Name
Chamberlain University
NR-442 Community Health Nursing
Prof. Name
Date
Health promotion emphasizes proactive measures to maintain well-being rather than waiting for illness to occur. Key factors influencing health include nutrition, rest, and hygiene. Broader determinants encompass biology, behaviors, social environment, physical environment, policies and interventions, and access to quality health care.
To simplify:
Biology refers to genetics.
Behavior includes habits such as smoking, lack of exercise, and poor diet.
Social environment reflects support systems, social engagement, and discrimination.
Physical environment covers housing and transportation.
Policies and interventions operate at various levels to improve population health.
Access to health care is crucial in reducing disparities.
A mnemonic often used is “But Brittney Says Please Pay Access” to recall these categories. Another mnemonic is “Every Person Enjoys Free Cable Hookups”, representing economic stability, physical environment, education, food, community/social context, and the health care system.
There has been a significant shift from curing illness to preventing it. Several models guide health promotion practice:
Pender’s Health Promotion Model (HPM): Explores biopsychosocial factors that encourage individuals to pursue healthy behaviors.
Health Belief Model (HBM): Examines how individuals perceive their own health and risks.
Transtheoretical Model (TTM): Integrates self-efficacy and processes of change, recognizing that people resist change because it can be uncomfortable or unpleasant. Stages include pre-contemplation, contemplation, preparation, action, maintenance, and termination.
Theory of Reasoned Action (TRA): Assumes behavior is determined by a person’s intentions.
Risk factors can be divided into:
Modifiable (e.g., lifestyle behaviors)
Non-modifiable (e.g., genetics, age)
It is also important to distinguish between serving size (standard measurement, e.g., 1 cup) and portion size (amount consumed).
Policy refers to a course of action adopted by governments, businesses, or institutions to achieve desired outcomes. Public policy involves principles and standards created by governmental bodies and is of general public concern.
Health policy outlines goals in health care and strategies for achieving them.
Nursing policy emphasizes leadership roles that shape health policy and practice.
Institutional policies guide operations, workplace standards, and employee treatment.
Social policy relates to individuals and communities.
Laws represent rules of conduct derived from legislation, judicial rulings, constitutional interpretations, and administrative actions. Public health law addresses legal concerns in public health practice, mainly in three areas: police power, disease/injury prevention, and population law. Statutes are formal laws enacted at federal, state, or local levels.
Different organizations and professional associations establish and enforce standards to protect professional and public interests. Medicaid eligibility depends on income and family size.
The U.S. government functions through three branches:
| Branch of Government | Role in Health Policy |
|---|---|
| Legislative | Enacts statutory laws |
| Executive | Enforces laws through regulatory agencies |
| Judicial | Protects against malpractice, fraud, and abuse |
Additionally, nurses play a vital role in policy because 1 in 44 women voters are nurses, making their influence significant in legislative and political arenas.
The health care system consists of both private subsystems (focused on individual care) and public health systems (aimed at population health). This dual approach highlights the balance between personal health needs and collective public health concerns.
Health care economics largely centers on Medicare and Medicaid. Medicare has four distinct parts:
| Medicare Part | Coverage |
|---|---|
| Part A | Hospital insurance |
| Part B | Primary and outpatient care, out-of-pocket expenses |
| Part C | Vision, hearing, dental, and gap coverage |
| Part D | Prescription drugs |
Medicaid, by contrast, provides coverage based on income and family size.
Environmental health addresses external factors that affect health. One example is Sick Housing Syndrome, where living environments contribute to symptoms like headaches, fatigue, and allergies.
The IPREPARE model is a framework for environmental health assessment:
| Letter | Meaning |
|---|---|
| I | Investigate potential exposures |
| P | Present work |
| R | Residence |
| E | Environmental concerns |
| P | Past work |
| A | Activities |
| R | Referrals and resources |
| E | Educate |
Stanhope, M., & Lancaster, J. (2020). Public Health Nursing: Population-Centered Health Care in the Community (10th ed.). Elsevier.
U.S. Department of Health and Human Services. (2022). Healthy People 2030. https://health.gov/healthypeople
Centers for Medicare & Medicaid Services (CMS). (2023). Medicare and Medicaid basics. https://www.cms.gov
