you will compare the health trends that are exhibited in Healthy People 2010 and 2020 frameworks.

CHE 6305, Issues and Trends in Community Health 1

Course Learning Outcomes for Unit I Upon completion of this unit, students should be able to:

1. Analyze a public health problem using problem-solving methodology. 1.1 Compare and contrast past and current data trends in community health. 1.2 Describe the connection between historical events and community health disparities.

Course/Unit Learning Outcomes

Learning Activity

1.1

Unit Lesson Chapter 1 Document: Healthy People 2010 Overview Document: Healthy People 2020 Framework Presentation: Health in the United States – A Review of the First Decade of the

21st Century Unit I Research Report

1.2 Chapter 1 Unit I Research Report

Required Unit Resources Chapter 1: Health Disparities: The Best of Times, the Worst of Times In order to access the following resources, click the links below. Healthy People 2020. (n.d.). Healthy people 2020 framework.

https://www.healthypeople.gov/sites/default/files/HP2020Framework.pdf Healthy People 2010. (n.d.). Healthy people 2010 overview. Centers for Disease Control and Prevention.

https://www.cdc.gov/nchs/data/hpdata2010/hp2010_final_review_overview.pdf Koh, H. K., Sondik, E. J., & Mullen, J. (2011, October 6). Health in the United States – A review of the first

decade of the 21st century. Healthy People. https://www.healthypeople.gov/sites/default/files/HealthInTheUS_Slides.pdf

Unit Lesson

Introduction The importance of providing well-organized community health programs has never been more clear to the general public than during the worldwide COVID-19 pandemic. Programs only have a hope of being properly funded and run when clear data is provided to decision-makers that spells out the trends and issues concerning public health. For example, states fought during the pandemic to receive adequate ventilators for patients in need due to COVID-19. Many states did not have enough to care for their patients. Essential frontline workers were also trying to work and save lives with a limited supply of personal protection equipment (PPE). It is crucial in times like these that accurate data is gathered in order for all parties involved to receive the necessary equipment. Even with accurate data, health disparities may prevent certain populations from receiving care. According to Yancy (2020), African Americans and other minorities were more likely to not only contract COVID-19 but are

UNIT I STUDY GUIDE

Introduction to Issues and Trends in Community Health

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also more like to die from the virus. This may partially be due to African Americans being more susceptible to a higher comorbidity rate. Comorbidity or comorbidities is defined as having two concurrent chronic diseases such as diabetes, obesity, or cardiovascular disease. The deeper root cause could be the disparities African American are faced with when compared to other races such as limited or no access to health care and not having health insurance. This lesson will introduce you to issues and trends in community health. We will discuss the importance of community health, define a healthy community, discuss how the health of a community is measured, define primary and secondary data, describe commonly used data sources (local, state, and national), discuss data collection types (primary and secondary), and life expectancy through the years.

What Is Community Health? Community health is not a new term; it has been around since the 20th century. “Community health is a term used to describe the state of health and how easy or difficult it is to be healthy where people live, learn, work and play” (Centers for Disease Control and Prevention [CDC], 2015, para. 1). It is not just looking to evaluate one’s physical health, but their overall or total health. Geographic location and demographics are also factors in community health as no community is the same or has the same needs. The health of a community is important and depends on not only just the individuals who reside there, but also the environment as a whole. A person’s health is contingent on the resources available to him or her in that community. If the community is healthy, which includes access to equal and ample employment opportunities, safe schools, healthy and nutritious foods, and quality health care for all, then each person’s health will mirror that of the community (Ashby & Pharr, 2012). When individuals do not have adequate and equal access to the aforementioned items, it can lead to poor health. This can include chronic diseases such as diabetes, cardiovascular diseases, cancers, and obesity; the spread of infectious disease such as COVID- 19, the flu, and sexually transmitted diseases (STDs); and not being able to prepare for natural disasters such as hurricanes or flooding. According to Ashby and Pharr (2012), the growth of a community is dependent on its health. The community cannot flourish as a whole if the health is poor. In addition to the elements listed in the paragraph above, other essential parts of a healthy community include a variety of educational opportunities, safe communities, and access to safe parks and other recreational areas. These are just a few of the components visible in a healthy community, all of which lead to an improvement in total health. When one group does not have access to the same amenities mentioned above, it causes health disparities. Disparities are differences in health status based on groups’ demographics, socioeconomic status, medical status, and other discriminatory factors (Braveman et al., 2011). These disparities, resulting from social determinants, are avoidable but occur in many communities affecting the overall health of the community.

