Introduction
The main aim of epidemiology is to collect and use data that is necessary for preventing and controlling diseases through interventions. Epidemiology in community health and partnerships has been evolving over the years. In the past, epidemiology associated the causes of diseases to commitment of sins. However, major historical developments in the field have evolved including the web of causation model to respond to chronic diseases, implying that health conditions may have multiple causes. The model has been widely applied in the nursing process and community health among other fields. This paper reviews the web of causation model by discussing its historical developments, concepts and highlights, and its application to the nursing process and community health. In addition, the paper stipulates the importance of community partnerships in community health projects.
Historical Developments
In the past, the occurrences of illnesses and diseases were associated with sin commitment (Barreto, 2005). Developments increased during the 1800s when disease was attributed to specific pathogens that were considered to be transmissible. However, unlike the beginning of the 20th century when epidemiology for infectious disease had their focus on single agents and attributed them to causing disease, major studies for epidemiology mainly for chronic infections begun during the middle of the 20th century (Vineis & Kriebel, 2006). Developments in infectious disease during this time shifted focus from mono-causal basis to multi-causal basis with first major studies done on lung cancer (Ervin, 2002). The studies implied that the specific cause of disease was established in a chain of causal relationships among the multiple causes with the chain being more of a web (Barreto, 2005). The “web of causation” model, a major contributor in the epidemiological developments, was developed in 1960 who suggested that there was no distinction between the causal factors, that is, there is no primary or more direct causal factor, hence prevention must be based on multiple steps (Vineis & Kriebel, 2006).
Concepts within the “Web of Causation” Model
The “web of causation” model’s aim was to respond to chronic diseases implying that such diseases and other health conditions may have multiple causes that are usually interconnected. Epidemiology studies based on the “web of causation” model analyze the interconnected factors through the main concepts of the model which include agents, the environment and host factors (Ervin, 2002). Clark (2008) explains that the host factors include the factors of the person with the disease or condition that include the intrinsic factors, immunity levels, psychological and physical factors among others. The environment concept focuses on environmental factors that contribute to the disease or condition such as social, physical or biological factors among others, while the agent concept focuses on aspects such as the amounts, cell reproductions, pathogenicity, chemical composition, infectivity and virulence among others (Clark, 2008).
Application of the “Web of Causation” Model to the Nursing Process
The nursing process is composed of complex factors and evidence, but its aim is to take preventive actions by taking into consideration the aspects of risks and vulnerability of patients (Barreto, 2005). The multi-causal concept of the model provides the nursing process with major dimensions to take preventive actions (Denise, 2009). For example, it is applied in advising pregnant women to avoid certain drugs used in treating morning sickness due to their association with malformation of newborn babies. It is also applied in giving advice to patients against risky behaviors and explanations for the same such as the prevention of obesity due to its relation to diabetes (Denise, 2009). Further, the model is constantly applied in the nursing process of vaccination, other disease prevention programs and during major disease outbreaks thus mitigating their impact (Barreto, 2005).
Application of the Model to Community Health Problems
The model has been applied in addressing major health problems that have led to death and that have complex causal factors. For example, the problem of malaria has been prevalent especially in developing countries. The model has been used to offer vaccination, anti-malarial medications and encouragement and supply of the mosquito nets (Barreto, 2005). Another instance in which the model has been applied in community health is in the mitigation of new disease outbreaks such as the H1N1 flu and other diseases associated with sudden outbreak and the unique aspects and contributions of disability and poverty to diseases (Denise, 2009).
The Importance of Community Partnerships in Community Health Projects
The effectiveness of community health projects lies in partnering with the community so as to avert inherent challenges such as resistance from the community, language barriers, trust and application of practical knowledge to the community (Denise, 2009). Health projects also require efforts from the community in terms of education or behavior change which cannot be imposed on the community without education and cooperation from the members (Barreto, 2005). Effective partnership with the community forms a good foundation for epidemiological research and effective tackling of issues related to risk and vulnerability of the community (Denise, 2009). Since most community health projects require much resource, partnership with the community helps to meet such needs. For example, community leaders can help in the administration of the health projects thus minimizing the costs of hiring additional experts (Clark, 2008).
Conclusion
This paper has evaluated and reviewed the “web of causation” model by discussing its historical development, its major concepts namely the agents, environment and host factors, as well as highlighting its application to the nursing process and community health. Lastly, the paper has discussed the importance of community partnerships in community health projects.
Reference List
Barreto, M. (2005). Epidemiologists and causation in an intricate world. Emerging Themes in Epidemiology, 2(3), 2-3.
Clark, M. (2008). Community health nursing: Advocacy for population health (5th ed.). Upper Saddle River, NJ: Prentice Hall.
Denise, O. (2009). Epidemiology and the delivery of health care services. New York, NY: Springer Publishers.
Ervin, N. (2002). Advanced community health nursing practice. Upper Saddle River, NJ: Prentice Hall.
Vineis, P., & Kriebel, D. (2006). Causal models in epidemiology: Past inheritance and genetic future. Biomedical Publications, 5(21), 5-21.