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Community and Public Health Unit 1

BS Medical Technology (Cagayan State University)

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CPH | I: INTRODUCTION TO COMMUNITY AND PUBLIC HEALTH

CONTENTS PUBLIC HEALTH KEY TERMS
I. Introduction  Clinical care : prevention, treatment, and
II. Dimensions of Health and Wellness management of illness and the preservation of
III. Determinants of Health and Disease mental and physical well-being through the
IV. Public Health services offered by medical and allied health
V. Levels of Prevention professions; also known as health care
 Determinant : factor that contributes to the
I. INTRODUCTION generation of a trait
 Epidemic or Outbreak: occurence in a
HEALTH : community or region of cases of an illness,
 Derived from the word hal which means specific health-related behavior, or other health-
“hale, sound, whole” related event clearly in excess of normal
 State of complete physical, mental, and expectancy.
social well-being and not merely the absence  Both terms can be use interchangeably
of disease and infirmity (WHO, 1948)  Epidemic usually refers to a larger
geographic distribution of illness or health-
COMMUNITY : related events
i. Collection of people who interact with one
another and whose common interests or COMMUNITY V.S. PERSONAL HEALTH
characteristics form the basis for a sense of unity and
belonging (Allender et., al., 2009) PERSONAL HEALTH COMMUNITY HEALTH
ii. Share something in common, exhibiting ACTIVITIES ACTIVITIES
commitment; share geographic boundary (Lundy and - Individual actions and - Activities that are aimed
Janes, 2009) decision making that at protecting or improving
iii. Functions collectively within a defined social affect the health of an the health of the
structure to address common concerns (Clark, 2008) individual or his or her community
immediate family
TWO TYPES OF COMMUNITY : members Example: Maintenance of
 Urban : developed and covilized, based on - May be preventive or accurate birth records and
geographical conditions, big city/town, often busy curative in nature but death records, protection
and crowded seldom directly affect the of food and water supply
 Rural : often farmlands, few businesses, behavior of others
establishments, and people.
Example: choosing to eat
ELEMENTS THAT CHARACTERIZED A wisely, to regularly wear a
COMMUNITY safety belt, and to visit a
 Membership : sense of identity and belonging physician
 Common symbol systems : language, rituals,
ceremonies FACTORS THAT AFFECT THE HEALTH OF A
 Shared values and norms COMMUNITY
 Mutual influence - to be an influence and to be
influenced 1. PHYSICAL FACTORS
 Shared needs and commitment to meeting a) Geography: altitude, latitude, and climate of
them a place can directly influence a community’s
 Shared emotional connection : common history, health problems
experiences, mutual support b) Environment : quality of environment is
directly related to the quality of our
COMMUNITY HEALTH : health status of a defined stewardship of it ; increase in population =
group of people and the actions and conditions, both depletion of non-renewable resources =
private and public (governmental), to promote, protect, future generation will most likely live in a less
and preserve their health. desirable environment
c) Community size : larger community =
POPULATION HEALTH : health status of people who greater range of health problems (quick
are not organized and have no identity as a group or spreading of communicable diseases) =
locality and the actions and conditions that promote, greater number of health resources
protect, and preserve their health d) Industrial development : provides
community with added resources for health
GLOBAL HEALTH : describes health problems, programs but also brings environmental
issues, and concerns that transcend national pollution and occupational injuries and
boundaries, may be influenced by circumstances or illnesses.
experiences in other countries, and are best addressed
by cooperative actions and solutions