Data Collection The health of a community is measured by collecting data. Data is information or observations that are collected and analyzed. The type of data gathered would depend on the goal of the organization collecting the data and what it intends to measure. It will also be contingent on research type such as qualitative, quantitative, or mixed methods. Qualitative research is non-numerical data used to delve into the thoughts and feelings of those participating in the research study (Sutton & Austin, 2015). In contrast, quantitative data measures numbers. In other words, quantitative data is the “what,” and qualitative data gives more details by answering the “why.” A mixed-method approach uses a combination of both previously mentioned forms of data. Typical information collected may include demographic information such as age, race, gender, education level, and annual earned income. It may also include health status including disease or disability and medical history, such as being a smoker or a nonsmoker. It is important that the methodology used to collect the data is both valid and reliable. Data that is not valid and reliable will result in inaccurate information and will also impede future researchers from repeating this process. Once collected, data is then analyzed using programs and software such as Statistical Package for Social Science (SPSS), Statistical Analysis System (SAS), or STATA and used to create a health profile of that community. “A community health profile is made up of

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indicators of socio-demographic characteristics, health status and quality of life, health risk factors, and health resources that are relevant for most communities” (Durch, et al., 1997, p. 127). A community’s health will either be assessed using primary or secondary data. Primary data is information collected directly from the source. Primary data is information collected directly from the researcher in order to answer a proposed research question (Liu, 2020). Examples include interviews, surveys, experiments, focus groups and observations. In contrast, secondary data is collected from another source. For example, researchers may use statistics that have been collected from the CDC in their research. Data collection is crucial in health because it allows one to gather information about the group being researched with respect to issues and trends. Information gleaned from data can measure healthy or unhealthy behaviors, health care costs, disease risk factors, and more. It will also give some insight into the strengths and weaknesses with the current public health programs.

Data Sources There are several commonly used data sources at the local, state, and national levels. Examples of local data sources would be the Detroit Health Department, Oakland County Health Department, or Wayne County Health Department. Researchers would be able to retrieve data specific to these local areas. Information can include COVID-19 cases in those particular counties and other public health information such as chronic disease, communicable and non-communicable diseases, and mental health. Easy-to-read fact sheets and pamphlets are also readily available for the public. State-level secondary data sources would include the Michigan Department of Health and Human Services. This organization lists a myriad of information and data from birth defects and health care statistics, to population trends and health disparities, all specific to the state of Michigan. Data is also divided by categories such as gender, age, and race. Lastly, national level secondary data sources include information collected at the national level. This includes organizations such as the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), the National Institutes of Health (NIH), the Surveillance Epidemiology and End Results, and the census. These sources allow individuals to compare and contrast data by state. For example, data from Michigan may show a positive correlation between education and reduced intravenous drug use. In contrast, the same education in Wisconsin may not show these positive results. The data allows us to ask the question “why” as well as perform additional assessments and implement interventions for the other group.

Data Analysis Once this data is collected, it can then reveal areas of concern in the community. For example, if the data shows that adults in minority communities participate in less physical activity due to the lack of parks in the neighborhoods, funding can then be allocated to those neighborhoods to develop community parks. Or, if the data shows the elderly population is not going to the doctor because of lack of transportation, a plan can be put in place to address that issue. Measuring the health of a community helps highlight areas of concern but also helps pull in needed resources as well.

