communities 1 - 1st half

what we do collectively to assure the conditions in which people can be healthy

• it is a specialty b/c of the distinct focus and scope of practice
• population focus
• community oriented

assessment= data collection to monitor population health status

policy development= change in public policy in response to pop's health stat

assurance= make sure activities are begin carried out to meet those changes

group of people that have one or more personal/enviromental charateristic in common

• active, health promoting activities designed to reduce the risk of specific occurrences
• applies generally to healthy population
• precedes any disease or disfunction
• education is key

• early Dx and prompt Tx of illness
• involves efforst to detect and Tx existing health problems at earliest possible stage

screenings

Tx, care, and rehab to prevent further progression of disease in the individual as well as further into the population

population is already "sick"

Lillian Wald

Lina Rogers

based= based on direct hands-on care with individual or family

oriented= focused on the entire population

• community focused
• systems focused
• individual focuesd

changes community norms, attitudes, awareness, practices, and behaviors

changes organizations, policies, laws, and power structures

can usually make the biggest changes at this level

changes knowledge, attitude, beliefs, practices, and behaviors of individuals

• windshield survey
• gather existing data= get usable info about the community and it's health. (interveiws, questionaires)
• data generation= qualitative data observed or reported to the data collector. New data, usually not statistical
• compose database= organize data, determine deficits and strengths
• Problem analysis= ID and analyze problems

• Cardiac
• Cancer
• Cerebral vascular

Japan

white have inc CA Dx, but more black die from it

• 1. heart disease
• 2. Cancer= inc. age is thought to be primary reason

• lung
• breast
• colorectal

• c-section
• hysterectomy

• increases incidents in Somalia
• 4 types= 1-4, least invasive to most
• Done to infants through adults (common 4-12)

psychosocial= maintain virginity/fidelity during marriage and to dec sexual pleasure

social culture= to ID w/ cultural heritage, initiation into adulthood, grants access to land

hygenic/asthetic= vag is seen as unclean

spiritual reasons

• race
• imprisonment
• disabilities
• impoverished
•  -inc rates of depression, PTSD, substance use

exercise, then sleep, and food last

• heart disease
• cancer= lung, then prostate, tesicular (15-35 yrs old), and skin
• cerebrovascular disease
• chronic lower respiratory
• accidents

suicide= inc rate 15-35 and >65

• lung
• prostate

• climate is not male friendly b/c of the hours of operation
• access to health care
• lack of health promotion

• lifestyle and health behavior is primary
• past payment systems
• unnecessary use of service
• lack of preventative care
• technology advances
• shift from non-profit to for profit health care

care= for the elderly

caid= for the poor, children, pregant, and disabled

• joint state and federal venture
• eligibilty is based on family size and income

priority given to children, pregnant, and disabled

must be 65 or older

parts A-D

primarily cover inpatient and is generally free w/ a deductible (no monthly fee)

Outpatient w/ premium (fee) and deductable

cannot have B w/o A

• "medicare gap"
• covers what A and B do not
• premium and deductable

• prescription coverage
• premium and deductable

cannot have D w/o A

retro= pays back after care is given

pro= $ for prediction of agency cost for the coming year before care is given. It does not matter what care is actually given that year, they only get one amount

• insufficient funds
• physical barriers
• sociological barriers= language difficutlies and fear of reprisals