Fundamentals - Community Health, part 2: Prevention Levels and Determinants of Health

Hi, I'm Ellis with Level Up RN. And in this video, I'll be chatting about prevention levels and determinants of health. These cards can be found in the community health section of our fundamentals flashcard deck. If you have that deck, go ahead and grab these cards and you can follow along with me. And if you don't have the deck, you can check us out at leveluprn.com. After I go over the content, make sure you hang out because I'll have a couple of questions to check your knowledge. We're going to start with prevention levels. There are three levels of prevention that you need to know. There is primary, secondary, and tertiary. Primary interventions are aimed at preventing a disease before it begins, before it is diagnosed, before it occurs. And a lot of this category is education. Educating about diet and nutrition and exercise and lifestyle modifications like not smoking and alcohol intake and all of those different things that we educate people about. Also, in primary prevention, immunizations are a big part of that as well so that we can prevent diseases and illnesses with immunizations.

Secondary is early detection of diseases or screenings. And a lot of those screenings are aimed at certain populations that have risk factors for particular diseases or illnesses, like mammograms or colonoscopies, but don't forget that there are also psychosocial screenings like screening for depression in certain populations or domestic violence. The final category is tertiary. Tertiary interventions are focused at slowing or stopping the disease process and its complications after that disease has already been diagnosed. So working with patients who have been diagnosed with the disease or illness and treating the complications and preventing the progress of that disease or illness. And that has a wide range of different things, all different treatments that we can do. But some of the things that fall into that category are rehabilitation, whether that's physical therapy or cardiac rehabilitation, and again, those psychosocial components might include support groups. So after someone has been diagnosed with a disease or illness, they might want to partake in a support group with other individuals with that disease or illness. The cool chicken on this card is pairing the first letter of the prevention level with what it does. So primary is aimed at preventing illnesses, secondary screens for illnesses, and tertiary treats existing illness.

We're going to move into determinants of health. Determinants of health are environmental or social factors that profoundly influence that individual's risk factors, as well as their health outcomes. And so we've split these into two big groups and different books and instructors and programs and what have you might have it split into smaller groups, but they all really fall under environmental factors and social factors. So let's start with environmental factors. These are things that are in somebody's environment that will have an impact on their risk factors and health outcomes. And that might be within their place of residence or within their larger community. And so that includes access to healthy food options and safe water and access to transportation. So whether they have a license or they have a car or a bicycle and have the physical capability to do those things, right? And it also includes infrastructure, so public transportation. Is there a bus system or a train or a subway for them to be able to get around? This also includes environmental hazards, whether that's pollution within the community itself, or tobacco smoke, which is more likely to be within the home if a family member smokes inside the home per chance. And public safety. So what is their environment like in terms of crime and violence?

Social factors are going to include things like your socioeconomic status, your race, culture, ethnicity, your support system. So do you have family or friends or caregivers that are around you? And not even necessarily in close proximity but are a social support for you. What kind of job opportunities are available to you? What education access and completion has occurred? And whether or not you have access to medical care. And that is kind of a combo effect. So medical insurance and access to medical care is part of it. Though medical care is also an environmental factor in terms of, what is regionally accessible to me? Are there specialty offices, or do I have to drive a really long distance to get to specialty offices? Are there urgent care facilities or are there only PCPs and hospitals with ERs? So there's lots of different types of access to medical care that gets involved in this. And the key point with determinants of health is to understand that individuals with low socioeconomic status or if they belong to a minority population or marginalized population or, interestingly enough, individuals that are socially isolated are going to have a higher risk for poor health outcomes.

All right, that wraps up the content for this video, and now I have a couple of questions just to check your knowledge. So go ahead and describe tertiary prevention. Tertiary prevention includes interventions that are aimed at slowing or stopping a disease progression into the complications that may occur after a disease has been diagnosed. Which level of prevention would a pap smear be considered? A pap smear is a screening, which makes it a secondary prevention level. What is one of the determinants of health that I mentioned that puts an individual at an increased risk for poor health outcomes? I listed low socioeconomic status, minority, or marginalized populations, and individuals that have social isolation. Thank you so much for studying with me. Up next in community health, I'll be talking about environmental hazards.