Trends Data not only shows where possible problems may be in a community, it also is able to highlight trends. A trend is used to determine the direction in which something is going (Gibbs & Gibbs, 2015). A trend can either be positive or negative depending on what is being measured. An example of a positive trend would be one where people start to utilize the company’s new exercise facility to improve their health. The exercise facility has a positive effect on the health of the employees. A negative trend is where one area goes down as a

Did You Know? Healthy People is a program created and

maintained by the Centers for Disease Control and Prevention dedicated to improving the

health of all Americans using science- supported objectives. Benchmarks and

progress are monitored over 10-year periods. Learn more about the 3 decades of Healthy

People at the following links:

Healthy People 2010 Healthy People 2020 Healthy People 2030

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result of the other. For example, the hotter the temperature is outdoors, the cooler the temperature you want inside the house and therefore, the more expensive the utility bill will be. Trends help give insight into what is happening in communities. They allow us to make changes to improve the health of the citizens who live there. They give insight into which way the health care industry is going. For example, doctors now use electronic medical records (EMR). These are critical in health care because they ensure patients are not being prescribed contraindicating medications. These EMRs allow doctors to treat you by making the best-informed decision based on the information provided in your chart. Trends also allow individuals to be current using best practices and align themselves with the way trends are going. For example, telehealth or Teledoc is a popular trend used in health care. Using telemedicine, patients are now able to receive virtual medical care through telecommunications. They can set up appointments using an app, and a doctor can treat the patient virtually. Prescriptions, if needed, are sent to the patient’s preferred pharmacist, and this is all done in the privacy of the patient’s home. This trend was particularly important during the COVID-19 pandemic. Some people were afraid to go the doctor for fear of contracting the virus there. This would be a perfect alternative for them, especially for non-threatening scenarios. Another trend researched throughout the years has been life expectancy. Life expectancy is the total sum of the overall health and wellness of a particular population, community, or group (Ho & Hendi, 2018). Researchers looked to understand and explain why certain populations were living longer while others were not. Was it socioeconomic status, demographics, or location? Through research they were able to see the issues and trends related to life expectancy.

Conclusion Understanding current issues and trends in community health helps to improve the overall quality of health by preventing or minimizing diseases, promoting overall health and wellness, and addressing all environmental and community factors that impact health, both current and future.

References Ashby, D. T., & Pharr, H. (2012, January). What is a healthy community? Building healthy communities in

Southern Nevada. Healthy Communities. https://www.unlv.edu/sites/default/files/24/Health- Community-January2012.pdf

Braveman, P. A., Kumanyika, S., Fielding, J., Laveist, T., Borrell, L. N., Manderscheid, R., & Troutman, A.

(2011). Health disparities and health equity: the issue is justice. American Journal of Public Health, 101 (Suppl 1), S149–S155. https://doi.org/10.2105/AJPH.2010.300062

Centers for Disease Control and Prevention. (2015, September 18). A healthy community is a prepared

community. Public Health Matters Blog. https://blogs.cdc.gov/publichealthmatters/2015/09/a-healthy- community-is-a-prepared-community/

Durch, J. S., Baily, L. A., & Stoto, M. A. (Eds). (1997). Improving health in the community: A role for

performance monitoring. Institute of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK233011/ Gibbs, N. M., & Gibbs, S. V. (2015). Misuse of ‘trend’ to describe ‘almost significant’ differences in

anaesthesia research. British Journal of Anaesthesia, 115(3), 337–339. https://doi.org/10.1093/bja/aev149

Ho, J. Y., & Hendi, A. S. (2018, August 15). Recent trends in life expectancy across high income countries:

Retrospective observational study. BMJ, 1–13. https://doi.org/10.1136/bmj.k2562 Liu, D., Burston, B., Collier-Stewart, S., & Mulligan, H. H. (2020). The challenges of health disparities:

Implications and actions for health care professionals. Jones & Bartlett Learning.

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Sutton, J., & Austin, Z. (2015). Qualitative research: Data collection, analysis, and management. The Canadian Journal of Hospital Pharmacy, 68(3), 226–231. https://doi.org/10.4212/cjhp.v68i3.1456

Yancy C. W. (2020, April 15). COVID-19 and African Americans. JAMA, 323(19), 1981–1892.

doi:10.1001/jama.2020.6548

Learning Activities (Nongraded) Nongraded Learning Activities are provided to aid students in their course of study. You do not have to submit them. If you have questions, contact your instructor for further guidance and information. Check your understanding of some of the key terms discussed in Unit I by completing the Unit I Crossword Puzzle. This puzzle will open up in Excel. Please note the first tab contains the activity and the second tab contains the answers, so you can check your work.