Health & Medical Question

Post ID: 3450896

Overview

Throughout this course, you will hone your foundational public health skills by analyzing a public health issue. You will first select an intervention and its corresponding public health topic and then frame this topic as a public health issue. Then, you will deconstruct the issue by analyzing its components-its historical underpinnings, its priority population or targeted community, its strategies and methods, and its relevant communities and individuals. Lastly, you will provide recommendations for addressing this public health issue in the future-specifically with respect to overcoming challenges and building coalitions or partnerships to achieve desired health outcomes. Throughout your project, there will be a strong emphasis on health equity concepts, including health

disparities or inequities and the social determinants of health. Brief definitions for these terms are provided below, but you are encouraged to seek additional sources from the library or through an internet search, for example, YouTube videos.

Outcomes

The final project outcomes have been detailed below-organized into three groups, as follows:

Course Outcomes (PHE-500): These outcomes focus on the content covered in PHE 500.
Foundational Competencies (CEPH): These outcomes focus on overarching skills for practicing public health.
Foundational Public Health Knowledge (FKO): These outcomes focus on the fundamental principles of public health.
Evaluate public health for its historical and current significance in protecting and promoting individual, community, and population health [PHE-500-01]
Analyze the role of the determinants of health in both the onset of and solution to public health problems [PHE-500-02]
Assess the impact of social and behavioral factors on individual and population health behaviors for informing design of effective public health programs [PHE-500-03]
Analyze the contributions of public health agencies, positions, and roles in effectively delivering public health's core functions and essential services [PHE-500-04]
Assess the extent to which public health programs utilize fundamental public health principles and theories in promoting individual and population health [PHE-500-05]
Assess the impact of local, national, or international programs or interventions on public health issues [PHE-500-06]
Compare the organization, structure, and function of healthcare, public health, and regulatory systems across national and international settings [CEPH.05]
Discuss how structural bias, social inequities, and racism undermine health and create challenges to achieving health equity at organizational, community, and societal levels [CEPH.06]
Propose strategies to identify relevant communities and individuals and build coalitions and partnerships for influencing public health outcomes [CEPH.13]
Identify the core functions of public health and the 10 essential services [FKO.02]
Discuss the science of primary, secondary, and tertiary prevention in population health, including health promotion, screening, and the like [FKO.05]
Explain behavioral and psychological factors that affect a population's health [FKO.09]
Explain the cultural, social, political, and economic determinants of health and how the determinants relate to population health and health inequities [FKO.10]

Course Outcomes

In this assignment, you will demonstrate your mastery of the following course outcomes:

Foundational Competencies (CEPH)

Upon successful completion of the final project, you will be able to:

Foundational Public Health Knowledge (FKO)

Upon successful completion of the final project, you will be able to:

Prompt

Your public health issue analysis will allow you to gain a deeper understanding of your selected public health issue, including why it has become a public health issue and its significance in the public health landscape. This project will also provide you the opportunity to hone your research skills for future use throughout the program.

Specifically, your analysis must address the following critical elements:

Introduction to Selected Public Health Issue
- Intervention: Identify and summarize an intervention related to a public health issue.
  - Identify your public health intervention by using either one Healthy People implementation story from HealthyPeople.gov or the Centers for Disease Control and Prevention.
  - When summarizing the public health intervention, include all of the following information:
    - Prevention Level: Using the CDC Prevention document, describe the main prevention level used by the intervention (for example, primary, secondary, tertiary). Examine the science of the prevention level using evidence and examples. [PHE-500-01]
      - Health Service Delivered: Determine the main public health service delivered using the CDC's 10 Essential Public Health Services. Explain how the service fulfills a core function of public health. [PHE-500-01]
        Notes: Focus on the specific issue that the intervention addressed, not the organization. Also, make certain to frame the intervention in terms of population or community health, not healthcare, medicine, or individual patients.
Public Health Issue Analysis
- WHO's Conceptual Framework: Analyze the population or community through the lens of the World Health Organization's (WHO) conceptual framework for action on the social determinants of health.
Coalition Description and Strategies
- Summarize a possible coalition whose efforts focus on supporting the intervention and addressing the public health issue described in this analysis. Then, describe strategies to identify relevant communities, organizations, individuals and strategies to bring them all together and increase their involvement. Note: This section is not included as part of your milestone submissions. Complete these additional sections as part of your final project submission.

