Discussion: NURS 8310 Population Health
Discussion: NURS 8310 Population Health
Briefly summarize your selected population health problem and describe how principles of
epidemiology is being applied—or could be applied—to address the problem.
Colorectal cancer (CRC) is the third leading cause of cancer-related death in the United States (CDC, 2021) thus its burden of disease is high. Symptoms of CRC such as a change in bowel habits, blood in stool, change in caliber of stool, weight loss, fatigue, and vomiting only manifest at late stages of the disease. Early detection is key to preventing morbidity and mortality. Bowel cancer screening aids in the prevention of colon cancer by detecting polyps early, allowing for more effective treatment and a lower fatality rate (Hamdan et al., 2021). An overall increase in the percent of the eligible population screened is needed to prevent morbidity and mortality. Specific measures to increase screening include client reminders, provider assessment, and feedback, and colorectal cancer screening champions have been found to increase screening rates (Sharma et al., 2021). Epidemiology, as defined by Friis and Sellers (2021) is the study of the occurrence and distribution of health-related events, states, and processes in specified populations, including its determinants. It regards CRC as a disease that would benefit from early detection and lifestyle modifications to prevent. Interestingly, black adults have the highest incidence of and mortality from CRC (USPSTF, 2021). This is reported to be due to inequality in access to and utilization of CRC screening.
Are there any lessons learned from the use of epidemiology in the eradication of smallpox
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that can be applied to your selected problem?
The eradication of smallpox holds lessons regarding patience in attacking the problem of CRC (Center for Global Development, n.d.). While we have not yet eradicated CRC, we have made strides in increasing the number of screening methods in recent years. We have improved the cooperation of patients by making direct screening (colonoscopy) preparation less onerous for the patient (Li et al., 2019). By increasing the variety of screening choices we have been able to increase the number of screenings performed annually (Frissora et al., 2021). Performing more screenings results in finding more precancerous growths that can be easily removed by polypectomy (Chen, 2021). This results in less morbidity. Finally, we have grown to understand lifestyle modifications that can prevent CRC (Wilkinson et al., 2019).
Evaluate the cost-effectiveness of addressing this health problem at the population level versus the individual level.
The high cost of treating colorectal cancer increases the level of importance in treating this disease at the population health level.
As reported by Mariotto et al., (2011) CRC accounts for eleven percent of all cancer treatment costs in the United States. The Centers for Disease Control report that increasing CRC screening to seventy percent from the current levels could reduce Medicare spending by fourteen billion dollars in 2050. Ran et al., (2019) share that fecal occult blood tests, fecal immunochemical tests and colonoscopy were cost effective compared to no screening. According to Chen et al., (2018), average costs to treat new CRC can range from forty to eighty thousand dollars.
References:
Center for Disease Control. (2021). Colorectal cancer statistics. https://www.cdc.gov/cancer/colorectal/statistics/index.htm
Center for Global Development. (n.d.). Case 1: Eradicating smallpox. Retrieved December 3, 2021, from https://www.cgdev.org/sites/default/files/archive/doc/millions/MS_case_1.pdfhttps://www.cgdev.org/sites/default/files/archive/doc/millions/MS_case_1.pdf
Chen, C. T., Li, L., Brooks, G., Hassett, M., & Schrag, D. (2018). Medicare spending for breast, prostate, lung, and colorectal cancer patients in the year of diagnosis and year of death. Health services research, 53(4), 2118.
Chen, Z. J. (2021). Toward safer and more efficacious colonoscopy polypectomy. Laparoscopic, Endoscopic and Robotic Surgery. https://doi.org/10.1016/j.lers.2021.10.003
Friis, R. and Sellers, R. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett.
