Chap 1 Community Health Yesterday Today and Tomorrow

Chap 1: Community Health Yesterday, Today, and Tomorrow • Anita Sego • Spring, 2005

Chap 1: Community Health Chapter Objectives • Accurately define the terms health, community health, population health, and public health. • Explain the difference between personal and community health activities • List and discuss the factors that influence a community’s health

Chap 1: Community Health Chapter Objectives • Briefly relate the history of community/public health, including the recent history of community and public health in the twentieth-century United States • Provide a brief overview of the current health status of Americans. • Describe the status of efforts to improve world health and list some plans for the future.

Chap 1: Community Health Chapter Objectives • Describe the purpose of the Health People 2010 goals and objectives as they apply to the planning process of the health of Americans.

Chap 1: Community Health INTRODUCTION • Definitions, Concepts, & Principles • Community Health vs. Personal Health • Brief History of Community Health • American Health Concerns in the 90’s

Chap 1: Community Health DEFINITIONS • HEALTH • A state of complete physical, mental, and social well being and not merely the absence of disease and infirmity. ” World Health Organization - 1947 • A dynamic state or condition which is multidimensional in nature and results from the adaptation to his/her environment.

Chap 1: Community Health DEFINITIONS • COMMUNITY Group of people who have common characteristics • COMMUNITY HEALTH – the health status of a defined group of people and the actions and conditions, both private and public, to promote, protect, and preserve their health.

Chap 1: Community Health • Population Health – the health status of people who are not organized and have no identity as a group or locality and the actions and conditions to promote, protect and preserve their health • PUBLIC HEALTH – health status of a defined group of people and governmental actions and conditions to promote, protect, and preserve the people’s health

Chap 1: Community Health COMMUNITY HEALTH Vs PERSONAL HEALTH – PERSONAL – Individual actions and decision making that affect the health of an individual or their immediate family – COMMUNITY – Activities aimed at protecting or improving the health of a population or community

Chap 1: Community Health FACTORS AFFECTING COMMUNITY PHYSICAL FACTORS Industrial development Community size HEALTH SOCIAL/CULTURAL FACTORS Beliefs, Traditions, and Prejudices Economy, Politics, Religion Environment Socioeconomic Status Geography Social Norms HEALTH COMMUNITY ORGANIZATION OF THE COMMUNITY INDIVIDUAL Ways in which communities organize their resources; Tax vs Non-tax supported services BEHAVIORS Takes the concerted effort of many - if not most - to make a community voluntary program work

Chap 1: Community Health Prehistory 7000+ BC Hammurabi 1750 BC Greeks 400 BC Egyptians 1500 -1050 BC Romans 450 BC - 410 AD Enlightenment 1700 s Renaissance 1500 - 1700 Middle Ages 410 - 1500 AD 20 th Century 21 st Century 19 th Century

Chap 1: Community Health Brief History and Public Health • EARLIEST CIVILIZATIONS • ANCIENT SOCIETIES - before 500 B. C. – Northern India: evidence of bathrooms and sewers – Sumarian clay tablet: evidence of prescription drugs – Code of Hammurabi: laws pertaining to physicians and health practices • CLASSICAL CULTURES - 500 B. C. - 500 A. D. – – Greeks: Games of strength and skill for men Greeks: Active in community sanitation Romans: Built aqueducts and sewer systems Romans: Built hospitals and infirmaries for slaves

Chap 1: Community Health Brief History and Public Health • MIDDLE AGES - 500 to 1500 A. D. – Spiritual era of public health – Great epidemics of plague • RENAISSANCE AND EXPLORATION 1500 to 1700 A. D. – Rebirth of thinking about nature of the world and of humankind – Belief that diseases were caused by environmental, not spiritual factors

Chap 1: Community Health Brief History and Public Health EIGHTEENTH CENTURY INDUSTRIAL GROWTH • Cities overcrowded – Water supplies inadequate – Streets heaped with trash and garbage • Occupational health – Workplaces unsafe and unhealthy – Workforce poor – Children forced to work long hours

Chap 1: Community Health Brief History and Public Health NINETEENTH CENTURY • EARLY APPROACH – Few advancements in public health – Federal government approach “Laissez faire” – Health quackery thrived • EPIDEMICS CONTINUED – London cholera epidemic struck in 1849 – Miasmas theory of contagious disease – Dr. John Snow and the Broad Street pump

Chap 1: Community Health Brief History and Public Health • LEMUEL SHATTUCK’S HEALTH REPORT, 1850 • FIVE PERIODS OF ERA – Miasma, 1850 to 1875 – Bacteriological, 1875 to 1900 – Health Resources Development, 1900 to 1960 – Social Engineering, 1960 to 1975 – Health Promotion, 1975 to present

Chap 1: Community Health HEALTH RESOURCES • BEGINNING OF TWENTIETH CENTURY – Life expectancy less than 50 years – Communicable diseases leading causes of death – Children health concerns

Chap 1: Community Health HEALTH RESOURCES (1900 -1960) • REFORM PHASE - 1900 to 1920 • GREAT DEPRESSION & WORLD WAR II 1929 - 1935 – Social Security Act of 1935 – National Institutes of Health established 1930’s • THE POSTWAR YEARS 1945 - 1960 – Communicable Disease Center established - 1946 – World Health Organization founded - 1948

Chap 1: Community Health HEALTH RESOURCES (1900 -1960) • SOCIAL ENGINEERING 1960 - 1973 – Congress passed Medicare and Medicaid bills - 1965 – OSHA Act Signed 1970 • Health Promotion Period (1975 - 1990) – Lifestyle related diseases – High medical care costs

Chap 1: Community Health HEALTH PROMOTION • LIFESTYLE CHANGES – World Health Organization’s “Health for All”, 1977 – Promoting Health/Preventing Disease: Objectives for the Nation, 1979 • 226 Objectives based on preventive services, health protection, and health promotion – Healthy People 2000 • Over 300 objectives – Healthy People 2010

Chap 1: Community Health in the 21 st Century • World Planning – reduce the burden of excess mortality and morbidity – developing effective health systems – expanding the knowledge base

Chap 1: Community Health CHAPTER 1 COMMUNITY HEALTH YESTERDAY, TODAY, AND TOMORROW