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Deborah Pasha WI Division of Public Health

Public Health Nursing Practice: Finding Evidence to Apply to Environmental Health Issues April 29th (or 30 th ), 2008 University of Wisconsin-Milwaukee. Urban Built Environments— where public health nursing intersects with the transportation culture. Deborah Pasha

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Deborah Pasha WI Division of Public Health

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  1. Public Health Nursing Practice: Finding Evidence to Apply to Environmental Health IssuesApril 29th (or 30th), 2008 University of Wisconsin-Milwaukee Urban Built Environments— where public health nursing intersects with the transportation culture Deborah Pasha WI Division of Public Health

  2. Would you want to walk here? (Dan Burden)

  3. . . . or would you rather walk here? (Michael Cynecki)

  4. Would you feel safe cycling along this road? (Dan Burden)

  5. . . . or would you prefer to cycle here? (Dan Burden)

  6. Community Client Assessment (Gabrielle Pasha) (Photographer unknown)

  7. Community Client Assessment (Photographer unknown)

  8. http://dhfs.wisconsin.gov/statehealthplan

  9. Social Environment Physical Environment Genetic Endowment • Individual • Response • Behavior • Biology Health & Function Health Care Disease Well Being Prosperity Determinants of Health Model Evans, R. G., & Stoddart, G. L. (1990). Producing health, consuming health care. Social Science and Medicine, 31, 1347-1363.

  10. The Precautionary Principle • Precautionary approach to environmental health • Opportunity for prevention • Contrast to focus of resources on curing disease that resulted from preventable exposures • Association to health disparities ANA’s Principles of Environmental Health for Nursing Practice with Implementation Strategies (2007)

  11. Public Health Nursing: Scope & Standards of Practice • The client or unit of care is the population • Primary obligation is to achieve the greatest good for the greatest number of people • Primary prevention is the priority when selecting activities • Focuses on strategies that create healthy environmental, social, and economic conditions in which populations may thrive . . . (ANA 2007)

  12. http://www.health.state.mn.us/divs/cfh/ophp/resources/docs/phinterventions_manual2001.pdfhttp://www.health.state.mn.us/divs/cfh/ophp/resources/docs/phinterventions_manual2001.pdf Public Health Interventions March 2001 Minnesota Department of Health Public Health Nursing Section

  13. Surveillance

  14. http://www.dot.wisconsin.gov/

  15. Health Teaching

  16. Community Organizing Collaboration Coalition Building

  17. Enforcement Advocacy Policy Development Social Marketing

  18. Business& Labor Advocacy Organizations Faith Community Media Healthcare Providers Professional Organizations Healthcare Consumers Community Health Centers Civic Organizations State & Local Public Health Departments Educators Foundations Hospitals & Clinics Managed Care Community Residents Healthcare Purchasers Colleges, Universities,& Technical Schools Law Enforcement Agriculture,Natural Resources, Public Instruction, and other governmental agencies State andLocal Elected Officials A System of Partners

  19. Community-System Interventions (Photographer unknown)

  20. Community-System Interventions

  21. Literature search

  22. Research findings • Modern cities associated with costly injuries and illness due to inactivity • 70% deaths, 60% medical expenditures in U.S. attributed to chronic disease • 30% of these preventable with increase in physical activity • Less than ½ of U.S. adults meet activity recommendations of 30 minutes most days

  23. Research Findings • U.S. bicycling and walking trips reduced from 10% (1977) to 6.3% (1995) • Pedestrian and cycling fatalities are triple • Canada and Northern European countries 20-40% of travel is by cycling and walking • 4 E’s: Engineering, Enforcement, Education, Encouragement

  24. Research findings • One prospective cohort study surveyed a random sample prior to and following a traffic calming intervention • Pedestrian counts at 3 places by age groups • Pedestrian activity increased after the traffic calming • Children were more likely permitted to play outside (Morrison, Thomson and Petticrew, 2004)

  25. http://www.wisconsinwalks.org/

  26. http://www.bfw.org/

  27. http://www.bikewalk.org/

  28. http://www.bikewalk.org/

  29. http://www.dhfs.state.wi.us/

  30. http://dhfs.wisconsin.gov/health/physicalactivity/StatePlan

  31. http://www.cdc.gov/

  32. http://www.apbp.org/website/

  33. Workgroup activity • Success Story: Issue, Intervention, Impact • Media release • Talking points • Community event flier • Letter of support • Issue paper

  34. Street Share (ITE Pedestrian Bicycle Council)

  35. Healthy Community (Photographer unknown)

  36. “One good community nurse will save a dozen policemen.” Herbert Hoover

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