Influencing Community’s Health

Dr Wong Yi Kai
Chiropractic Department
Centre for Complementary and Alternative Medicine
International Medical University
WongYiKai@imu.edu.my
Learning outcomes

At the end of the session, the learner will be able to:

1. List and describe the factors influencing the health of

the community.
2. Define community diagnosis and how the process is
carried out.
3. Describe the characteristics of health indicators.

Acknowledgement: some of the ppt slides are by Prof. Dr. John T. Arokiasamy,
Dr Siew Wei Fern
 Factors influencing community health
They can be grouped into:
• Physical factors
• Social/Cultural / Economical factors
• Community organisation
• Education
• Individual behaviour

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 Physical factors
Eg: Industrial development
Communities that are industrially developed are more
likely to be exposed and affected by:
 numerous diseases  toxic waste products from the
industries released into water bodies and the
atmosphere;

 congestion of settlement leading to slum development

hence the risk of exposure to contagious diseases
compared to areas that are not industrially developed.

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 Physical factors
Eg: Community size
A densely populated or over populated community can
easily risk contracting communicable diseases

Eg: Geographical location

Some communities are located in swampy areas are more
prone to diseases, especially during heavy rains: 
diseases caused by pathogens from contaminated flood
water
 Mosquitoes infected sites: malaria, dengue,
chikungunya

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 Physical factors
Eg: Environment
A clean environment is very vital to the proper health of a
community which minimises the occurrence and
transmission of diseases, unlike a dirty environment which
easily leads to outbreak of diseases.

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 Social / cultural / economical factors
Eg: Traditions Beliefs
Beliefs or traditions possessed by communities greatly
affect the health of it’s people

Eg: Economy
A community that is economically well off has low chances
of suffering from disease breakouts because they have
proper health care and water drainage systems unlike a
poor community.

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 Social / cultural / economical factors
Eg: Government
Since the government involves planning, implementing
and provision of community services such as water supply,
medical supplies and other needs which can directly affect
the community health.

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 Community organisation
Eg: organising resources
Ways in which communities organise their resources such
as taxes which contributes to governmental funds to help
in providing facilities to the community
 supply of sufficient and efficient medical care even in
times of crisis unlike communities without proper
accountability of their taxes which can partly be allocated
to the health sector.

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 Education
Eg:
Illiteracy or low level of education affects the health of a
community  communicable and non communicable
diseases

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 Individual Behaviour
Eg:
Community health is greatly influenced by individuals,
their personal health, habits etc.

Risk factors (modifiable and non modifiable)  wellness

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Definition of Community Diagnosis

• Community diagnosis generally refers to the identification and

quantification of health problems in a community as a whole in terms
of mortality and morbidity rates and ratios, and identification of their
correlates for the purpose of defining those at risk or those in need of
health care.

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The Community Diagnosis Process

• “A means of examining aggregate and social statistics in addition to

the knowledge of the local situation, in order to determine the health
needs of the community”

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 Community diagnosis process

Planning

Community Diagnosis
(Routine data/measures Implementation
Surveys, Surveillance)

Community

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Goal

• The mission of community diagnosis is to:

• Analyse the health status of the community

• Evaluate the health resources, services, and systems of care within the
community
• Assess attitudes toward community health services and issues
• Identify priorities, establish goals, and determine courses of action to improve
the health status of the community
• Establish an epidemiologic baseline for measuring improvement over time.

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Community Analysis

• Community analysis is the process of examining data to define needs,

strengths, barriers, opportunities, readiness, and resources.
• The product of analysis is the “community profile”.

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Community Analysis (cont.)

• To analyse assessment data is helpful to categorise the data. This may

be done as following:

• Demographic
• Environmental
• Socioeconomic
• Health resources and services
• Health policies
• Study of target groups.

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Indicators of health are variables used for the assessment of
community health.

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Characteristics of Indicators:
• a. should be valid, i.e., they should actually measure what they are
supposed to measure;

• b. should be reliable and objective, i.e., the answers should be the same if
measured by different people in similar circumstances;
• c. should be sensitive, i.e., they should be sensitive to changes in the
situation concerned,

• d. should be specific, i.e., they should reflect changes only in the situation
concerned,

• e. should be feasible, i.e., they should have the ability to obtain data
needed, and;

• f. should be relevant, i.e., they should contribute to the understanding

of the phenomenon of interest.
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Classification of Health Indicators
• Mortality indicators
• Morbidity indicators
• Disability rates
• Nutritional status indicators
• Health care delivery indicators
• Utilisation rates
• Indicators of social and mental health
• Environmental indicators
• Socio-economic indicators
• Health policy indicators
• Indicators of quality of life
• Other indicators
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 Disability Indicators

 Disability rates  No. of days of restricted activity

 Bed disability days
 Work/School loss days within a specified
period.
 Expectation of life free of disability

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Health Care Delivery Indicators
 Health Care Delivery
Indicators
- Reflect the Equity / Provision of
health care
 Doctor / Population ratio
 Doctor / Nurse ratio
 Population / Bed ratio
 Population / per health center
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 Utilisation Indicators
 Health care utilisation
Rates
- Extent of use of health services
- Proportion of people in need of service
who actually receive it in a given
period
 Proportion of infants who are
fully immunised in the 1st year
of life.
i.e..immunisation coverage.
 Proportion of pregnant women
who receive ANC.
 Hospital-Beds occupancy rate.
 Hospital-Beds turn-over ratio
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 Health Policy Indicators
 Health Policy Indicators
- Allocation of adequate resources.
 Proportion of GNP spent on
health services.
 Proportion of GNP spent on
health related activities.
 Proportion of total health
resources devoted to primary
health care

Gross national product (GNP) is the market value of all the goods and services
produced in one year by labour and property supplied by the citizens of a country.

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 Other Indicators
 Other health  Indicators of quality of life.
indicators  Basic needs indicators.
 Health for all indicators.

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References

• Encyclopedia of Public Health A-Z (2 Volume Set) (2008). Springer

Netherlands
• International Encyclopedia of Public Health – 2nd Ed (2016). Elsevier

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THANK YOU