Community, Organization, and Health

COMMUNITY, ORGANIZATION, AND ITS HEALTH Accdg to WHO ◦“ a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity  HE ◦ Is a state of being in which an individual does the be...

COMMUNITY, ORGANIZATION, AND ITS HEALTH Accdg to WHO ◦“ a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity  HE ◦ Is a state of being in which an individual does the best with the capacities he has, and acts in ways that maximizes his capacities ◦ Based in terms of standard physiological parameters- the vital signs, the presence of various chemicals in the blood, electro- neurological readings, gross anatomy and physiology AL (Biomedical mode) ◦ Defines it according to how individual function and interact with the environment and even with deformities as long as he can cope up with his daily needs and interact with people (Behaviorist Model) TH Some Key Factors in determining if the person is healthy or unhealthy ◦Income and social status ◦Education and literacy ◦Social environments ◦Physical environments ◦Personal health practice ◦Biology and genetics ◦Culture ◦ Illness ◦ Suffering from something that makes one sick ◦ unwell or unhealthy state of mind and body ◦ Associated with signs and symptoms ◦ Interchangeably used with disease, morbidity and disorder ◦ Disease ◦ suffering from a malfunctioning organism or function within the body itself  Illness Disease Affect the body or mind in a Has specific result on a body part myriad of different capacities of function Perceived notion of unwellness or Must be diagnose by a medical derive from self-diagnosis expert Can fall under a generalized Named by a pathological persicope of health maladies identification label or marker such as diabetes, sickle cell etc. Community Health ◦ : Environmental, Social, and Economic resources to sustain emotional and physical well being among people in ways that advance their aspirators and satisfy their needs in their unique environment. ◦ Indicators for a Healthy Community: ◦ All residents should: ◦ ~access to quality education ◦ ~safe and healthy homes ◦ ~adequate homes & transportation ◦ ~physical activity & nutrition ◦ ~quality health care Models of health  Social Model of Health Medical Model ◦ factors which contribute to ◦ belief that science could cure health such as: social, cultural, all illness and disease political and the environment. ◦ makes health an attribute you can measure simply by determining is a disease is present or not. Biopsychosocial Model Salutogenic Model ◦ looks at the biological ◦ focuses how and why we stay factors which affect health, well. such as age, illness, gender ◦ This model increases etc. understanding of the ◦ Psychological factors- relationship between stressor, individual beliefs & coping and health. perception. ◦ The social- community, presence or absence of relationships  Ecosystem health ◦ humanity is part of and among many in an environment that is being changed as a result of human activity ◦ changes harm people, domestic animal, wildlife, the oceans, and the forest. ◦ The crucial response has to be redesign our relations with the rest of nature Dunn's High-Level Wellness and GRID model WHO Model of Health Maslow’s Hierarchy of Needs Physiological ◦people’s need for survival  Safety and Security Needs ◦Personal security ◦Financial security ◦Health and well-being ◦Safety net against accidents/illness and their adverse impacts Love and Belonging ◦Friendship ◦Intimacy ◦Family Esteem ◦ All humans have a need to feel respected ◦ includes the need to have self-esteem* and self-respect ◦ Inferiority complex** → imbalances can lead to depression ◦ 2 Versions of Esteem accdg to Maslow ◦ Low esteem – need respect from other ◦ need for status, recognition, fame, prestige, and attention ◦ High esteem- "higher" version manifests itself as the need for self- respect ◦ need for strength, competence, mastery, self-confidence, independence, and freedom Self Actualization ◦ Maslow believed that to understand this level of need, the person must not only achieve the previous needs, but master them. 3 Principal Strategies in Promoting Health ADVOCACY- awareness and interest and to impel societal forces that influence public policy and resources to support health SUPPORT- to foster healthful social norm alliances and systems that are sensitive and responsive to health needs and concerns of people EMPOWERMENT- help people develop knowledge and skills to make positive health choices and the ability to act individually and collectively to improve health  ORGANIZATION, HEALTH SERVICES AND TECHNOLOGY WHO’S Community Health Needs Assessment  WHO’S Community Health Needs Assessment 1.Physical environment 2.The social environment- level of social and emotional support people receive from friends and/or family 3.Poverty- a significant factor worldwide, which shortens and reduce enjoyment of life 4.Behaviour and lifestyle 5.Family genetics and individual biology  Community Profiling ◦Population ◦Housing ◦economic characteristics and trends of the broader community and the study area. ~this is to understand the growth trends, ethnicity, income, and mobility needs of a population.  