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2. SOCIAL AND CULTURAL FACTORS : arise

from the interaction of individuals or groups
within the community
Example: People in urban areas experience
higher rates of stress-related illnesses because of a
fast-paced life than those who live in rural areas where
life is more leisurely. However, people in rural areas
have limited access to the same quality or selection of
health care services compared to the urban
communities.
a) Beliefs, Traditions, and Prejudices :
traditions can influence the type of food,
restaurants, retail outlets, and services
available in a community ; Racism is an
example of a prejudice which can result to
violence and crimes
b) Economy : affects health of community
through reductions in health and social
services
 Example: Employers usually find it
increasingly difficult to provide health
benefits to their employees as their
income drops. Those who are
unemployed and underemployed face
poverty and deteriorating health
c) Politics : Those who are in position can
improve or jeopardize the health of their
community by the decisions they make
d) Religion : some religious communities limit
the type of medical treatment their members
may receive ; some do not permit
immunizations and prevent their members to
be treated by physicians
e) Social norms
 Back in 1940s-’60s, smoking in most
settings is socially acceptable but things
change in the 21st century. Because of
this, there is less secondhand smoke in
many public places and the community
health improved
f) Socioeconomic Status : individuals in lower
SES groups, regardless of other
characteristics, have poorer health status
DEATH : mortality rates, potential years of life
DISEASE : refers to the pathological processes
affecting the physical and psychological make up of the
individuals, self-reported or clinically diagnosed
DISABILITY : any condition of the body or mind
(impairment) that makes it more difficult for the person
with the condition to do certain activities (limitations)
and interact with the world around them (participation
restrictions)
FUNCTION LIMITATION : restriction in function
customarily expected of the body or its organ
components or systems
DISCOMFORT : restriction in activity and subjective
appraisal of well-beings.
 Treated as a socio-medical measure because
it is subjectively perceived and may be
experienced in the absence of underlying
clinical condition
DISABILITY : behavior concept defined as any
limitation in or lack of the ability to perform the activites
of daily living, physically, psychologically, or socially.
HANDICAP : disadvantages due to disease or either
as loss of opportunities or social deprivation and
dissatisfaction
WELLNESS : further describes health status. It allows
health to be placed on a continuum from one’s optimal
level (wellness) to an maladaptive state (illness).

3. COMMUNITY ORGANIZATION : process

through which communities are helped to
identify common problems or goals, mobilize
resources, and in other ways develop and
implement strategies for reaching their goals
they have collectively set

4. INDIVIDUAL BEHAVIORS (HERD IMMUNITY) :

 Individual behaviors : the behavior of the
individual community members contributes to
the health of the entire community
 Herd immunity : resistance of a population
to the spread of an infectious agent based on
the immunity of a high proportion of
individuals
WELL-BEING : A component of health
 Subjective perception of vitality (energy) and
II. DIMENSIONS OF HEALTH AND WELLNESS
feeling well
DIMENSIONS OF HEALTH

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 Can be described objectively, experiences,

and measured UNIQUE FEATURES OF PUBLIC HEALTH

III. DETERMINANTS OF HEALTH

(MARC LALONDE)

a. Human biology
b. Environment
c. Lifestyle
d. Health Care Organizations

Other authors have modified these categories to

include the following:
a. Early Childhood and Development
b. Genetics
c. Personal health practices
d. Gender and culture
e. Health services

IV. PUBLIC HEALTH

10 ESSENTIAL SERVICES
PUBLIC HEALTH: According to C.E.A. Winslow
(Charles-Edward Amory Winslow), PH is science and
art of preventing disease, prolonging life, and
promoting health and efficiency through organized
community efforts for the:
a) Sanitation of the environment
b) Control of community infection
c) Education of the individual in personal health
d) Organization of medical and nursing services
for the early diagnosis and treatment of
disease
e) Development of social machinery which will
ensure to every individual in the community a 1) Monitor health status to identify community
standard of living adequate for the health problem
maintenance or improvement of health 2) Diagnose and investigate health problems and
health hazards in the community
PUBLIC HEALTH ACTIVITIES 3) Inform, educate, and empower people about
a. Health promotion health issues
b. Disease Prevention 4) Mobilize community partnerships to identify
c. Treatment and solve health problems
d. Rehabilitation 5) Develop policies and plans that support health
efforts
PUBLIC HEALTH FUNCTIONS 6) Enforce laws and regulations that protect health
a. Prevents epidemics and the spread of and ensure safety
disease 7) Link people to personnel health services and
b. Protects against environmental hazards assure the provision of health care
c. Responds to disasters and assists 8) Assure a competent public health and health
communities in recovery care workforce
d. Prevents injuries 9) Evaluate the effectiveness, accessibility and
e. Promotes health behaviors quality of services
f. Assures the quality and accessibility of health 10) Research for new insights and innovative
services solutions to health problems

