Abstract
This research presentation consists of an in-depth study into a community public health problem derived from two separate epidemiological approaches. It is also written in two parts; namely Part I and I1.The goal, primarily, is to demonstrate the fundamental community health nursing skills involved in describing a population’s health problem using appropriate descriptive epidemiological straxtegies. Secondly, it encompasses applying statistical interpretations and Healthy People 2020 objectives. Thirdly it embraces analyzing the development of health problems integrating epidemiology and theoretical models for explanations. Fourthly, it affords community health practitioners the opportunity to identify levels of prevention when applied to the chosen health problem. Asthma has been the topic of choice for discussion in this research and will be thoroughly addressed based on the foregoing requirements.
Descriptive Epidemiology: Epidemiological Description of the Problem
Theoretical epidemiological approaches towards interpreting disease conditions occurring within communities fall into seven distinct phases; namely diagnostic, descriptive, investigative; experimental, analytical, interventive and decision making. (Putt et. al, 2008). Each has its unique relevance towards outcomes of the process.
Part 1 of this study on Asthma the writer will adopt the descriptive epidemiological approach into investigating the condition for the purpose of public health scrutiny. There are also three main types of studies into which these theoretical concepts can be integrated. Precisely, they are prospective, retrospective and cross-sectional. (Putt et. al, 2008).
For this descriptive analysis of Asthma, the author will adapt the theoretical cross-section model in accounting for the incidence and prevalence as it pertains to person, place and time. Supporting details will be cited from reliable sources in projecting the condition as not only a social problem, but more importantly a grave public health concern.
Identification and Description of Asthma as a Public Health Concern
Asthma has been described as a chronic inflammatory disorder affecting the respiratory tract and organs. It is characterized by hyper-responsiveness to stimuli and restriction of membranes and blood vessels within the system. It often manifests as wheezing, tightness of the chest, shortness of breath and a dry cough (Lyon-Callo et. al, 2000).
Figures derived from a study conducted in Michigan USA (Place) between 1990-1997(time) revealed that Asthma accounted for 10, 854 hospitalizations yearly, people ranging from the ages between 1-44. 56% of that population were whites (People). Further figures were indicative of a low mortality rate, generally, but even though more whites were affected, death rates among blacks were higher. Precisely, during this eight year investigation there were 47 children deaths between the ages of 1-14 and 323 adults between the ages of 15-44. ((Lyon-Callo et. al, 2000).
Globally, however, the incidence and prevalence of Asthma in relation to people place and time vary based on cultural adaptations. Dr’s Padmaja Subbarao, Piush J. Mandhane and Malcolm R. Sears (2009) of the Canadian Medical Association conducted cross- sectional studies to describe contemporary trends in the evolution of Asthma world wide. (Subbarao et.al, 2009)
With regards to time, place and people as it relates to incidence and prevalence, these researchers discovered that the prevalence varies around the world largely due to environmental factors. This was shown to be occurring in many industrialized societies/ countries. However, higher mortality rates world wide were found among poorer countries. Importantly, the rising incidence among pregnant women and children presented great concerns. In 2005, 6 million children in United States alone were affected. (Subbarao et.al, 2009).
Precisely, the problem is escalating among children who develop this symptoms from smoking mothers. According to Dr Subbarao (2009) ‘ the allergic sensitization, environmental tobacco smoke, exposure to animals, breastfeeding, decreased lung function in infancy, family size and structure, socio-economic status, antibiotics and infections, and sex and gender.’ (Subbarao et.al, 2009) are all contributory factors which need to be considered.
Healthy People 2020 objective
The healthy people 2020 objectives embrace a number of guidelines applicable to controlling Asthma globally. Its intervention is expected to forge a better quality of life so that people could live longer through the implementation of public health policies that offer equal opportunities to every citizen on earth in accessing quality health care and emotional support.
Conclusion
Globally, as any other public health concern children mortality is of paramount public health significance since they are the population of tomorrow and valuable human resources. Therefore, when Healthy People Objectives are applied Public Health control of asthma, it is imperative that a holistic approach be tendered in lieu of isolated methods of intervention
References
Lyon-Callo S, Reeves M, Wahi R, Hogan J (2008) Epidemiology of Asthma Fact Sheet. Bureau
Of Epidemiology, Michigan Department of Community Health
Putt S, Shaw A, Woods A, Tyler L, James A. (2008) Veterinary Epidemiology and Economics
Research Unit. Department of Agriculture. Berkshire. University of Reading.
