malimu intro to community health

Chap 1: Community Health - Yesterday, Today, and Tomorrow

Malimu

Chap 1: Community Health

• Accurately define the terms health, community health, population health, and public health.

• Explain the difference between personal and community health activities

• List and discuss the factors that influence a community’s health

Chapter Objectives


Chapter Objectives• Briefly relate the history of

community/public health, including the recent history of community and public health in the twentieth-century .

• Describe the status of efforts to improve world health and list some plans for the future.


Chapter Objectives• Describe the purpose of the Health

People 2010 goals and objectives as they apply to the planning process of the health of Tanzanians.


Introduction

• Definitions, Concepts, & Principles• Community Health vs. Personal

Health• Brief History of Community Health• American Health Concerns in the

90’s


HEALTH• A state of complete physical, mental,

and social well being and not merely the absence of disease and infirmity.” World Health Organization - 1947

• A dynamic state or condition which is multidimensional in nature and results from the adaptation to his/her environment.

Definitions


Definitions• COMMUNITY

Group of people who have common characteristics

• COMMUNITY HEALTH– the health status of a defined group of

people and the actions and conditions, both private and public, to promote, protect, and preserve their health.


• Population Health– The health status of people who are

not organized and have no identity as a group or locality and the actions and conditions to promote, protect and preserve their health

• Public Health– Health status of a defined group of

people and governmental actions and conditions to promote, protect, and preserve the people’s health


Community Health vs. Personal Health

• PERSONAL– Individual actions and decision making that

affect the health of an individual or their immediate family

– COMMUNITY– Activities aimed at protecting or improving

the health of a population or community

Chap 1: Community HealthFactors Affecting Community Factors Affecting Community

HealthHealth

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PHYSICAL FACTORSIndustrial development

Community sizeEnvironmentGeography

SOCIAL/CULTURAL FACTORS

Beliefs, Traditions, and Prejudices

Economy, Politics, Religion Socioeconomic Status

Social Norms

COMMUNITY ORGANIZATION

Ways in which communities

organize their resources;Tax vs Non-tax supported services

INDIVIDUAL BEHAVIORS

Takes the concerted effort of many - if not most - to make a community

voluntary program work


Prehistory7000+ BC

Egyptians1500 -1050 BC

Greeks400 BC

Romans450 BC - 410 AD

Middle Ages410 - 1500AD

Renaissance1500 - 1700

Hammurabi1750 BC

Enlightenment1700s

19th Century

20th Century

21st Century

Chap 1: Community HealthBrief History and Public Health• EARLIEST CIVILIZATIONS• ANCIENT SOCIETIES - before 500 B.C.

– Northern India: evidence of bathrooms and sewers– Sumarian clay tablet: evidence of prescription

drugs– Code of Hammurabi: laws pertaining to physicians

and health practices• CLASSICAL CULTURES - 500 B.C. - 500 A.D.

– Greeks: Games of strength and skill for men– Greeks: Active in community sanitation– Romans: Built aqueducts and sewer systems– Romans: Built hospitals and infirmaries for slaves


Brief History and Public Health• MIDDLE AGES - 500 to 1500 A.D.

– Spiritual era of public health– Great epidemics of plague

• RENAISSANCE AND EXPLORATION - 1500 to 1700 A.D. – Rebirth of thinking about nature of the world

and of humankind– Belief that diseases were caused by

environmental, not spiritual factors


Brief History and Public Health• EIGHTEENTH CENTURY • INDUSTRIAL GROWTH• Cities overcrowded

– Water supplies inadequate – Streets heaped with trash and garbage

• Occupational health – Workplaces unsafe and unhealthy– Workforce poor– Children forced to work long hours


Brief History and Public Health• NINETEENTH CENTURY • EARLY APPROACH

– Few advancements in public health– Federal government approach “Laissez faire”– Health quackery thrived

• EPIDEMICS CONTINUED – London cholera epidemic struck in 1849– Miasmas theory of contagious disease– Dr. John Snow and the Broad Street pump


Brief History and Public Health• LEMUEL SHATTUCK’S HEALTH

REPORT, 1850

• FIVE PERIODS OF ERA – Miasma, 1850 to 1875– Bacteriological, 1875 to 1900– Health Resources Development, 1900 to 1960– Social Engineering, 1960 to 1975– Health Promotion, 1975 to present


Health Resources• BEGINNING OF TWENTIETH CENTURY

– Life expectancy less than 50 years– Communicable diseases leading causes of

death– Children health concerns


Health Resources (1900-1960)• REFORM PHASE - 1900 to 1920• GREAT DEPRESSION & WORLD WAR

II 1929 - 1935– Social Security Act of 1935– National Institutes of Health established -

1930’s• THE POSTWAR YEARS 1945 - 1960

– Communicable Disease Center established - 1946

– World Health Organization founded - 1948


Health Resources (1900-1960)• SOCIAL ENGINEERING 1960 - 1973

– Congress passed Medicare and Medicaid bills - 1965

– OSHA Act Signed 1970• Health Promotion Period (1975 -

1990)– Lifestyle related diseases– High medical care costs


HEALTH PROMOTION• LIFESTYLE CHANGES

– World Health Organization’s “Health for All”, 1977

– Promoting Health/Preventing Disease: Objectives for the Nation, 1979• 226 Objectives based on preventive services, health

protection, and health promotion – Healthy People 2000

• Over 300 objectives – Healthy People 2010


Community Health in the 21st Century • World Planning

– reduce the burden of excess mortality and morbidity

– developing effective health systems– expanding the knowledge base


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