Community Health

• Assessment: CDC, inspections, CPS, gathering data about a population in order to develope policy/regulations. EPA.
• Policy developement: Regulartion, laws, oversight. 
• Assurance: protecting public, assuring competence in those who provide protection for the public.

Wald: Henry Street Settlement House (1893)--5,000 families, 48,000 home visits by 1905

• 1920
• Global institution, not a US original. Clara Barton brought it home. 
• Provided direct care in-home.

• 1960s
• Before then, see Jessie Sleet, 1900 and National Health Circle for Colord People, 1919

• Economics
• Science
• Disease/threats to life and quality of life

Perception is everything. 

• Address areas of:
• infectious disease
• Heart disease
• Chronic illnesses
• health promotion/disease management/disease prevention

• Prevention: Active steps taken to prevent a specific condition. 
• --Primary: before the disease exists
• --secondary: early detection of possible disease. Includes education on HOW to detect those SnSs. Also, screening. 
• ----Screening only provides a non-specific indicator of health. Cannot rule in or out any specific disease process. 
• --Tertiary: Goals are oriented toward preventing sequelae. 

Promotion: A wholistic approach to health

Philosophy: CO, people should be in  charge of their own health and we exist to help them make those decision. CB, we are experts and exist to provide the care you need when you need it. 

Goals: CO, preseve, protect and maintain health. CB, manage acute and chronic illness.

Interaction patterns: CO, 1-1, groups, whole communities/populations, may be organized, partnerships. CB, 1-1 almost exclusively in a provider/patient relationship.

Activities: CO, community/group based. CB, patient education on an interdisciplinary manner. 

• Population Based Health Care Services: Focuses on populations within communities
• Clinical Preventive Services
• Primary Health Care: Meet basic needs of a community
• Secondary Health Care: Detect and treat disease
• Tertiary Health Care: Limit progression of a disease

• PHC: fully participatory. as such, involves the community in all aspects of health and subsequent action. Primary emphasis is on PREVENTION. 
• PC: focuses on the individual. Primary emphasis is on CURE. 

• Healthy people in a healthy community
• Healthy people cannot exist within an unhealthy community. 

• Advocacy:
• --housing
• --education
• --access
• Education: Populations and communities
• Policy-making
• Community partnerships
• Surveillance
• Prevention

• Communication
• Cultural competency
• Commuity dimensions of practice skills: People, fnxn, location. 
• Basic public health science skills, ie epidemiology.
• Financial Planning and management
• PUBLIC HEALTH NURSE = GENERALIST
• In addition to that, you can be a PHN manager, cns/consulant, etc. 

• Breast cancer screening
• assure access to services and care
• housing
• day care facilities to ensure national standards
• immunizations in communities
• Case finding
• providing emergency care

• Nola Pender: Health promotion model.
• --cetain factors must be present to change behavior, ie "belief." 
• Betty Neuman: Systems Model, ie all systems work towards equilibrium.
• --levels of preventions: all interaction with stressors/client reactions/interactions between client and resources: physical, emotional, lines of defense to reach adaptation (reconstruction) to environment and levels of health. 
• Orem: self-care deficit
• Imogen King: Theory of goal attainment
• --human beings interacting with environment state of health 
• --defined health as: ability to function in a social role. 

http://rhchp.regis.edu/NR/Wheel/Wheel.html

• Census data
• Churches, senior centers
• Civic groups
• Chamber of Commerce
• Key Informants

• Online Governmental sources (CDC)
• Maps
• Local newspapers
• Library
• Local Housing Office
• http://www.piton.org/

• Online Governmental sources (CDC)
• Business and labor
• Library
• Police Station
• Recreation Centers
• United Way