Chapter 1: Community and Public Health: Yesterday, Today, and Tomorrow

Question 1

what is “health” defined as?

Answer 1

• a dynamic state (can fluctuate) or condition of a human that’s multidimensional (ex. physical, emotional, social intellectual, occupational) in nature
• resource for living
• results from a person’s interactions with and adaptations to his or her environment
• can exist in varying degrees and is specific to each individual and his or her situation

Question 2

what are the 5 major domains that determine a person’s health?

Answer 2

1. gestation endowments (ex. genetic makeup)
2. social circumstances (ex. education, employment, income)
3. environmental conditions where ppl live and work (ex. toxic agents, microbial agents)
4. behavioural choices (ex. diet, physical activity, substance use and abuse)
5. availability of quality medical care

Question 3

what are some of the 20th century achievements in public health?

Answer 3

• Vaccination
• Motor vehicle safety
• Control of infectious diseases
• Decline of deaths from CHD (coronary heart disease) and stroke
• Healthier mothers and babies
• Safer and healthier foods
• Safer workplaces
• Family planning
• Fluoridation of drinking water
• Recognition of tobacco use as a health hazard

Question 4

what is “community”?

Answer 4

group of people who have common characteristics, can be def’ned by location, race, ethnicity, age, occupation, interest in particular problems or outcomes, or common bonds

Question 5

what is community characterized by?

Answer 5

• membership (sense of identity and belonging)
• common symbol systems (similar language, rituals, ceremonies; something that everybody looks at and immediately knows what it is ex. Waving to someone and they wave back = hello)
• shared values and norms
• mutual influence (community members have influence and r influenced by each other)
• shared needs and commitment to meeting them
• shared emotional connection

Question 6

what is “public health”?

Answer 6

actions that society takes collectively to ensure that the conditions in which people can be healthy can occur; most inclusive term

Question 7

what is “community health”?

Answer 7

health status of a defined group of people and the actions and conditions to promote, protect, and preserve their health

Question 8

what is “population health”?

Answer 8

health outcomes of a group of individuals, including distribution of such outcomes within the group (Larger group than just a community, ex. Population of canada’s health)

Question 9

what is “public health systems”?

Answer 9

the organizational body of those activities that are undertaken within the formal structure of gov’t and associated efforts of private and voluntary organizations and individuals designed to enhance public health

Question 10

what is “global health”?

Answer 10

• health problems, issues, and concerns that transcend national boundaries
• May be influenced by circumstances or experiences in other countries
• Best addressed by cooperative actions and solutions

Question 11

what are “personal health activities”?

Answer 11

individual actions and decision making that affect the health of an individual or his or her immediate family members or friends

Question 12

what are “community/public health activities”?

Answer 12

activities aimed at protecting or improving the health of a population or community (ex. Maintaining birth and death records, protecting food and water supply, etc)

Question 13

what are examples of physical factors that affect the health of a community?

Answer 13

• geography
• environment (ex. deforestation)
• community size (ex. larger the comm. = more resources needed/avail)
• industrial development (ex. big factories = more jobs, benefits but bad 4 environ.)

Question 14

what are examples of social and cultural factors that affect the health of a community?

Answer 14

• Beliefs, traditions, and prejudice (ex. belief that it is bad to smoke, tradition of Mediterranean diet, prejudice and race can lead to violence in the community)
• Economy (ex. economic downturns can create less tax revenues and less funding for programs and services)
• Politics (ex. How committed is the gov’t to our health care?)
• Religion
• Social norms (ex. Cigarette smoking, alcohol consumption)
• Socioeconomic status (SES) (ex. Education, employment and income)

Question 15

what is “community organizing”?

Answer 15

• Process through which communities are helped to identify common problems or goals, mobilize resources, and in other ways develop and implement strategies for reaching the goals they have collectively set
• art of consensus building within a democratic process

Question 16

what does “individual behaviour” entail?

Answer 16

Takes the concerted effort of many individuals to make a program work

Question 17

what is “herd immunity”?

