OVERVIEW OF

PREVENTIVE AND
COMMUNITY
MEDICINE
UERMMMMCI College of Medicine
Science of Medicine
■ Dynamic specialty
■ Advent of new technology
■ Become more knowledgeable
■ Researches are being conducted –
promotion of health, screening for and early diagnosis
of diseases, prompt administration of treatment,
prevention of complications, and reintegrating a
sick individual back into society (i.e., rehabilitation,
etc.).
Fields of Medicine
■ Two classifications:
– Clinical and Curative Medicine
– Preventive and Community (Social) Medicine
■ Both are founded upon and premised on the
same basic fundamental sciences of
Biology, Chemistry, Mathematics, Physics, and
Sociology
Development of
Preventive Medicine
■ Believed to become a specialty in 1873 after
Louis Pasteur conceptualized Germ Concept of
Communicable Disease
■ Discovery of causative agents for diseases
(e.g., typhoid, pneumonia, tuberculosis, cholera,
diphtheria, and other microbial infections)
■ Use of specific preventive measures (e.g., vaccination)
■ Discovery and development of disinfectants and
antiseptics
Public Health
■ Under Preventive Medicine
■ Winslow (1851):
– The science and art of preventing disease,
prolonging life, promoting health and efficiency
through organized community measures,
such as control of infection, sanitation,
health education, health services and legislation
Social Medicine
■ Studies man as a social being in his total environment,
including societal factors, which may influence health
outcome
■ Appears to conform to the biopsychosocial model that
was proposed as a scientific paradigm of George
Engel.
Biopsychosocial Model
Biopsychosocial Model
■ Biological factors
– Genetics
– Environmental factors that can affect physiologic
functioning (such as those causing cancer)
– Behaviors that affect biologic functioning
(like exercise, diet or smoking).
Biopsychosocial Model
■ Psychological factors
– Affective, cognitive, and behavioral dimensions
– Feelings, beliefs, expectations, personality, and
coping styles are all relevant psychological factors
affecting health and illness.
Biopsychosocial Model
■ Social factors
– Social systems such as family, school, work, church,
government and social values, customs, and social
support
– Access to health care and the quality of the
patient’s health care are all other important social
factors affecting health.
Epidemiology
■ Field of medical science concerned with the
relationship of the various factors and conditions that
determine the frequencies and distributions of
infectious processes, diseases or physiologic states in
a human community.
Community Medicine
■ Focuses on health and diseases within
a population of a defined community or group
■ Main Objectives:
– identifying health problems and felt needs of members
of the community (i.e. community diagnosis)
– planning, implementing, and evaluating the extent to
which health measures effectively address the
community’s health problems and felt needs --- the
planning, implementing, and evaluating ought to be
done together with the members of the community to
ensure self-reliance of the community
Family Medicine
■ Concerned with the total health of the individual, the
family, and the community
■ The scope of family practice is thus not limited by age,
sex, organ system, or disease entity
■ Family Medicine aims to provide holistic
patient-centered, family-focused, community-oriented
health care.
 REVIEW OF HEALTH
SYSTEMS FRAMEWORK
AND DETERMINANTS OF
HEALTH
What is a health system?
■ Consists of organizations, institutions, resources and
people
■ Primary purpose is to improve health
■ Delivers preventive, promotive, curative, rehabilitative
■ Actions must be responsive, financially fair, treating
people respectably
HEALTH SYSTEMS FRAMEWORK
Six Building Blocks
of a Healthcare System
■ Service Delivery
– Provides effective, safe, quality personal
and non-personal health intervention
with minimum waste of resources
■ Health Workforce
– Includes main drivers of the healthcare system
– Essential for efficient management and
operation of the public health system
Six Building Blocks
of a Healthcare System
■ Health Information System
– Ensures the production, analysis, dissemination,
use of reliable and timely information on health
determinants, health system performance, health
status
■ Access to Essential Medicine
– Universal access to healthcare that is heavily
dependent on affordable essential medicine,
vaccines,
diagnostics and health technologies of assured
Six Building Blocks
of a Healthcare System
■ Financing
– Aims to improve health and reduce health
inequalities, raises adequate funds for health, in
ways that ensure people can use needed services
and are protected from financial catastrophe,
impoverishment associated with being sick or
hospitalized
Six Building Blocks
of a Healthcare System
■ Leadership/Governance
– Ensures that health authorities take full
responsibility for steering the entire health sector
– Provides health policies, strategies and plans that
set a direction for the health sector
– Example: Department of Health
Units of Care
■ Apply the basic knowledge of the building blocks in the
implementation of policies, addressing the needs of
people in the units of care:
– Individual patients
– Families
– Communities
Social Determinants of
Health
■ Conditions in which people are born, grow, live, work,
and age which are shaped by distribution of money,
power, resources at global, national, and local levels.
■ The social determinants of health are mostly
responsible for health inequities
– Health inequities: unfair and avoidable differences
in health status seen within and between countries.
Commonly Identified
Social Determinants of Health
Commonly Identified
Social Determinants of Health
■ Childhood experiences
– Stable, caring relationships with parents and adults
– Safe, cohesive child-centered environment
– Exposure to physical trauma, biological diseases,
and chemical hazards risks during early years
Commonly Identified
Social Determinants of Health
■ Housing
– What type of housing are there in the community?
– Are there enough housing facilities available?
– Are there housing laws/regulations governing the
people?
Commonly Identified
Social Determinants of Health
■ Education
– Laws and Regulations
– Facilities
– Activities affecting education
– Ratio of health educators to learners
– Distribution of educational facilities
– What informal educational and activities exist in the
community
Commonly Identified
Social Determinants of Health
■ Social Support
– Civic participation
– Discrimination
– Incarceration
– Social cohesion
Commonly Identified
Social Determinants of Health
■ Family Income
– Availability of income and resources to meet daily
needs (e.g., safe housing, food)
■ Employment
– Access to job opportunities
– Quality of job training
Commonly Identified
Social Determinants of Health
■ Communities
– Availability of community- based resources
in support of community living
– Opportunities for recreational and leisure-time
activities
Commonly Identified
Social Determinants of Health
■ Access to health services
– Access to health care
– Health facilities and activities
– Distribution
– Utilization
– Ratio of providers to clientele served
– Priorities in health programs developed
Some Problems Encountered in
“Ang Kwento ni Rosario”
■ Nurse advised Lucy to bring Rosario to a private
hospital
but they do not have money for down payment.
■ The cost of overnight stay in the private hospital led
them to discharge Rosario early

