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Community/Public Health Nursing

Promoting the Health of Populations

SEVENTH EDITION

Mary A. Nies, PhD, RN, FAAN, FAAHB

Director of Nursing Research and Professor College of Nursing, Joint Appointment MPH Program, Kasiska
Division of Health Sciences, Idaho State University, Pocatello, Idaho

Melanie McEwen, PhD, RN, CNE, ANEF

Professor, University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, Texas

2
Table of Contents

Cover image

Title page

Copyright

Dedication

About the Author

Acknowledgments

Contributors

Preface
Unit 1. Introduction to Community Health Nursing

1. Health: A Community View

Definitions of Health and Community

Determinants of Health and Disease

Indicators of Health and Illness

Definition and Focus of Public Health and Community Health

Preventive Approach to Health

Definition and Focus of Public Health Nursing, Community Health Nursing, and Community-
Based Nursing

Population-Focused Practice and Community/Public Health Nursing Interventions

Public Health Nursing, Managed Care, and Health Reform

Summary

Evolve Website

2. Historical Factors: Public Health Nursing in Context

Evolution of Health in Western Populations

3
 Advent of Modern Health Care

Consequences for The Health of Populations

Social Challenges and Public Health Nursing

Challenges for Public Health Nursing

Summary

Evolve Website

3. Thinking Upstream: Nursing Theories and Population-Focused Nursing Practice

Thinking Upstream: Examining the Root Causes of Poor Health

Historical Perspectives on Nursing Theory

How Theory Provides Direction to Nursing

Microscopic Versus Macroscopic Approaches to the Conceptualization of Community Health

Problems

Assessing a Theory’s Scope in Relation to Community Health Nursing

Review of Theoretical Approaches

Healthy People 2020

Summary

Evolve Website

4. Health Promotion and Risk Reduction

Health Promotion and Community Health Nursing

Determinants of Health

Theories in Health Promotion

Risk and Health

The Relationship of Risk to Health and Health Promotion Activities

Summary

Evolve Website

Unit 2. The Art and Science of Community Health Nursing

5. Epidemiology

Use of Epidemiology in Disease Control and Prevention

Calculation of Rates

Concept of Risk

4
 Use of Epidemiology in Disease Prevention

Use of Epidemiology in Health Services

Epidemiological Methods

Summary

Learning Activities

6. Community Assessment

The Nature of Community

Healthy Communities

Assessing the Community: Sources Of Data

Needs Assessment

Diagnosing Health Problems

Summary

Evolve Website

7. Community Health Planning, Implementation, and Evaluation

Overview of Health Planning

Health Planning Model

Health Planning Projects

Health Planning Models in Public Health

Health Planning Federal Legislation

Nursing Implications

Summary

Evolve Website

8. Community Health Education

Connecting With Everyday Realities

Health Education in the Community

Learning Theories, Principles, and Health Education Models

The Nurse’s Role in Health Education

Enhancing Communication

Framework for Developing Health Communications

Health Education Resources

5
 Social Media

Summary

Evolve Website

9. Case Management

Overview of Case Management

Origins of Case Management

Purpose of Case Management

Trends that Influence Case Management

Education and Preparation for Case Managers

Case Manager Services

Case Manager Roles and Characteristics

Case Identification

The Referral Process

Application of Case Management in Community Health

Research in Case Management

Summary

Evolve Website

Unit 3. Factors That Influence the Health of the Community

10. Policy, Politics, Legislation, and Community Health Nursing

Overview: Nurses’ Historical and Current Activity in Health Care Policy

Definitions

A Major Paradigm Shift

Structure of the Government of the United States

Overview of Health Policy

Public Policy: Blueprint for Governance

The Effective Use of Nurses: a Policy Issue

Nurses’ Roles in Political Activities

Health Care Reform and Restructuring of the Health Care Industry

Nurses and Leadership in Health Policy Development

Summary

6
 Evolve Website

11. The Health Care System

Overview: The Health Care System

Components of the Health Care System

Critical Issues in Health Care Delivery

Future of Public Health and the Health Care System

Summary

Evolve Website

12. Economics of Health Care

Factors Influencing Health Care Costs

Public Financing of Health Care

Philanthropic Financing of Health Care

Private Health Care Insurance

Cost Containment

Trends in Health Financing

Health Care Financing Reform

Roles of the Public Health Nurse in the Economics of Health Care

Best Care at Lower Cost

Summary

Evolve Website

13. Cultural Diversity and Community Health Nursing

Cultural Diversity

Transcultural Perspectives on Community Health Nursing

Population Trends

Cultural Perspectives and Healthy People 2020

Transcultural Nursing

Overview of Culture

Culture and Socioeconomic Factors

Culture and Nutrition

Culture and Religion

7
 Culture and Aging

Cross-Cultural Communication

Health-Related Beliefs and Practices

Management of Health Problems: A Cultural Perspective

Management of Health Problems in Culturally Diverse Populations

Role of the Community Health Nurse in Improving Health for Culturally Diverse People

