Community Health Concepts

Basic Concepts of Health Promotion

• A community involves a social group interacting, sharing common goals, and residing within geographic boundaries.
• A community can be defined as a group linked by social ties, sharing perspectives, interests, and possibly a location.
• A community is any group, population, or cluster sharing at least one common trait like location, occupation, ethnicity, age, gender, or social status.
• The primary elements of a community are people, place, culture, and its social system.

Different Health Perspectives

• The Biomedical Concept defines health by standard physiological parameters.
• The Ecological Concept sees health as a dynamic equilibrium between humans and their environment.
• The Psychosocial Concept says health includes biomedical aspects plus other factors.
• The Holistic Concept incorporates all factors from other concepts, encompassing all human activities.

Community Health Defined

• Community health is the health status of a group of people.
• Activities/practices protect or improve community health by identifying and solving health problems.
• Reagan and Fisher (1997) define community health as a field coordinating public health at the local level.

Vicious Cycle of Development

• A good level of living is connected to having a good efficiency of labor
• Having a good efficiency of labor allows for a high production output
• A high production output can result in high income
• Having high income allows for a good level of living

Characteristics of a Healthy Community

• Members are aware of their health and biologic status.
• Members give credit to the governing authority.
• Natural and biologic resources are available to everyone with controlled consumption.
• A healthy community has a strong and reliable governing body.
• People work together to achieve independence.
• Environmental and physiologic needs are sustained by community and families.
• Parents/guardians are role models.
• People are concerned about their health status.
• Health services are accessible and affordable, potentially free for the indigent.
• Everyone works to attain a healthy citizenry.

Factors Affecting Community Health

• Key factors include income/social status, education, physical environment, employment/working conditions, social support networks, genetics
• Additional factors include personal behavior, health services, and gender.

Health Determinants for Filipino Communities

• Health determinants specific to Filipino communities include the health care delivery system.
• Other determinants include family structure/heredity, the policy and political environment.
• Further determinants include the environment, health status, and socio-demographic, economic, and cultural factors.

Socio-Demographic, Economic, and Cultural Determinants

• Demographic factors include age, gender or age-sex structure, civil status, educational or literacy level.
• Economic elements include income, occupation, employment, house type, expenses, insurance, and education level.
• Cultural factors include religion, ethnicity, health beliefs, value systems, health behavior, health-seeking behavior factors, and responsible parenthood.

Policy and Political Environment

• Examples include the type of leadership, accessibility of community resources and participation of multisectoral groups in policy making
• Existing policies, implementation of policies, good disparity between rich and underprivileged, peace and order of the place
• Community programs and their implementation, presence of infrastructures which promotes health are also involved

Health Status and Health Care Delivery System

• Examples include population and density, vital rates/statistics (birth rate, death rate, fertility rate, mortality and morbidity rates)
• Examples of delivery of health services, utilization f health resources, health policies and programs, health facilities and supplies
• Delivery of basic health needs (i.e. water and sanitation), adequacy of manpower resources, food safety, mode of communication and transportation, presence of organized groups
• Supports prompt delivery of health services, well-managed financial resources and health facility

Environmental Factors

• Topography/geography, garbage disposal, food and water safety are environmental factors.
• Occurrence of natural/man-made calamities, excreta disposal/sewerage systems, vector-borne diseases, and community peacefulness are also environmental factors.

Health Promotion Defined

• Health promotion, according to the American Journal of Health Promotion, helps people change their lifestyle for optimal health.
• Health promotion, according to WHO, enables people to increase control over and improve their health, beyond individual behavior.
• Health promotion combines health education, service improvement, and advocacy in public health.

Key Concepts of Health Promotion

• Behavior significantly impacts health risks, diseases, and death.
• Health behavior maintains, attains, or regains good health and prevents illness.
• Positive behavior change contributes to overall health.
• Individuals, families, communities, and health systems can impede positive behavioral modification.