PUBLIC HEALTH VERSUS PREVENTIVE MEDICINE THREE CORE FUNCTIONS

Preventive medicines : science and art of preventing

disease, prolonging life, and promoting physical health,
mental, and efficiency for:
 A group and communities by organized mass
action for public health
 Individual and families by private patient care
for medical and dental health in order to
intercept the natural history of the disease at
any stage of development

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 Motor Vehicle Safety

 Control Infectious Diseases
 Family Planning
 Decline In Deaths From Heart Disease And Stroke
 Recognition Of Tobacco Use As Health Hazard
 Healthier Mothers And Babies
 Fluoridation Of Drinking Water

US, 2001-2010
 Vaccine-Preventable Deaths
 Prevention and Control of Infectious Diseases
 Tobacco Control
Assessment  Maternal and Infant Health
 What are the health problems of a population or  Motor Vehicle Safety
individual?; Assessing what needs to be done  Cardiovascular Disease Prevention
 Occupational Safety
Policy Development  Cancer Prevention
 Collectively deciding which actions or  Childhood Lead Poisoning Prevention
interventions are most appropriate for the  Public Health
problems identified; is being part of the solution
to get it done
V. LEVELS OF PREVENTION
• Assurance
PREVENTION: refers to the goals of medicine that are
 The necessary interventions will be put into place,
to promote, to preserve, and to restore health when it
assuring conditions in which people can be
is impaired, and to minimize suffering and distress
healthy; is making sure it gets done
THREE LEVELS OF PREVENTION
PUBLIC HEALTH APPROACH
I. PRIMARY PREVENTION : activities that are
undertaken to prevent the disease and injury from
occurring.

A. HEALTH PROMOTION
1. Health education about the fundamental
facts of health and diseases
2. Good standard of nutrition
3. Healthful living habits
4. Adequate housing, recreation and
agreeable working condition
5. Attention to personality development
6. Avoidance of fatigue as much as
 Define the health problem possible
 Identify risk factors associated with the problem 7. Guidance and counseling
 Develop and test community-level interventions to
control or prevent the cause or the problem B. SPECIFIC PROTECTION
1. Routine specific immunization and
booster doses
2. Selective immunization based on
exposure (Rabies immunization)
3. Good personal hygiene
4. Proper handling of vehicle of
transmission of the disease (food, water,
etc.)
5. Concurrent and terminal disinfection
6. Satisfactory vector control
7. Other environmental sanitation
measures
PUBLIC HEALTH ACHIEVEMENTS
II. SECONDARY PREVENTION : early diagnosis and
1900-1999
management to prevent complications from a disease.
 Vaccination
It includes steps to isolate cases and treat or immunize
 Safer Workplaces
contacts to prevent further epidemic outbreaks.
 Safer And Healthier Food
A. EARLY DX AND PROMPT TREATMENT

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a. Case findings by survey and selective

examination
b. Use of all available laboratory procedures
c. Use of consultant, specialist in communicable
diseases
d. Examination of contacts

B. DISABILITY LIMITATION
a. Complete Therapy
b. Hospitalization when indicated
c. Use of home nursing care if indicated
d. Adequate and prompt treatment

III. TERTIARY PREVENTION : involves activities

directed at the host but also at the environment in
order to promote rehabilitation, restoration, and
maintenance of maximum function after the disease
and its complications have stabilized.

A. REHABILITATION
a. Hospitalization and work therapy
b. Public education

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