chap 1: community health - yesterday, today, and tomorrow dr. ping luo department of pe and health...
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Chap 1: Community Health - Yesterday, Today, and Tomorrow
Dr. Ping Luo
Department of PE and Health
CSU Stanislaus
Fall, 2004
Chap 1: Community Health
• 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
Chapter Objectives
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
HEALTH• A state of complete 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.
Definitions
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 HealthFactors Affecting Community Factors Affecting Community
HealthHealth
HHEALTH EALTH OF THEOF THE
CCOMMUNITYOMMUNITY
PHYSICAL FACTORS
Industrial development
Community size
Environment
Geography
SOCIAL/CULTURAL FACTORS
Beliefs, Traditions, and Prejudices
Economy, Politics, Religion
Socioeconomic Status
Social Norms
COMMUNITY ORGANIZATION
Ways in which communities
organize their resources;Tax vs Non-tax supported services
INDIVIDUAL BEHAVIORS
Takes the concerted effort of many - if not most - to make a community
voluntary program work
Chap 1: Community Health
Prehistory7000+ BC
Egyptians1500 -1050 BC
Greeks400 BC
Romans450 BC - 410 AD
Middle Ages410 - 1500AD
Renaissance1500 - 1700
Hammurabi1750 BC
Enlightenment1700s
19th Century
20th Century
21st Century
Chap 1: Community HealthBrief 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
Community Health in the 21st Century • World Planning
– reduce the burden of excess mortality and morbidity
– developing effective health systems– expanding the knowledge base
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