Did you know that the United States has a higher rate of infant mortality than Japan (CIA, n.d.)? Or, as Dr. Beilenson states in this week’s media presentation, that “your zip code that you live in makes more difference in your health and well-being than the genetic code that you’re born with?” What causes these differences in health outcomes?

To effectively develop policies and programs to improve population health, it is useful to use a framework to guide the process. Different organizations and governmental agencies (for example, Healthy People 2020) have created a variety of such frameworks, which establish measures for assessing population health. These measures frequently are derived from the examination of epidemiologic data, which include key measures of population health such as mortality, morbidity, life expectancy, etc. Within each measure are a variety of progress indicators that use epidemiologic data to assess improvement or change.

For this Discussion, you will apply a framework developed by Kindig, Asada, and Booske (2008) to a population health issue of interest to you. This framework includes five key health determinants that should be considered when developing policies and programs to improve population health: access to health care, individual behavior, social environment, physical environment, and genetics. 

To prepare:

• Review the article “A Population Health Framework for Setting National and State Health Goals,” focusing on population health determinants.
• Review the information in the blog post “What Is Population Health?”
• With this information in mind, elect a population health issue that is of interest to you.
• Using this week’s Learning Resources, the Walden Library, and other relevant resources, conduct a search to locate current data on your population health issue.
• Consider how epidemiologic data has been used to design population health measures and policy initiatives in addressing this issue.

Post a summary of how the five population health determinants (access to health care, individual behavior, social environment, physical environment, and genetics) affect your selected health issue, and which determinants you think are most impactful for that particular issue and why. Explain how epidemiologic data supports the significance of your issue, and explain how this data has been used in designing population health measures and policy initiatives.

Reflect on a patient who presented with a behavioral or mental health issue during your Practicum experience. Describe your experience in assessing and managing the patient and his or her family. Include details of your “aha” moment in identifying the patient’s behavioral or mental health issue. Then, explain how the experience connected your classroom studies to the real-world clinical setting. If you did not have an opportunity to evaluate a patient with this background during the last 4 weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

  

Observational Study Designs

A clinical pediatric nurse has noticed a rise in childhood cancer diagnoses among the Hispanic population served by the local clinic. The nurse is concerned about this increase in cancer incidence in the patient population and turns to the literature to explore current research on this topic. The nurse finds through the reading that there appears to be an association between parental smoking and childhood cancer and wonders if this could be the cause of the rise in cases.

This type of suspected association between a risk factor (exposure) and a particular outcome (childhood cancer) can be evaluated using an observational study design. This week, you were introduced to observational study designs used in epidemiology. For this Discussion, you will identify an epidemiologic association of interest (e.g., smoking and lung cancer, obesity and heart disease, hormone replacement/modification therapy and breast cancer) and determine an appropriate observational study design for exploring that association.

To prepare:

• Review      the different types of observational study designs presented in the      Learning Resources: ecologic, cross-sectional, case-control, and cohort.
• Carefully      examine the characteristics, strengths, and limitations of each design.
• Consider      an association between a risk factor and a particular health outcome that      is of interest to you. Then, select the observational study design you      think would be the most appropriate for exploring this association.
• Consider      how using observational study designs can lead to improvements in      population health.

By tomorrow 03/14/2018 12 noon, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below:

Post a cohesive response that addresses the following:

1) Identify the association between the risk factor and health outcome you selected and suggest which observational study design you feel is most appropriate for examining that association.

2) Support your selection of the observational design, noting its strengths and limitations for addressing the health problem.

3) What might you be able to learn by using your selected study design that might lead to improvements in population health? Support your response with evidence from the literature.

Required Readings

Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.

Chapter 6, “Study Designs: Ecologic, Cross-Sectional, Case Control”

Chapter 7, “Study Designs: Cohort Studies”

Chapter 6 presents an overview of analytic study designs used in epidemiology, differentiating between experimental studies (which will be addressed next week) and observational studies (the focus of this week). In the chapter, the authors address three varieties of observational studies—ecological, cross-sectional, and case control. Chapter 7 addresses cohort studies, another form of observational design.