Community Profiling Important Datum to gather: >work levels of employment and unemployment ~Occupational disease, Income levels, Self-worth >Poverty and Income >Environment ~Pollution, Good sanitation, Lack of home, Transport system, Social support, Family and friendship networks, Migration, Marginal group In general, there are three broad factor that affect the health of a community: Physical Factors Social and Individual Cultural Factors Factors Geography Traditions Behaviour Environment Norms Community size Beliefs Industrial Economy development Politics Income livelihood Community Organization ◦Distinct Models of Community: 1.Locality- process-oriented, creating a consensus and sense of cooperation 2.Social planning- task-oriented, emphasizing rational empirical problem-solving 3.Social Action-both task and process oriented 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 and Solutions 7. Monitoring and Evaluation 8. Sustaining Gains, Addressing Emerging Problems For epidemiologist the following data are important: ~Rates- Definition of Terms: Birth rate- average number of births during a year per 1,000 persons in the population at the mid-year ◦*AKA Crude birth rate. Dominant factor in determining the rate of population growth. For epidemiologist the following data are important: Morbidity Rate- rate at which disease or illness occurs in a population and can be used to determine the health of a population and its healthcare needs. o Incidence rate- describes how quickly disease occurs in a population. Can be calculated as: ◦Incidence= (New cases)/ (Population x Timeframe) o Prevalence rate- total number of cases of disease existing in a population divided by the total population o Attack rate- the proportion of those who became ill after a specified exposure For epidemiologist the following data are important: Morbidity Rate- rate at which disease or illness occurs in a population and can be used to determine the health of a population and its healthcare needs. o Incidence rate- describes how quickly disease occurs in a population. Can be calculated as: ◦ Incidence= (New cases)/ (Population x Timeframe) o Prevalence rate- total number of cases of disease existing in a population divided by the total population o Attack rate- the proportion of those who became ill after a specified exposure Mortality Rate- number of deaths due to a disease divided by the total population o Infant mortality rate- number of deaths under 1 year of age. High rate means that human health needs in sanitation, medical care, nutrition and education are not met. o Neonatal rate- number of deaths under 28 days of age, “excess mortality”. ◦ Case fatality rate- percentage of cases that result in death. Measures the severity of disease and is proportionate to the virulence of a disease agent. Behavioural Change Theories According to these theories behaviour is determined by: Environmental characteristics Personal characteristics Behavioural characteristics ◦Understanding this will improve the services offered in there areas: Health, education, criminology and energy General Theories and Models ❖Learning theories/behavioural analytic theories of change ❖Social learning/Social cognitive theory ❖Theory of Reasoned Action ❖Theory of Planned Behaviour ❖Health Action Process Approach ❖Transtheoretical theory/Stages of Change Model The Transtheoretical Model Stages of Behaviour Changes Termination The Transtheoretical Model Decisional Balance: Relative weighing of the pros and cons of changing ◦ Pros- the benefits of changing (accdg to Janis and Mann 1977) ✓ Instrumental gains for self ✓ Instrumental gains for others ✓ Approval for self ✓ Approval for others ◦ Cons- cost of changing ✓ Instrumental costs to self ✓ Instrumental costs to others ✓ Disapproval from self ✓ Disapproval from others The Transtheoretical Model ◦Self-efficacy- belief in one’s own ability to complete tasks and reach goals such as facing an exam or undergoing surgery. A.Confidence Behaviour specific Situation specific “here and now” Build small steps A.Temptation- counteract stress; avoid negative social occasions, control cravings ~important in preparation and action stages The Transtheoretical Model ◦ Consciousness Raising- increased awareness of behaviour; feedback, confrontation, interpretations ~important in contemplation, preparation and action stage ◦ Dramatic Relief- transition to emotional awareness: psychodrama, role playing, personal testimony, grieving ~important in contemplation and preparation stage The Transtheoretical Model ◦ Self-Reevaluation- cognitive and affective assessment of one’s self-image: value clarification, healthy role modeling, mental imagery ~important in preparation and action stage ◦ Environmental Reevaluation- affective and cognitive of how one’s behaviour affects the social environment: empathy training, documentary reflection ~important in contemplation, preparation and action stages The Transtheoretical Model ◦ Self-Liberation- belief that one can change,, behavioral process, commitment and recommitment: “skill power”, resolution, public testimony ~important in contemplation and preparation stages ◦ Counterconditioning- learning of healthy coping: relaxation, assertion, desensitization, nicotine replacement, positive self statements ~important in preparation, action, and maintenance stages The Transtheoretical Model ◦ Contingency Management- consequences for taking steps in a particular direction: contingency contracts, overt and covert reinforcement, group recognition ~important in action and maintenance stages ◦ Stimulus Control- removes cues for unhealthy habits: avoidance, environmental reengineering, self- help groups ~important in action and maintenance stages The Transtheoretical Model ◦Social Liberation- increase in social opportunities or alternatives: smoke-free environment, access to healthy alternatives ~important in action and maintenance stages Thank you for listening!