Health Promotion Tools

• Health education and health communication are essential tools
• Social marketing, mass media, community mobilization, and policy and client provider interactions are beneficial as well

Steps in Health Promotion

• Community assessment and community organization
• Program design, implementation, evaluation and sustaining the effort

Principles of Health Promotion

• Health promotion should be equitable and guided by social justice
• Initiatives should be sustainable as well, even after initial funds run out
• Health promotion initiatives should have a plan, and consider policy development, organizational change, legislation, advocacy, education and communication

More Principles of Health Promotion

• Health promotion should be empowering, and give communities and individuals more power over social, economic and environmental factors to affect their health
• Individuals should have opportunities for participation in all stages of planning and evaluation
• Health promotion initiatives should foster physical, mental, social and spiritual health and be holistic
• Initiatives will involve collaboration of agencies

Health Education

• Is is defined as “any combination of learning experiences designed to facilitate voluntary actions conducive to health”
• Aligned with the behavioral and social sciences as one of the core dimensions of public health study and practice, from education, health studies and communications

Health Communication

• Health communication studies communication strategies that inform and influence health decisions.
• The purpose is to disseminate health information.

Health Communication to the General Public

• Done through mass media, television, radio, newspaper, posters, etc.
• The best way of conveying information to a large population
• However it is not effective in changing behavior

Organizing a Community

• Involves a process
• Community identifies its needs or objectives, order (or ranks); which develops confidence and self-reliance.
• The community finds the resources (internal or external) to deal with these needs or objectives,
• The community takes action, and in so doing, extends and develops cooperative and collaborative attitudes and practices

Core Traits in Community Organizing

• Ideology - Development of a creative interrelationship between individuals and groups
• Value Orientation - Individual's right to help in time of need and crisis. Individual's right and responsibility to participate in the affairs of his/her community.
• Empowerment - development of management control of resources and institutions to enhance own livelihoods and secure sustainable use of resources
• Equity - There is equal access to opportunities among all
• Capability building - means empowering the community through education, training and organizational development
• Community Based - Resource tenure improvement means gaining/ensuring access and management control by the community over productive resources

Stages of Community Organizing

• Pre-entry phase
• Integration or entry to a community phase
• Community planning and implementation phase
• Strengthening the organization phase
• Monitoring and evaluation phase
• Termination phase

Planning

• Setting objectives and guidelines.
• Meeting with representatives of local governing bodies
• Courtesy call to leaders of selected site
• Building rapport with people in the the community
• Perform environmental mapping, and use an ocular survey to inform the community
• Prepare survey forms, collect data and analyze
• Identifying health issues/problems
• Planning for Intervention
• Setting target dates or timetable

Implementation

• Organizing people and build their own organizing
• Implementing the agreed activities
• Meeting with organizational leaders
• Evaluation of the current progress
• If goals are not meeting the requirements, re-evaluate and perform the program again
• Implementing health education
• Networking and linking
• Mobilizing for health concerns
• Implementing livelihood projects
• Developing secondary leaders

Monitoring and Evaluation

• Monitoring assesses the process of a program
• Evaluate the effect and outcome
• Real evaluation is done by community residents
• Leave the site
• Documentation
• Assess impact and effect of the project
• Leaves the community to stand alone for the organizations which were built are ready to sustain the project

Key Action Areas of Health Promotion

• Reorient health services.
• Create a supportive environment.
• Develop personal skills.
• Strengthen community action.
• Building healthy public policy.

Reorienting Health Services

• Seeks to improve the health of the overall population and provide opportunities for everyone to have access to health resources.

Creating a Supportive Environment

• Environments that support health make achieving wellness easier.
• Fostering a physically and socially supportive environment aids health success.
• Removing harmful practices helps create a supportive space.

Develop Personal Skills

• People should have an understanding of health information so they can take the next steps
• By knowing what can cause illness you can be proactive about your health

Strengthen Community Action

• Encourages people living in proximity or who share health concerns to unite.
• United people can advocate for policy changes and develop new programs.