Understanding Community Types and Subsystems

• Community is a social group with geographical boundaries and/or common interests.

Types of Communities

• Geopolitical/Territorial: Formed by natural and man-made boundaries like barangays, cities or regions.
• Phenomenological: Relational or interactive groups sharing perspectives based on culture, values, and goals.
• Urban: High-density, socially homogenous population with non-agricultural jobs.
• Rural: Small, focused on farming or fishing, with close-knit relationships.
• Rurban: Combination of rural and urban areas; transition zone with mixed land use.

Subsystems of a Community

• Housing: Includes types, availability, and regulations.
• Education: Covers laws, facilities, educator-to-learner ratios, and informal activities.
• Fire and Safety: Availability of fire protection services.
• Politics & Government: Political structure and leadership styles.
• Health: Health facilities, services, accessibility, and provider-to-client ratio.
• Communication: Systems and types of communication influencing community health.
• Economics: Types of economic activities.
• Recreation: Recreational activities and appropriateness for consumers.

Characteristics of a Healthy Community

• Members have a high degree of awareness and feeling of unity.
• Natural resources are conserved for future generations.
• A healthy community openly recognizes subgroups and welcomes participation in community affairs.
• Prepared to meet crises.
• Has open communication channels in all directions.
• Seeks to make each system's resources available to all members.
• Effective ways to settle disputes.
• Encourages maximum citizen participation in decision-making.
• Promotes a high level of wellness among its members.

Conditions Affecting Community Health

People

• Population variables: size, density, composition, growth rate, cultural characteristics, mobility, social class, and education level.
  • Size and Density: Affect the number and size of healthcare institutions.
    • Overcrowding: Easy spread of communicable diseases, increase stress, housing degradation.
    • Sparsely populated areas: Limited resources.
  • Composition: Health needs vary by age, sex, occupation, and education level.
  • Rapid population growth: Increases demands for health services.
• Decrease economic activity in the community and lower government revenue.
• Decrease resources accessible to the community.
  • Cultural characteristics: homogenous or multicultural influence community action.
  • Mobility: Impacts feeling of belonging and community participation.
  • Level of Education & Social Class: Affects living conditions and access to opportunities.

Location

• Natural Variables: Climate, temperature, and humidity.
• Community boundaries are urban/rural
• Flora and fauna

Social System

• Social determinants of health: Conditions in environments affecting health, such as resources for daily needs and access to opportunities.
• Physical determinants of health: Natural and built environments, worksites, housing, exposure to hazards, aesthetic elements.

Principles of Community Health Nursing

• Focus on the community as the unit of care.
• Give priority to community needs.
• Work with the community as an equal partner.
• Focus on primary prevention.
• Promote a healthful environment.
• Reach out to all for specific services.
• Promote optimum use of resources.
• Collaborate with others in the community.

Epidemiology

• Study of disease distribution and determinants in populations.
• Practical Applications: Assess health status, determine disease causation, implement prevention, and provide evidence for policy.

Natural History of Disease

• Stage of Susceptibility: Person is not yet sick but maybe exposed to the risk factors of the disease.
• Stage of Subclinical Disease: Person is healthy; Pathologic changes have already occurred.
• Stage of Clinical Disease: Pt. manifest recognizable signs & symptoms.
• Resolution Stage: Patient either recovers completely, becomes chronic case with or without disability or dies.

Epidemiologic Triangle

• Agent, host, and environment analyzed for disease patterns

Classification of Agent, Host, Environment

Agents of Disease

• Nutritive elements (cholesterol, vitamins).
• Chemical agents (Carbon monoxide, drugs).
• Physical agents (heat, light, radiation).
• Infectious agents (virus, bacteria, fungi).

Host Factors (Intrinsic)

• Genetic, age, immunology, human behavior.

Environmental Factors

• Physical, biologic, and socioeconomic environments.

Disease Distribution

• Time: Period of exposure and illness.
• Persons: Characteristics of those affected.
• Place: Features of the environment where the disease occurs.

Pattern of Occurrence & Distribution

• Sporadic: Intermittent, isolated cases.
• Endemic: Continuous occurrence in a given locality.
• Epidemic: Unusually large number of cases in a relatively short period.
• Pandemic: Epidemic occurring in several countries at the same time.
• Cluster: Disease occurring in larger numbers, cause may be uncertain.

Health Indicators

• Quantitative measures describing population health status.
  • Health Status Indicators (Morbidity): Prevalence and incidence.
  • Health Status Indicators (Mortality): Crude, specific, maternal, infant, and neonatal mortality rates.
• Morbidity Indicators: Based on disease-specific incidence or prevalence.
• Prevalence: Total existing cases at a point in time.
• Incidence: Number of new cases over a period.
• Mortality Indicators: Death statistics.

Vital Statistics

• Collect, organize, and analyze numerical facts.
• Use:
  • Indices of community health.
  • Basis for implementing programs.

Sources of Vital Statistics Data

• Census, hospitals, vital registration, disease notification/registries, surveillance, insurance, school health, surveys

Data Presentation Forms

• Line graphs show trends.
• Bar graphs represent quantities.
• Pie charts show importance of parts to the whole.

Vital Statistics Rates

• Numerator: person experiencing the event.
• Denominator: total population exposed to event.
  • Crude/General Rates: Refer to the total living population
  • Specific Rate: For specific population class/group.
  • Crude Birth Rate: A Measure of population Growth
  • Crude Death Rate: A measure of one mortality from all causes which may result in a decrease in population
  • Infant Mortality Rate: Measures the risk of dying during the first year of life
  • Maternal Mortality Rate: Measures the risk of dying from causes related to pregnancy, childbirth and puerperium.
  • Fetal Death Rate: measures pregnancy wastage.
  • Neonatal Death Rate: Measures the risk of dying during the 1st month of life.
  • Specific Death Rate: Specific population groups
  • Case Specific Death Rate: Specific Causes
  • Age Specific Death Rate: Age Population
  • Sex Specific Death Rate: Sex Population
  • Incidence Rate: Measures the frequency of occurrence of the phenomenon during a given period of time
  • Prevalence Rate: Measures the proportion of the population which exhibits a particular disease at a particular time

Functions of the Nurse

• Collect, tabulate, analyze, and evaluate data.
• Recommends redirection or strengthening of health programs.