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aggregate

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population subgroup in a community made up of people who share one or more common characteristics

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census tract

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population boundary that subdivides larger communities and is used expressly for data collection and population assessment by the US Bureau of the Census

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community diagnosis

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consists of four components: identification of the health problem/risk aggregate or community affected etiological or casual statement evidence or support for the diagnosis

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community health

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organized efforts for health at the community level through both government and private efforts, including private agencies supported by private funds, such as the American Heart Association or the Red Cross

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community health nursing

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the provision of nursing service to the community or population as a wholeñ

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community of solution

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individuals coming together because of a common problem

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conservative scope of practice

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framework that focuses its energies exclusively on intrapatient and nurse-patient factors

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critical theoretical perspective

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uses societal awareness to expose social inequalities that keep people from reaching their full potential

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disease prevention

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efforts to protect persons from disease and its consequences

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district nursing

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Stemmed from public health nursing and was developed in England. The community was separated into districts, each with a nurse and social worker who met the needs of those in the district. William Rathbone.

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Edward Jenner

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In 1796, he observed that people who worked around cattle were less likely to have small pox. He discovered that immunity to smallpox resulted from an inoculation with the cowpox virus.

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Edwin Chadwick

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Called attention to the consequences of unsanitary conditions in Liverpool in 1842 that resulted in health disparities that shortened the life span of the laboring class in particular.

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Elizabethan Poor Laws

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Exacted in England in 1601, held the church parishes responsible for providing relief for the poor. This law governed health care for the poor for more than two centuries and became a prototype for later US laws.

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Flexner Report

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Outlined, in 1910, the shortcomings of US medical schools that did not use the German model that promoted medical education on the principles of scientific discovery.

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health

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a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

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health belief model (HBM)

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theoretical approach based on the premise that it is the world of the perceiver that determines what one will do

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health visiting

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enlisted home visitors in Manchester in 1862 to distribute health information to the poor

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health promotion

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efforts or activities aimed at improving well-being

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Healthy Cities and Healthy Communities

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A movement whose purpose is to help community citizens bring about positive health changes in their communities; stresses that interconnectedness among people and among public and private sectors is essential for a communities to address causes of poor health.

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House on Henry Street

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Nurses Lillian Wald and Mary Brewster established this district nursing service on the Lower East Side of New York City in 1893.

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Joseph Lister

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Observed the healing processes of fractures. When the bone was broken, but the skin was not, he noted that recovery was uneventful. However, when both the bone and the skin were broken, fever, infection, and even death were frequent. He found that something outside the body entered the wound through the broken skin causing the infection. His surgical successes eventually improved when he soaked the dressings and instruments in mixtures of phenol and oil.

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John Snow

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Demonstrated that cholera was transmissible through contaminated water in 1845.

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Lemuel Shattuck

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A Boston bookseller and publisher with an interest in public health who organized the American Statistical Society in 1839 and issues a Census of Boston in 1845.

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Lilian Wald

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Early twentieth-century community health nurse and political activist who recognized the connections between health and social conditions. She was a driving force behind the federal government's development of the Children's Bureau in 1912.

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Louis Pasteur

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Proposed the existence of germs while experimenting with wine production in 1845.

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macroscopic

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Perspective that examines interfamily and intercommunity themes in health and illness. Delineates factors in the population that perpetuate the development of illness or foster the development of health.

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metropolitan statistical areas

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large metropolitan areas that consist of a central city with more than 50,000 people and include the associated suburban or adjacent counties, which yields a total metropolitan area with more than 100,000 people

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microscopic

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perspective that examines individual (and sometimes family) responses to health and illness

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Milio's framework for prevention

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outlines six propositions that relate the ability of an individual to improve healthful behavior to a society's ability to provide options for health choices that are both accessible and socially affirming

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needs assessment

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collection of data about a community's health status, concerns, and services they use or require

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population

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a group of people having common personal or environmental characteristics; can also refer to all of the people in a defined community

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population-focused nursing

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nursing practice that concentrates upon specific groups of people, focusing on health promotion and disease prevention, regardless of geographic location

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primary prevention

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Activities directed at preventing a problem before it occurs by altering susceptibility or reducing exposure for susceptible individuals. It consists of two elements: general health promotion and specific protection.

