Public Health Exam 3 PPP Study Guide 2023-2024
Chapter 6: Environmental Health
• ANA scope and standards for health (2007)
o Healthy environment is essential for optimal health & healthcare.
o We get chemical, biological, and radiological exposures that affect our health in the air we breathe, the water we drink,
the food we eat, and the products we use.
• Relationship between the environment and health:
o Florence nightingale: Crimean War
o Mary Brewster: Henry Street Neighborhood
▪ worked to improve the environment of the Henry Street neighborhood. Aimed to improve physical environment
and social conditions that affected health.
o Environmental Contamination
o Poverty and exposure to environmental factors
• Climate Change:
o According to the World Health Organization, “climate change is a significant and emerging threat to public health
and changes the way we must look at protecting vulnerable populations.”
• Environmental Factors: WHO, 1993
o An estimated 24% of the global burden of disease and 23% of all deaths can be attributed to environmental factors
(World Health Organization [WHO])
o Besides using these WHO factors, we can also divide and examine the environment from the perspective of the media
in which environmental degradation takes place: air, water, soil, and food. And a third approach would be to divide
environmental exposures into categories: biological, chemical, and radiological.
• Global Disease Burden Risk Factors:
o Risk factors are defined as personal habits and behaviors, environmental conditions, or inborn or inherited
characteristics that are known to affect a health-related condition.
▪ Childhood and maternal malnutrition, Other nutrition-related risk factors and inactivity, Addictive substances, Sexual
and reproductive health, Environmental risks
• Environmental Health Assessment
o Air (indoor/outdoor), water, land, or food
o Chemical, biological, radiological, social, & psychosocial
o Environmental health assessment
o “I PREPARE”
o Windshield survey
o Environmental databases
o Environmental health assessment form
,Public Health Exam 3 PPP Study Guide 2023-2024
o Inquire/observe about unintended environmental exposures
• Environmental Exposures
o Herbicides
o Pesticides
o Other chemical carcinogens
o Lead – Wet sanding to prevent loose particles flying in the air.
o Radiation
• Vulnerable Populations
o Social determinants contribute to risk levels.
o Economic factors: lower-income clients are at increased risk for health problems
▪ Lives in substandard housing
▪ Lives in close proximity to pollution sources
▪ Employed in more dangerous occupations
▪ Have less access to healthy food options
o Life cycle factors
▪ Very young and very old are more vulnerable
▪ EPA report: “Growing Smarter/Living Healthier: A Guide to Smart Growth and Active Aging”
• The Millennium Development Goals
o Eradicate extreme poverty and hunger. Achieve universal primary education. Promote gender equality and empower
women. Reduce child mortality. Improve maternal health. HIV/AIDS, malaria, and other diseases. Ensure
environmental sustainability. Develop a global partnership for development.
• Healthy People 2020 Objectives for ENVIROMENTAL HEALTH
o Eliminate elevated lead blood levels in children. Minimize risks posed by hazardous sites.Reduce significant pesticide
exposures. Reduce the amount of toxic pollutants. Reduce indoor allergen levels. Decrease lead-based paint or
related hazards.
• Healthy People 2030 Overachieving Goals
o Achieving these broad and ambitious goals requires setting, working toward, and achieving a wide variety of much
more specific goals.
o Healthy People 2030’s overarching goals are to:
▪ Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death.
▪ Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being
of all. Create social, physical, and economic environments that promote attaining the full potential for health and
well-
being for all. Promote healthy development, healthy behaviors, and well-being across all life stages. Engage
leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the
,Public Health Exam 3 PPP Study Guide 2023-2024
health and well-being of all.
, Public Health Exam 3 PPP Study Guide 2023-2024
• Children’s Environmental Health
o Children’s bodies operate differently than adults, putting them at potentially increased risk for toxic exposure. Increased
respiratory rate translates to a proportionately greater exposure to air pollutants. Immature blood-brain barrier.
Kidneys less effective at filtering undesirable chemicals
• Policy & Advocacy
o Nurses can guide and drive policy. 1 in every 100 Americans is a registered nurse! Nurses have a responsibility to be
informed and take action in the best interest of public. Nurses can serve as resources for state and federal legislators
and staff. Nurses also work as advocates for environmental justice and rights of others.
o 2008—Alliance of Nurses for Healthy Environments. Created to coalesce nurses and nursing organizations
around relevant issues
Chapter 3: The Changing US Health & Public Health Care Systems
• How public health systems are organized: The central goal of public health is the reduction of disease through prevention
and the improvement of health in the community, both nationally and internationally.
• Challenges for the future:
o Barriers to specializing in PHN: Changing mindset that nursing is only at bedside, Work structure and role
socialization, Few nurses receive graduate-level PHN education.
o Developing population-focused nurse leaders
o Shifting public policy from cure to Prevention: we want to shift it to prevention in the community rather than
individualized care
• Demographic Trends:
o Increased fertility and decreased mortality. Baby booms are living longer and surviving & baby busts; increasing in
average age. Changes in minority group: Hispanics. The minority population is the majority. More single parents =
economic stress especially with children. Declining in mortality for both genders in all age groups
• Social and Economic Trends
o Changing lifestyles, growing appreciation of quality of life, health seen as an irreplaceable commodity, changing
composition of families, changing household incomes, growing gap between richest and poorest (no more middle
class), revised definition of quality health care, rise in complementary and alternative therapies, economic downturn of
2008, Affordable Care Act
• Health Workforce Trends
o Not enough primary-care providers, advanced-practice nursing (APN) specialties, move to contain costs and move
to community-based care, current nursing shortage, need to increase number of minority nurses to help decrease
health disparities
• Technological trends
o Telehealth, electronic records
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