Environmental epidemiology involves the study of human beings. Interventional studies are used to determine if a preventive intervention or a treatment lowers disease rates. Observational studies are used to identify risk factors or causes of disease in human populations. In evaluating the weight of evidence for causality, one of the Bradford Hill criteria—biologic plausibility—addresses evidence from laboratory toxicology studies of test animals, cells, and other laboratory data.

In your response, address the following:

• Explain how environmental epidemiology and toxicology are similar in terms of study objectives and study designs.
• Explain how environmental epidemiology and toxicology are different in terms of study objectives and study designs and the certainty with which conclusions from each type of research can be generalized to human populations.
• Discuss an example in which epidemiologic and toxicologic data are complementary in providing evidence of causality in a specific exposure-disease relationship.

Support your answers with appropriate research and reasoning and initiate comments on the postings of at least two of your peers.

Evaluation Criteria:

• Explained how environmental epidemiology and toxicology are similar in terms of study objectives and study designs.
• Explained how environmental epidemiology and toxicology are different in terms of study objectives and study designs and the certainty with which conclusions from each type of research can be generalized to human populations.
• Discussed an example in which epidemiologic and toxicologic data are complementary in providing evidence of causality in a specific exposure-disease relationship.
• Supported answers with appropriate research and reasoning and initiated comments on the postings of at least two peers.

Family Home Health is a small community-based provider of in-home nursing and therapy. It is a division of the local community hospital. The service employs the equivalent of 15 full-time staff members and currently has about 100 patients. Its vision and mission statements are:

Vision: With a focus on aging adults and rural health care, we will be the leader, partner, and provider for health care delivery in our community.
Mission: Family Home Health provides a spectrum of services with special concern for the community. The organization is committed to providing high-quality services.

The home care agency is unable to create a sustainable model as the reimbursements received are below the costs of operating the program. The hospital is considering discontinuing the home care business.

The proposed termination of the home care division has met with much opposition throughout the community. There is no other viable home care agency to serve many of the current patients, though services are available in a larger community 50 miles away.

Many physicians are angry. As community hospital employees, physicians value the home care agency to refer patients for follow-up care. The home care agency staff enjoy their roles in providing care and value the freedom in the home care atmosphere. They will be unemployed if the agency closes because the parent hospital currently has a hiring freeze and cannot offer positions to these employees.

Community leaders are concerned. They built the foundations for both the hospital and the home care agency. The issues of financial viability have not been a priority as much as serving the needs of the community. In the past, fundraising was sufficient to provide the needed resources, but times have changed.

You are a member of the board of directors, and it is your task to maintain a fiscally responsible organization while remaining true to the community hospital mission and vision. Based on the information, determine your response to this situation. Do the following:

• Complete a SWOT analysis or use the BSC approach to the dilemma.
• State your decision to close or not close the home care agency. Give reasons for your decision.
• If you decide to close the agency, explain how you will minimize the negative impact on the stakeholders.
• If you decide to not close the agency, explain how you will address its financial difficulties.

Write your assignment in a Word document. The assignment should be 3 pages long.