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by: Dasia blackmon


Dasia blackmon
GPA 3.2
Principles of Community Health
Erica Danielee Payton (P)

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About this Document

This a study guide for Principles of Community Health. This study guide has all the basic information that is needed to score well on the midterm exam. I also sectioned it so that you know what cha...
Principles of Community Health
Erica Danielee Payton (P)
Study Guide
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This 13 page Study Guide was uploaded by Dasia blackmon on Sunday October 25, 2015. The Study Guide belongs to HSC 180 - 1 at Ball State University taught by Erica Danielee Payton (P) in Fall 2015. Since its upload, it has received 103 views. For similar materials see Principles of Community Health in Nursing and Health Sciences at Ball State University.

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Date Created: 10/25/15
o HSC 180 MIDTERM STUDY GUIDE Chapter 8 Adolescents Young Adults and Adults Demography Adolescents and young adults 1024 0 Adults 2564 0 Years between 10 and 64 some of the most productive years of people s lives Number of adolescents and young adults 0 In 2010 over 15 of US population 0 In 2012 55 of adolescents were nonHispanic white 0 Living arrangements 0 In 2010 gt 14 lived in single parent families 0 Variations by race and ethnicity 0 Number of adolescents and young adults 0 In 2010 over 15 of US population 0 In 2012 55 of adolescents were nonHispanic white 0 Living arrangements 0 In 2010 gt 14 lived in single parent families 0 Variations by race and ethnicity 0 Employment status and health care access 0 Participation in labor force has remained fairly constant in recent decades 0 Disparities by race and ethnicity 0 Employment status impact on access to health insurance health care Mortality Adolescents and Young Adults Significant decline in death rates over past several decades mostly due to advances in medicine and injury and disease prevention Male mortality rate higher than female Unintentional injuries 42 homicide 16 suicide 16 0 Significant racial disparities among race and leading causes of death Morbidity Adolescents and Young Adults Communicable diseases 0 Measles immunizations important Sexually transmitted diseases This age group acquires nearly half of all new STDs in the US Some effects can last a lifetime Health Behaviors of High School Students Unintentional injuries Violence Tobacco use Alcohol and other drugs Sexual behaviors unintended pregnancies and STDs Physical activity and sedentary behaviors Overweight and weight control Health Behaviors of College Students Unintentional injuries Violence Tobacco use Alcohol and other drugs Sexual behaviors unintended pregnancies and STDs Protective Factors Protective factors individual or environmental characteristics conditions or behaviors that reduce the effects of stressful life events increase the ability to avoid risks or hazards and promote social and emotional competence Examples community service Adu s Ages 2564 Represent more than half of US population Health Pro le Mortality Many associated With unhealthy behaviors and poor lifestyle choices Lifestyle improvements and public health advances have led to decline in death rate for adults Cancer 1 cause of death for adults ages 4564 Males prostate lung and colorectal 0 Females breast lung and colorectal Cardiovascular Diseases Ageadjusted mortality rates dropped over past 60 years Mainly due to public health efforts related to smoking cessation increased physical activity and nutrition Health Behaviors Risk factors for chronic disease 0 Most significant for adults smoking lack of exercise BMI alcohol Risk factors for personal injury 0 Motor vehicle safety seatbelts and alcohol use Awareness and screening of certain conditions 0 Hypertension diabetes cholesterol Top Chronic Diseases that lead to deaths in the United States Overall rates 0 Heart Disease Cancer Diabetes Type 2 Three interrelated risk factors 0 Lack of exercise 0 Failure to maintain an appropriate body weight 0 Alcohol and tobacco consumption Public Health Prevention amp Intervention What can we do 1 Improve nutrition in schools work with school boards to change the food and snacks available to kids in school 2 Increase physical activity in schools introduce during andor after school activities sponsor teams contests or clubs that will get kids outdoors or into the gym 3 Health education Kids need to know Why good eating habits and physical exercise are important Crucial for adult understanding and practice of healthy lifestyles Why is obesity a problem in the United States Social Determinants of health 0 The circumstances in which people are born grow up live work and age and the systems put in place to deal with illness These circumstances are in turn shaped by a wider set of forces economics social policies and politics 0 Determinants of health Socioenviromental or context Psychosocial or behavioral Biophysiological Inequities in health health care services education neighborhoods employment opportunities Community Health Strategies Role of individual behavior social factors environmental factors and previous in uences on their health across lifespan 0 Primary secondary and tertiary prevention efforts for adults 0 Primary exercise and nutrition programs Secondary self and clinical screenings to identify and control disease processes 0 Tertiary medication compliance Chapter 9 Older Adults in the United States Introduction Older Adults 65 represent 131 of population in US 0 l in every 78 Americans 0 By 2030 20 of US population 0 Young old 6574 0 Middle old 7584 Old old 85 0 Fastest growing segment of population Significant growth in median age in US Factors Affecting Population Size and Age 0 Fertility rates 0 Baby boomers 19461964 0 Mortality rates Life expectancy has continued to increase significant increase in 20th century Symbolic Age Pyramid Olvd old III IC real 5 ing age and Idlecreasing n u m hers I Middle old 7 1397qu rig mild 7 FIG U RE 94 Symbolic age pyramid Older Adults and Community Health Needs of populations of people impacted by age Community and