Epidemiology, the Basis for Public Health

The study of epidemiology includes the examination of infectious disease, mental health and health-related events such as accidents or violence, and occupational and environmental exposure and their effects, as well as the examination of positive health states (Stanhope & Lancaster, 2016). Additionally, the study of epidemiology includes research into the morbidity and mortality of chronic illnesses that are found in the United States and across the globe. Infectious diseases like polio, TB, measles, and malaria have been almost eliminated in the United States; however, these diseases continue in other parts of the world for a variety of reasons. Highly contagious infectious diseases can and do lead to death despite the fact that many are preventable. The United States has used childhood vaccinations to prevent and eradicate illnesses such as smallpox and polio. In order to reduce the incidence of malaria in the United States, DDT—a known carcinogen in humans that is also toxic to birds—and other pesticides were used in the past and have since been replaced with nontoxic insecticides and larvicides to reduce the numbers of mosquitoes.

Unfortunately, developing countries often do not have the resources to engage in the same sorts of prevention programs and may have to resort to unsafe or toxic means to control vectors. They may not have the financial resources or health care personnel available to engage in mass vaccination campaigns. In addition, countries that experience frequent wars, acts of terrorism, and political instability face additional challenges to the provision of health care to their populations, especially when faced with an outbreak of an infectious disease.

This week, you will focus on the epidemiology of infectious and communicable disease and how nursing practices change in response to threats and outbreaks.

Learning Objectives

Students will:
  • Analyze public health settings in relation to prevention of disease transmission
  • Analyze public health nurse’s role in outbreak investigations
  • Apply the epidemiological triangle for an infectious or communicable disease outbreak
  • Analyze leadership roles of nurses in bringing an outbreak under control
  • Evaluate nursing strategies for health promotion in mitigating outbreaks

Photo Credit: IAN HOOTON/Science Photo Library/Getty Images


Learning Resources

Required Readings

Holtz, C. (2013). Global health care: Issues and policies (2nd ed.). Burlington, MA: Jones & Bartlett.

  • Chapter 7, “Infectious Diseases from a Global Perspective” (pp. 159–182)
  • Chapter 13, “Global Perspectives on Violence, Injury, and Occupational Health” (pp. 325–354)
  • Chapter 15, “Global Perspectives on Mental Health” (pp. 385–408)

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.

  • Chapter 13, “Infectious Disease Prevention and Control” (pp. 286–318)

Public Health Nursing: Population-Centered Health Care in the Community, 9th Ed. by Stanhope, M., & Lancaster, J. Copyright 2015 by Elsevier Health Science Books. Reprinted by permission of Elsevier Health Science Books via the Copyright Clearance Center.

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.

  • Chapter 12, “Epidemiology” (pp. 256–285)

Public Health Nursing: Population-Centered Health Care in the Community, 9th Ed. by Stanhope, M., & Lancaster, J. Copyright 2015 by Elsevier Health Science Books. Reprinted by permission of Elsevier Health Science Books via the Copyright Clearance Center.

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.

  • Chapter 24, “Public Health Surveillance and Outbreak Investigation” (pp. 529–544)

Public Health Nursing: Population-Centered Health Care in the Community, 9th Ed. by Stanhope, M., & Lancaster, J. Copyright 2015 by Elsevier Health Science Books. Reprinted by permission of Elsevier Health Science Books via the Copyright Clearance Center.

HealthyPeople.gov. (2016). Global health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/global-health

Required Media

Laureate Education, Inc. (Producer). (2016). The role of the nurse in public and global health with Dr. Letitia Robinson. Baltimore, MD: Author.

Note: The approximate length of this media piece is 7 minutes.

TED. (2014). What makes us get sick? Look upstream. Retrieved from https://www.ted.com/talks/rishi_manchanda_what_makes_us_get_sick_look_upstream

Note: The approximate length of this media piece is 18 minutes.

Dr. Rishi Manchanda suggests physicians and health care workers look upstream to discover the root causes of why patients are sick.

Writing Resources and Program Success Tools

Document: AWE Checklist (4000) (Word document)

This checklist will help you self-assess your writing to see if it meets academic writing standards for this course.

Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (6th ed.). Retrieved May 20, 2016, from http://academicguides.waldenu.edu/ld.php?content_id=7980455

Dr. Mary Bassett (Health Commissioner of New York City) discusses why physicians, nurses, and other health care professionals should not keep silent about health care disparities, based on her insights from her work in Zimbabwe.


Discussion: Preventing Disease in Communities:
The Role of Public Health, the Silent Sentinel

Our “world” starts with our own community, county, and state, then moves out in concentric rings from that point to include our country and eventually the world. Disease is transmitted from person to person through direct contact, or from a source such as a vector or contaminated water through a variety of means, such as flood waters or even terrorist actions. Individuals with limited or no knowledge of safe sex methods may have unprotected sexual relations and knowingly or unknowingly transmit disease to their partners, then to their partners’ partners, and on and on. Often it is the role of the public health nurse to investigate a disease outbreak, contain it, and then educate others so that the same situation doesn’t happen again.

In this Discussion, you will visit a site and interview people who work there about risks for disease transmission, then report on your findings.

To prepare, select which site you will visit from the following options:

  • High school nurse’s office
  • Water treatment plant
  • Public health department
  • Pediatrician’s office

Create a brief description of your setting, providing some context; for example, how many patients are seen, size or capacity of the facility as applicable, and/or the location of the office or organization.

While you are at the site, check to see if you are allowed to take pictures. If so, include your photos in your Discussion post to give your colleagues a better understanding of the environment you are describing.

Then, during your site visit, pose the questions listed in the following chart:

High school nurseWhat is the school’s policy on giving students advice about birth control?How often do you get requests for information about birth control or how to protect oneself from an STD?How do you track vaccination compliance, and what happens to students who fall out of compliance?
Local water treatment plantWhere does your community’s water come from?Where is it stored?How often is it tested for purity?What safeguards are in place to prevent tampering with the water supply?
Local public health departmentDoes this department have an STD clinic?In addition to testing, does the department offer treatment of one party or both parties?What is the most frequently diagnosed STD?
A pediatrician’s officeWhat is your policy on accepting patients who refuse vaccinations?What are the most common reasons parents decline vaccinations for their children in this particular office?What is the policy at this office for giving antibiotics to treat viral syndromes?

Now, look at the site you visited through the eyes of the public health nurse (PHN). Imagine you are the PHN and have been asked to investigate an outbreak at this facility.

  • What questions would you ask?
  • What suggestions could you make to avoid a disease outbreak at the facility?
  • What would your role as a change agent be for any deficiencies you find in your on-site inspection?

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