community week 10

Health in the Global Community.

Women’s health

Read chapters 15 and 17 of the class textbook and review the attached PowerPoint presentations.  Once done, answer the following questions.

1.  Describe globalization and international patterns of health and disease.

2.  Identify international health care organizations and how they collaborate to improve global nursing and health care.

3.  Identify and discuss the major indicators of women’s health.

4.  Identify and discuss the barriers to adequate health care for women.

As stated in the syllabus present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard titled “Week 10 discussion questions” and the SafeAssign exercise in the assignment tab of the blackboard “Week 10 SafeAssign APA”.  For you to receive the total points of the assignment it must be posted in both places.  I will have DL monitoring, so we don’t have the same problem that happened in week 6.   A minimum of 3 evidence-based references besides the class textbook no older than 5 years must be used.  You must post two replies to any of your peers sustained with the proper references no older than 5 years as well and make sure the references are properly quoted in your assignment.  A minimum of 800 words is required.  Please make sure to follow the instructions as given and use either spell-check or Grammarly before you post your assignment.

Chapter 17

Women’s Health

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Women’s Health
“… essential to the development of health care for women are the concepts of health promotion, disease and accident prevention, education for self-care and responsibility, health risk identification and coordination for illness care when needed.”
– Preamble to a New Paradigm for Women’s Health,
Choi (1985)

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
2

Major Indicators of Health
Mortality rates
Cardiovascular disease (CVD) continues to be the number one overall killer of women.
Cancer rates are increasing because of lifestyle choices, environmental carcinogens, and increase in life expectancy.
Diabetes mellitus causes the premature death of many women and is a risk factor for CVD.
Gaps exist in the availability and quality of reproductive health care services globally.
Life expectancy for Americans is at an all-time high.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
3

From http://ndep.nih.gov/partners-community-organization/campaigns/SmallStepsBigRewards.aspx
From http://www.nhlbi.nih.gov/educational/hearttruth/

Major Indicators of Health (Cont.)
Morbidity rates
More women than men are hospitalized each year in the United States.
Women are more likely than men to be disabled from chronic conditions.
Women are more likely than men to have surgery; many surgeries relate to reproductive health.
The most frequently occurring interruption in women’s mental health relates to depression.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
4

Social Factors Affecting Women’s Health
Health care access
Education and work
Employment and wages
Working women and home life
Family configuration and marital status
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
5

Health Promotion Strategies for Women
Collaboration and an interdisciplinary approach are necessary to meet the health care needs of women.
Women should receive services that promote health and detect disease at an early stage.
Many women seek information that will allow them to be in control of their own health.
Women desire to become more knowledgeable about their own health.
Health promotion for low-income, underserved women may differ from that for middle-class women.
Knowledge deficits about one’s own health prevail among women regardless of socioeconomic or educational level.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
6

Common Acute Illnesses in Women
Urinary tract infection and dysuria
Diseases of the reproductive tract
Vaginitis, vulvovaginitis, pelvic inflammatory disease (PID), and toxic shock syndrome (TSS)
Chronic diseases
Coronary vascular disease (CVD) and metabolic syndrome, hypertension, diabetes, arthritis, osteoporosis, and cancer (breast, lung, gynecological)
Mental disorders and stress
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
7

Reproductive Health Concerns
Nutrition
Includes total life nutritional experience
Dysmenorrhea
Family planning
Includes fertility control and infertility
Need multiple safe options designed to meet the individual needs of all women
STIs, HIV, and AIDS
Women need age-appropriate STI prevention, education, and counseling.
Worldwide, AIDS is a leading cause of death among young women.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
8

Other Issues in Women’s Health
Unintentional injury or accidents
Domestic violence is the single largest cause of injury to women between the ages of 15 and 44 in the United States.
Disabilities resulting from acute and chronic conditions
Women have fewer disabilities than men because they tend to report their symptoms earlier and receive necessary treatment.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
9

Major Legislation Affecting Women’s Health Services
Public Health Service Act (1982)
Provides biomedical and health services research, information dissemination, resource development, technical assistance, and service delivery.
Includes the Family Planning Public Service Act
Title VII of the Civil Rights Act of 1964
Prevents discrimination based on sex, race, color, religion, or national origin
Amended to also include pregnancy and childbirth
Sexual harassment is violation of Civil Rights Act
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
10

