A nurse and a community team are assessing their community using the built environment assessment tool. Which of the following is a core feature of the built environment assessment tool?

Choice A Reason:
Assurance of services refers to the guarantee that health services are available and accessible to the population. While this is crucial for public health, it primarily affects the structural level of society rather than multiple levels. The Ecological Model emphasizes the interaction between individual, interpersonal, community, and societal factors. Assurance of services is more of a systemic factor and does not directly influence individual behavior across multiple levels.

Choice B Reason:
Health beliefs are a significant factor in the Ecological Model as they influence individual behaviors and decisions regarding health. These beliefs are shaped by personal experiences, cultural norms, and societal influences. Health beliefs operate at multiple levels, including the individual level (personal beliefs), interpersonal level (influence of family and friends), and community level (cultural and societal norms). They play a critical role in determining how individuals perceive health risks and engage in health-promoting behaviors.

Choice C Reason:
Medical funding is essential for the provision of healthcare services and the functioning of health systems. However, it primarily affects the structural and policy levels rather than multiple levels of society. While adequate funding is necessary for ensuring access to healthcare, it does not directly influence individual health behaviors across different levels of the Ecological Model.

Choice D Reason:
Laws and local ordinances that relate to health are crucial in shaping the environment in which individuals live. These regulations can influence health behaviors by creating supportive environments, such as smoke-free zones, safe drinking water standards, and regulations on food safety. These laws operate at the community and societal levels, impacting individual and collective behaviors by establishing norms and standards that promote health.

Choice E Reason:
Interaction with others is a key component of the Ecological Model, affecting health behavior at multiple levels. Social interactions influence individual behaviors through peer pressure, social support, and the sharing of information. At the interpersonal level, family and friends can encourage or discourage healthy behaviors. At the community level, social networks and community organizations play a role in shaping health norms and behaviors. These interactions are integral to understanding how health behaviors are adopted and maintained.

Choice A: Proportionate Mortality
Proportionate mortality refers to the proportion of deaths in a specified population over a period of time attributable to different causes. It is expressed as a percentage of the total number of deaths. While this measure can provide insight into the relative importance of different causes of death, it does not give the actual mortality rate for each cause. Therefore, it is not the best measure for identifying the top three causes of death in a county.

Choice B: Crude Mortality Rate
The crude mortality rate is the total number of deaths from all causes per 1,000 or 100,000 population in a given year. This measure provides an overall picture of the mortality level in a population but does not specify the causes of death. It is useful for general mortality trends but not for identifying specific causes of death.

Choice C: Cause-Specific Mortality Rate
The cause-specific mortality rate is the number of deaths from a specific cause per 100,000 population in a given year. This measure is the most appropriate for identifying the top three causes of death because it provides detailed information on the mortality rate for each specific cause. By calculating the cause-specific mortality rates, the nurse can determine which causes are the most significant contributors to mortality in the county.

Choice D: Case Fatality
Case fatality refers to the proportion of individuals diagnosed with a particular disease who die from that disease within a specified period. It is usually expressed as a percentage. While case fatality provides information on the severity of a disease, it does not give the overall mortality rate for the population or help identify the top causes of death.