This book represents the lessons learned and the prog-ress made in more than 100 years of population health nursing in the United States. The year 1993 marked the 100th anniversary of the founding of the Henry Street Settlement, the acknowledged beginning of modern American population health nursing. Since then, the work of population health nurses and others has led to better health for individuals, families, and population groups. In this book, I have tried to dis- till the wisdom of early pioneers and present-day practitioners to guide and direct future generations toward nursing excellence. POPULATION AND COMMUNITY HEALTH

Locally, nationally, and globally, society is in greater need of population health nursing services than at any time since our be- ginning. Although expected longevity has increased significantly in the last century, quality of life has not kept pace for a large por- tion of the world’s population. Previously controlled communi- cable diseases are resurfacing, and new diseases are emerging to threaten the public’s health. Malnutrition is a fact of life for many people. Chronic physical and emotional diseases are taking their toll on the lives of large numbers of people. Substance abuse and violence are rampant, and more and more frequently, environ- mental conditions do not support health. All of these are problems that population health nurses can and do help to solve. POPULATION AND COMMUNITY HEALTH

Population health nurses must have the depth and breadth of knowledge that allows them to work independently and in conjunction with clients and others to improve the health of the world’s populations. In part, this improvement occurs through care provided to individuals and families, but it must also occur on a larger scale through care provided to communi- ties and population groups. Population and Community Health Nursing, Sixth Edition, provides population health nurses with the knowledge needed to intervene at these levels. This knowl- edge is theoretically and scientifically sound, yet practical and applicable to society’s changing demands.

Nursing Excellence Through Advocacy Like prior editions, this edition focuses on the central facet of population health nursing—advocating for the health of the public. The theoretical concept of advocacy is introduced in Chapter 1 and is based on qualitative research by the author that examines the process of advocacy as it is performed by population health nurses. Practical application of the concept occurs in each of the subsequent chapters. POPULATION AND COMMUNITY HEALTH

Advocacy Then and Advocacy Now The Advocacy Then and Advocacy Now vignettes that open each chapter showcase the efforts of population health nurses,

other health professionals, and members of the lay public to advocate for the health of populations. Some of the Advocacy Now vignettes were contributed by population health nurses and are gratefully acknowledged. Other vignettes celebrate the past and present contributions of population health nurses and others to promoting health and addressing health needs in the United States and the world. We offer our appreciation to these contributors for their heartfelt descriptions of nursing in the population and for their generosity in permitting us to tell their stories. The Advocacy Now vignette that opens Chapter 2 de- scribes the work of Susie Walking Bear Yellowtail, the first Na- tive American registered nurse and an exemplary population health nurse advocate. The other stories, past and present, are equally inspiring for the population health nurses of today and those in the ages to come. POPULATION AND COMMUNITY HEALTH

Population and Community Health Nursing, Sixth Edition, provides students with a strong, balanced foundation for pop- ulation health nursing practice. The book is designed to help students first achieve excellence in the classroom through the many features and exercises that accompany the narrative. The additional tools and supplemental information will help stu- dents succeed at applying those concepts in clinical settings with families, communities, and population groups, with the ultimate goal of preparing nurse generalists who will exhibit nursing excellence in any setting.

The underlying intent of this book is to convey to nurs- ing students at the beginning of the 21st century the excite- ment and challenge of providing nursing care to populations. As we begin a new era of population health nursing, I believe that well-educated population health nurses can provide a fo- cal point for resolution of the global health problems presented throughout the book. Early population health nurses changed the face of society; we can be a strong force in molding the so- ciety of the future by striving for nursing excellence through advocacy. POPULATION AND COMMUNITY HEALTH

Organization This textbook is designed to present general principles of population health nursing and to assist students to apply those principles in practice. It is organized in five units. The first three units address general concepts and strategies of popula- tion health nursing practice, and the last two examine the ap- plication of those concepts to specific populations, settings, and population health problems.


