Chapter 1community And Public Health Yesterday Today And Tomorrowch ✓ Solved

Chapter 1 Community and Public Health: Yesterday, Today, and Tomorrow Chapter Objectives After studying this chapter, you will be able to: Define the terms health, community, community health, population health, public health, public health system, and global health. Briefly describe the five major determinants of health. Explain the difference between personal and community health activities. List and discuss the factors that influence a community’ s health. Briefly relate the history of community and public health, including the recent U.S. history of community and public health in the twentieth and early twenty-first centuries.

Provide a brief overview of the current health status of Americans. Describe the purpose of the Healthy People 2020 goals and objectives as they apply to the planning process of the health of Americans. Describe the major community and public health problems facing the United States and the world today. Introduction Much progress made over last 100 years in health and life expectancy Still room for improvement Achievement of good health is worldwide goal of 21st century Requires individual actions to improve personal health and organized community actions 20th Century Achievements in Public Health Vaccination Motor vehicle safety Control of infectious diseases Decline of deaths from CHD and stroke Healthier mothers and babies Safer and healthier foods Safer workplaces Family planning Fluoridation of drinking water Recognition of tobacco use as a health hazard Definition: 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 Definition: Community A group of people who have common characteristics Can be defined by location, race, ethnicity, age, occupation, interest in particular problems or outcomes, or common bonds Characterized by Membership, common symbol systems, shared values and norms, mutual influence, shared needs and commitment to meeting them, shared emotional connection Other Definitions (1 of 2) Public health – actions that society takes collectively to ensure that the conditions in which people can be healthy can occur; most inclusive term 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 Other Definitions (2 of 2) Global health – health problems, issues, and concerns that transcend national boundaries May be influenced by circumstances or experiences in other countries Best addressed by cooperative actions and solutions Personal Health Activities Versus Community/Public Health Activities Personal health activities Individual actions and decision making that affect the health of an individual or his or her immediate family members or friends Community/public health activities Activities aimed at protecting or improving the health of a population or community Maintaining birth and death records, protecting food and water supply, etc.

Factors that Affect the Health of a Community Physical Social and Cultural Interconnections of the determinants of health. Physical Factors Geography Environment Community size Industrial development Social and Cultural Factors Beliefs, traditions, and prejudices Economy Politics Religion Social norms Socioeconomic 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 the goals they have collectively set Is not a science, but an art of consensus building within a democratic process Individual Behavior Takes the concerted effort of many individuals to make a program work Herd immunity The resistance of a population to the spread of an infectious agent based on the immunity of a high proportion of individuals A History of Community and Public Health Almost as long as the history of civilization Knowledge of the past helps us better prepare for future community health challenges Earliest Civilizations Many community health practices went unrecorded Practices may have involved taboos, rites, and spiritual beliefs Archeological evidence of community health activities dating back to 2000 B.C.E.

The 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 First census taken: 1790 The Second Half of the Nineteenth Century Epidemic problems in major cities London cholera epidemics and Dr. John Snow Many scientific discoveries 1850: Shattuck report 1850: Modern era of public health begins The Twentieth Century 1900: life expectancy less than 50 years Leading causes of death were communicable diseases Vitamin deficiencies and poor dental health common in slums Health Resources Development Period () Growth of healthcare facilities and providers Reform phase (s Great Depression and WWII Postwar years Period of Social Engineering () Federal government became active in health matters 1965: Medicare and Medicaid established Improved standards in health facilities Influx of federal dollars accelerated rate of increase in 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 National Prevention Strategy The 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 and Public Health in the Twenty-First Century Communicable diseases Poor sanitation and unsafe drinking water Hunger Migration and health 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 Control of neglected tropical diseases Tobacco control Global road safety Improved preparedness and response Discussion Questions How do you define health?

How can understanding the history of community health efforts better help today’s planning? How can Healthy People documents affect health outcomes? What role does the United States play in world health planning?

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Objectives

Upon studying this chapter, readers will gain a clear understanding of critical concepts related to community and public health, such as health, community health, and global health, along with their historical context, current challenges, and future directions.

Definitions

Health

Health is not merely the absence of disease; it is a dynamic state characterized by a person's interactions and adaptations to their environment. This multidimensional aspect encompasses physical, mental, and social well-being (World Health Organization, 1946).

Community

A community consists of individuals sharing common characteristics, which may include geographic location, ethnicity, interests, and shared values. These elements enhance mutual influence among community members and create emotional connections (Kahn, 2008).

Public Health

Public health represents collective actions society takes to ensure conditions where people can maintain good health. It is an inclusive term that encompasses various activities, from preventing epidemic diseases to safeguarding food and water supplies (CDC, 2018).

Community Health

Community health focuses on the health status of specific population groups and the actions taken to promote, protect, and preserve their well-being (Schneider, 2017).

Population Health

Population health refers to health outcomes and their distribution within defined groups, assessing the factors that affect these outcomes (Kindig & Stoddart, 2003).

Global Health

Global health transcends national boundaries, addressing various health issues influenced by global circumstances. It requires cooperative actions to devise effective solutions (Frenk & Gomez-Dantes, 2017).