Answer 17

The resistance of a population to the spread of an infectious agent based on the immunity of a high proportion of individuals

Question 18

how did WHO define health in 1946? how has it been modified?

Answer 18

• in 1946: health is a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity
• changed to health as a resource for everyday life, not the object of living, is a +ve concept emphasizing social and personal resources, and physical capabilities

Question 19

what are the 4 major factors that affect the health of a community? provide examples.

Answer 19

• physical factors
• social and cultural factors
• community organization
• individual behaviours

Question 20

what are the major periods of of community and public health?

Answer 20

1. early civilizations (b4 500 CE)
2. middle ages (500-1500 CE)
3. renaissance and exploration (1500-1700 CE)
4. 18th century
5. 19th century

Question 21

what is a “healthy” community characterized by?

Answer 21

• place where ppl provide leadership in assessing their own resources and needs
• where public health and social infrastructure and policies support health
• where essential public health services including quality health care are available

Question 22

what are the major events in community and public health that happened in the earliest civilizations (b4 500 CE)?

Answer 22

• many community health practices unrecorded
• practices involve taboos, rites, spiritual beliefs
• archaeological evidence of community health activities (sewage disposal, med perscriptions) dating back to 2000 BCE

Question 23

what are the major events in community and public health that happened in the middle ages (500-1500 CE)?

Answer 23

• growth of spirituality and remedies for health probs had spiritual causes & solutions
• physical and bio environment as a cause for disease = epidemics (ex. black plague, leper, small pox, TB, diptheria, measles, influenza, syphilis)

Question 24

what are the major events in community and public health that happened in the renaissance and exploration (1500-1700 CE)?

Answer 24

• belief that disease was caused by environmental factors
• led to more accurate descriptions of symptoms and outcomes of disease
• still had epidemics
• colonizers spread their diseases

Question 25

what are the major events in community and public health that happened in the 18th century?

Answer 25

• characterized by industrial growth
• overcrowded cities, inadequate and unsanitary water supplies, unsafe workplaces
• 1796: dr. jenner demonstrated process of vaccination against smallpox
• 1st census taken in 1790
• avg age of death 29 y/o

Question 26

what are the major events in community and public health that happened in the 19th century?

Answer 26

• epidemic probs in major cities (ex. london cholera epidemic)
• dr. john snow considered father of epidemiology
• lots of scientific discoveries
• 1850: shattuck report
• 1850: modern era of public health begins

Question 27

what are the major events in community and public health that happened in the 20th century?

Answer 27

• 1900: life expectancy less than 50 years
• Leading causes of death were communicable diseases
• Vitamin deficiencies and poor dental health common in slums

Question 28

what are the major events in community and public health that happened in the health resources development period (1900-1960)?

Answer 28

1. reform phase (1900-1920)
   - 1st volunteer agencies, public health nursing, 1st school of public health came around this time
   - microbiology discoveries didn’t improve health of avg citizens
   - involved social, moral and health issues
2. 1920s
   - life expectancy rose in this time, public health slowly grew
   - prohibition = decline of alcoholics and related deaths
3. great depression and WWII
   - social security assistance
   - WWII = restrictions on resources form public health programs
   - CDC formed
4. postwar years
   - polio vaccine created
   - heart disease and exercise promotion

Question 29

what are the major events in community and public health that happened in the social engineering peirod (1960-1973)?

Answer 29

• Federal gov’t became active in health matters
• 1965: medicare and medicaid established
• Improved standards in health facilities
• Influx of fed dollars accelerated rate of increase in cost of health care

Question 30

what are the major events in community and public health that happened in the health promotion period (1974-present)?

Answer 30

• Identification that premature death traceable to lifestyle and health behaviours
• Healthy people publication established
• MAP-IT: tools for planning behavioural modification interventions
• National prevention strategy - guide that outlined ways that are most effective to improve health and wellbeing of the population

Question 31

what are some of the problems in community and public health that are being addressed in the 21st century?

Answer 31

• Health care delivery
• Environmental probs
• Lifestyle diseases
• [Communicable diseases
• Alcohol and other drug abuse
• Health disparities
• Disasters
• Public health preparedness