Resources for Minority Health

Summary

Evolve Website

14. Environmental Health

A Critical Theory Approach to Environmental Health

Areas of Environmental Health

Effects of Environmental Hazards

Efforts to Control Environmental Health Problems

Emerging Issues in Environmental Health

Approaching Environmental Health at the Population Level

Critical Environmental Health Nursing Practice

Summary

Evolve Website

15. Health in the Global Community

Population Characteristics

Environmental Factors

Patterns of Health and Disease

International Agencies and Organizations

International Health Care Delivery Systems

Research in International Health

Summary

Evolve Website

Unit 4. Aggregates in the Community

16. Child and Adolescent Health

8
 Issues of Pregnancy and Infancy

Childhood Health Issues

Adolescent Health Issues

Factors Affecting Child and Adolescent Health

Strategies to Improve Child and Adolescent Health

Public Health Programs Targeted to Children and Adolescents

Sharing Responsibility for Improving Child and Adolescent Health

Legal and Ethical Issues in Child and Adolescent Health

Summary

Evolve Website

17. Women’s Health

Major Indicators of Health

Life Expectancy

Social Factors Affecting Women’s Health

Working Women and Home Life

Health Promotion Strategies for Women

Major Legislation Affecting Women’s Health

Health and Social Services to Promote the Health of Women

Levels of Prevention and Women’s Health

Roles of the Community Health Nurse

Research in Women’s Health

Summary

Evolve Website

18. Men’s Health

Men’s Health Status

Use of Medical Care

Theories that Explain Men’s Health

Factors that Impede Men’s Health

Men’s Health Care Needs

Community Health Nursing Services for Men

New Concepts of Community Care

9
 Summary

Evolve Website

19. Senior Health

Concept of Aging

Theories of Aging

Demographic Characteristics

Psychosocial Issues

Physiological Changes

Wellness and Health Promotion

Common Health Concerns

Additional Health Concerns

Elder Safety and Security Needs

Psychosocial Disorders

Spirituality

End-of-Life Issues

Summary

Evolve Website

20. Family Health

Challenges Facing U.S. Families

Understanding Family Nursing

The Changing Family

Approaches to Meeting the Health Needs of Families

Approaches to Family Health

Assessment Tools

Family Health Assessment

Extending Family Health Intervention to Larger Aggregates and Social Action

Applying the Nursing Process

Summary

Evolve Website

Unit 5. Vulnerable Populations

10
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21. Populations Affected by Disabilities