Frissora, K. D., Biernacki, P. J., & Walloch, J. (2021). Increasing Awareness of Screening Methods for Colorectal Cancer Improves Outcomes. The Journal for Nurse Practitioners, 17(6), 697–701. https://doi.org/10.1016/j.nurpra.2021.03.003
Goede, S. L., Kuntz, K. M., van Ballegooijen, M., Knudsen, A. B., Lansdorp-Vogelaar, I., Tangka, F. K., Howard, D. H., Chin, J., Zauber, A. G., & Seeff, L. C. (2015). Cost-Savings to Medicare From Pre-Medicare Colorectal Cancer Screening. Medical care, 53(7), 630–638. https://doi.org/10.1097/MLR.0000000000000380
Hamdan, R., Johnson, J., Fatemi, M., Benjamin, K., & Moosa, A. (2021). Exploring the barriers toward colorectal cancer screening: A literature review. Middle East Journal of Nursing, 15(2), 3-12. https://doi-org.ezp.waldenulibrary.org/10.5742/mejn.2021.937804
Li, C.-X., Guo, Y., Zhu, Y.-J., Zhu, J.-R., Xiao, Q.-S., Chen, D.-F., & Lan, C.-H. (2019). Comparison of Polyethylene Glycol versus Lactulose Oral Solution for Bowel Preparation prior to Colonoscopy. Gastroenterology Research & Practice, 1–6. https://doi.org/10.1155/2019/2651450
Mariotto, A. B., Robin Yabroff, K., Shao, Y., Feuer, E. J., & Brown, M. L. (2011). Projections of the cost of cancer care in the United States: 2010–2020. Journal of the National Cancer Institute, 103(2), 117-128.
Ran, T., Cheng, C.-Y., Misselwitz, B., Brenner, H., Ubels, J., & Schlander, M. (2019). Cost-Effectiveness of Colorectal Cancer Screening Strategies—A Systematic Review. Clinical Gastroenterology and Hepatology, 17(10), 1969–1981. https://doi.org/10.1016/j.cgh.2019.01.014
Sharma, K., DeGroff, A., Maxwell, A., Cole, A., Escoffery, N., & Hannon, P. (2021). Evidence-Based Interventions and Colorectal Cancer Screening Rates: The Colorectal Cancer Screening Program, 2015-2017. American Journal of Preventative Medicine, 61(3), 402-409.
US Preventive Services Task Force. (2021). Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA, 325(19):1965–1977. doi:10.1001/jama.2021.6238
Wilkinson, A. N., Lieberman, D., Leontiadis, G. I., Tse, F., Barkun, A. N., Abou-Setta, A., Marshall, J. K., Samadder, J., Singh, H., Telford, J. J., Tinmouth, J., & Leddin, D. (2019). Colorectal cancer screening for patients with a family history of colorectal cancer or adenomas. Canadian Family Physician Medecin de Famille Canadien, 65(11), 784–789.
Question
NURS6700/NURS8310 Epidemiology & Population Health
Week 1 Discussion
Epidemiology and Population Health
Reflect on your nursing practice for a moment. If you could wipe out one illness, what would it be? How would that impact not just an individual patient, but your entire patient population? What would be the long-term benefits of eliminating that one illness?
The eradication of smallpox by 1979 provides an excellent example of this scenario. This eradication came about as a result of global collaborative efforts involving many countries and organizations, as well as the application of epidemiologic methods. In spite of high initial financial costs, it is estimated that millions of dollars continue to be saved around the world each year as a result of the eradication of this disease.
The eradication of smallpox illustrates the rich history of epidemiology and demonstrates the cost/benefits and implications of improving health at the population level. The application of epidemiologic methods and principles to other critical population health issues continues to play an essential role in improving health and health outcomes.
For this Discussion, you will identify a current population health problem, and you will examine how, and if, the problem is being addressed through the application of epidemiologic principles. You will also discuss the cost-effectiveness of dealing with the problem at the population level.
To prepare:
Review the Learning Resources, focusing on the smallpox epidemic of the 1960s and 1970s and how health organizations applied principles of epidemiology to eradicate this disease.
In light of this example, consider the cost effectiveness of addressing smallpox at the population level.
Using the Learning Resources, research a current population health problem (local or global). Select one on which to focus for this Discussion.
Think about how principles of epidemiology are being applied—or could be applied—to address the problem.
What lessons from the use of epidemiology in the eradication of smallpox might be applicable to this selected problem? What are the financial benefits of addressing this issue at the population level as opposed to the individual level?
By Day 3
Post a cohesive response that addresses the following:
Briefly summarize your selected population health problem and describe how principles of epidemiology are being applied—or could be applied—to address the problem.
Are there any lessons learned from the use of epidemiology in the eradication of smallpox that can be applied to your selected problem?
Evaluate the cost effectiveness of addressing this health problem at the population level versus the individual level.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues in one or more of the following ways:
(Make sure that you respond to at least one colleague who selected a population health problem different than the one you selected.)
Ask a probing question, substantiated with additional background information, evidence or research.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
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