FUNDAMENTAL CONCEPTS OF
COMMUNITY HEALTH NURSING
By: Jude Muassab, RN
A brief introduction
- Nursing practice + public health
practice = community/public
health nursing
- The major goal is the
preservation of the health of the
community and the surrounding
populations by focusing on health
promotion and health
maintenance of individuals,
families and groups within the
community.
- Through what? By conducting
activities that focuses on health
promotion and disease
prevention.
- How to? Through the
identification of populations at
risk rather than an episodic
response to patient demand.
- What’s the nurse got to do? By
aligning themselves to public
health programs that promote
and preserve the health of
populations.
HEALTH
- According to the WHO (1958), is “a
state of complete physical,
mental and social well-being and
not merely the absence of disease
or infirmity”.
- Social means “of relating to living
together in organized groups or
similar close aggregates” and is
used in the context of units of
people in communities who
interact with each other.
- “Social health” connotes
community vitality and is a result
of positive interaction among
groups within the community
with an emphasis on health
promotion and illness prevention.
- In Mid 1980s, WHO expanded the
definition of health which
includes;
● To realize aspirations and
satisfy needs
● To change or cope with
the environment
- Health is therefore seen as a
resource for everyday life, not the
objective of living; it is a positive
concept emphasizing social and
personal resources and physical
capacities.
- Saylor (2004) pointed out that the
WHO definition considers several
dimensions of health, these
includes:
❖ Physical
(structure/function)
❖ Social
❖ Role
❖ Mental (emotional and
intellectual)
❖ General perceptions of
health status.
- It also conceptualizes health from
a macro perspective, as a
resource to be used rather than a
goal in and of itself.
NURSING LITERATURE CONTAINS
MANY VARIED DEFINITIONS OF
HEALTH
1. MURRAY et. al., 2009
- “A state of well-being in
which the person is able to
 use purposeful, adaptive
responses and processes
physically, mentally,
emotionally, spiritually,
and socially”.
2. PENDER et al., (2006)
- “The actualization of
inherent and acquired
human potential through
goal-directed behavior,
competent self-care, and
satisfying relationships
with others”.
3. OREM, (2001)
- “A state of a person that is
characterized by
soundness or wholeness
of developed human
structures and of bodily
and mental functioning”.
DETERMINANTS OF HEALTH AND
DISEASE
➢ Income and social status
- Higher income and social
status are linked to better
health. The greater the
gap between the richest
and poorest people, the
greater the differences in
health.
➢ Education
- Low education levels are
linked with poor health,
more stress and lower
self-confidence.
➢ Physical environment
- Safe water and clean air,
health workplaces, safe
houses, communities and
roads all contribute to
good health.
➢ Employment and working
conditions
- People in employment are
healthier, particularly
those who have control
over their working
conditions.
➢ Social support networks
- Greater support from
families, friends and
communities is linked to
better health.
➢ Culture
- Customs and traditions,
and the beliefs of the
family and community all
affect health.
➢ Genetics
- Inheritance plays a part in
determining lifespan,
healthiness and the
likelihood of developing
illnesses.
➢ Personal behavior and coping
skills
- Balanced eating, keeping
active, smoking, drinking,
and how we deal with
life’s stresses and
challenges all affect
health.
➢ Health services
- Access and use of services
that prevent and treat
disease influences health.
➢ Gender
- Men and women suffer
from different types of
diseases at different ages.
INDICATORS OF HEALTH AND
ILLNESS
- The National Epidemiology
Center of the Department of
Health, the National Statistics
Office, or now the philippine
statistics authority, and local
health centers/offices/
departments provide morbidity,
mortality, and other health
status- related data.
- Local health
centers/offices/departments
are responsible for collecting
morbidity and mortality data
and forwarding the information
to the higher level health facility,
such as the Provincial Health
Office.
- Some of the more commonly
reported indicators are life
expectancy, infant mortality,
maternal mortality, age adjusted
death rates, and disease incidence
rates.
COMMUNITY
1. ALLENDER et al., (2009)
- “A collection of people
who interact with one
another and whose
common interest or
characteristics form the
basis for a sense of unity
or belonging”.
2. LUNDY & JANES (2009)
- “A group of people who
share something in
common and interact
with one another, who
may exhibit a
commitment with one
another and may share a
geographic boundary”.
3. CLARK (2008)
- “A group of people who
share common interests,
who interact with each
other, and who function
collectively within a
defined social structure to
address common
concerns”.
4. SHUSTER AND GOEPPINGER
(2008)
- “A locality -based entity,
composed of systems of
formal organizations
reflecting society’s
institutions, informal
groups and aggregates”.
5. MAURER & SMITH (2009)
- Further addressed the
concept of community
and identified four
defining attributes:
1) People
2) Place
3) Interaction
4) Common
characteristics,
interests, or goals.
- Maurer and Smith noted
that there are two main
types of communities:
geopolitical communities
and phenomenological
communities.
GEOPOLITICAL COMMUNITIES
- Geopolitical communities may
also be called territorial
communities.
 - Are most traditionally recognized personal or environmental
or imagined when considering characteristics.
the term community. - It can also refer to all of the
- Geopolitical communities are people in a defined community.
defined or formed by both MAURER & SMITH (2009).
natural and man-made AGGREGATES
boundaries and include - Are subgroups or subpopulations
barangay, municipalities, cities, that have some common
provinces, regions, and nations. characteristics or concerns.
- Other commonly recognized CLARK (2008).
geopolitical communities are - Examples of aggregates are age
congressional districts and groups or groups undergoing
neighborhoods. similar physiologic processes like
pregnancy and menopause.
PHENOMENOLOGICAL - Community health nursing
COMMUNITIES interventions may be directed
- On the other hand, refer to toward a community (e.g.,
relational, interactive groups, in residents of a small town), a
which the place or setting is population (e.g., all elders in a
more abstract, and people share rural region), or an aggregate
a group perspective or identity (e.g., pregnant teens within a
based on culture, values, history, school district).
interests, and goals.
- Examples of phenomenological
communities include schools,
colleges, and universities;
churches and mosques; and
various groups or organizations.
- These communities can also be
described as functional
communities.
- A community of solutions is a
type of phenomenological
community, and is a collection of
people who form a group
specifically to address a common
need or concern. The gawad
kalinga is an example.

POPULATION
- Is typically used to denote a
group of people having common