Corporate Involvement in Community Health

Corporations affect community health:

● the way it treats the environment
● by its use of natural resources
● by the discharge of wastes
● the safety of the work environment
● type of products & services

Bottom line:
HEALTH CARE BENEFITS TO EMPLOYEES
● Provision of health and benefits packages
● health and safety education programs
● worksite fitness and recreation programs

Review of Objectives:

● Discussed the various health organizations that help shape a community's

ability to respond effectively to health-related issues/problems
● Described each type of health agency
● Explained the differences in their purposes and responsibilities, their
organizational structures, and their funding

LEVELS OF HEALTH CARE AND REFERRAL SYSTEM IN THE PHILIPPINES

LEVELS OF CARE:
Primary Level of Care
● Primary health facility = usually the first contact between the community
members & the other levels of health facility
● Health care provided by:
center physicians, public health nurses, rural health midwives, barangay
health workers, traditional healers, and others at the barangay health stations
and rural health units
.
Secondary Level of Care
● Health facilities either privately owned or government-operated (infirmaries,
municipal, & district hospitals & out-patient departments of provincial
hospitals)
● Capable of performing minor surgeries, and simple laboratory examinations
● Given by physician with basic health training
● Referral center for the primary health facilities

Tertiary Level of Care

● Rendered by specialists in health facilities including medical centers (regional
& provincial hospitals, and specialized hospitals)
● Referral center for the secondary care facilities.
● Complicated cases & intensive care
● Example: Phil. Heart Center

NOTE:

The higher the level:

The more qualified the health personnel
The more sophisticated the health equipment

TEACHING COMMUNITY AND PUBLIC HEALTH USING SERVICE-LEARNING

APPROACH

NEED TO INCORPORATE?
- Allied Medical Courses: BSMLS
● An important role in diagnostic services
● Public health laboratory professionals bacteriologists, microbiologists &
biochemists test biological & environmental samples in order to diagnose,
prevent, treat, & control infectious diseases in the community

Service Learning- a teaching and learning approach that integrates community

service with academic study to enrich learning, teach civic responsibility, and
strengthen communities, while engaging students in reflection upon what was
experienced, how the community benefited, and what was learned.

Health-related Agencies
Other agencies with health-related activities:
- Department of Agriculture
- Department of Education
- Department of Public Works and Highways
- Department of Interior and Local Government
- Department of Social Welfare and Development
…… many others

Regional (State) Health Departments

17 Centers for Health Development (CHD)
● Formerly by region, headed by medical directors
● Dr. Teogenes Baluma, Region XI

Centers for Health Development (CHD):

Former Regional Structure:
Headed by Medical Directors: The Centers for Health Development were organized
by region, with each region being led by a medical director. This decentralized
structure allows for a more localized approach to health management and promotion.

Example of Regional Head:

Dr. Teogenes Baluma, Region XI: This indicates that each region had its own medical
director responsible for overseeing health development initiatives. Dr. Teogenes
Baluma, in this context, is associated with Region XI.

50 states (US), State Health Department

● Led by a doctor appointed by the governor
3 purposes:
To promote, protect, and maintain the health and welfare of the citizens of the state

State Health Departments (50 States in the US):

Governor-Appointed Medical Directors:
Doctor Appointed by the Governor: In each of the 50 states in the United States, the
state health department is led by a doctor appointed by the governor. This
appointment ensures alignment with the state's health policies and priorities.

Purposes represent the core functions of public health:

● health assessment
● policy development
● health assurance

Local Health Departments

Local-level governmental health organizations

● Fund: local tax
● Purpose: provide health services to the people in their cities, counties, and
parishes.
● Organization and services vary
● Examples of mandated local health services:
Inspection of restaurants, buildings, public transportation systems, vital
statistics (death & birth rates), and detection and reporting of certain diseases

Local Health Departments (LHDs) play a crucial role in public health by focusing on
the specific health needs of communities at the local level. Here's an overview of key
aspects related to Local Health Departments:

Funding and Purpose:

Funding Source:

Local Tax Revenue: Local Health Departments are typically funded through local tax
revenue. This funding mechanism ensures that the resources are generated within
the community they serve.
Purpose:

Provide Health Services Locally: The primary purpose of Local Health Departments
is to provide health services directly to the residents of their cities, counties, or
parishes. This includes both preventive and essential health services tailored to the
specific needs of the local population.
Organization and Services:
Varied Organization:

Adaptation to Local Needs: The organizational structure of Local Health Departments

may vary based on the specific needs and characteristics of the community they
serve. They often adapt their services to address the unique health challenges faced
by their local population.
Diverse Services:

Tailored Health Programs: Local Health Departments implement a range of health

programs based on the unique health priorities of their communities. These may
include initiatives related to maternal and child health, infectious disease control,
chronic disease prevention, and health education.