Levels of Prevention

Level 0: Primordial

Eliminating disparities and risk factors toward zero (social and environmental)

Level 1: Primary

Preventing adverse health status by minimizing risk factors (behavioral)

Level 2: Secondary

Minimizing the impact on health status(screening and early intervention)

Level 3: Tertiary

Minimizing the adverse impactof disease or condition through treatment

Level 4: Quaternary

Minimizing harm from medical intervention itself (e.g., overmedicalization)

Table 1

Figure 1

10 Essential Services of Public Health

Monitor health status to identify community health problems.
Diagnose and investigate health problems and hazards in the community.
Inform, educate, and empower people abouthealth issues.
Mobilize community partnerships to identify and solve healthproblems.
Develop policies and plans that support individual and community efforts.
Enforce laws and regulations that protect health and ensure safety.
Link people to needed personal health services and assure the provision of healthcare when unavailable.
Assure a competent public and personal healthcare workforce.
Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
Research innovative solutions to health problems.
- Significance: Discuss your issue's significance to public health. [PHE-500-01]
  - Identify one Healthy People topic area that connects to the intervention. You may find a list of topic areas on HealthyPeople.gov by visiting the Objectives and Data tab.
    - Note: Sometimes, multiple topic areas are aligned to the same intervention. For example, if the intervention topic focuses on childhood obesity, the following topic areas could be relevant: nutrition and weight status, physical fitness, and diabetes. Select only one topical area.
  - Review the topic area's main page (that is, only the Overview and Objectives tab-which is the default). If provided, explore the list of sources on this page that are provided as hyperlinks or detailed in the reference list-if it is available for free in the library or online. Continue to explore this topic area until you can address the following prompts:
    - Identify the population or community that was the focus of the intervention. Describe the shared characteristics among this population or community and whether these characteristics were merely geographical or included other characteristics, for example, demographics.
    - Describe why this population or community was identified as needing public health services.
    - Include data or evidence to support your claims.
- Historical: Provide a historical public health perspective about your issue. [PHE-500-01]
  - Examine the evidence or data from three different publications. Each source should have a different publication year. The publications should illustrate an understanding of the issue with respect to the particular periods in time that are chosen.
  - Compare these sources and summarize the similarities and differences. Provide examples, as needed.
    - CSDH Element 1-Socioeconomic and Political Contexts: The first element of CSDH constructs the socioeconomic and political contexts related to a health issue and related public health efforts by using six dimensions. Considering the definitions for each dimension of CSDH (Section 5.4 in the WHO resource link above), explain how each dimension relates to the public health issue and its population or community. You do not need to spend time summarizing the definition for each dimension in your analysis. In 1 to 3 sentences, summarize the contexts for the following dimensions: [PHE-500-03]
      - Microeconomic Policy
      - Social and Public Policies
      - Cultural and Societal Values
      - Epidemiological Conditions
    - CSDH Element 2-Structural Determinants and Socioeconomic Position: Structural determinants generate social stratification and divisions in society and define individual socioeconomic position within hierarchies of wealth, prestige, and power. They are embedded in key
      - Analyzing the Socioeconomic Position: Begin this part by examining socioeconomic position as it relates to the public health issue and population or community.
      - Behavioral and Biological Factors
      - Psychosocial Circumstances
      - Health System
      - Describe how the strategy was delivered by the intervention. Provide details about the intervention activities related to the strategy (for example, the public health "effort"). Why was the strategy used?
      - Impact: Discuss how the strategy impacted the health of the priority population or community and the measurable changes in health status that occurred through the intervention. [PHE-500-06]
      - Strengths and Limitations: Conclude this section by assessing the strengths and limitations of the intervention. [PHE-500-04]
- Connections With Health Equity
- Analyze the impact of prior public health efforts.
- Compare systems and settings and the challenges faced by the intervention, and improvements to public health made by the intervention.
  - Agencies:
    - Systems and Settings: With regard to your public health issue, compare the organization, structure, and function of healthcare systems, public health systems, and regulatory systems across local, national, and international settings. [PHE-500-04]
  - Challenges: Discuss the challenges that this intervention may have faced. If you feel that it has not faced any challenges, what do you feel are some potential challenges that it could have faced? Be certain to justify your reasoning. [PHE-500-06]
  - Improvements: Explain how you feel this intervention could have been improved by applying basic public health principles or theories discussed in the course. Be certain to support your claims. [PHE-500-05]
    - Coalition Description: Develop a mission statement that outlines the driving purpose of the coalition. [PHE-500-04]
    - Coalition Goals: Develop two SMART goals for your coalition. Ensure that the coalition's goals focus on the intended public health outcomes. [PHE-500-04]
      - Discuss their interest and influence with your public health issue.
      - State their roles and responsibilities in the coalition.
    - Strategies to Bring Everyone Together: Describe two strategies that you might use to bring your members together and increase collaboration. [PHE-500-04]
    - Fostering Engagement: Developing and maintaining a public health coalition is an ongoing process. How will you continue to foster long-term engagement with your members and partners? How will you evolve and adapt to new challenges and opportunities with your public health issue? [PHE-500-04]
    - Community and Individual Engagement: Propose strategies for how to bring relevant communities and individuals together in order to promote improvement of the public health issue. [PHE-500-02]

