Community Health Overview

Doctor's Preparation / Fatoom Abdullah Awad

• A document, likely for a course, on community and public health.

Community Health: Yesterday, Today, and Tomorrow

• Definitions:

  • Health: A state of complete physical, mental, and social well-being, not merely the absence of disease.
  • Community: A group of people with shared characteristics (location, race, ethnicity, etc.) and a sense of belonging, common interests, shared values. It is not only geographically defined.

• Factors that affect the health of a community:

  • Physical factors: Geography, environment, community size, industrial development.
  • Social and cultural factors: Beliefs, traditions, prejudices, economic factors, politics, religion, social norms.

• Brief History of Community and Public Health:

  • Earliest Civilizations: Community health practices, possibly taboos regarding waste disposal near water sources.
  • Ancient societies (Before 500 B.C.): Evidence of community health activities.
  • Classical Cultures (500 B.C.-A.D. 500): Greek influence, knowledge sharing from other cultures
  • Middle Ages (A.D. 500-1500): Greco-Roman influence on health, preserved knowledge by churches and monasteries but different approach than Roman Empire
  • Renaissance and Exploration (1500-1700): Rebirth of thinking, trade, population growth, increase in disease knowledge, colonialism.
  • The 18th Century: Industrial growth, poor living conditions, beginnings towards understanding of disease.
  • The 19th Century: Few advancements in public health, unsanitary conditions in Europe/England, greater population concentration, public awareness about disease.
  • The Bacteriological Period of Public Health: Significant discoveries in Europe and America. First laws and practices.
  • The 20th Century: Life expectancy still less than 50 years, communicable diseases still significant concern, increasing awareness.

Health Resources Development Period

• Growth of healthcare facilities and providers.
• Significant changes in public health awareness and practices.

The Reform Phase (1900-1920)

• Growing concern about social problems in America
• Increase in urban population to 45% compared to 19% around 1860
• Immigrants contribute to workforce.
• Social issues of economic inequality between social classes.

Period of Social Engineering (1960-1973)

• Federal government involvement in health matters
• Recognition of disparities in health among Americans (poor/elderly).

Period of Health Promotion (1974-present)

• Focus on saving lives and reducing healthcare costs through methods other than healthcare

Community Health in the Early 2000s

• Societies have an obligation to provide an environment for good health.
• Specific population groups may need additional specific support (education etc).

Health Care Delivery

• Exorbitant cost of healthcare impacting the US economy.
• Expenditures far exceed those of other countries.
• National healthcare expenditures were nearly 15% of the gross domestic product in 2002 and grew.

Environmental Problems

• Millions of Americans live in communities with unsafe air, water, or inadequate waste disposal.
• Environmental deterioration continues.

Lifestyle Diseases

• Chronic illnesses are now leading causes of death.
• Obesity and diseases like diabetes are rising.

Communicable Diseases

• Although not the leading causes of death, they still represent a health concern.
• Factors include: Days missed from school/work, complacency about vaccines, lack of eradication of some diseases (like measles).

Factors Affecting Health

• Includes various factors like social norms, religion, economics, and political structures in addition to physical environment.
• Importance of addressing multiple factors across the spectrum.

Public Health Policy and Advocacy

• Advocacy is taking action to support specific health issues or policies. It aims for a healthier population within a community or country.
• Policy change is the intention of advocacy.

Public Health Policy

• Defined as laws, regulations, actions, and decisions to promote health and meet health goals.
• Plays a vital role in the wellness and safety of a population.
• Includes aspects like healthcare, insurance, education, etc.

The Importance of Public Health Policy

• Brings theory and research to real-world solutions
• Initiates strategies for prevention/health interventions.

Public Health Planning and Evaluation

• Multi-step process: Starts with defining the problem and developing an evaluation plan.
• Stages: Mobilization/assessment/planning/implementation/tracking
• Activities: Identifying issues, prioritising issues, developing objectives, planning steps, monitoring progress, evaluating efforts.
• Importance: Allows for community-specific adaptations

Emergency Preparedness and Response

• Definitions of emergencies, disasters, and hazards.
• Includes mitigation, preparedness, response, and recovery phases.

Health in Aging

• Importance of promoting healthy aging
• Common conditions/syndromes of aging

Four Challenges Faced by Long-Term Care Facilities

• Workforce Crisis: Staffing shortages, low wages, demanding workloads, increasing infection rates, falls, and re-hospitalization.
• Financial Pressures/Medicaid Shortfalls: Reimbursement rates inadequate, needing support from Medicaid/private pay, new PDPM guidelines create challenges.
• Changing Needs of Residents: Longer life expectancy, higher prevalence of complex conditions, greater need for specialized care and support systems.
• Rise of Telehealth/Technology: Need for integration of technology and remote services. This creates a wider use of healthcare resources but also poses challenges.