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Public Health Nursing Practice: Finding Evidence to Apply to Environmental Health Issues April 29th (or 30 th ), 2008 University of Wisconsin-Milwaukee. Urban Built Environments— where public health nursing intersects with the transportation culture. Deborah Pasha - PowerPoint PPT Presentation
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Public Health Nursing Practice:
Finding Evidence to Apply to Environmental Health
Issues
April 29th (or 30th), 2008 University of Wisconsin-
Milwaukee
Deborah Pasha
WI Division of Public Health
Urban Built Environments—where public health nursing intersects
with the transportation culture
Would you want to walk here?
(Dan Burden)
. . . or would you rather walk here?
(Michael Cynecki)
Would you feel safe cycling along this road?
(Dan Burden)
. . . or would you prefer to cycle here?
(Dan Burden)
Community Client Assessment
(Gabrielle Pasha)(Photographer unknown)
Community Client Assessment
(Photographer unknown)
http://dhfs.wisconsin.gov/statehealthplan
Health &Function Disease Health Care
Well Being Prosperity
IndividualResponse• Behavior• Biology
Social Environment Physical Environment Genetic Endowment
Evans, R. G., & Stoddart, G. L. (1990). Producing health, consuming health care. Social Science and Medicine, 31, 1347-1363.
Determinants of Health Model
The Precautionary Principle
• Precautionary approach to environmental health• Opportunity for prevention• Contrast to focus of resources on
curing disease that resulted from
preventable exposures• Association to health disparities
ANA’s Principles of Environmental Health for Nursing Practice with Implementation Strategies (2007)
Public Health Nursing: Scope & Standards of Practice
• The client or unit of care is the population
• Primary obligation is to achieve the greatest good
for the greatest number of people • Primary prevention is the priority when selecting activities • Focuses on strategies that create healthy environmental, social, and economic conditions in which populations may thrive . . .
(ANA 2007)
http://www.health.state.mn.us/divs/cfh/ophp/resources/docs/phinterventions_manual2001.pdf
Public Health Interventions
March 2001
Minnesota Department of Health Public Health Nursing Section
Surveillance
http://www.dot.wisconsin.gov/
Health Teaching
Collaboration
Coalition Building
Community Organizing
Enforcement
Advocacy
Social Marketing
Policy Development
A System of Partners
State & Local Public Health Departments
Educators
Colleges, Universities,& Technical Schools
Healthcare Consumers
Managed Care
Hospitals & Clinics
Healthcare Purchasers
Community Health Centers
Healthcare Providers
Faith Community
Professional Organizations
Civic Organizations
Foundations
CommunityResidents
Law Enforcement
State andLocal Elected
Officials
Agriculture,Natural Resources, Public Instruction,
and other governmental
agencies
Advocacy Organizations
Media
Business& Labor
(Photographer unknown)
Community-System Interventions
Community-System Interventions
Literature search
•“Built environment” •“Public health”
•“Traffic” •“Physical activity”
•“Speed” •“Injuries”
•“Aggressive driving behaviors” •“Social efficacy”
•Literature Review: Credible authors and sources
Research findings
• Modern cities associated with costly injuries
and illness due to inactivity• 70% deaths, 60% medical expenditures in U.S.
attributed to chronic disease• 30% of these preventable
with increase in physical activity• Less than ½ of U.S. adults meet activity
recommendations of 30 minutes most days
Research Findings
• U.S. bicycling and walking trips reduced from 10% (1977) to 6.3% (1995)• Pedestrian and cycling fatalities are triple• Canada and Northern European countries 20-40% of travel is by cycling and walking
• 4 E’s: Engineering, Enforcement,
Education, Encouragement
Research findings
• One prospective cohort study surveyed a random sample prior to and following a traffic calming intervention
• Pedestrian counts at 3 places by age groups• Pedestrian activity increased after the traffic
calming• Children were more likely permitted to play
outside(Morrison, Thomson and Petticrew, 2004)
http://www.wisconsinwalks.org/
http://www.bfw.org/
http://www.bikewalk.org/
http://www.bikewalk.org/
http://www.dhfs.state.wi.us/
http://dhfs.wisconsin.gov/health/physicalactivity/StatePlan
http://www.cdc.gov/
http://www.apbp.org/website/
Workgroup activity
• Success Story: Issue, Intervention, Impact
• Media release • Talking points• Community event flier• Letter of support • Issue paper
Street Share
(ITE Pedestrian Bicycle Council)
(Photographer unknown)
Healthy Community
“One good community nurse will save a dozen policemen.”
Herbert Hoover