Subbarao P, Mandhane P, Sears M. (2009). Asthma: epidemiology, etiology and risk factors.
CMAJ. 181(9) E180-191
Analytic Epidemiology and Levels of Prevention
Analytical approaches to interpreting disease conditions occurring within communities are among seven other distinct theoretical concepts; namely diagnostic, descriptive, investigative; experimental, interventive and decision making. (Putt et. al, 2008). Each paradigm is important for adequate evaluation of any public health concern. However, for the purposes of this Part 11 segment of the research presentation, emphasis would be placed on analytic epidemiological theory perspective of Asthma
Application of statistical interpretations
Statistics have shown where in 2009, 300 million people were affected by Asthma internationally, with a subsequent mortality rate of 250,000 annually. Approximately 7% of the US population has developed the dysfunction according to 2009 statistics. In 2005, 22 million people were hospitalized with asthma.. Since then it has been accounting for more than 4,000 deaths annually. (Fanta, 2009).
Comparatively, in the United Kingdom 5% of its population are Asthmatics. From 2005 statistical knowledge some 261, 400 were newly diagnosed and a total 5.7 million people treated with 32 million prescriptions. (Simpson & Sheikh, 2010).
Statistical interpretation is highly suggestive of marked increases in the incidence and prevalence of asthma overtime within various sections of the world’s population among diverse groups of people. Precise analysis points to United States of America as having the most people affected. This has increased tremendously within the past two-three decades 1960-2008. (Fanta, 2009).
What does this mean to public health intervention? Is it that industalization has a negative impact on the health of people living in those societies. Another marked concern is that even when pollution of modern technology does not affect the comunity enough to create mortality from asthma attacks, people in poorer countries are still more likely to die from the condition compared to ones living in developed societies. These are the two pertinent issues facing public health practice as a discussion on levels of prevention is entertained.
Asthma: Control measures
With reference to Subbarao and others( 2009) ‘allergic sensitization, environmental tobacco smoke, exposure to animals, breastfeeding, decreased lung function in infancy, family size and structure, socio-economic status, antibiotics and infections, and sex and gender’ (Subbarao et.al, 2009) were all contributory factors which need to be considered. These are very sensitive issues, which must be addressed at each level of intervention.
Theories pertaining to health promotion posit that the primary level from a community perspective focuses on prophylactic measures. This includes vaccination, healthy sanitation practices and environmental safety. So far there is no vaccine for asthma. Therefore, at this preventative stage the two other techniques to be employed are healthy sanitation practices and environmental safety.
From a secondary perspective education during prenatal management regarding smoking must be emphasized as community wide sensitization. If mothers do not smoke they should avoid being in the company of smokers too. Early screening, detection and treatment of the condition throughout all age groups is advocated.
At the tertiary level, hospitalization becomes inevitable and support measures must be available to guide asthma suffers into overcoming the condition and lead a normal life. Heartening reports are, despite the severity of the infection, children usually overcome this dysfunction by adulthood, once they survive. Most likely, adults who frequent hospitals have developed the chronic phase with associating Chronic Obstructive Pulmonary Disease (COPD) pathology. After hospital or nursing home discharge, emotional support becomes extremely necessary.
Conclusion
Statistically asthma can be considered to be moving towards pandemic proportions. Developed countries are most affect due to the impacts of industrialization. Poorer countries, however, tend to suffer from non-recovery due to, perhaps, poor sanitation, socio-economic issues; along with environmental pollutants. This is a public health concern requiring immediate intervention.
References
Fanta, C (March 2009). “Asthma.” New England Journal of Medicine 360 (10): 1002–14.
Putt S, Shaw A, Woods A, Tyler L, James A. (2008) Veterinary Epidemiology and Economics
Research Unit. Department of Agriculture. Berkshire. University of Reading.
Subbarao P, Mandhane P, Sears M. (2009). “Asthma: epidemiology, etiology and risk factors.”
CMAJ. 181(9) E180-191
Simpson C, Sheikh A (2010). "Trends in the epidemiology of asthma in England: a national study of 333,294 patients". J R Soc Med 103 (3): 98–106