Coordinated School Health Programs:

"an organized set of policies, procedures and activities designed to protect, promote
and improve the health and well-being of students and staff, thus improving a
student's ability to learn"

Include:
● Health education
● Healthful school environment and
● Health services.
Problems/Barriers:
● Insufficient local administrative commitment
● Inadequately prepared teachers
● Too few school days to teach health in the school year
● Inadequate funding
● Lack of credibility of health education as an academic subject
● Insufficient community/parental support
● Concern for the teaching of controversial topics (sex education)

Quasi-governmental Health Organizations

● Receive funding from both public and private sources
 ● Have official health responsibilities but operate independently of government
supervision.
● Best known example: The American Red Cross

Other quasi-government organizations:

1. National Science Foundation
2. National Academy of Sciences

Nongovernmental Health Agencies

● Funded by private contributions, membership dues, and grants
● Not headed by government officials

TYPES OF NGOS

Voluntary Health Agencies Service or Social org

Professional Health Org Religious org

Philanthropic Foundations Corporate

Voluntary Health Agencies,

Arose because of unmet health needs
FOUNDATIONS, SOS, etc.
Examples: American Cancer Society and Philippine Red Cross (RA# 0072, 2009)

Purposes:
● Raise money to fund programs (majority on research)
● Educate both the professionals and the public
● Provide services to those with a health problem
● Advocate for beneficial policies, laws, & regulations

Professional Health Organizations

● Funded by membership dues
● Serve to protect and promote the standards of the profession
● Examples: PAMET, PNA, PASMETH

MISSION: To promote high standards of professional practice for their specific

profession, thereby improving the health of the society by improving the people in the
profession.

Philanthropic Foundations
● Provide money for projects and research to benefit society, more directed
toward improving health
● Have money to give away; can support long-term or innovative research
projects
● Examples:
Bill and Melinda Gates Foundation
 Rockefeller Foundation (vaccine for yellow fever)
Robert Wood Johnson Foundation (access to medical & dental care)

Service, Social, & Religious Organizations

Members enjoy social interaction with similar interests
• Examples:
Jaycees American Legion
Kiwanis Club Lion’s Club
Rotary Club Missionaries of Charity

MISSION: Service to others in their communities

ORGANIZATIONS THAT CONTRIBUTE TO COMMUNITY HEALTH

Objectives:
● Discuss the various health organizations that help shape a community's ability
to respond effectively to health-related issues/problems
● Describe each type of health agency
● Explain the differences in their purposes and responsibilities, their
organizational structures, and their funding

Introduction:
A. Size and complexity of today's communities
● hindrance to respond effectively to health needs
B. Types of community health organizations:
● basis source of funding & organizational structure
1. Governmental
2. Quasi-governmental
3. Non-governmental
GOAL: to promote, protect, and maintain health in a community

Governmental (Official) Health Agencies"

● Governmental (official) health agencies
● funded by tax and headed by government officials

Exists at 4 governmental levels:

● International, national, regional (state) and local

● International Health Agencies

● National Health Agencies
● Regional/State Health Agencies
● Local Health Departments
● Coordinated School Health Programs

International Health Agencies

World Health Organization (WHO)-primary intl hx agency
● Founded in 1948, headquarters in Geneva, Switzerland
World Health Assembly
● Primary operating body
● comprises delegates from each of the member nations

Purpose:
To assist the people of member nations attain the best level of health possible

Noteworthy work of WHO:

- Eradication of smallpox
1967: 10 to 15M contracted; 2M dies, others disfigured or blinded
1980: WHO declared total eradication of smallpox

National Health Agencies

● A national government health department/agency
● Primary responsible for the protection of the health & welfare of its citizens,
example?
Responsibilities:
● development of health policies
● Enforcement of health regulations
● provision of health services and programs
● Funding of research and
● support of their respective state/regional and local health agencies

Department of Health & Human Services (DHHS)

