Identify a population of interest. What determinants of health are associated with this population? Consider the impact of associated risk factors and the determinants of health as relate
1.Identify a population of interest. What determinants of health are associated with this population? Consider the impact of associated risk factors and the determinants of health as related to this population and the health condition(s).
2.Determine strategies required to address health inequities focusing on determinants of health for population health improvement among disparate populations.
3.Explain the following statement:
- .Utilizing an epidemiologic approach to disease occurrence targeting risk factors and addressing determinants of health can improve population health.
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Epidemiology for the Advanced Practice Nurse
© Springer Publishing Company, LLC.
1
Demetrius J. Porche, DNS, PhD, APRN, FNP, PCC, ANEF, FACHE, FAANP, FAAN
A Population Health Approach
POWERPOINTS TO ACCOMPANY
Chapter 2 Determinants of Health
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WHO Determinants of Health
Social and economic environment
Physical environment
Personal characteristics and behaviors
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Risk Factors
Modifiable
Nonmodifiable
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Healthy People Initiative and Determinants of Health
Healthy People
Healthy People 1990
Healthy People 2000
Healthy People 2010
Healthy People 2020
Healthy People 2030
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Healthy People 2030 Focus
Health equity
Social determinants of health
Health literacy
Well-being
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Healthy People 2030 Goal is . . .
“create social, physical, and economic environments that promote attaining the full potential for health and well-being for all”
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Social Determinants of Health
Economic stability
Education access and quality
Health care access and quality
Neighborhood and built environment
Social and community context
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Health Status Disparities
“differences in the incidence, prevalence, mortality and burden of diseases and other adverse conditions that exist among specific populations”
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Health Disparity 2020 defined
“a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage”
Disparities adversely affect groups of individuals who have “systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.”
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Measures of Disparity—Broad Categories
Burden of disease
Access to care
Quality of care
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CDC Defines Health Disparities as
“preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations”
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Discussion
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Epidemiology for the Advanced Practice Nurse
© Springer Publishing Company, LLC.
1
Demetrius J. Porche, DNS, PhD, APRN, FNP, PCC, ANEF, FACHE, FAANP, FAAN
A Population Health Approach
POWERPOINTS TO ACCOMPANY
Chapter 4 Epidemiology Primer
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2
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Epidemiology Defined
epi which means upon, demos which means people, and logos which means science
Epidemiology is the study of the distribution and determinants of health and health-related conditions or events in populations to promote and preserve population health while preventing and controlling health-related conditions or events in specific populations
Table 4.1
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Table 4.1 Epidemiology Definitions
Source: From Frerot, M., Lefebvre, A., Aho, S., Callier, P., Astruc, K., & Aho Glélé, L. S. (2018). What is epidemiology? Changing definitions of epidemiology 1978–2017. PLoS One, 13(12), e0208442. https://doi.org/10.1371/journal.pone.0208442
Components of Epidemiology
Substantive epidemiology
Descriptive epidemiology
Analytic epidemiology
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Descriptive Characteristics
Person
Place
Time
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Descriptive Epidemiology Process
Define the population
Define the health condition or disease under investigation
Describe the health condition or disease in terms of person, place, and time
Measure the health condition or disease
Compare health condition or disease measurement to known epidemiologic data
Generate etiological hypothesis about health condition or disease in population
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Science
Rigorous methods used to understand the natural and social world. Science is also known as a methodology to develop knowledge through the scientific method
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Scientific Method
Define the purpose of the investigation
Construct hypothesis
Collect data to test the hypothesis
Analyze data
Propose conclusions from the data and integrate the information into the existing state of knowledge
Communicate findings through peer-reviewed dissemination
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Epidemiology Science
The body of knowledge accumulated through epidemiology, the methods used to collect epidemiologic data, and the underpinning philosophical and theoretical information that guides epidemiologic thinking and data collection
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Epidemiology Objectives
Study the natural history and prognosis of health conditions/diseases
Identify syndromes and classification of health conditions/diseases
Examine effective screening and diagnostic testing strategies
Determine the extent of health conditions/diseases in a population
Surveillance of health conditions in a population
Identify and prevent or decrease the impact of the risk factors of health conditions/diseases
Identify and prevent the cause or etiology of a health condition/disease
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Epidemiology Objectives (cont.)
Evaluate the efficacy and effectiveness of preventive and therapeutic measures
Evaluate the efficacy, outcome, and impact of various modes of health care delivery
Provide epidemiologic information that informs the development of health-related and public policy
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Epidemiologic Approach
Thought process utilized by epidemiologist to approach or resolve a health condition
Steps
Determine the population structure
Characterize the exposure or risk factor in the population or characterize the health condition within the population
Determine if there is an association between the exposure or risk factor, the population characteristics, and health condition
Infer hypothesis about the causal or associative relationships between the population characteristics, exposure or risk factor, and the health condition
Examine the impact of preventive or therapeutic strategies on the exposure or risk factor within the population and on the health condition
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Epidemiologic Approach (cont.)
Presence of health condition/disease
Exposure
Population structure
Age
Characterize health condition/disease in population
Who has disease
Determine association or causation
Risk factors
Race/ethnicity
Sex
Income
Where is disease geographically
When did disease occur
What are the disease characteristics
What are the risk factors present
Case definition
How is the population structure, risk factors/exposure, and health condition associated
Why does the risk factors/exposure cause health condition
Potential agents present
Host characteristics
What environmental factors promote associations
How does agent, host, and environment interact to produce health condition/disease
Epidemiologic Triangle
Agent
Host
Environment
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Epidemiologic Triangle (cont.)
Agent
Host
Environment
Epidemiologic Tools
Counts
Frequency
Rates
Ratio
Proportion
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Discussion
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Epidemiology for the Advanced Practice Nurse
© Springer Publishing Company, LLC.
1
Demetrius J. Porche, DNS, PhD, APRN, FNP, PCC, ANEF, FACHE, FAANP, FAAN
A Population Health Approach
POWERPOINTS TO ACCOMPANY
Chapter 1 Population Health
© Springer Publishing Company, LLC.
2
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Population Health
Health outcomes of a group of individuals, including the distribution of such outcomes within the group
A concept
Field of study
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Population Health Focus
Patient
Group
Cohort
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WHO Health is . . .
“a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”
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Drivers of Health
Genetics
Behavior
Physical environment
Medical care
Social factors
Policymaking
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Population Health Strategies
Collaboration
Health in All Policies (HiAP)
Affordable Care Act, 2010
National Prevention Council and National Prevention Strategy
RWJF Culture of Health
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National Prevention Strategy Strategic Directions
Healthy and safe community environments
Clinical and community preventive services
Empowered people
Elimination of health disparities
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National Prevention Strategy Priorities
Tobacco-free living
Preventing drug abuse and excessive alcohol use
Healthy eating
Active living
Injury and violence-free living
Reproductive and sexual health
Mental and emotional well-being
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Culture of Health Action Areas
Making health a shared value
Fostering cross-sector collaboration to improve well-being
Creating healthier, more equitable communities
Strengthening integration of health services and systems
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Population Management Strategies
Triple Aim
Cost
Quality
Health status/satisfaction
Triple Aim Goals
Improve patient experience
Improve population health
Reduce per capita health care cost
Care Coordination
Community Health Needs Assessment
CDC 6/18 Initiative
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Prevention and Population Health
Primary
Secondary
Tertiary
12
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Epidemiology and Population Health
What are the linkages between epidemiology and population health?
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Discussion
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