Chapter 1: Community and Public Health PDF

Community and Public Health Yesterday, Today, and Tomorrow Chapter 1 Outline Health & Community Public/Community/Population/Global Health Health of a Community History of Community and Public Health Achievements Health Can mean different things to di...

Community and Public Health Yesterday, Today, and Tomorrow Chapter 1 Outline Health & Community Public/Community/Population/Global Health Health of a Community History of Community and Public Health Achievements Health Can mean different things to different people A dynamic state or condition of the human organism that is multidimensional in nature, a resource for living, and results from a person’s interactions with and adaptations to his or her environment. Genetics, social circumstances, environmental conditions, behavioral choices, medical care. Community Individuals with a common characteristic (e.g., geography, race/ethnicity, age, etc.) Characterized by: Membership, common symbol systems, shared values and norms, mutual influence, shared needs and commitment to meeting them, shared emotional connection Definitions Public Health: actions that society takes collectively to ensure that the conditions in which people can be healthy can occur Community Health: health status of a defined group of people and the actions and conditions to promote, protect, and preserve their health Population Health: health outcomes of a group of individuals, including the distribution of such outcomes within the group Global Health: health problems, issues, and concerns that transcend national boundaries What’s the difference between Personal Health Activities and Community/Public Health Activities? Health Activities Personal: Individual actions and decision making that affect the health of an individual or his or her immediate family members or friends Community/Public: Activities aimed at protecting or improving the health of a population or community Physical Factors Geography Ex. Tropical countries → ↑parasitic/infectious diseases Environment Quality of natural environment is directly related to the quality of our stewardship of it. Built environment: Design, construction, and management of human-made surroundings… Community Size Larger community = Greater range of health problems Industrial Development Provides a community with added resources for community health programs. Social and Cultural Factors Beliefs, Traditions, and Prejudices: Ex. Beliefs about exercise and smoking can influence policy makers Economy: Ex. Poor economy = less charitable contributions = less dollars for assistance Politics: Ex. Extent to which government should involve itself in health care (D/R) Religion: Ex. Limitations of type of medical treatment members may receive Social Norms: Ex. Smoking: 1965 (51%/34%) -> Present (19%/15%) Socioeconomic Status (SES): Education, Employment, income, etc. Ex. Lower SES = poorer health status Community Organizing A process through which communities are helped to identify common problems or goals, mobilize resources, and in other ways develop and implement strategies for reaching their goals they have collectively set Individual Behavior Behavior of the individual community members contributes to the health of the entire community. What are some examples? History of Community and Public Health Early Civilizations Eighteenth Century Nineteenth Century Twentieth Century Twenty-First Century Early Civilizations Ancient Societies (before 500 BCE) Sewage disposal, written medical prescriptions, laws for medicine, guidelines for personal cleanliness and sanitation Classical Cultures (500 BCE – 500 CE) Sanitation, aqueducts, cleaning/repair, building regulations Middle Ages (500 – 1500 CE) Dark Ages… Health problems considered to have spiritual causes/solutions Plague, Leper houses, Epidemics Renaissance and Exploration (1500 – 1700 CE) Disease caused by environmental and not spiritual Observations led to more accurate descriptions of symptoms Eighteenth Century Characterized by industrial growth Cities overcrowded, water supplies inadequate and unsanitary, problems with trash, workplaces unsafe (1796) Dr. Jenner demonstrated process of vaccination against smallpox Average age at death: 29 years First census taken: 1790 Nineteenth Century 1850: Modern Era of Public Health Lemuel Shattuck and health report for Commonwealth of Massachusetts Health boards, vital statistics, sanitary measures, etc. 1854: Cholera epidemic and John Snow (epidemiology) Sponanous generation (organisms arise from inorganic or nonliving matter) was disproved and replaced by germ theory of disease Twentieth Century Life expectancy less than 50 years. Leading causes of death were communicable diseases (influenza, TB, etc.) Vitamin deficiencies and poor dental health common in slums Unavailability of adequate prenatal and postnatal care = deaths in pregnancy and childbirth Health Resources Development Period (1900-1960) Period of Social Engineering (1960-1973) Period of Health Promotion (1974-present) Health Resources Development Period (1900-1960) Larger differences between upper and lower classes Urban population: 1860 (19%) -> 1910 (45%) American Cancer Society, first nursing program, school of public health, National Cancer Institute Social Security Act of 1935: support for state health departments, etc. Medical discoveries: antibiotic penicillin, DDT, etc. Polio vaccine Eisenhower’s heart attack Period of Social Engineering (1960-1973) Federal government increased involvement in health matters Medicare: assists older adults and certain people with disabilities Medicaid: assists in the payment of medical bills for the poor Influx of federal dollars accelerated rate of increase of cost of health care Period of Health Promotion (1974-present) Identification that premature death traceable to lifestyle and health behaviors Healthy People publication established Healthy People 2020 MAP-IT (Mobilize, Assess, Plan, Implement, Track) Twenty-First Century U.S. Community/Public Health in Early 2000s Health care delivery Environmental problems Lifestyle diseases Communicable diseases Alcohol and other drug abuse Health disparities Disasters Public health preparedness World Community/Public Health in Early 2000s Communicable diseases 5 out of 10 leading causes of death are infectious diseases in low-/middle- income countries 9 out of 10 leading causes of death are non-communicable in high-income countries Poor sanitation and unsafe drinking water 1 out of 5 deaths in children under 5 years due to water-related disease Hunger 27% reduction in hunger worldwide since 2000 11% decline in malnourished children in developing countries since 1990 795 million people (1 out of 9), suffer from chronic undernourishment 780 million live in developing countries Twenty-First Century Global Health Achievements Reductions in child mortality Vaccine-preventable deaths Access to safe water and sanitation Malaria prevention and control Prevention and control of HIV/AIDS Tuberculosis control of infections diseases Control of neglected tropical diseases Tobacco control Global road safety Improved preparedness and response