Doll, R., & Hill, A. B. (1999). Smoking and carcinoma of the lung. Bulletin of the World Health Organization, 77(1), 84–93.

This landmark case-control study established the relationship between smoking and lung cancer.

Framingham Heart Study. (1998). Epidemiological background and design: The Framingham study. Retrieved from https://biolincc.nhlbi.nih.gov/static/studies/framcohort/Epidemiological_Background_and_Design.pdf

The Framingham Heart Study is one of the first and largest cohort studies that measured the distribution of suspected risk factors in a large population and then tracked the development of heart disease in that cohort.

Papathanasiou, A. A., & Zintzaras, E. (2010). Assessing the quality of reporting of observational studies in cancer. Annals of Epidemiology, 20(1), 67–73. 

In this article, the authors assess the quality of reporting of observational cancer studies, noting opportunities for improvement.

Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). Strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Annals of Internal Medicine, 147(8), 573–577.

A consortium of scientists and medical researchers created a checklist of 22 recommended items that should be included in reports about three common observational study designs: case-control, cohort, and cross-sectional studies. This collaborative effort is an important step toward the goal of improving the quality, credibility, and generalizability of analytical research.

Healthy People 2020. (2011). Topics & objectives index. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/default.aspx

Healthy People 2020 focuses on improving population health locally and nationally. Review the topics and objectives of Healthy People 2020 as you prepare for Assignment 2.

Required Media

Laureate Education, Inc. (Executive Producer). (2012). Epidemiology and population health: Observational studies [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 9 minutes.

In this week’s program, the presenters discuss observational studies as a means of establishing an association between an exposure or risk factor and a disease outcome. Two types of observational designs are featured: cohort and case control studies.

Optional Resources

The following ERIC notebook guides present information in a reader-friendly study guide format.

Ibrahim, M., Alexander, L., Shy, C., & Farr, S. (1999). Cohort studies. ERIC Notebook, 3, 1–4. Retrieved from http://cphp.sph.unc.edu/trainingpackages/ERIC/eric_notebook_3.pdf

Ibrahim, M., Alexander, L., Shy, C., & Farr, S. (1999). Incidence measures in cohort studies. ERIC Notebook, 4, 1–4. Retrieved from http://cphp.sph.unc.edu/trainingpackages/ERIC/eric_notebook_4.pdf

Ibrahim, M., Alexander, L., Shy, C., & Farr, S. (1999). Case-control studies. ERIC Notebook, 5, 1–4. Retrieved from http://cphp.sph.unc.edu/trainingpackages/ERIC/eric_notebook_5.pdf

Ibrahim, M., Alexander, L., Shy, C., & Farr, S. (1999). Cross-sectional studies. ERIC Notebook, 7, 1–4. Retrieved from http://cphp.sph.unc.edu/trainingpackages/ERIC/eric_notebook_7.pdf

Ibrahim, M., Alexander, L., Shy, C., & Farr, S. (2000). Ecologic studies. ERIC Notebook, 12, 1–4. Retrieved from http://cphp.sph.unc.edu/trainingpackages/ERIC/eric_notebook_12.pdf

Please Read Instructions carefully. The memo is about your clients ANXIETY DISORDER

 

Imagine the subject of the selected case study is a client of yours.

Draft a short, one-page (350 to 700 words) memo describing the situation and requesting specific services for your afflicted client.

Include the following in your memo:

• Describe the disease of focus and its progression of mental illness. Based on the disease and stage it presents, what level (primary, secondary, or tertiary) of care does the patient require?
• Where can more information regarding the identified disease be found?
• What cultural issues can be identified as pertaining to this disease that might affect the individual and family in this case? How does this influence society and resources as a whole?