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public health

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organized efforts made through governmental agencies such as health departments, which are authorized by legislation, serve all people, and are supported by taxes

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public health nursing

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a synthesis of public health and nursing practice

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Robert Koch

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a nineteenth century scientist who discovered the causative agent for cholera and the tubercle bacillus (for tuberculosis)

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sanitary revolution

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a period in the nineteenth century when a link was established between microorganisms and infectious disease

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secondary prevention

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Early detection and prompt intervention during the period of early disease pathogenesis. It is implemented after a problem has begun, but before signs and symptoms appear and targets those populations who have risk factors.

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self-care deficit theory

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Theory based on the assumption that self-care needs and activities are the primary focus of nursing practice. Nursing is a response to a sick person's inability to administer self-care.

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social system

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interacting members making up various subsystems within the community which provide embers with socialization, role fulfillment, goal achievement, and support

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stages in disease history

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hunting and gathering stage settled villages stage preindustrial stage industrial cities stage present stage

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tertiary prevention

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Targets populations who have experienced disease or injury and focuses on limitation of disability and rehabilitation. Aims of tertiary prevention are: to keep health problems from getting rose, to reduce the effects of disease and injury, and to restore individuals to their optimal level of functioning.

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theory

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a set or system of concepts that provide a way of structuring or explaining phenomena

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upstream thinking

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orientation to viewing a problem which emphasizes variables that precede or play a role in the development of health problems

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vital statistics

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the official registration records of births, deaths, marriages, divorces, and adoptions

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windshield survey

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survey by driving through a community and making observations in an organized fashion

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market justice

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you get what you can afford

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social justice

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entitles all people to basic necessities (adequate income/health protection)

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goal of Health People 2020

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increase quality and years of health life eliminate health disparities

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Public Health Intervention Wheel

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helps to identify and define public health interventions is population based has levels of practice (community/systems/individual and family)

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endemic

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diseases that are always present in a society (ex. colds/pneumonia)

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epidemic

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diseases that are not always present but flare up occasionally

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pandemic

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diseases in large proportion of the population (ex. HIV/AIDS)

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Florence Nightingale

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helped British soldiers in the Crimean War concern for environmental determinants of health established nursing education emphasis on sanitation, community assessment, and analysis use of graphically depicted stats and gathered census data political advocate for population

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modifiable risk factor

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patient has control over the severity and can change their susceptibility of these (poor diet/obesity/sedentary lifestyle)

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non-modifiable risk factor

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patient has no control over the severity (gender/age/family history)

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Public Health Core Functions

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assessment policy development assurance

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epidemiology

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Provides broad understanding of the spread, transmission, and incidence of injury and disease. Relies on statistical evidence to determine the rate of spread of disease and the proportion of people effected.

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person-place-time model

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identifies all factors involved in health and determines which factors are more at risk

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epidemiological triangle

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states that disease is dependent on exposure of the host to the agent, strength of the agent, and environmental conditions at the time

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descriptive epidemiology

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focuses on the amount and distribution of health and health problems within a population; person-place-time model

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analytic epidemiology

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investigates the causes of disease by determining why a disease rate is lower in one population group than another (observational, cross sectional, retrospective, and prospective studies and environmental design)

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observational studies (analytic epidemiology)

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descriptive purposes etiology of disease

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cross-sectional studies (analytic epidemiology)

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sometimes called prevalence or correlational studies examine relationships between potential causal factors and disease at a specific time

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retrospective studies (analytic epidemiology)

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compare individuals with a particular condition or disease with those who do not have the disease

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prospective studies (analytic epidemiology)

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monitor a group of disease-free individuals to determine if and when disease occurs

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experimental design (analytic epidemiology)

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to test treatment and prevention strategies also useful for investigating chronic disease prevention

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health determinants

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biology (genetics; family history; physical/mental health problems) behaviors (response to individual stimuli/external conditions) social environment (interactions/relationships in community) physical environment (things smelled/seen/touched/heard/tasted) policies/interventions access to quality health care

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stages of the natural history of disease

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prepathogenesis period (primary prevention) pathogenesis period (secondary and tertiary prevention)

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screening

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identify risk factors and diseases in the earliest stages

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surveillance

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ongoing collection of community health information

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