Week 1 Flashcards
T or F: the strongest predictor of longevity is the quality of your relationships
true
define: population health
- an approach to health that aims to improve the health of the entire population & to reduce health inequities among population groups
what does population health act upon?
- acts upon the broad range of factors and conditions that have a strong influence on our health
what are the core themes of population health (6)
- focus on the health & wellness preventions rather than on illness
- is oriented towards population rather than indiv
- understanding needs and solutions thru community outreach
- addressing equity, health disparities, and health in vulnerable groups
- addressing the social and multiple DOH
- embracing intersectoral action and partnerships
what are the 4 underlying population health assumptions
- health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity
- health pomotion includes, but is more than, disease prevention
- health promotion requires upstream thinking
- health promotion is based on strong values
what is included under the population health assumption “health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity” (3)
- to be healthy, an individual must be able to identify and realize aspirations, to satisfy needs, and to change or cope w the enviro
- health is a resource for everyday living
- health is a positive concept that emphasizes social and personal resources, as well as physical capacities.
what is included under the population health assumption “health pomotion includes, but is more than, disease prevention” (3)
- health promotion is the process of enabling individuals and communities to increase control over & improve their health
- focuses on achieving equity in health by providing equal opportunities and resources to enable people to achieve their optimum health potential
- health promotion actions deal w factors in social, economic, physical, and other enviros that affect the health of Manitobans
what is included under health promotion assumption “health promotion requires upstream thinking” (2)
- HP requires taking action on root causes of preventable diseases/injuries/health issues
- sometimes divided into “midstream” and “upstream” thinking
according to the health promotion assumption “health promotion is based on strong values”, what values is HP based on ? (4)
- social justice
- equity in health
- social responsibility for health
- the public/common good
different per country
define: harm reduction
- a philosophy and approach to healthcare delivery, programs, or policies, implemented with a goal to protect the health of, and reduce secondary harm for, individuals who engage in high risk actions that are associated w poor health outcomes
what is the goal of harm reduction (3)
- not cessation of the high risk behavior but rather to reduce the more immediate and related harms arising from engaging in that behavior
- protect health by reducing harm while recognizing the complex social issues that form the root causes of many high-risk behaviors
- promotes the health of the public as well as the individual
harm reduction (HR) us grounded in? (4)
- social justice
- equity
- public good
- social responsibility
what are the principles of primary health care (3)
- harm reduction
- PHC is a model of health care delivery
- PHC does not equal primary medical or nursing care
primary health care (PHC) is a model of…? what is it not?
- a model of health care delivery
- it is not primary medical or nursing care
define: PHC
- essential healthcare based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation, by means of acceptable to them, and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-raliance and self-determinants
PHC addresses…
- the main health problems of the community, providing promotive, preventive, curative, supportive, and rehabilitative services accordingly
PHC forms…
- an integral part both of the country’s health system, of which it is the central function and main focus, and of the overall social & economic development of the community
what is the first contact of individiduals?
- PHC –> it is the first lvl of contact of individuals, the family, and community with the national health system brining healthcare as close as possible to where people live and work, and constitutes the first element of continuing healthcare proces
define: primary care
- narrower concept that refers to a person-centered comprehensive approach (often biomedical) to care delivery at the point of entry into the healthcare system
what are the 5 key components of PHC?
- reducing exclusion and social disparities
- organizing health services around peoples needs and exception
- integrating health into all sectors
- pursuing collaborative models of policy dialogue
- increasing stakeholder participation
define: public health
- an organized activity of society to promote, protect, improve, and when necessary, restore the health of individuals, specified groups, or the entire population
public health is a combo of…
- sciences, skills, and values that function thru collective societal activities and involves programs, services, and institutions aimed at protecting and improving the health of all people
the term “public health” can describe…
- a way of thinking, a set of disciplines, an institution of society, and a manner of practice
public health has always been…
- decentralized & often invisible
what are goals of public health (3)
- enhance & optimize health status
- protect & promote health
- prevent disease & injury
what do public health nurses do (6)
- health protection
- health promotion
- population health assessment
- health surveilance
- disease and injury prevention
- emergency preparedness & response
public health nursing practice is _____ focused (6)
- population focused
- equity/social justice focused
- community as client & context
- health & prevention focused
- upstream focused
- empowerment focused
what are the 5 principles of PHC
- accessibility
- community participation in decision making (input from people)
- emphasis on health promotion and primary prevention
- use of appropriate technology with certain populations (ex. teens respond different to technology than older adults)
- intersectoral collaboration for health and social development (ex. education & health system)
what are the 8 WHO guiding principles of PHC
- education about health problems and prevention techniques
- promotion of food supply and proper nutrition
- adequate supply of safe water and basic sanitation
- maternal and child healthcare, including family planning
- immunization against major infectious diseases
- appropriate treatment of common diseases and injuries using the PHC principle of appropriate technology
-provision of essential drugs
define health
- a state of sound, body, mind, and spirit; a state of wholeness
- a state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity
what is the traditional euro-canadian understanding of health & healthcare?