Table 2

This section is the core focus for Milestone Two. Access and review the WHO's conceptual framework for action on the social determinants of health (CSDH) by going to the World Health Organization's Social Determinants of Health Publications webpage and downloading discussion paper 2.

Chapter 5 contains the CSDH. For the health intervention and its related public health issue, address all the following areas within your analysis.

institutions and processes of the socioeconomic and political context. Examples include income, education, occupation, social class, gender, and race. Analyze the structural determinants by addressing the following prompts: [PHE-500-02]

The role of social stratification. Specifically, explain how wealth (for example., economic situation), prestige (for example status situation), or power (for example, parties-political, agenda-centered, and so on) may connect to the public health issue or intervention and the population or community.
Explain how social differentiation (through wealth, prestige, or power) may affect health outcomes. Note: If you need to search the library for more information, this approach to social stratification is called the "three-component theory of

stratification" by Max Weber.)

Provide examples of how the health intervention may have targeted these determinants by making connections with the general public health strategies and initiatives and the targeted population or community.
Conclude this part by discussing how structural determinants relate to the cross-cutting determinants of social capital and social cohesion. Provide evidence to support your claims.

CSDH Element 3-Intermediary Determinants: Intermediary determinants are factors that directly shape individual health choices and outcomes and through which structural determinants operate. They span material circumstances, psychosocial circumstances, and behavioral and biological factors-and these determinants have a relationship with the society's health system. Examples include the nearby shop that sells cigarettes and alcohol, tensions among local leaders in an underserved community, or the nonfunctioning rural health center that lacks essential medicines and health personnel. To address the intermediary determinants, summarize in 1 to 2 sentences the relationship between the health issue and intervention (and community or population) and the following: [PHE-500-02] [PHE-500-03]

Study the public health issue by reviewing peer-reviewed literature (via the library) or by using public health data tools.
Summarize the priority population or community using the following prompts:
- Health Disparity: Describe the health disparity or disparities common to the population or community. Explain why these disparities could make these factors health inequities. Support your responses with evidence. [PHE-500-02]
- Health Determinants: Describe the health determinants: What are the health determinants that may relate to these health disparities or inequities? Please include evidence to support your claims. [PHE-500-02]

Proximal and distal determinants: Discuss the proximal (downstream) or distal (upstream) determinants related to the health intervention's priority population or community. Identify any determinants that cannot be defined as proximal or distal (that is, midstream) and be certain to add an explanation.
Modifiable and non-modifiable determinants: Discuss the modifiable (for example, exposure to hazard, access to healthcare) or non-modifiable (for example, age, sexual orientation, race or ethnicity) determinants related to the health intervention's priority population or community.