Self-Assessment: Perception of Disability

Definitions and Models for Disability

A Historical Context for Disability

Prevalence of Disability

Disability and Public Policy

The Experience of Disability

Health Promotion and Disease Prevention for Pwd

Ethical Issues for People Affected by Disabilities

Summary

Evolve Website

22. Veterans’ Health

Overview of the American Uniformed Services

Veteran Health Risks

Veterans Health Assessment

Interventions for Veteran Health Problems

Summary

Evolve Website

23. Homeless Populations

Definitions, Prevalence, and Demographic Characteristics of Homelessness

Factors that Contribute to Homelessness

Health and Homeless Populations

Health Status of the Homeless Population

Community Public Health Nursing: Care of Homeless Populations

Summary

Evolve Website

24. Rural and Migrant Health

Rural United States

Rural Health

Rural Health Disparities: Context and Composition

11
 Specific Rural Aggregates

Rural Health Care Delivery System

Community-Based Care

Legislation and Programs Affecting Rural Public Health

Rural Community Health Nursing

New Models Of Health Care Delivery for Rural Areas

Evolve Website

25. Populations Affected by Mental Illness

Overview and History of Community Mental Health: 1960 to the Present Day

Healthy People 2020: Mental Health and Mental Disorders

Factors Influencing Mental Health

Mental Disorders Encountered in Community Settings

Identification and Management of Mental Disorders

Community-Based Mental Health Care

Role of the Community Mental Health Nurse

Summary

Evolve Website

Unit 6. Population Health Problems

26. Communicable Disease

Communicable Disease and Healthy People 2020

Principles of Infection and Infectious Disease Occurrence

Chain of Transmission

Breaking the Chain of Transmission

Public Health Control of Infectious Diseases

Vaccines and Infectious Disease Prevention

Vaccine Needs for Special Groups

Healthy People 2020 Focus on Immunization and Infectious Diseases

Healthy People 2020 Focus on Sexually Transmitted Diseases

Healthy People 2020 Focus on Hiv/Aids

Prevention of Communicable Diseases

12
 Summary

Evolve Website

27. Substance Abuse

Etiology of Substance Abuse

Historical Overview of Alcohol and Illicit Drug Use

Prevalence, Incidence, and Trends

Adolescent Substance Abuse

Conceptualizations of Substance Abuse

Sociocultural and Political Aspects of Substance Abuse

Course of Substance-Related Problems

Legal and Ethical Concerns Related to Substance Abuse

Modes of Intervention

Social Network Involvement

Vulnerable Aggregates

Nursing Perspective on Substance Abuse

Summary

Evolve Website

28. Violence

Overview of Violence

History of Violence

Interpersonal Violence

Community Violence

Factors Influencing Violence

Violence from a Public Health Perspective

Prevention of Violence

Summary

Evolve Website

29. Natural and Manmade Disasters

Disaster Definitions

Types of Disasters

13
 Characteristics of Disasters

Disaster Management

Disaster Management Stages

Recovery Stage

Summary

Evolve Website

Unit 7. Community Health Settings

30. School Health

History of School Health

School Health Services

School Nursing Practice

School-Based Health Centers

Future Issues Affecting the School Nurse

Summary

Evolve Website

31. Occupational Health

Evolution of Occupational Health Nursing

Demographic Trends and Access Issues Related to Occupational Health Care

Occupational Health Nursing Practice and Professionalism

Occupational Health and Prevention Strategies

Skills and Competencies of the Occupational Health Nurse

Impact of Federal Legislation on Occupational Health

Legal Issues in Occupational Health

Multidisciplinary Teamwork

Summary

Evolve Website

32. Forensic and Correctional Nursing

Subspecialties of Forensic Nursing

Correctional Nursing

Health Issues in Prison Populations

14
 Mental Health Issues in Correctional Settings

Education and Forensic Nursing

Summary

Evolve Website

33. Faith Community Nursing

Faith Communities: Role in Health and Wellness

Foundations of Faith Community Nursing

Roles or Functions of the Faith Community Nurse

Education of the Faith Community Nurse

The Faith Community Nurse and Spirituality

Issues in Faith Community Nurse Practice

Summary

Evolve Website

34. Home Health and Hospice

Types of Home Health Agencies

Certified and Noncertified Agencies

Special Home Health Programs

Reimbursement for Home Care

OASIS

Nursing Standards and Educational Preparation of Home Health Nurses

Conducting a Home Visit

Documentation of Home Care

Application of the Nursing Process

Hospice Home Care

Summary

Evolve Website

Index

IBC

15
16
Copyright

3251 Riverport Lane

St. Louis, Missouri 63043

COMMUNITY/PUBLIC HEALTH NURSING: PROMOTING THE HEALTH OF POPULATIONS,

SEVENTH EDITION ISBN: 978-0-323-52894-8

Copyright © 2019 by Elsevier, Inc. All rights reserved.

Chapter 22: Veteran’s Health—Contributions made by Alison C. Sweeney, Angelic Denise

Chaison, and Joanna Lamkin are in public domain.

No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and
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can be found at our website: www.elsevier.com/permissions.

This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).

Notices

Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical
treatment may become necessary.

Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described herein. In
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Library of Congress Cataloging-in-Publication Control Number: 2018944741

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Content Strategist: Jamie Blum
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18
Dedication

To Phil Yankovich, my husband, companion, and best friend, whose love, caring, and true support
are always there for me. He provides me with the energy I need to pursue my dreams.

To Kara Nies Yankovich, my daughter, for whom I wish a happy and healthy life. Her energy, joy,
and enthusiasm for life give so much to me.

To Earl (who passed away October 15, 2017, at the age of 92) and Lois Nies, my parents, for their
never-ending encouragement and lifelong support. They helped me develop a foundation for
creative thinking, new ideas, and spirited debate.

Mary A. Nies

To my husband, Scott McEwen, whose love, support, inspiration, and encouragement have been
my foundation for more than 40 years. I can’t wait to see what happens next!

Melanie McEwen

19
About the Author

Mary A. Nies
Mary A. Nies, PhD, RN, FAAN, FAAHB, is the Director of Nursing Research and Professor
College of Nursing, Joint Appointment MPH Program, Kasiska Division of Health Sciences, Idaho
State University. Dr. Nies received her diploma from the Bellin School of Nursing in Green Bay,
Wisconsin; her BSN from the University of Wisconsin, Madison; her MSN from Loyola University,
Chicago; and her PhD in Public Health Nursing, Health Services, and Health Promotion Research at

20
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Typographical errors corrected by the etext transcriber:

uture of the sex=> future of the sex {pg 51}
my way anxiously to ou=> my way anxiously to our {pg 121}
vortex of feminity=> vortex of femininity {pg 122}
the dignified movemene=> the dignified movement {pg 153}
seated royalties oppositt=> seated royalties opposite {pg 153}
Nor far from the Schloss=> Not far from the Schloss {pg 170}
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