■ Republic Act 8344 – “Anti-Hospital Deposit Law”

Some Problems Encountered in
“Ang Kwento ni Rosario”
■ Physicians prescribed her three branded medicines
that were expensive.
■ The cost of the medicines was equivalent to three days
wages of Rosario’s father

■ Republic Act 9502 – “Generics Act”

Some Problems Encountered in
“Ang Kwento ni Rosario”
■ Rosario's family belonged to the underprivileged and
poor sector of society and yet they did not have free
access to health care.
■ They suffered financially just to get the treatment they
needed.
■ If only they were enrolled to a health insurance
program, they could have received the medical
assistance for Rosario and saved her
■ Philhealth and Universal Health Care
 OVERVIEW OF
PREVENTIVE AND
COMMUNITY
MEDICINE
UERMMMMCI College of Medicine
Thank you!
References

■ Ang Kwento ni Rosario: The Philippine Healthcare System Problems. (2020).

Retrieved 5 August 2020, from
https://prezi.com/p/f9axmbcqvdtw/ang-kwento-ni-rosario-the-philippine-he
althcare-system-problems/
■ Javier, Ramon Jason M. (2020). Disease Prevention and Control [Powerpoint].
Ramon Jason M. Javier, MD, MSTM, FPAFP.
■ Social Determinants of Health | Healthy People 2020. (2020). Retrieved
August 2020, from
https://www.healthypeople.gov/2020/topics-objectives/topic/social-determ
inants-of-health
■ UERMMMCI College of Medicine Department of Preventive and Community
Medicine Handbook