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Week 11: Practical Application of Epidemiological Interventions in Settings and Populations

Most people can recall where they were and what they were doing on the morning of September 11, 2001, when terrorists flew two airplanes into the Twin Towers. One week after that attack, anthrax was sent through the U.S. Postal Service to news media offices and politicians. In addition to these human-made emergencies, notable natural disasters have also occurred: the tsunami in Japan, a large earthquake in Haiti, tornadoes throughout the central United States, wildfires in California and Texas, flooding in the Northeast, etc. Out of all these disasters, many heroic stories unfolded as cities quickly responded to the needs of the citizens. For example, the New York Visiting Nurses Association had over 1,400 patients in the lower Manhattan area affected by the September 11th terrorist attacks. Within 3 days, they had tracked down each of their patients either in shelters or in the homes of family members.

In this final week of the course, you will consider emergency preparedness and disaster management strategies, and you will evaluate how these strategies are used to cope with disasters. In doing so, you will look through the lens of the epidemiologist and consider interventions for settings and populations. Additionally, you will be asked to synthesize your learning as you explore a case study on ethics and population health. You will also consider the effect of health care reform on a selected population health issue.

Learning Objectives

Students will:

· Analyze epidemiological considerations resulting from natural or human-made disasters

· Apply an epidemiological methods in a community-based or clinical setting to effectively address a population’s needs

· Analyze the impact of culture, ethics, regulatory, and legal issues on population health

· Evaluate the effects of health care reform as it relates to a selected population health initiative

Learning Resources

Required Readings

Nash, D. B., Skoufalos, A., Fabius, R. J. & Oglesby, W. H.  (2021). On the path to health equity. In Population health: Creating a culture of wellness (3rd ed.). Jones & Bartlett Learning.

Chapter 3  addresses non-biomedical influences on health that impact health equity. This chapter is explored in four sections: (a) meaning of health equity, (b) issues of racism and discrimination, (c) cultural competency, and (d) achieving health equity. The authors ask the reader to consider how current efforts to the address social determinants of health may be applied to your workplace.

Nash, D. B., Skoufalos, A., Fabius, R. J. & Oglesby, W. H.  (2021). Policy and advocacy. In Population health: Creating a culture of wellness (3rd ed.). Jones & Bartlett Learning.

Chapter 13  discusses the role that public policy and advocacy play  in promoting and adapting public health initiatives and policies. Key players at the national level are identified. A common form of advocacy, lobbying is introduced. A vignette describing a successful coalition was described. 

Levin, A. B., Bernier, M. L., Riggs, B. J., Zero, S. D., Johnson, E. D., Brant, K. N., Dwyer, J. G., Potter, C. J., Pustavoitau, A., Lentz, T. A., Jr, Warren, E. H., Milstone, A. M., & Schwartz, J. M. (2020). Transforming a PICU into an adult ICU during the Coronavirus disease 2019 pandemic: Meeting multiple needs. Critical Care Explorations, 2(9), e0201. https://doi-org/10.1097/CCE.0000000000000201

Sprung, C. L., Cohen, R., & Adini, B. (2010). Chapter 1. Introduction. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster. Intensive Care Medicine, 36(Supplement 1). S4-10

This reading describes the efforts put forth as a result of a task force established by the European Society of Intensive Care Medicine in December 2007. The chapter examines the purpose and development of standard operating procedures (SOPs) to better address population needs during an infectious disease breakout or disaster.

Richards, G. A., & Sprung, C. L. (2010). Chapter 9. Educational process. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster. Intensive Care Medicine, 36(Supplement 1), S70–S79.

As noted in this chapter, planning and education are imperative to adequately prepare intensive care units (ICUs) and hospitals for an influenza pandemic or mass disaster. The authors provide standard operating procedures (SOPs) and recommendations.

Veenema, T. G., Deruggiero, K., Losinski, S., & Barnett, D. (2017). Hospital administration and nursing leadership in disasters. Nursing Administration Quarterly, 41(2), 151-163. doi: 10.1097/NAQ.0000000000000224.

Wu, X., Zheng, S., Huang, J., Zheng, Z., Xu, M., & Zhou, Y. (2020). Contingency nursing management in designated hospitals during COVID-19 outbreak. Annals of Global Health, 86(1), 70. https://doi-org.ezp.waldenulibrary.org/10.5334/aogh.2918

Federal Emergency Management Agency. (2011). Retrieved from http://www.fema.gov/

Explore the Federal Emergency Management Agency website, whose mission is to “support our citizens and first responders to ensure that as a nation we work together to build, sustain, and improve our capability to prepare for, protect against, respond to, recover from, and mitigate all hazards.”

 

Required Media

Laureate Education (Producer). (2012). Epidemiology and population health: Population health issues, part 1 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 6 minutes.

In part 1 of this week’s media, the presenters discuss how epidemiology can be utilized to improve population health.

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

Laureate Education (Producer). (2012). Epidemiology and population health: Population health issues, part 2 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 3 minutes.

In part 2, Dr. Hull discusses lessons learned from global efforts to eradicate polio.

Accessible player  –Downloads– Download Video w/CC Download Audio Download Transcript 

The following document provides credit for Laureate-produced media within this course: Credits (PDF)

More Sources

https://www.fema.gov

https://doaj.org/article/3fee75604bff4bf59cb1005ce49a0ef1?

https://pubmed.ncbi.nlm.nih.gov/32984831/

Discussion 1: Applied Epidemiology

On September 11, 2001, terrorist attacks created a grave disaster that included the destruction of the World Trade Center in New York. The day after 9/11, epidemiologists were asked to assess the environment around Ground Zero for potential hazards that might put those engaged in rescue and recovery at risk of harm. Beside the dust, what toxins might be in the air? Was the air quality safe or should rescue workers wear canister respirators or particle masks? What other protections might be necessary in the days following the disaster?

In this Discussion, you will look at the impact of a disaster through the lens of an epidemiologist, addressing such questions as, “What epidemiological considerations arise in the wake of a disaster? And, what makes disaster planning or emergency preparedness effective in terms of mitigating or preventing negative aftereffects?”

To prepare:

· Identify a disaster that led to a population health issue. Consider this disaster through the lens of an epidemiologist, using the information presented in the Learning Resources to examine the epidemiological considerations resulting from the disaster. Conduct additional research as necessary using the Walden Library and credible websites.

· Ask yourself, “What factors made the community’s and/or nation’s response effective or ineffective? What aspects of disaster planning or emergency preparedness did the community have in place that helped it cope with the disaster and resulting population health issue?”

By Day 3

Post a cohesive scholarly response that addresses the following:

· Identify the disaster and resulting population health issue.

· Describe the epidemiological considerations resulting from this disaster. Support your response with specific examples and evidence from the literature.

· Discuss the factors that made the community’s and/or nation’s response effective or ineffective.

Write 1.5 page and cite at least 3 sources