Determinants of Health

The determinants of health are complex interrelated factors that impact the health of individuals and communities. They can be classified into five categories:
1. Genetics: Genetic predispositions significantly influence health outcomes.
2. Behavior: Lifestyle choices, such as diet and exercise, have a profound impact on health.
3. Environmental Factors: Surroundings, including access to clean water, air quality, and socioeconomic conditions, reflects overall health.
4. Social Determinants: These include education, income, and social support systems which contribute to health disparities.
5. Health Services: Access to medical care and health information plays a vital role in health (Healthy People, 2020).

Personal vs. Community Health Activities

Personal Health Activities

These refer to individual actions that affect health, such as lifestyle choices, personal hygiene, and seeking medical care (Rosenstock, Strecher, & Becker, 1988).

Community/Public Health Activities

Conversely, these include systematic efforts aimed at improving health across populations. This involves maintaining public records, implementing health promotion campaigns, and enforcing regulations to ensure safe environments (McKenzie et al., 2017).

Factors Influencing Community Health

Several factors influence a community's health, categorized into physical and social-cultural aspects.
- Physical Factors: Geographic location, industrial development, and environmental conditions shape health opportunities within communities.
- Social and Cultural Factors: These include shared beliefs, norms, religion, economic conditions, and social statuses, which collectively influence health behaviors and outcomes (Berkman et al., 2000).

Historical Overview of Community and Public Health

Early Civilizations

The roots of community health can be traced back to early civilizations, where health practices incorporated spiritual beliefs, taboos, and basic hygiene (Rosenberg, 2007).

The Eighteenth Century

The industrial revolution led to urban overcrowding and inadequate sanitation, resulting in public health challenges. Key developments such as Edward Jenner's smallpox vaccination in 1796 marked significant advances in health measures.

The Nineteenth Century

The mid-nineteenth century witnessed transformative public health movements characterized by scientific discoveries and efforts to combat epidemics, exemplified by Dr. John Snow's investigation into the London cholera outbreaks (Leavell & Clark, 1965).

The Twentieth Century

Significant milestones obtained during the 20th century included advances in healthcare facilities, the establishment of major health programs such as Medicare and Medicaid, and the realization of lifestyle-related diseases prompting the "Health Promotion" era post-1974 (Loeppke et al., 2015).

Current Health Status of Americans

Despite improved life expectancy and a decrease in communicable diseases, Americans face significant public health challenges, including lifestyle diseases, health disparities, and environmental issues. Obesity, diabetes, substance abuse, and mental health concerns remain pressing (U.S. Department of Health and Human Services, 2019).

Healthy People 2020

The Healthy People 2020 initiative provides a framework for enhancing the nation's health by setting measurable objectives to improve overall health outcomes. Its goals emphasize preventive care, reducing health disparities, and promoting healthy lifestyles (U.S. Department of Health and Human Services, 2010).

Major Community and Public Health Problems Today

Public health faces multifaceted challenges, including:
- Chronic Diseases: Conditions like heart disease and diabetes account for a majority of healthcare costs.
- Behavioral Health: Mental health issues and substance abuse continue to rise.
- Environmental Health: Pollution, climate change, and lack of access to clean water are growing concerns.
- Health Disparities: Persistent inequalities in health outcomes among different population groups undermine community health efforts (Deaton, 2018).

Global Challenges

Globally, issues such as infectious disease resurgence, lack of sanitation, hunger, and migration-related health problems call for collaborative and comprehensive approaches to public health (WHO, 2021).

Conclusion

Understanding the historical context, current statistics, and global health challenges is essential in planning effective community and public health strategies. Implementation of the Healthy People 2020 framework offers a pathway to respond to existing health issues, demonstrating the necessity of collective efforts in fostering health improvements.

References

1. Berkman, L. F., & Glass, T. (2000). Social integration, social networks, social support, and health. In: Social Epidemiology. Oxford University Press.
2. CDC. (2018). Community health assessment: A process for positive change. Retrieved from https://www.cdc.gov/nceh/lead/publications/health_assessment.html
3. Deaton, A. (2018). The Age of Surveillance Capitalism. Public Affairs.
4. Frenk, J., & Gomez-Dantes, O. (2017). Global health: Solutions for a new era. Health Affairs, 36(6), 949-953.
5. Healthy People. (2010). Healthy people 2020: An opportunity to address societal determinants of health in the United States.
6. Kahn, R. S. (2008). Community health in the 21st century. Social Health and Illness, 30(4), 451-471.
7. Kindig, D. A., & Stoddart, G. (2003). What is population health? American Journal of Public Health, 93(3), 380-383.
8. Leavell, H. R., & Clark, E. G. (1965). Preventive Medicine for the Doctor in His Community. McMillan.
9. Loeppke, R. R., et al. (2015). Health and productivity as a business strategy. Journal of Occupational and Environmental Medicine, 57(4), 408-415.
10. Rosenberg, C. (2007). Our Present Complaint: American Medicine, Then and Now. Johns Hopkins University Press.
11. Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the health belief model. Health Education Quarterly, 15(2), 175-183.
12. U.S. Department of Health and Human Services. (2019). Health, United States, 2018.
13. WHO. (2021). World Health Statistics 2021: Monitoring health for the SDGs. Geneva.