social services impacted by age Instrumental Needs 0 Determine lifestyle for people of all ages 0 Aging process can alter needs in unpredictable ways 0 Income Housing 0 Personal care 0 Health care 0 Transportation Community facilities and services Demographic Variables Affect community health programs for older Americans Marital status Racial and ethnic composition Education Economic status Geographic distribution Living arrangements Housing Educann Percentage of elders Who completed high school 28 in 1970 795 in 2010 Just over 22 of elders had a bachelor s degree or higher in 2010 Differences by race and ethnicity Baby boomers most educated cohort in US history Economic Status Poverty 0 1970 25 of elders lived in poverty 0 2010 9 lived in poverty Unmarried women and minorities highest rates of poverty Major sources of income Social Security reported by 90 0 Income from assets reported by 53 0 Private pensions reported by 28 Gov t employee pensions reported by 14 0 Earnings reported by 26 Income Change in types of expenses in elder years Achieving elder status often reduces income needs Income has improved significantly in recent years Social Security is major source of income Geographic Distribution More than half live in 11 states CA FL NY TX PA OH IL MI NC NJ GA CA greatest number FL greatest proportion Reasons some states age 0 Inward migration FL young people leave farm belt states 79 of elders live in metropolitan areas Living Arrangements and Housing Closely linked to income health status and availability of caregivers Most live in adequate affordable housing 80 own 20 rent For owners housing represents an asset Homes tend to be older lower value in greater need of repairs Women more likely to live alone Only 4 of elders live in nursing homes of nursing home residents are women 0 More than half of nursing home residents are 85 Major needs appropriateness accessibility adequacy affordability Changing residence can have negative effects Variety of housing options available 0 Independent living 0 Assisted living Continuing Care Retirement Communities Nursing HomesSkilled Nursing Facilities 0 Affordable Housing Health Pro le of Elders Health status of elders has improved over the years living longer and functional health Chronically disabled has been decreasing Health status usually not as good as younger counterparts Mortality and Morbidity Top causes of death for elders 23 of deaths 0 Heart Disease Cancer CLRD Stroke Alzheimer s Disease Activity limitations increase with age Chronic conditions Substantial burden on health and economic status of individuals families and nation Impairments Very prevalent in older adults sensory physical memory Health Behaviors and Lifestyle Choices Generally have more favorable health behaviors than younger counterparts Less likely to consume large amounts of alcohol smoke cigarettes or be overweight Areas for improvement 0 Physical Activity Nutrition Obesity Vaccinations Health Ca re Elders heaviest users of health care services Use of health care services increases With age Most money spent on health care is in last years of life Medicare primary source of payment for health care services of elders 0 Will see major changes in future years Personal Care Four levels of tasks that may need assistance 0 Instrumental tasks expressive tasks cognitive tasks tasks of daily living Activities of daily living ADLs measure functional limitations Instrumental activities of daily living IADLs measure more complex tasks Elder Abuse and Neglect Reports have increased greatly in recent years All states have set up reporting systems Special problem for elders May be frail Unable to defend themselves Vulnerable to telemarketing and mail scams Most common victims of theft of benefit checks Ca re 9 ive rs 0 Caregivers for elders face number of problems 0 Increased financial burden lack of privacy demands on time and energy 0 Need for personal care and paying for longterm care services for elders is projected to increase in coming years 0 National Family Caregiver Support Program Eldercare support for working caregivers a growing concern Transportation Transportation allows elders to remain independent On average elders live 10 year after they stop driving Greatest in uence on transportation needs Income and health status Many public transportation challenges Solutions for transportation needs of elders Community Facilities and Services Older Americans Act of 1965 OAA to increase services and protect rights of elders National nutrition programs for elders State Departments on Aging and Area Agencies on Aging Other programs Services can vary greatly across the country Meal service Homemaker service Chore and home maintenance Visitor service Adult day care Respite care Home health care Senior centers Other services Chapter 11 Community Mental Health Stress A Contemporary Mental Health Problem Stress one s psychological and physiological response to stressors Stressors General adaptation syndrome Fight or ight reaction Diseases of adaptation Experts recommend combination of physical social environmental and psychological approaches to managing stress Causes of Mental Disorders Symptoms can arise from various causes 0 Poor prenatal care postnatal environment genetics environmental factors brain function impairment substance abuse maladaptive family functioning stress Introduction 0 Mental Illnesses leading cause of disability in North America and Europe 0 20 of American adults have diagnosable mental disorders during a given year 0 Only 38 receive treatment 0 Needs of people With mental illnesses diverse 0 Services required to meet needs include therapeutic and social services De n itio n 0 Mental health Emotional and social wellbeing including one s psychological resources for dealing With dayto day problems of life 0 Mental illness 0 all diagnosable mental disorders 0 Mental disorders 0 Health conditions characterized by alterations in thinking mood or behavior associated With distress andor impaired functioning Good Mental Health 0 Adults With good mental health are able to 0 Function under adversity 0 Change or adapt to changes around them 0 Maintain control over their tension and anxiety 0 Find more