The levels of prevention in epidemiology help provide a framework for health professionals to intervene and prevent disease, injury, or disability. What is epidemiology? The World Health Organization (2014) states “epidemiology is the study of the distribution and determinants of health-related states or events and the application of the study to the control of disease and other health problems” (para. 1). The National Asthma Education and Prevention Guidelines data showed that exacerbations of acute asthma episodes have gotten more severe over the years (Dougherty & Fahy, 2009). In 2010, one out of eleven children was diagnosed with asthma (Centers for Disease Control and Prevention, 2014). Children are presenting with a combination of symptoms that show an increase in severity with expiratory airflow and decreased lung function testing (Dougherty & Fahy, 2009).
When children present with shortness, wheezing, chest tightness or cough in school, the student has to report to the school nurse for their asthma protocol treatment ordered by a physician. If symptoms are not easily controlled, the child may have to be treated in and outpatient setting. According to the Centers for Disease Control and Prevention (2014), children missed a total of ten million days of school and cost the United States fifty-six billion dollars a year for treatment. In 2009, the yearly average cost was $1,039 per child with asthma. The Healthy People 2020 made pediatric asthma an initiative due to the increasing prevalence and cost in the United States.
The epidemiology framework consists of three levels of prevention; primary, secondary and tertiary. Primary prevention strive to reduce the occurrence rate of new cases in disease. Primary prevention approach to promoting a healthier lifestyle is to emphasize on educating individuals on risk factors and protective strategies. A primary prevention strategy for asthma patient is educating on avoiding cigarette smoke, insect allergens, molds and pet dander (Agency for Toxic Substance & Disease Registry, 2010). Secondary prevention concentrates on early recognition and fast treatment of the disease. This level of prevention focuses on slowing down the progression of the disease process and decreasing the impact of the disease process on an individual or community. There are a number interventions that one can do to reduce the exposure to allergens, pollutants, or irritants that may trigger an asthma episode. Schools and homes may use a free standing air purifier for rooms, purchase a vacuum with an HEPA filter or us an HEPA filter in the air duct system.
These systems help to eliminate animal dander, smoke, air pollution, molds, dust mites, and animal allergens. Several schools have introduces reading dogs in the elementary schools to reduce the fear of reading. Depending on the severity of the allergy, the student many not be able to be in the classroom. Families can select a pet that has low dander levels. It is difficult to get out dander and dust particles out of the carpet, hardwood floor may need to replace the carpet. Tobacco smoking affects approximately forty-two percent of children between the age ages of two months to eleven years of age (Agency for toxic substances & Disease Registry, 2010). Educated tobacco smokers the effects that tobacco smoke can have on the respiratory system in people of all ages. Tertiary Prevention strategies is implemented to stabilize and restoring functionality from damage that has resulted from a chronic disease. Education on medication compliance for pediatric patients and families is key for this level of prevention.
The ecosystem of children’s health is a complex model that has the child and family at the center of the core (Friedman, 2010). Circling the center core are individuals and organizations that interrelate closely with the child and family such as schools, faith community, doctors, community services, and environment (Friedman, 2010). The further circle in the model are health insurance agencies, businesses, philanthropy, and research (Friedman, 2010). The model identifies several areas that impacts childhood asthma. First looking at the genetics of the child and then assessing the social, natural, and built environments that influence acute asthma attacks for the child. These are all areas that need to be closely examines to figure out why children are having amplified severity during an acute asthma attacks. Frequency and duration of asthma attacks affect children’s social and academic life.
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