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

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

2. 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

3. 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.

4. 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.

5. Introduction • Definitions, Concepts, & Principles • Community Health vs. Personal Health • Brief History of Community Health • American Health Concerns in the 90’s

6. Definitions 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.

7. Definitions • COMMUNITYGroup 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.

8. 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

9. 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

10. Factors Affecting Community Health 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 HEALTH OF THE COMMUNITY

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

12. 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

13. 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

14. 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

15. 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

16. 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

17. Health Resources • BEGINNING OF TWENTIETH CENTURY • Life expectancy less than 50 years • Communicable diseases leading causes of death • Children health concerns

18. 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

19. 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

20. 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

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

22. CHAPTER 1 COMMUNITY HEALTH - YESTERDAY, TODAY, ANDTOMORROW