Community, Public , Global Health Nursing

Historical Approach, Population Care & Culture of Health

Prepared by Michele Lani Bray MS, APHN,RN Fall 2016
THE EXPERT IN ANYTHING WAS ONCE A BEGINNER
(Helen Hayes)

Course Overview
• 450/ 450L
• Chain of Command
• Laulima – Syllabi, Calendar, Module, Gradebook
• Socrative
• Midterm/Final Exam – ExamSoft
• 450L Documentation – Rules – No white out, scratch out
etc….

Course Etiquette
• Cell phone use
• Laptop, I Pad use
• Attendance
• Respect
• Teamwork
Student Learning Outcomes:
Learn strategies to work effectively with individuals, families,
and communities to promote optimal health and provide safe,
high quality care.
Analyze the development of critical thinking and sound clinical
judgment in designing and evaluating community based
nursing interventions and outcomes

Objectives:
• Discuss historical events that have influenced the
development of Public Health/PHN.
• Identify key influential figures and their contributions to
public health nursing.
• Explain the concept of the Nursing Theories & evolution of
Determinants of Health in terms of populations and the
Culture of Health.
FLORENCE NIGHTINGALE
Lillian Wald: The First Public Health Nurse
HENRY STREET SETTLEMENT NEW YORK
MABEL SMYTH of HAWAII
1892 – 1936
 PALAMA SETTLEMENT
PALAMA SETTLEMENT OFFERRED HOME ECONOMICS
CLASSES IN 1935 AIMED AT TEACHING WOMEN TO COOK
 Nursing Leadership for Healthier
Communities

Nursing leadership refers to the influence that nurses

exert on improving client health, whether clients are
individuals, families, groups, or entire communities

Population-focused nurses have a responsibility to

provide leadership in creating a new FUTURE for
healthier communities.
 CULTURE

What's a
UPSTREAM Nursing ENVIRONMENT

Theory

SELF

Focus of Change : Theory of Nursing

OREM: Self-Care Deficit – Self-care is the primary focus 
lacking aspects of other contributing factors to health issues.

Health Belief Model: Prevention is disease avoidance  lacking

aspects of examining the Root Cause of unhealthy behaviors.

Milo’s: Framework for Prevention – Upstream Thinking, lack of

knowledge and personal priorities are key factors
Determinants of Health
H------------Health Policy
E-------------Environmental- Physical/Economic
A------------Access to Care
L-------------Linking with people-Social/Spiritual
T-------------The Culture of Health
H-------------Hereditary – biology - behavior

The Determinants of Health

 DETERMINANTS OF HEALTH EXAMPLES
(Healthy People 2020)

H Health Policymaking–> Tobacco tax, MVAs – Seat belts, change behavior.

E Environment/Physical –> where born, zip code, live, play, work, school etc…
(food, crime, norms, segregation, transport., safety, space, trash-hazards, climate
change).

A Access to Health–> Access to care – insurance, cost, language, preventive

services.

L Linking Socially –> Social space, support of friends – family – community engaged
T The Culture of Health –> Individual and Community Well-being
H Heredity,Individual--> Age, gender, Thalassemia, Ca-BRCA1/2, Cystic Fibrosis,
Sickle Cell. Drugs, ETOH, Diet
http://www.healthypeople.gov/2020/about/DOHAbout.aspx
 Culture of Health Action Framework

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

Improved Population Health, Well-Being, and Equity

(RWJF http://www.rwjf.org/en/library/annual-reports/presidents-message-2015.html)
 Making Health a Shared Value,
measured by indicators such as the percentage of people who strongly agree
that health is influenced by their peers and their communities and the
percentage who indicate they have adequate social support from family and
friends.
Fostering Cross-Sector Collaboration to Improve Well-Being,
denoted by measures like the number of local health departments that
collaborate with community organizations and employers who promote better
health in the workplace.

Creating Healthier, More Equitable Communities,

using measurements such as the number of grocery stores, farmers’ markets,
and safe sidewalks in communities; the ratio of children attending preschool;
and the affordability of housing.

Strengthening Integration of Health Services and Systems,

gauged by measures such as the percentage of people served by a
comprehensive public health system and the percentage of physicians sharing
electronic data with other clinicians, health systems and patients.

(RWJF- http://www.rwjf.org/en/library/annual-reports/presidents-message-2015.html)
 References
Healthy People 2020 retrieved from:
http://www.healthypeople.gov/2020/about/DOHAbout.aspx

Rankin, S.H., & Stallings, K.D. (1996). Patient Education: Issues, Principles, Practices,
3rd ed. Philadelphia: Lippincott-Raven, 128-129.

Culture of Health, Robert Wood Johnson Foundation retrieved from:

http://www.evidenceforaction.org/what-culture-health
http://www.rwjf.org/en/library/annual-reports/presidents-message-2015.html

Stanhope & Lancaster (2012). Public Health Nursing, Population-Centered Care in

the Community. 8th ed. Missouri: Elsevier Inc.

US Department of Health and Human Services. Draft report of the Secretary’s

Advisory Committee on National Health Promotion and Disease Prevention
Objectives for 2020 on Social Determinants. Revised 2009 Sep 9.