Major Legislation Affecting Women’s Health Services (Cont.)
Social Security Act
Provides monthly retirement and disability benefits to workers and survivor benefits to families
Occupational Safety and Health Act (OSHA)
Enacted in 1970
Ensures safe and healthful working conditions
Family and Medical Leave Act (FMLA)
Enacted in 1993
Provides 12 weeks of unpaid leave each year for family and medical reasons
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
11

Health and Social Services to Promote the Health of Women
Affordable Care Act (ACA) of 2010
Protection from being denied coverage by insurance companies
Protection from being charged more for health care services because of their gender
Preventive care without copays including:
Well-women visits with screening and counseling for gestational diabetes, HPV, STIs, HIV, contraception, and domestic violence
Breastfeeding counseling support and supplies
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
12

Health and Social Services to Promote the Health of Women (Cont.)
Medicaid (1965)
A federal- and state-funded health insurance program for the poor
Expanded under ACA to persons under 65 with an income below 133% of poverty level
Largest source of funding for people with limited income, regardless of age eligibility
Five broad coverage groups:
Children, pregnant women, adults in families with dependent children, individuals with disabilities, individuals 65 years or older
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
13

Health and Social Services to Promote the Health of Women (Cont.)
Women’s health services
Provide primary health care needs, as well as reproductive and maternity care services including:
Eating disorders
All forms of abuse
Disease prevention, including smoking cessation
Health promotion focusing on nutrition, exercise, and stress management
The National Women’s Health Network is a strong advocate for women’s concerns.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
14

Other Community Voluntary Services
Women’s organizations
Promote voluntary involvement with community; many others have made women’s health a major item on their agenda.
Networking
Help women advance careers, improve lifestyles, and increase income and success.
Crisis hotline services
Provide counseling to battered women, battering parents, rape victims, those considering suicide, and those with multiple needs.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
15

Levels of Prevention
Primary prevention
Recognize risk for disease and target health care behaviors to reduce risk
Never smoking, following a nutritious diet, safe sex practice, avoiding drugs, limiting alcohol consumption, and staying physically active
Secondary prevention
Routine screening for cervical cancer, STIs, breast self-exams, and mammograms
Tertiary prevention
Education and resource utilization
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
16

Roles of the Community Health Nurse
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
17
Direct care
Educator
Counselor
Researcher

Research in Women’s Health
Research efforts to include women in studies have grown; not based only on male subjects
NIH Office of Research on Women’s Health (ORWH) established in 1990
Many topics examined based on special task force recommendations
Research on financing and delivery of health services for women
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
18

Office of Research on Women’s Health
Overarching themes for research:
Developmental, psychological, spiritual, and physiological factors effect on lifespan
Female determinants’ (such as genetics and gender expectations) effect on health
Health disparities and diversity
Diseases and conditions affecting women
Career development and advancement of women in the sciences
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
19

“Women are at the center of the health of the United States; therefore, if better models are developed for improving the health of women, the health of the entire nation will benefit.”
– Nies and McEwen (2015)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
20

Chapter 15

Health in the Global Community

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Human health and its influence on every aspect of life are central to the global agenda.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
2

Health in the Global Community
Population characteristics
Environmental factors
Patterns of health and disease
International agencies and organizations
International health care delivery systems
The CHN’s role in the global community
Research in international health
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
3

International Community Assessment Model
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
4
Courtesy J. C. Novak.

Population Characteristics
Large populations create pressures
Goal is to improve quality of life (QOL)
Health promotion
Effective health care delivery systems
Enhancement of the environmental infrastructure
World population distribution is uneven
More than 50% live in China, India, United States, and Indonesia; 30% are children; 8% are over 60
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
5

Population Characteristics (Cont.)
Life expectancy varies significantly in different countries.
Japan 86 years, Zambia 43 years
As the world population grows, a global trend toward urbanization occurs.
Live closer together and migrate to urban areas for employment
Increased living density and global travel threatens health of general population by environmental factors
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
6

Environmental Factors
Environmental stressors
Directly assault human health
Damage society’s goods and services
Affect quality of life (QOL)
Interfere with the ecological balance
Natural disasters, terrorism, and war affect all of the above
The field of environmental health and sustainable development has exploded since 1990.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
7