satisfaction in giving than receiving 0 Show consideration for others 0 Curb hate and guilt 0 Love others Mental Illness in the United States 0 One of nation s most pervasive health problems 0 Indicators of mental illness problem in US 0 High rates of alcohol tobacco and other drug use History of Mental Health Care in the United States Response to mental illness characterized by periods of enthusiastic reform followed by periods of Widespread ambivalence Mental Health Care before World War II 0 Colonial America people With mental illness cared for by families or private caretakers 0 Institutionalization first appeared in 18th century 0 Population growth led to institution growth 0 Harsh treatments and unpleasant conditions The Moral Treatment Era Began in 1792 Belief that environmental changes can affect the mind and alter behavior 0 Move people from settings causing life stressors into rural peaceful setting Appeared to have success and became widely acceptable The State Hospitals Supposed to provide therapeutic environment based on close personal relationships between patients and welltrained staff Deterioration of services occurred as chronic nature of mental illness was discovered long term or lifetime stays were the norm Maximum capacities quickly reached personalized care lost restraints became more practical staff turnover high 1940 population in state mental institutions was nearly a half million Staff case loads so large only subsistence care possible 0 Electroconvulsive Therapy ECT introduced in response Lobotomies practiced 0 Appearance of new medications in 1950s made widespread use unnecessary Mental Health Care after World War II National Institute of Mental Health NIMH established To foster and aid research related to cause diagnosis and treatment of neuropsychiatric disorders 0 To provide training and award fellowships and grants for work in mental health To aid states in the prevention diagnosis and treatment of neuropsychiatric disorders Deinstitutionalizing discharging of thousands of patients from state mental hospitals Propelled by economics idealism legal considerations and antipsychotic drugs Community Mental Health Centers Mental Retardation Facilities and Community Mental Health Centers Act Community mental health centers fully staffed centers originally funded by the federal government providing comprehensive mental health services to local populations 0 Five core services pg 349 Inpatient care Outpatient services 0 24 hour a day emergency care Day treatment or other partial hospitalization services Consultation and education Problem of transinstitutionalization Community Support Program Mental Health Care Concerns in the United States Today Experiences of people With serious mental illness has improved significantly in past 50 years Challenges remain How to provide services to the homeless Changing perception that mental illness is linked to extreme violence Resolving problems of those with mental illness who are incarcerated Homelessness 21 million adults experience homelessness over the course of a year 80 temporarily homeless 10 episodically homeless 10 chronically homeless About half of all homeless adults have substance use disorders major depression and other cooccurring mental illness Successful interventions include provision of housing and services they need Mental Illness and Violence Extreme Violence rare in people With mental disorders 0 Much of risk attributable to comorbid factors What should be done to prevent Violence is unclear Constitutional issues related to individual freedoms privacy and other rights Mental Health Care in Jails and Prisons More than half of all prison and jail inmates have mental health problems Correctional facilities designed to confine and punish not to treat disease Lack space adequate number of qualified treatment personnel and timely access to services Once released back into community more likely to commit crime if untreated Prevention Primary secondary and tertiary prevention applicable to mental disorders 0 Primary reduces incidence of mental illness and related problems Secondary reduces prevalence by shortening duration of episodes 0 Tertiary treatment and rehabilitation Treatment Approaches Goals of treatment of mental disorders To reduce symptoms To improve personal and social functioning To develop and strengthen coping skills 0 To promote behaviors that make a person s life better Main Approaches to treating mental disorders Psychopharmacological therapy treatment with medications Psychotherapy treatment through verbal communication ex Cognitivebehavioral therapy Psychiatric Rehabilitation current recoveryoriented services 0 Primary objective is most often recovery rather than cure Additional Approaches Technology Use of technology in treatment via telephone video conferencing internet email computer software Benefits 0 Delivers exible help directly to clients living environments 0 Lowers cost to patient 0 Increases privacy of patient 0 May reduce feelings of coerciveness Additional Approaches SelfHelp Groups Selfhelp groups concerned members of the community who are united by a shared interest concern or deficit not shared by other members of the community National Alliance on Mental Illness NAMI Challenges Facing Mental Health Care in the United States Multiple services needed Staff turnover relatively high System is decentralized and fragmented Lack of licensed providers in rural and lowincome counties Lack of cultural competence among providers Government Policies and Mental Health Care Following deinstitutionalization government s role in funding and policy became substantial Medicaid Mental Health Parity and Addiction Act of 2008 Parity concept of equality in health care coverage for people with mental illness and those with other medical issues or injuries The Affordable Ca re Act of 2010 0 Medicaid coverage for individuals with mental disorders grew 0 Individuals with mental disorders disproportionately benefit from coverage expansions 0 They tend to have lower incomes and less like to be insured Communities may lack infrastructure to adequately meet needs of newly insured


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