(EDAPT WEEK 1)
Community Health Nursing
,COMMUNITY HEALTH EDAPT WEEK 1 NOTES
NR 442
Community health nursing is a population-focused approach to planning, implementing,
and evaluating care in a wide variety of settings for clients across the lifespan and from
diverse backgrounds.
The major goal is to preserve the health of the community by focusing on health promotion
and the health maintenance of individuals, families, and groups within the community. The
focus shifts from illness and episodic response to health and identification of at-risk
populations.
The health status of populations across the United States varies greatly, reflecting the
severe disproportion of funding for preventative services and social and economic
opportunities.
Health is a state of complete physical, mental, and social well-being. Community is a
group of individuals that share a geographic location, common interests, characteristics,
values, and goals while population is a group of people with common personal or
environmental characteristics.
What is included in the scope of public health? The following are all components of
public health:
Living conditions
Environmental sanitation
Personal hygiene education
Preventative care
Policy development
Control of communicable infections
The five primary causes of premature death in adults in the United States include heart
disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries.
The World Health Organization defines health as a "state of complete physical, mental,
and social well-being and not merely the absence of disease or infirmity" (Nies & McEwen,
2019). The word "social" in this definition is essential. Social health indicates community
strength resulting from group collaboration to prevent illness and promote health.
Considering this social context, health depends on the goals and performance of
individuals, families, communities, and societies.
Public health is the science of protecting and improving the health of communities through
organized community effort. This is achieved by:
, promoting healthy lifestyles through education, outreach, and policy
recommendations
researching disease and injury prevention
detecting, preventing, and responding to infectious disease
Community is a group of individuals that share a geographic location, common interests,
characteristics, values, or goals
Population is used to define a group of people with common personal or environmental
characteristics or a group within a defined community (Nies & McEwen, 2019). Aggregates
are subpopulations or subgroups with some shared characteristics or concerns .
According to the Centers for Disease Control and Prevention (2020), public health is the
science of protecting and improving the health of communities through organized
community effort achieved by promoting healthy lifestyles through education and policy
recommendations, preventing injuries, and detecting, preventing, and responding to
illnesses (CDC, 2020).
Community and public health nursing can be traced as far back as Florence Nightingale,
as she used a community assessment to implement a statistical method to meet the needs
of the community (Nies & McEwen, 2019). This holistic approach to caring for communities
was not formally established until the late nineteenth and early twentieth centuries (Nies &
McEwen, 2019), so Nightingale’s work was truly visionary. District nursing was established
in England where nursing care was delivered to disadvantaged families, and public health
in the United States was developed from this model.
Social determinants of health such as access to healthcare, socioeconomic status,
environmental issues, and cultural practices greatly influence today’s community health
nursing practice. In order to provide effective care, the nurse must understand the factors
that affect an individual’s health. Community health nursing is population-focused, quality-
driven, and science-based way to inform, prevent, and protect the population served.
Public health is the science and art of (1) preventing disease, (2) prolonging life, and (3)
promoting health and efficiency through organized community effort for:
sanitation of the environment,
control of communicable infections,
education of the individual in personal hygiene,
organization of medical and nursing services for the early diagnosis and
preventative treatment of disease, and
development of the social machinery to ensure everyone a standard of living
adequate for the maintenance of health, so organizing these benefits as to enable
every citizen to realize his birthright of health and longevity” (Nies & McEwen, p. 6).
Determinants of health
, The health status of the community depends on many factors, including individual
determinants, social determinants, economic and cultural conditions, and health services
and policy. The nurse must understand determinants of health and recognize the influence
of these factors on disease, death, and disability.
Annually, approximately one million Americans die prematurely from the five leading
causes of death: heart disease, cancer, chronic lower respiratory diseases, stroke, and
unintentional injuries (Centers for Disease Control and Prevention, 2014). However,
according to the Centers for Disease Control and Prevention, up to 40% of these deaths
could be prevented (CDC, 2014). Biology and behaviors work together to influence health,
but modifiable risk factors are largely responsible for each of the leading causes of death.
Personal behavioral changes could minimize many of these risks. Others are due to
disparities attributed to social, demographic, environmental, economic, and geographic
conditions of the community. If health disparities were mitigated or eliminated, all states
would be closer to achieving the lowest rates possible for the leading causes of death (CDC,
2014). According to the Office of Disease Prevention and Health Promotion, Healthy People
2030 represents a tangible, measurable plan for all people to achieve health and well-being
by 2030.
Determinants of Health
Individual Determinants
age
gender
diet
physical activity
substance use
family health history
Social Determinants
social norms and attitudes
exposure to media and emerging technologies
socioeconomic conditions
quality schools
transportation options
public safety
residential segregation
General Socioeconomic, Cultural, and Environment Conditions
agriculture and food production
education
work environment
unemployment
water and sanitation
healthcare services