- the biomedical model absence of disease & illness
what is the traditional understanding of health & healthcare in nursing?
- evolving, holistic human experience
anthropology added that health is bound within…
- the political, economic, and religious domains of society
define: sociology r/t health
- person-centered care mvmt added human capabilities (such as ability to use imagine) and senses to enjoy everyday experiences
- social factors & provider-client relationships
- integrating services to improve function, longevity, and access to quality care
how do community health nurses define health?
- as a resource for everyday life that is influenced y circumstances, beliefs, and determinants of health
- unique experience
define: health promotion
- process of enabling people to increase control over and to improve their health
health promotion states that to reach a state of complete physical, mental, and social well-being, and individual or group must be able to…
- identify and to realize aspirations, to satisfy needs, and to change or cope w the enviro
with health promotion, health is seen as…
- a resource for everyday life, not the objective of living
- a positive concept emphasizing social & personal resources, as well as physical capabilities
health promotion is the responsibility of…
- not just the health sector, but goes beyond healthy lifestyles to well-being
health promotion represents a comprehensive _____ and ____ process
- a comprehensive social and political process
health promotion not only embraces actions directed at strengthening the skills and cabilities of individuals, but also action towards…
- changing social, enviro, and economic conditions so as to alleviate their impact on public & individual health
describe the Indigenous perspective of health
- broader
- more holistic
- community focused lens
- wellness is achieved thru a balance of the body, mind, emotion, and spirit
- requires the family & community to work together
in the Indigenous perspective of health, good health is connected to…
- having a sense of community, personal identity, and the practice of cultural and spiritual traditions
what are the 3 models of health
- medical
- behavioral
- socioenvironmental
describe the biomedical perspective
- health is the absence of disease or disability
- focus on reducing physiological risk factors for disease & disability of individuals
what are examples of the biomedical perspective
-screening for risk factors
- immunizations
- pt education/counselling
- overdose reversal
- preventing infections
describe the behavioral model
- use of strategies that encourage the adoption of behaviors/lifestyles that promote ability & wellbeing
what are examples of the behavioral model
- health education & communication
- social marketing
- behavior modification
- regulatory measures
- lactation support
- eating well
- sex ed
- school health
- education about safe drug use, not sharing needles, finding veins
- education about spread of COVID, masks, social distancing
what are some critques of the behavioral model
- individuals need to be willing to change, motivated, recognize risks involves, risk of victim blaming
describe the socioenviro model
- based on 5 key principles of PHC (?)
what are examples of the socioenviro model
- ensure safe water supply
- access to resources
- global warming
- addressing structural racism & stigma
- impact of trauma on DNA
- social inequality
- poverty
- addressing crowded housing conditions that lead to increased risk of infection
define: population health promotion
- the process of taking action on the interrelated conditions that affect a population’s health to create healthy change
- focuses on the reduction of disparities that have an impact on health
define: home care
- wide range of health services delivered at home & throughout the community to recovering, disabled, chronically, or terminally ill persons in need of medical, nursing, social, or therapeutic treatment and/or assistance with the essential ADLs
home health nurses are committed to…
- the provision of accessible, responsive, and timely care which allows people to stay in their homes with safety & dignity
cultural competencies contribute to…
- reducing health inequities and improving health outcomes
in primary care we see an individual’s health. What plays a role in someone’s health in the “big picture” (15)
- values
- assumptions
- beliefs
- income & social status
- employment and working conditions
- biology and genetic endowment
- culture
- health services
- social support networks
- social enviro
- personal health practices & coping skills
- education
- physical enviro
- health child development
- gender
what are the categories of the population health model? (4)
- determinants (what?)
- action strategies (how?)
- lvls of action (who? to address SDOH)
- foundations (why?)
in the population health model, what are the 5 lvls of action
- society
- structural or system
- community
- family
- individual
in the population health model, what are the determinants (12)
-income & social status
- social enviro
- work & working conditions
- education
- social support networks
- genetic endowment
- personal coping skills
- health services
- healthy child development
- culture
- physical enviro
- gender
in the population health model, what are the action strategies (5)
- building healthy public policy
- strengthen community action
- create supportive enviro
- develop personal skills
- re-orient health services
in the population health model, what are the foundations based on?
