NURS 8310 POPULATION HEALTH AND EPIDEMIOLOGY THEN AND NOW

The practice and scope of population health have evolved significantly over the years, shaped by advancements in epidemiology and the broadening understanding of health determinants. Historically, the focus was more on combating infectious diseases through sanitary reforms and controlling environmental factors. Today, population health encompasses a wide array of factors including genetics, social determinants, and lifestyle choices, aiming to improve health outcomes and reduce health disparities across large groups.

Epidemiology plays a central role in this evolution, serving as the foundation for understanding disease patterns and health outcomes in populations. It guides public health interventions, policy-making, and health promotion strategies by identifying risk factors and evaluating the effectiveness of health programs (Friis & Sellers, 2021). The discipline has expanded from tracking the spread of infectious diseases to include chronic disease epidemiology, environmental health, and behavioral health, reflecting the complex interplay of factors that influence population health.

In the 1800s and early 1900s, nurses like Florence Nightingale, Clara Barton, and Lillian Wald pioneered the integration of individual and population-based care. They recognized the importance of environmental factors in health outcomes and advocated for sanitary reforms, public health education, and community nursing practices. These early nurses played crucial roles in shifting the focus from individual care to a broader population health perspective, laying the groundwork for modern public health nursing (Gallagher, 2020; Michals, 2015; Rothberg, 2020).

Today, nurses can advance population health through various roles and strategies. Firstly, they can leverage their positions to advocate for policies that address social determinants of health, such as poverty, education, and housing. By participating in policy development and implementation, nurses can influence the broader factors that impact population health (Curley, 2020). Secondly, nurses can lead and participate in community-based health promotion and disease prevention programs. This involves working directly with communities to develop tailored interventions that address specific health needs, thereby reducing health disparities and improving overall health outcomes.

Significant developments in the history of epidemiology and population health, such as the transition from infectious to chronic disease epidemiology, have influenced current practices. Unlike the early days when the focus was primarily on controlling environmental factors to prevent diseases, today’s approach is multi-faceted, addressing a wide range of determinants from genetics to lifestyle and environmental exposures.

Nurses play a vital role in promoting population health by bridging the gap between individual care and population-based strategies. Their direct engagement with communities and individuals positions them uniquely to advocate for and implement changes that improve health outcomes at the population level (Curley, 2020; Friis & Sellers, 2021).

References:

Curley, A. L. C. (Ed.). (2020). Population-based nursing: Concepts and competencies for advanced practice (3rd ed.). Springer.

Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett.

Gallagher, A. (2020). Learning from Florence Nightingale: A slow ethics approach to nursing during the pandemic. Nursing Inquiry, 27, e12369. https://doi.org/10.1111/nin.12369Links to an external site.

Michals, D. (Ed.). (2015). Clara Barton. National Women’s History Museum. https://www.womenshistory.org/education-resources/biographies/clara-bartonLinks to an external site.

Rothberg, E. (2020). Lillian Wald. National Women’s History Museum. https://www.womenshistory.org/education-resources/biographies/lillian-waldLinks to an external site.

SAMPLE 2

When discussing population health, the first thing that should be done is identifying exactly what it is. The New York State Department of Health defines population health as “the health status and health outcomes within a group of people rather than considering the health of one person at a time” (n.d.). Next is understanding how that has changed over time. One of the main ways to identify the change in population health over time is by looking at the mortality rates in populations over a period of time (Mackenbach, 2020). Over the last century or so, the mortality rates have gone down while life expectancy rates have risen (having an inverse relationship).

In order to fully understand this trend a basis in epidemiology is also needed as earlier population health was more focused on combatting communicable diseases compared to modern practices. Epidemiology is defined by the National Institutes of Health as, “the branch of medical science that investigates all the factors that determine the presence or absence of diseases and disorders. Epidemiological research helps us to understand how many people have a disease or disorder, if those numbers are changing, and how the disorder affects our society and our economy” (2011). In other words, population health is influenced by epidemiology by the data produced; if it is noticed that a particular group or population is experiencing influenza at a higher rate (data gathered by epidemiological study), then population health’s goal is to reduce that incidence through some kind of intervention (hand washing stations around the community, masking efforts, etc.). This has changed over time with economic development and resources. This is best put by Mackenbach (2020),

…long-term trends in population health have been the result of many superimposed disease-specific trends, and the latter are more often than not characterized by a distinct pattern of ‘rise-and-fall’. One way to understand this endless succession of ‘rises-and-falls’ is to regard them as an accompaniment of socioeconomic development. As a result of the drive for socioeconomic improvement, and the changes in behaviour associated with this drive, mankind is continuously confronted with new disease risks. However, because higher levels of development also bring higher living standards and a greater desire and capacity to control disease, after some time these disease risks decline again (but often to be replaced by new disease risks)

As noted from the above quotation this increase in life expectancy has allowed population health to take on a bigger role in health outcomes, focusing not only on physical health but on mental, social and financial health as well.

            Nursing’s role in these concepts came into view primarily in the 19^th and 20^th centuries. When prominent individuals spearheaded the integration of individual and community-centered healthcare. They grasped the importance of environmental factors on health and advocated for better sanitation, public health education, and community nursing methods. Their efforts were crucial in shifting healthcare’s focus from individual patients to a broader perspective on population health, laying the groundwork for modern population health nursing.

            Nurses can influence population health today in a multitude of different ways, the first being that nursing is still one of the most trusted professions in the country (University at Buffalo, 2024). This allows nurses to be very influential when discussing health matters, whether individual or population based. Putting out information from a trusted profession improves the chances of a better reception, this in turn can lead to a more positive long-term outcome. Nurses are traditionally the “boots on the ground” healthcare personnel, as such we are traditionally already engaged with the communities and populations we serve. Giving us an easier insight into the challenges that might be faced. Ultimately though there is no magic bullet when it comes to population health and so the main thing that needs to be done when trying to affect positive change is to partner with the population you are trying to serve.

References:

Mackenbach, J. P. (2020). Chapter 2: Long-term Trends in Population Health. In A History of Population Health. Brill. Retrieved from https://brill.com/display/book/9789004429130/BP000003.xml

National Institutes of Health. (2011). What is Epidemiology. Retrieved from National Institute on Deafness and Other Communication Disorders: https://www.nidcd.nih.gov/health/statistics/what-epidemiology

New York State Department of Health. (n.d.). Retrieved from https://www.health.ny.gov/events/population_health_summit/docs/what_is_population_health.pdf

University at Buffalo. (2024, January 25). Nurses most trusted profession in new Gallup survey. Retrieved from UBNow: https://www.buffalo.edu/ubnow/briefs/2024/01/nurses-gallup.html#:~:text=Nurses%20once%20again%20ranked%20at,of%20UB%27s%20School%20of%20Nursing.