schools
Generation and intergenerational trauma resulted and continue i.e. high rates of suicide, addictions violence and abuse; incarceration
Indigenous Health Status
High rates of TB- 70 times that of general population
Trauma and injuries i.e. burns, firearms accidents
Diabetes secondary to obesity and food insecurity
Cancer rates increasing
Indigenous women overrepresented in poverty, abuse, missing and murdered women and girls
First Nations Health Authority: Self-determination in Health Care
First of its kind in Canada
In British Columbia
Transfer from Federal government in 2013
As of 2019 specific regional initiatives in Quebec, Saskatchewan, Ontario, & in Northern Manitoba to improve regional capacity for health governance
- Paving way toward self-determination
- Building on lessons of First Nations Health Authority in British Columbia
LGBTQIA2S+ Health inequities
Societal stigma and discrimination
- Harassment/ bullying at school or in the workplace
- Higher rates of physical or sexual abuse
- Stress
- Increase in mental health issues (depression, SI, anxiety)
- Higher substance abuse and homelessness
CHN Role LQBTQ
Address assumptions, beliefs and values
Use inclusive language and material
Challenge discriminatory attitudes
Social Justice
The fair distribution of society’s benefits, responsibilities and their consequences.
Social justice looks at the position of social groups in relation to others and attempts to understand the root causes of disparities and how to eliminate them.
Features of Social Justice
Power
Influence stemming from the professional position we hold and that we have an impact on a person physically, mentally, emotionally
Need ethical use of power
Persons viewed as unique,
Includes entire context each person’s life (SDOH)
Everyday life decisions
Attend to how every day actions are carried out
Ethical dilemmas arise when there are equally compelling reasons for or against an action
Social Justice Assumptions
All societies experience broad systemic oppression and inequities (i.e., racism, sexism, ageism, classism, etc.)
We all contribute to this inequitable distribution even if unintentional
Thus, we are all responsible to contribute to the achievement of social, economic and political parity
Socio-environmental Perspective on Health
Recognizes:
that basic resources and prerequisite conditions are necessary to achieve health
that social justice is the foundational moral justification for public health
the need to address systemic disadvantage that severely limits the well-being of vulnerable/oppressed/marginalized groups
Barriers to Equitable Access
Barriers impact
Equitable access and distribution of health services
SDOH
Some barriers include
Age
Sexual orientation
Mental health challenges
SES
Poverty and homelessness are increasing in Canada
Homelessness is a barrier which limits access to health services
Strategies to Achieve Social Justice
Lobby for and work toward income security, housing, nutrition, education, and environment as essential in improving the health of vulnerable population
Promote radical policy and social change
Research
The power of one: Recognize that small change is important in working towards social justice
Global Health
Global health is an area for study, research, and practice that places a priority on improving health and achieving health equity for all people worldwide.
- Focuses on issues that directly affect health but that can transcend boundaries
- Requires global cooperation to develop and implement solutions
- Addresses both prevention in populations and clinical care of individuals
- Major goal is for health equity among nations and for all people
- Is interdisciplinary and multidisciplinary
Global factors impacting health
increasing inequalities within and between countries
new patterns of consumption & communication
commercialization
global environmental change
urbanization
What are the Measures of Population Health?
Life expectancy – the average life span
Healthy life expectancy – not just life span but years of healthy and unhealthy life
Mortality – number of deaths in a given population
Disability – a person’s abilities or limitations relative to a group standard including physical, mental, and cognitive
Leading causes of death in low-income countries vs high-income countries
Low income - neonatal conditions, lower respiratory infections, ischaemic heart disease
High-Income: ischaemic heart disease, Alzheimers, stroke
Global Health Considerations for CHNs
ethics, politics, social factors
Beneficence
doing good, of benefit
nonmaleficence
do NO harm
Social Factors
Culture
Religion
Language
Values, beliefs, and social norms
communicable diseases
Illnesses caused by
a “specific infectious agent, or its toxic products
that arise through transmission of that agent, to a host
(either directly or indirectly)”
Transmission of Infection/diseases
Epidemiologic Triangle - host, environment, agent
Agent
Host
- Resistance: The ability of the host to withstand infection
Immunity: A resistance to an infectious agent
- Herd immunity: The resistance of a group of people to invasion and spread of an infectious agent
- Infectiousness: A measure of the potential ability of an infected host to transmit the infection to other hosts
Environment
associations between the determinants of health and communicable and infectious diseases
Low income is linked to increased rates of sexually transmitted infections (STIs).
Low literacy levels are a barrier to receiving effective care for STIs.
Nursing Trends
Shift from biomedical based perspective of health care toward self-care in the socio-environmental/political (i.e., SDOH) context
It is anticipated that there will in an increase in nurse practitioners as primary care givers
Nursing Trends - Future
Nursing practice is expected to be increasingly community based
It is predicted that in the future, 2/3 of nurses will work in community care
We will most likely see increased advocacy and system navigator roles
Health Equity Future Considerations
CHNs must address health inequities
Must develop health equity strategies to create environments of empowerment
Health equity approaches are rooted in social justice
Must address root causes of inequities: ask “Yes, but why?” regarding inequities
Outbreak
increased numbers of what you would expect
Endemic
its always present – it exists in that environment (ex malaria)
Pandemic
worldwide
Syndemic
a state of two or more concurrent disease states that are the result of interactions between biological, social, environ- mental, economic, and structural factors that amplify the risk of disease or worsen the disease process
Paternalism
Paternalism is the interference with the liberty or autonomy of another person, with the intent of promoting good or preventing harm to that person. Examples of paternalism in everyday life are laws which require seat belts, wearing helmets while riding a motorcycle, and banning certain drugs.
What is evidence-informed practice
Previously called evidence-based nursing
Is the conscious, explicit, and judicious use of current best evidence in making care decisions (Stamler & Yiu, 2012)
Sources of evidence include:
Research evidence
Health care resources
Patient preferences and actions
Clinical state and circumstances
Meta-analysis
In statistics, a meta-analysis refers to methods focused on contrasting and combining results from different studies, in the hope of identifying patterns among study results, sources of disagreement among those results, or other interesting relationships that may come to light in the context of multiple studies.
IS a source of pre-processed evidence
where is research used?
practice
community program development
policy development/legislation
Concepts in Epidemiology
Susceptibility and risk
- Vulnerability determining host response
Causation
- Definite, statistical cause/effect relationship between stimulus/response not due to chance
Mortality = Death rate
Morbidity = Rate of illness – disease and health challenges over time in a particular population
- Prevalence – specific status of disease at one point in time
- Incidence – identification of new cases in a population during a specified period– see map in next slide