Patterns of Health and Disease
Lifestyles, health and cultural beliefs, infrastructure, economics, and politics affect existing illnesses and society’s commitment to prevention.
Disease patterns vary throughout the world.
Racial, ethnic, and access disparities exist within and between countries.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
8

International Organizations
WHO (World Health Organization)
PAHO (Pan American Health Organization)
UN (United Nations)
UNICEF (United Nations International Children’s Fund)
World Bank
CDC (Centers for Disease Control and Prevention)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
9

“Health for All by the Year 2000”
(WHO Goal, 1978)
Goal framed at the Alma-Ata conference in the Soviet Union in 1978; now extended to 2010 again without attainment
Concept of primary health care
Health as a fundamental human right for individuals, families, and communities
Unacceptability of the gross inequalities in health status
Importance of community involvement
Active role for all sectors
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
10

Millennium Development Goals
(United Nations, 2000, 2006)
Target date of 2015
Eradicate extreme hunger and poverty
Achieve universal primary education
Promote gender equality, and empower women
Reduce child mortality
Improve maternal health
Combat HIV/AIDS, malaria, and other infectious diseases
Ensure environmental sustainability
Develop global partnerships
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
11

Other Organizations Impacting International Health
Nongovernmental organizations (NGOs)
Carter Center
Bill and Melinda Gates Foundation
ICN (International Council of Nurses)
HHS (U.S. Department of Health and Human Services)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
12

HHS and Healthy People
Serves as a foundation for efforts across the HHS to create a healthier nation
1979 Surgeon General’s Report, Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention
Healthy People 1990: Promoting Health/Preventing Disease: Objectives for the Nation
Healthy People 2000: National Health Promotion and Disease Prevention Objectives
Healthy People 2010: Objectives for Improving Health
Healthy People 2020: Improving the Health of Americans
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
13

International Health Care Delivery Systems
Much to learn from one another.
Research and development must be relevant to infectious diseases that affect the poor.
Need to systematically generate an information base.
Need to consider determinants of health.
Use population-based approaches to address access, cost, efficiency, and effectiveness.
Collaborate to solve the problems of health care delivery systems.
Market- and population-based approaches need to learn from each other.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
14

International Health Care Delivery Systems (Cont.)
Effective health care delivery systems must:
Increase access and efficiency.
Improve health status through health promotion and disease prevention.
Eliminate health disparities.
Protect individuals, families, and communities from financial loss caused by catastrophic illness.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
15

Role of the CHN in International Health Care
Seek to ensure the attainment of health for all in a cost-effective, efficient, accessible health care system.
Be involved in research, community assessment, planning, implementation, management, evaluation, health services delivery, emergency response, health policy, and legislation.
Coordinate work with other health care personnel and community leaders as well as local and global community leaders.
Utilize changes in the health environment to form the basis for the nursing role.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
16

Role of the CHN in International Health Care (Cont.)
Primary health care
Essential services that support a healthy life.
Involves access, availability, service delivery, community participation, and the citizen’s right to health care.
Primary care
First line or point-of-access medical and nursing care controlled by providers and focused on the individual.
May not be the norm as needs of the group outweigh the needs of the individual.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
17

Role of the CHN in International Health Care (Cont.)
All nurses in the world must understand and learn from one another. Nurses are health care’s most valuable assets.
Community public health nurses can improve access to care for the most vulnerable and hard-to-reach groups in any country.
The future demands evidence-based learning, engagement, service, and growth in information technology and local and global health policy.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
18

Figure 15-2 Distinction Among Service Programs. Furco, Andrew. “Service-Learning: A Balanced Approach to Experiential Education.”  Expanding Boundaries: Service and Learning. Washington DC: Corporation for National Service, 1996. 2-6.  
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
19

Population-based nursing experts are critical to solving the challenges of the fragmented, mismanaged, expensive, ineffective, inefficient health care delivery system that exists in many parts of the global community.
– Nies and McEwen (2015)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
20

Research in International Health
Since 1990, international nursing research has focused predominantly on:
Student and faculty educational exchange programs
Diverse clinical experiences
The international development of home care or transition from hospital to home
WHO Collaborating Centers contributed to a partnership for educational programming, clinical practice, and research for graduate students in primary health care nursing and community health
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
21