- evidence based decision making
in the population health model, what are the foundations (5)
- research
- evaluation
- values
- experiential learning
- assumptions
according to the Ottawa Charter Logo, what are the 5 action areas to achieve health promotion
- strengthen community action
- develop personal skills
- create supportive enviro
- reorient health services
- build healthy public policy
according to the Ottawa Charter, what is meant by “building healthy public policy”
- involves creating policies that support health by protecting health of individuals and communities and making it easier for individuals to make healthy choices
ex. laws abt where can/can’t smoke
according to the Ottawa Charter, what is meant by “creating supportive enviro”
- creating enviros that support health
- create enviros that increase an individual’s ability to make healthy choices in those settings
- focuses on where people live, work, etc.
ex. decreased speed limits in school areas
according to the Ottawa Charter, what is meant by “strengthen community action”
- collective actions of the community to improve their health
ex. community kitchens that promote healthy eating
according to the Ottawa Charter what is meant by “reorienting health services”
- aims to make health systems focus on supporting the needs of individuals and communities
- changing from medical view to holistic view
according to the Ottawa Charter, what is meant by “develop personal skills”
- focuses on supporting personal and social development
according to the Ottawa Charter, what are the 3 strategies to health promotion
- mediate
- enable
- advocate
what is the continuum of interventions to address the DOH (3)
- upstream
- midstream
- downstream
what is meant by “upstream”
- addressing structural determinants of population health
- marco policy lvl
- focuses on diminishing root causes or causes-of-the-causes
- indirect intersectoral action
what are examples of upstream interventions for smoking (2)
- legislation to limit ability of tabacco companies to advertise or sell their products
- reducing social conditions that predispose people to smoke in the first place (poverty, unemployment, low education, social exclusion/marginalization)
what is mean by midstream
- addressing intermediate determinants of health, or material circumstances affecting population
- meso-lvl, community lvl
- changing causes
- direct public health action
what are examples of midstream interventions for smoking (4)
-smoking prevention programs in schools
- social marketing/media campaigns to communicate risks of smoking
- enforcing bans on sales of cigarettes to minors
what is meant by downstream
- meeting immediate health needs of individuals or populations
- micro lvl, individual/family lvl
- changing the effects of causes
- healthcare
what are examples of downstream interventions for smoking (2)
- smoking cessation therapy/techniques for individuals
- counselling individuals re healthy ways to deal w stress
what are examples of upstream versus downstream
(continuum, 1 = upstream , 6 = downstream, see diagram on slide 6)
1. social & structural determinants
2. living conditions
3. risk behaviors
4. disease and injury
6. mortality
what are examples of social & structural determinants (3)
- economic and social policies
- politics
- social identity stigmas
ex. racism, sexual stigma, gender identity stigma, ableism
what are examples of interventions for social & structural determinants (3)
- poverty reduction strategies
- decolonizing
- anti-racism policies
what are examples of living conditions that impact health (3)
- physical (housing, land, transportation, exposure to toxins)
- social (culture, discrimination, violence)
- economic & work enviro (employment, income, occupational hazards)
what are examples of interventions for living conditions
-culturally safe health & social services
- affordable and high-quality childcare
what are examples of risk behaviors that impact health (6)
- smoking
- poor nutrition
- low physical activity
- alcohol & substance use
- violence
- sexual behaviors
what are examples of interventions for risk behaviors (2)
- smoking cessation programs
- sexual health education
what are the 5 lvls of prevention
- primordial
- primary
- secondary
- tertirary
- quaternary
what is primordial prevention
- measures that alter societal structures and thereby change underlying DOH
ex. changing public policies, increasing minimum wage
what is primary prevention
- measures that alter exposures that lead to disease
- preventing people from getting sick
ex. immunizations, identifying risk factors, addressing them
what is secondary prevention
- measures that detect pathological process at an earlier stage when treatment can be effective
- determining whether someone is sick
ex. population-based screening, pap smear
what is tertiary prevention
- measures that prevent relapses and further deterioration
- focuses on limiting affect of disease & injury
ex. follow up care, rehab
what is quaternary prevention
- measures that identify people who are at risk for harms from overmedicalization
- preventing harm from the health system
ex. preventing polypharmacy, overdiagnosis
what is the etiologic phase
- a stimulus is produced within the host and balance is disrupted
what lvls of prevention apply to the etiologic phase (2)
- primordial
- primary
what is the pathogenesis phase
- reaction of the host to the stimulus
- biologic onset of disease –> onset of symptoms –> advanced disease –> recovery/rehab/death
what lvls of prevention are included in the pathogenesis phase (3)
- secondary, tertiary, and quaternary prevention
what lvls of prevention are included in health promotion
- all of them
see diagram in ppt on prepathogenesis and pathogensis
…
describe the health impact period: what are the 5 interventions from top of the pyramid to bottom? what does the top impact? bottom?
