POPULATIONS AS THE FOCUS OF COMMUNITY HEALTH NURSING

DEFINING POPULATIONS - 1 § Population: the general public or society or a collection of communities. § Aggregates: populations with some common characteristic who frequently have common concerns, but may not interact with each other to address those concerns.

DEFINING POPULATIONS - 2 § Community: a group of people who share common interests, who interact with each other, and who function collectively within a defined social structure to address common concerns. § Neighborhood: a smaller, more homogeneous group than a community that involves interaction and a level of identification with others living near-by

TYPES OF COMMUNITY § Geopolitical communities: communities characterized by geographic and jursidictional boundaries. § Community of identity: communities with a common identity and interests

DEFINING POPULATION HEALTH §The attainment of the greatest possible biologic, psychological, and social well- being of the population as an entity and of its individual members.

CHARACTERISTICS OF HEALTHY POPULATIONS - 1 § Provide a healthful physical environment § Maintain a stable ecosystem § Comprise a strong, supportive, non- exploitive membership § Provide for extensive participation in decision making §Provide for members’ basic needs

CHARACTERISTICS OF HEALTHY POPULATIONS - 2 § Provide access to resources and opportunities for interaction § Sustain a vital economy § Maintain connectedness with their cultural and biological heritages § Provide governance structures that promote health

CHARACTERISTICS OF HEALTHY POPULATIONS - 3 § Provide appropriate and accessible services for all members § Display strong positive health indicators and low incidence of health problems § Displays the ability to adapt to changing conditions and circumstances

CHARACTERISTICS OF HEALTH POPULATIONS - 4 § Create a shared vision for future development § Celebrate diversity among members § Periodically assess needs and assets § Create a sense of group responsibility and belonging in members § Deal effectively with conflict among members

PUBLIC HEALTH PRACTICE § “What we, as a society, do to assure the conditions in which people can be healthy.” (Institute of Medicine, 1988).

CORE FUNCTIONS OF PUBLIC HEALTH § ASSESSMENT § POLICY DEVELOPMENT § ASSURANCE

DEFINING THE CORE FUNCTIONS § Assessment: monitoring the occurrence of health-related problems within the population as well as identifying factors that contribute to, or prevent, those problems.

DEFINING THE CORE FUNCTIONS § Policy development: advocacy and political action to develop local, state, and national policies conducive to population health.

DEFINING THE CORE FUNCTIONS § Assurance: the responsibility of the public health sector to assure availability of and access to health care services essential to sustain and improve the health of the population.

OUTCOMES OF PUBLIC HEALTH PRACTICE § HEALTH PROMOTION § HEALTH PROTECTION § ILLNESS PREVENTION

DEGINING OUTCOMES OF PUBLIC HEALTH PRACTICE § Health promotion: activities designed to promote the overall health of the population, “a process of enabling individuals and communities to increase control over the determinants of health, partly through political actions, to create a healthier environment.” (World Health Organization, 1984).

DEFINING OUTCOMES OF PUBLIC HEALTH PRACTICE §Health protection: minimization of health risks arising from the environment. §Illness prevention: activities designed to prevent the occurrence of specific health problems

LEVELS OF PREVENTION § PRIMARY PREVENTION § SECONDARY PREVENTION § TERTIARY PREVENTION

DEFINING THE LEVELS OF PREVENTION - 1 § Primary prevention: Action taken prior to the occurrence of health problems and directed toward avoiding their occurrence. Primary prevention includes health promotion, health protection, and illness prevention.

DEFINING THE LEVELS OF PREVENTION - 2 § Secondary prevention: The early identification and treatment of existing health problems. § Tertiary prevention: Activity aimed at returning the client to the highest level of function and preventing further deterioration in health.

CHANGES IN NATIONAL OBJECTIVES - 1 Overall Goal § 1990: Reduce mortality § 2000: Increase the span of healthy life Reduce disparities in health status among groups Achieve access to preventive health for all § 2010: Increase quality and years of healthy life Eliminate disparities in health status among groups

CHANGES IN NATIONAL OBJECTIVES -2 Objective categories 1990: Preventive health objectives Health protection objectives Health promotion objectives 2000: Health status objectives Risk reduction objectives Services and protection objectives 2010: Objectives promoting healthy behaviors Objectives promoting healthy and safe communities Objectives to improve systems for personal and public health Objectives to prevent and reduce diseases and disorders

CHANGES IN NATIONAL OBJECTIVES - 3 Focus areas § 1990:15 priority areas designated § 2000:22 priority areas designated § 2010:28 focus areas designated

CHANGES IN NATIONAL OBJECTIVES - 4 Number of Objectives Addressed § 1990: 226 objectives identified § 2000: 319 objectives identified § 2010: 467 objectives identified

CHANGES IN NATIONAL OBJECTIVES - 5 Other changes § 2000: Lead agencies identified Emphasis on quality of life as well as longevity Special attention to high-risk groups Emphasis on access to services Baseline data provided

CHANGES IN NATIONAL OBJECTIVES - 6 Other Changes (cont.) § 2010: Widespread input in development Designation of leading indicators Single target for each objective Included developmental objectives Common structure for each focus area Standard table for reporting progress

Figure 1–1 A Systematic Approach to Health Improvement Source: U.S. Department of Health and Human Services. (2000). Healthy people 2010: Understanding and improving health (2nd ed.). Washington, DC: Author.