● lead health agency (federal government), U.S.A.
● Public Health Service (PHS) comprises the following agencies:
The Centers for Disease Control & Prevention (CDC)
The Food and Drug Administration (FDA)

Department of Health (DOH), Philippines

● Headed by Secretary of Health
● Appointed by the president & a member of his cabinet
Descriptive Epidemiology
- Describes the distribution of health status in terms of: age, gender, race, geography,
time etc.
- Assessing health status, health problems, health needs through collections &
surveys
- Disease Surveillance
● what (case definition)
● who (person)
● where (place)
● when (time), and
● how many (count)

Analytical Epidemiology
-study of the determinants (causes) of health-related states or events
-Answers: why and how
-test hypotheses about relationships between health problems & possible risk factors,
factors that increase that increase the probability of disease

Experimental Epidemiology
- Evaluate the effects of intervention
- Identify the cause of a disease
- Determine the effectiveness of a vaccine, therapeutic drug, or surgical procedure

To control the occurrence of disease...

• The conditions surrounding its occurrence & the factors favoring the development of
the disease must first be known.
• Epidemiologic Triangle

Epidemiologic Triangle
- 3 components:

Components of Epidemiologic Triangle

HOST - any susceptible organism invaded by an agent
AGENT - the element that must be present in order for disease to occur
ENVIRONMENT - includes all factors - physical, biological, or social - that inhibit or
promote disease transmission
AGENTS OF DISEASE:
A. NUTRITIVE ELEMENTS
● Excess
● Deficiencies
B. CHEMICAL AGENTS
● Poisons
● Allergens
C. PHYSICAL AGENTS
● Heat, Light, Ionizing Radiation
D. INFECTIOUS AGENTS
● Parasites, Protozoa, Bacteria, Fungi, Viruses

HOST FACTORS:
INTRINSIC FACTORS
- Influenced by exposure, susceptibility or response to agents

● Genetic- ex. Sickle cell disease ● Immunologic experience

● Age Active- prior to
● Sex infection/immunization
● Ethnic group Passive- maternal antibodies,
● Physiologic- fatigue, pregnancy, gamma globulins
stress
● Pre-existing disease/intercurrent
disease & human behavior

ENVIRONMENTAL FACTORS

EXTRINSIC FACTORS
- influence the existence of the agent, exposure, or susceptibility to agent
● PHYSICAL - inanimate surroundings
● SOCIOECONOMIC-ENVIRONMENT
Occupation, urbanization and disruption
● BIOLOGICAL - living things around us
Intermediate Host: PASSIVE - cockroach, flies, plants, etc.; ACTIVE - vectors

Epidemiologic Data:
● Characteristic data & factors - not constant
Epidemiologic variables
● To analyze epidemiologic data
Organize data according to the variables of:
TIME
PERSON
PLACE
VARIABLES:
I. TIME
refers both to the period of exposure to the source of infection & the period during
which the illness occurred
II. PERSONS
- Characteristics of the individual (exposed & contacted to the infection)
- Described in terms of inherent or acquired characteristics (age, race, sex, immune
status, marital status)
VARIABLES: Persons...
AGE:
● Single most useful variable in describing occurrence & distribution of disease
● Potential for exposure to a source of infection
● Level of immunity or resistance
● Physiologic activity at the tissue level.

SEX & OCCUPATION:

● Male: higher mortality rate; Female: higher morbidity rate
● Differ in pattern of behavior, activities, travel, occupation, exposure to
infection
● Activities (work, play, & customs)
● Circumstances (social, economic & environmental)

Prioritizing Prevention and Control efforts

1. Leading causes of death
● most common way people prioritize health problems.
● The U. S. spends 66.5% of its healthcare budget on four leading causes of
death.
2. Years of Potential Life Lost (YPLL)
● measurement that emphasizes the importance of those diseases that kill
people at an early age.
3. Economic cost to society
● Evaluate the impact of a particular disease or health problem
● Example:
• Cost of treatment
• Loss of productivity

Prevention, Intervention, Control, and Eradication of Diseases

Prevention
taking action to prevent or delay the onset of illness injury before pathogenesis
occurs.
more desirable than intervention.

Intervention
is taking action to control a disease in progress.