counselling & education –> clinical interventions –> long lasting protection interventions –> changing the context to make individuals default decisions health –> socioeconomic factors
- top factors = individual effort
- bottom = population impact
what kind of prevention is done when the person is not sick
- primary = health promotion & specific protection
what are examples of health promotion for when the person is not sick (6)
- replacing pop machines in elementary schools w water machines
- instead of handing out Halloween candy, giving out swimming passes
- advocating for low income and affordable housing
- regularly exercise bc its super fun & makes you feel awesome
- advocating for walking trails and rec areas
- healthy and safe activities for youth
what are examples of specific protecti9on for when the person is not sick (6)
- childhood immunization
- protecting the water supply of ur community
- disaster preparedness
- harm reduction for injection drug users such as using clean needles
- taking a back care program at work (teaching you how to move pts)
- blood & body fluid policy at work
what kind of prevention is done for when the person is sick but doesnt know it yet?
- secondary —> early diagnosis and prompt treatment
what are examples of early diagnosis & prompt treatment (6)
- pap tests
- screening diners at a restaurant who may have been exposed to hep A
- regular physical exam
- regular breast exam
- COVID screening clinic for people who had symptoms
- vascular risk assessment
what kind of prevention is done for when the person is sick?
- tertiary –> disability limitation
what are examples of disability limitation (6)
- treatment for cervical cancer
- treatment for hep A
- lumpectomy
- treatment for breast cancer
- CABG
- surgery to stabilize spinal cord injury
what kind of prevention is done for a person who is recovering
- rehab
what are examples of rehab (6)
- drug rehab after crystal meth addiction
- living well w hep C from drug using
- learning how to use O2 tank, now that you have COPD from smoking
- gradual return to work after radical mastectomy
- cardiac rehab (exercise & education)
- helping quadriplegics learn how to live w new limitations
see linda’s notes for historical milestones
…
what are prerequisites for health (9)
- peace
- shelter
- education
- food
- income
- stable ecosystem
- sustainable resources
- social justice
- equity
what are examples of empowerment strategies (5)
- individual empowerment
- small group development
- community organization/development
- coalition advocacy
- political action
what is the main hindrance to operationalizing PHC?
- lack of political will
how does health promotion differ from health education
- education focuses on knowledge deficits
- promotion = looking at the big picture, goal is not to increase knowledge, more difficult, hard to measure outcomes
what are limits to health education (6)
- language barrier
- lack of motivation
- time
- cultural background
- wanting to please the nurse = “lying”
- beliefs (abt health, need for screening if feeling fine)
what is the health concept of the biomedical approach?
- absence of disease or disability
what is the health determinant of the biomedical approach?
- physiological risk factors
ex. HTN
what is the target of the biomedical approach?
- primarily high risk individuals (bc of above risk factors)
what is the principal strategies of the biomedical approach? (3)
- screening for risk factors
- pt education & compliance for behavior change
- immunization
what is the program development of the biomedical approach?
- professionally mnged
what is the success criteria of the biomedical approach? (2)
- decrease in morbidity and mortality rates
- decrease in prevalence of physiological risk factors
what is the health concept for the behavioral approach
- physical-functional ability
- physical-emotional wellbeing
what is the health determinant for the behavioral approach
- behavioral risk factors
- lifestyle
ex. smoking
what is the target for the behavioral approach
- primarily high risk groups (bc of above factors)
what is the principal strategies for the behavioral approach
- social marketing
- regulatory measures and public policies support healthy lifestyle choices
ex. smoking ban
what is the program development for the behavioral approach (2)
- professionally managed
- or community based
what is the success criteria for the behavioral approach (3)
- decrease in behavioral risk factors
- improved lifestyles
- enactment of healthy public policies related to health behaviors
what is the health concept of the socio-environmental approach (2)
- goes beyong physical-emotional wellbeing to include social wellbeing at individual and community lvls
- may be viewed as a resource for daily living rather than a “state” of aspires to
what is the health determinants of the socio-environmental approach (2)
- psychosocial risk factors (ex. low self esteem)
- socio-environmental risk conditions (ex. poverty)
what is the target of the socio-environmental approach
- high risk conditions and enviros
what are the principle strategies of the socio-environmental approach (2)
- ottawa charter strategies
- empowerment strategies (personal empowerment, small group development, community development, advocacy for healthy public policy, political action)
what is the program development of the socio-environmental approach
- community development
what is the success criteria of the socio-environmental approach (4)
- improved personal perception of health
- improved social networks, quality of social support
- improved community group actions to create more equitable social distribution of power/resources
- enactment of healthy public polciies related to social equity and enviro sustainability
