Dr. Ping Luo Department of PE and Health CSU Stanislaus Fall, 2004

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


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.


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.


Introduction

• Definitions, Concepts, & Principles

• Community Health vs. Personal Health

• Brief History of Community Health

• American Health Concerns in the 90’s


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


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.


• 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


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

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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


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


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


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


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


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


Health Resources• BEGINNING OF TWENTIETH CENTURY

– Life expectancy less than 50 years– Communicable diseases leading causes of

death– Children health concerns


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


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


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


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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Dr. Ping Luo Department of PE and Health CSU Stanislaus Fall, 2004