(Source: Bay Area Regional Health Inequities Initiative (BARHII) Conceptual Framework, 2006) A text-only version of this image is available in Module Four of your course.

Analyze the issue's challenges to achieving health equity at all levels.
- Summarize the health inequities from the previous section.
- Equity Challenges: Analyze the factors that may create challenges to achieving health equity, such as structural bias, social inequities, and racism. Explain how these factors undermine the health status of the community or population.
- Equity Social Ecological Model: Analyze the challenges to achieving health equity at the following levels of the social ecological model: societal and community levels. [PHE-500-03]

(Source: Bay Area Regional Health Inequities Initiative (BARHII) Conceptual Framework, 2006) A text-only version of this image is available in Module Four of your course.

Throughout this section, explain how these behavioral and psychological factors may affect a population's health status.

Theories: Analyze public health theories related to the issue. [PHE-500-05]

III. Intervention Analysis

Strategies: Identify and explain three public health strategies used by the intervention you summarized in Milestone One. Address the following for each strategy explanation: [PHE-500-06]

Determinants of Health: Align the strategy to relevant health determinants by identifying the determinants of health that each strategy addressed and discussing whether addressing these issues led to intervention success, providing justification. [PHE-500-02]

Strategies to Identify Coalition Members: Identify two primary and two secondary coalition members. For both primary and secondary coalition members you will: [PHE-500-04}

Milestones

You will complete the final project in parts throughout the term. These parts are called milestones. There are three milestone projects. You will collate these milestone project parts, making revisions as needed, and submit all parts for the final project.

Milestone One: Introduction to Selected Public Health Issue

In Module Two, you will select an intervention and its corresponding health topic and then frame this topic as a public health issue. This milestone is submitted with the Final Project Template and graded with the Final Project Milestone One Rubric.

Milestone Two: Public Health Issue Analysis

In Module Four, you will expand upon your previous work by analyzing the public health issue. More specifically, you will deconstruct the issue by analyzing its components-its historical underpinnings, its priority population or targeted community, its strategies and methods, and its relevant communities and

individuals. This milestone is submitted with the Final Project Template and graded with the Final Project Milestone Two Rubric.

Milestone Three: Intervention Analysis

In Module Seven, you will submit your intervention analysis. You will analyze the impact of prior public health efforts. You will evaluate the success of the selected intervention, identifying the social and behavioral factors and determinants of health that the intervention addressed. You will identify any contributions that have been made by public health agencies, positions, or roles with regard to your selected issue and then analyze the intervention's use of public health principles and theories to promote behavior change. You will discuss challenges that the intervention may have faced and explain how the

intervention could have been improved. This milestone is submitted with the Final Project Template and graded with the Final Project Milestone Three Rubric.

Final Submission: Public Health Issues Analysis

In Module Nine, you will submit your public health issue analysis. Your final project will propose a coalition for future capacity building and should include a conclusion where you summarize your public health issue as well as the selected intervention and discuss the impact of this issue on your future role as a public

health practitioner. The Final Project Template should be a complete, polished artifact containing all the critical elements of the final product. It should incorporate feedback gained throughout the course. The final submission will be submitted with the Final Project Template and graded using the Final Project Rubric.

Key Terms

Health disparity: The difference in health status between two groups, such as the difference in mortality rates-or life expectancy-between men and women, or the difference in infant mortality rates between African American and white infants
Health equity: A perspective that everyone has a fair and just opportunity to be as healthy as possible, which may require removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing,
Health inequity: Differences related to health access, utilization, and outcomes that are unfair and unjust; this concept can be contrasted with health disparities, which simply indicate a difference in health that may or may not be related to fairness and justice
Social Determinants of Health: The economic and social conditions under which people live that largely determine their health status; the complex, integrated, and overlapping social structures and economic systems, including the social environment, physical environment, health services, and structural and societal factors; factors that affect health status that relate directly-or indirectly-to societal, cultural, or social structures

safe environments, and healthcare