Community Health & Human Behavior PDF

COMMUNITY HEALTH & HUMAN BEHAVIOR FACTORS AFFECTING HEALTH CITED FROM WHO’S COMMUNITY HEALTH NEEDS ASSESSMENT 1. The physical environment in which people live – such as the quality of air and water 2. The social environment – the level of social and emotional support people receive from fri...

COMMUNITY HEALTH & HUMAN BEHAVIOR FACTORS AFFECTING HEALTH CITED FROM WHO’S COMMUNITY HEALTH NEEDS ASSESSMENT 1. The physical environment in which people live – such as the quality of air and water 2. The social environment – the level of social and emotional support people receive from friends/family 3. Poverty – a significant factor worldwide, which shortens and reduces enjoyment of life 4. Behaviour and lifestyle – such as smoking causes lung cancer and coronary heart disease 5. Family genetics and individual biology These factors remind us that public health or community health is not a matter of presence or absence of a disease. COMMUNITY PROFILING The following data are recommended to be considered when one does community profiling: A. WORK AND LEVELS OF EMPLOYMENT AND UNEMPLOYMENT B. POVERTY AND INCOME C. ENVIRONMENT A. WORK AND LEVELS OF EMPLOYMENT AND UNEMPLOYMENT 1. OCCUPATIONAL DISESASE. Silicosis in mine & quarry workers, machinery accidents among farm workers, repetitive strain injury for keyboard operators 1. INCOME LEVELS. The amount of income people earn has an important influence on their health, affecting their ability to choose a healthy lifestyle and to access health services. 1. SELF-WORTH. The status of an occupation affects how people feel about themselves. People’s level of satisfaction at work contributes to their well being. Many define people by their work or lack of it. The unemployed may feel excluded, and lack of paid employment has been shown to contribute to poor health. B. POVERTY AND INCOME Poverty can be absolute (inadequate to sustain health) or relative (how poor one person is compared to another). HEALTH INEQUALITY is one of the most significant factors affecting health across the world and therefore information on this issue will be essential. C. ENVIRONMENT 1. POLLUTION of air and water causes disease and death and this is evident throughout the world, whether it is lead in petrol or a chemical spill from a factory, or drinking water contaminated by sewage. 1. GOOD SANITATION eliminates some diseases such as cholera and dysentery completely, and where it is absent, gastrointestinal illnesses are quickly evident. In communities lacking basic sanitation, threats to health arise from the contamination of water supplies by human excreta. 1. The LACK of a HOME affects all aspects of health – shelter from the weather, an environment to sustain a family, a place to feel safe. The availability and type of housing reflect local history, culture, the economy and political climate. 4. TRANSPORT SYSTEMS are important to record, as they can influence people’s access to services, social support networks and employment. Transport may also have an impact on health through accidents, noise and air pollution. 5. SOCIAL SUPPORT is essential for the well being of a community. There are number of elements that need to be taken into consideration when describing the extent of social cohesion in a community. 6. FAMILY and FRIENDSHIP NETWORKS provide people with emotional support that is fundamental to well being. Social networks can be hard to describe and quantify. It may be possible for them to describe social networks through flow diagrams, maps, drawings, stories and drama. 7. MIGRATION causes disruption to a population, as large numbers of people move location. It is often the younger working-age population who emigrate, and this is a loss to the population left behind while a gain to the community they move to. Population movements could be traumatic owing to the upheaved caused, especially if forced by armed conflict, threat of discrimination or severe economic necessity. 8. MARGINAL GROUPS are outside the dominant community, yet may form a distinct population themselves. Some groups such as religious sects, travelers and gypsies may choose to remain outside mainstream society. Others such as homeless, may be forced to that position. Access to health for both these groups, who may have greater need for service. 9. The OPPORTUNITIES for NON-WORK SOCIAL ACTIVITIES are signposts that can be used to indicate the extent of social cohesion and support in a community. Such activities reinforce a community’s identity and the emotional well being of individuals DESTABILIZING FACTORS THAT CAN AFFECT THE HEALTH STATUS OF THE COMMUNITY BY WHO: 1. War 2. Economic recession 3. Natural disasters such as earthquakes, floods or drought Direct Effect: mortality, disease patterns and lifestyle change Indirect Effect: reducing the resource available for health service, increasing poverty and lowering the social and economic wellbeing of the population. “Radically lower population numbers and increase fear and mental ill health.” THREE BROAD FACTORS THAT AFFECT COMMUNITY HEALTH 1. PHYSICAL FACTORS Geography, Environment, Community Size, Industrial Development 2. SOCIAL AND CULTURAL FACTORS -Traditions, Norms, Beliefs, Economy, Politics, Income, Livelihood 3. INDIVIDUAL FACTORS -Behavior Perhaps the fourth factor that can determine the health of a community is the process of COMMUNITY ORGANIZING. COMMUNITY ORGANIZING MINKLER & WALLERSTEIN, 1997 “The process by which community groups are helped to identify common problems or goals, mobilize resources and in other ways develop and implement strategies for reaching the goals they collectively have set. “ COHEN & SYME, 1985 “Improving perceived control, individual coping capacity, health behaviors and health status.” COMMUNITY ORGANIZING ROTHMAN & TROPMAN, 1987 Three distinct models of community organizing: 1. Locality Development – process oriented, creating consensus & sense of cooperation 2. Social Planning – task oriented, emphasizing rational-empirical problem solving 3. Social Action – both task and process oriented HIMMELMAN, 1992 Developed a more collaborative empowerment model emphasizing that communities should play a lead role in order to achieve real empowerment and not just community betterment. THE STEPS IN COMMUNITY ORGANIZING: 1. Problem Identification 2. Interface With Community 3. People Organization 4. Community Profile And Assessment 5. Goal-setting And Formulation Of Strategies 6. Implementation Of Agreed Strategies Or Solutions 7. Monitoring And Evaluation 8. Sustaining Gains, Addressing Emerging Problems