Control
- means containment of a disease
Levels of Prevention

Primary prevention
- Prevent or forestall (delay)the occurrence
• Vaccines
• Diet
• Exercise
• Non-risky behaviors

Secondary prevention
- early diagnosis and prompt treatment of a disease before the disease
becomes advanced and disability becomes severe.
• Diabetes: blindness, amputation, dialysis
• Health screenings

Tertiary prevention
- Retrain, re-educate, and rehabilitate patient who has the disability
• Stroke patients

Prevention of Communicable disease

● Do primary, secondary, and tertiary prevention of communicable diseases

Primary
• Pasteurization
• Antibiotics/antivirals
• Disinfectants

Secondary
• Isolation
Surveillance
• Quarantine
• Drug treatment

Tertiary
• Control for the individual
-Convalescence
-PT/OT

HOW?
● Application of preventive measures for control of a communicable disease
● Know the chain of infection – prevention control measures can be used at
each link
● Practice Universal precautions (barriers hand washing, disposal of “sharps”)
EXAMPLE: AIDS
● progressive disease caused by HIV
● Infection occurs when person comes in contact with the virus
● 2-6 months before antibody appears
● HIV+
● HIV weakens the immune system
- Opportunistic infections
- Leads to AIDS
● Prevention or control exist for each link
- Condoms (entry/exit portals)
- Needle exchange
- Gloves (entry/exit portals)
- Reduction of partners/abstinence-stop transmission

Prevention of noncommunicable diseases

Primary prevention
● Adequate food supplies (healthy foods)
● Housing
● Education opportunities
● Efficient community services

Secondary prevention
● Mass screenings for chronic diseases
● Personal screenings

Tertiary prevention
● Adequate emergency medical personnel
● Adequate services
● Adequate facilities

Application of Preventive Measures on non-Communicable Disease

● CHD remains leading cause of death
● Community role:
Recognize the importance
Supportive environment
• Smoking cessation/restricting smoking
• Gym facilities
• Safe neighborhoods
● Individual role:
- Modifiable risk factors - vices (CHANGE)
- Non-modifiable risk factors - genetics
LESSON 4
Epidemiology, Prevention, and Control of Diseases and Health Condition

Classification of Diseases and Health Problems

• Diseases and health problems can be classified in several meaningful ways.
- Communicable vs. non-communicable diseases
- Acute vs. chronic diseases and illnesses

Communicable diseases
- caused by pathogenic agents that can be transmitted from an infected host to
a non-infected but susceptible host.

Non-communicable diseases
- cannot be transmitted from a diseased host to a susceptible one.

Acute diseases
- Diseases classified by:
• Duration (3 months or less)
• Peak severity of symptoms occur & subsides within 3 months or sooner

Chronic diseases last longer than three months, sometimes for the remainder of
one's life.
Diseases classified by:
• Duration (longer than 3 months)
• Recovery is slow and often incomplete

Communicable Diseases

The communicable disease model includes three basic elements.

- disease agent, the host, and the environment.

Chain of Infection
● model that conceptualizes the transmission of a communicable disease from
its source to a new susceptible host.

Modes of transmission
● direct and indirect transmission.

Direct transmission
● Immediate transfer of the disease agent between the infected and susceptible
person
● touching, kissing, biting, sneezing and sexual contact.
Non-communicable Diseases
Non-communicable diseases can best be visualized by the multi-causation disease
model (Difficul discern cause).

Contributing factors:
• Genetics
• Environmental
• Behavior

PHIL. = 4 major non-communicable diseases (chronic diseases or lifestyle-related

diseases):
- Cardiovascular diseases (CVD)
- Cancer
- Chronic Obstructive Pulmonary Disease (COPD)
- Diabetes Mellitus

Non- communicable diseases.

● Remain an important concern for communities
● rank high among the nation's leading causes of death
Heart disease
• Number 1 killer of Americans

Stroke
• 3rd leading cause of death
• Blood supply to brain is interrupted

Cancer
• 2nd cause of death
• Common cancer sites: breast, prostate but can occur other sites

Complex etiologies:
-Multicausation model

• Other non-communicable diseases:

- COPD (4th leading cause of death)
- Diabetes-type II (7th leading cause of death)
- Chronic liver disease and cirrhosis (10th leading cause)

• Phil. = urbanization & lifestyle changes

- Brought considerable change in the health status of Filipinos.

Globalization & social changes

- Influenced the spread of non-communicable /lifestyle degenerative diseases
- Increased risk exposure