UNIT I sets the stage for practice by describing popula- tion health nursing and the context in which it occurs. Read- ers are introduced to population health nursing as an area of

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vi Preface

specialized practice and to its emphasis on advocacy for the health of individuals, families, and population groups. The attributes and features that make population health nursing unique, standards for practice, and typical roles and func- tions of population health nurses are addressed. Then, the concept of populations as recipients of nursing care and the historical and theoretical underpinnings and development of population health nursing are presented followed by a discus- sion of epidemiology as a core content area for population health care. POPULATION AND COMMUNITY HEALTH

A unique feature of this book is the consistent use of the Population Health Nursing model to structure the discussion of principles of practice. The model is introduced in Chapter 1. Further Information about other theoretical models that may be useful in population health nursing practice is provided in ancillary materials found at www.nursing.pearsonhighered .com. Other relevant models dealing with epidemiology, family nursing, health promotion, and so on, are included in specific chapters.

The population health nursing (PHN) model is used as the organizing framework for most of the chapters in the book, providing students with a systematic approach to determining factors that influence health and relevant strategies designed to promote health, prevent illness and injury, resolve existing health problems, and restore health in individuals, families, communities, and populations. The consistent use of the PHN model permits students to readily identify commonalities and differences among processes, populations, settings, and health problems. POPULATION AND COMMUNITY HEALTH

UNIT II examines influences on population health and ad- dresses environmental, cultural, economic, healthcare delivery system, and global influences on population health. Knowledge of the influence of these factors on population health leads to the application of specific strategies to improve population health addressed in UNIT III. Strategies addressed include po- litical, empowerment, health promotion and health education, case management, and home visiting approaches to population health nursing as a specialized area of practice. Other aspects of population health nursing practice (e.g., community engage- ment, referral, delegation, social marketing, group dynamics, and leadership) are integrated into these and other chapters as appropriate.

UNIT Iv addresses health care provided to special popu- lation groups. In each chapter, students are assisted to apply principles of care to individuals and families, as well as to these populations as aggregates. For example, Chapter 16 emphasizes population health nursing care for children and adolescents as population groups, as well as strategies for improving the health of individual children and adolescents. Similar approaches are taken to other population groups in the unit: families, com- munities, men, women, the elderly, the GLBT population, and people experiencing poverty and homelessness.

UNIT Iv also addresses population health nursing in spe- cialized settings such as the school, work, correctional, and di- saster settings. For example, Chapter 22 examines the role of the

population health nurse in school settings, whereas Chapter 23 addresses employee health in the work setting. In each chapter in the unit, students are guided in the use of the nursing pro- cess and application of the PHN model in the special practice setting. Consideration is given to factors influencing determi- nants of health in each setting, and population health nursing interventions related to health promotion, illness and injury prevention, resolution of existing health problems, and health restoration are discussed. POPULATION AND COMMUNITY HEALTH

UNIT v focuses on population health nursing practice re- lated to the control of common population health problems such as communicable diseases, chronic physical and men- tal health conditions, substance abuse, and societal violence. Again, students are assisted to apply the nursing process and the PHN model to identify factors contributing to problems in each of these areas and in designing nursing interventions at each of the four levels of health care. Consideration is given to the care of individuals and families with these problems as well as to resolving common health problems at the population level.

How to use this book to foster success in POPULATION HEALTH advocacy

The various features in the sixth edition of Population and Community Health Nursing provide tools to help you succeed in the classroom and in practice. They offer opportunities to apply the principles presented in the book in real and virtual practice settings, promoting your ability to be an advocate for health at multiple levels.

Learning Outcomes Learning outcomes at the beginning of each chapter help you to focus on the outcomes expected of you in relation to your knowledge and application of principles of population health nursing. They highlight the important content for each chapter and assist you in applying the PHN model to specific circum- stances and settings. POPULATION AND COMMUNITY HEALTH

Key Terms The list of key terms at the beginning of each chapter alerts you to significant concepts to be addressed in the chapter, concepts with which an effective population health nurse needs to be fa- miliar. At the point of definition within the chapter, each term is set in boldface type.

Healthy People 2020: Objectives for Population Health These boxes present relevant objectives from Healthy People 2020 to familiarize you with these important population health goals. You also learn about the current status of objectives here POPULATION AND COMMUNITY HEALTH

Also check: Nursing Practice Problem