1.Primary
2.Secondary
3.Tertiary
Stages of Health/Disease & Levels of Prevention
Comes before disease or disability – upstream approach
Purpose is to decrease vulnerability of individual or groups
Examples: health education, immunizations, advocating for health policy
Primary prevention
Early identification of disease/disability
Purpose is to minimize effects of disease/disability in order to maximize function
Examples: screening, harm reduction programs, nurse actions that address early stages of diseases/disabilities
Secondary prevention
Disease or disability is permanent and/or irreversible.
Minimizes the effects of disease and disability.
Purpose is to return the individual to a useful role
Examples: rehabilitation, treatment
Tertiary prevention
§Focus is on the health of populations
§Address the determinants of health and their interconnection
Health to Death Continuum
Interventions
§assess upstream issues impacting population
§base care decisions on best evidence
§apply multiple intervention strategies
§collaborate with communities and across health system sectors and levels of prevention
Population Health
2.Assess the population's health status
3.Consider broad determinants of health
4.Consider all levels of prevention - with a preference for primary prevention
5.Consider individual/family, community, systems
Population Health Attributes
Individual/Intrapersonal:
The individual characteristics that influence behavior, including knowledge, skills, motivation, and personality traits.
(Microsystem)
·Genetics & epigenetics
·Age
·Gender
·Sexual Orientation
·Nutrition
·Health Status/Risks
·Health Beliefs
·Self-Care Practices
·Spiritual practice
·Overall health & wellbeing
·Resilience/trauma history
·STIs, HIV, AIDS
·Habits: smoking, alcohol, substance abuse
·Stress
Interpersonal:
Relationships with others and effects on social identity.
(Mesosystem)
·Relationship with Significant Other
·Health of spouse/ sperm donor
·Culture/customs or traditions
·Family environment
·Social support
·Friendships
·Peers
·Co-workers
·Religious networks
Community:
Availability and location of resources that promote health, social networks, and social norms.
(Exosystem)
·Transportation
·Healthcare services
·Access to healthy food
·Parks & recreation
·Neighborhood safety
·Child-friendly
·Poverty vs prosperity
·Community center
·Places to walk
·Clean / safe environment
·Nutrition programs (e.g. WIC, food stamps, community gardens)
Individual Role in Health Promotion
“The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for inequities – the unfair and avoidable differences in health status seen within and between countries.”
Family Role in Health Promotion –
“Vulnerable populations are those with a greater than average risk of developing health problems by virtue of their marginalized sociocultural status, their limited access to economic resources, or their personal characteristics such as age and gender.”
Community Role in Health Promotion –
social determinants of health
13% of U.S. population lives in poverty (40 million persons) (2016)
America leads the world in rates of:
•Poverty
•Infant mortality
•Incarceration
•Obesity
•Gun violence
Emotional
Mental
Spiritual
Physical
Support Systems
Role Models
Knowledge of Hidden rules
•Social environment
•Behaviors/lifestyle
•Educational and occupation opportunities
•Access to and use of health care
Impact of Poverty in the U. S.