PRESENTATION PROJECT
Summary: The student will identify an organization that helps shape community health identified in Chapter 1 of your textbook. The student will research this organization and develop a comprehensive PowerPoint presentation elucidating the key elements of the organization defined below.
The student’s PowerPoint presentation should address the following:
Chapter 1
Understanding Community Health and the Organizations that Help Shape It
Chapter 1
Introduction
Much progress made over last 100 years in health and life expectancy.
Achievement of good health is worldwide goal of 21st century.
Requires organized community actions.
Community health organizations play a key role.
This session focuses on the principles of community health and the organizations that help shape the health of communities.
Definition: Health
Can mean different things to different people
A dynamic state or condition of the human organism that is multidimensional in nature, a resource for living, and results from a person’s interactions with and adaptations to his or her environment
Definition: Community
A group of people who have common characteristics
Can be defined by location, race, ethnicity, age, occupation, interest in particular problems or outcomes, or common bonds
Characterized by
Membership, common symbol systems, shared values and norms, mutual influence, shared needs and commitment to meeting them, shared emotional connection
Other Definitions
Public health – actions that society takes collectively to ensure that the conditions in which people can be healthy can occur
Community health – health status of a defined group of people and the actions and conditions to promote, protect, and preserve their health
Population health – health status of people who are not organized; have no identity as a group
Public health is the most inclusive term
Personal Health Versus Community Health
Personal health
Individual actions and decision making that affect the health of an individual or his or her immediate family members or friends
Community health
Activities aimed at protecting or improving the health of a population or community
Maintaining birth and death records, protecting food and water supply, etc.
Factors that Affect the Health of a Community
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Physical Factors
Geography
Environment
Community Size
Industrial Development
Social and Cultural Factors
Beliefs, traditions, and prejudices
Economy
Politics
Religion
Social norms
Socioeconomic status
Community Organizing
A process through which communities are helped to identify common problems or goals, mobilize resources, and in other ways develop and implement strategies for reaching their goals they have collectively set
Is not a science, but an art of consensus building within a democratic process
Individual Behavior
Takes the concerted effort of many individuals to make a program work
Herd immunity
The resistance of a population to the spread of an infectious agent based on the immunity of a high proportion of individuals
Brief History of Community and Public Health
Almost as long as the history of civilization
Knowledge of the past helps us better prepare for future community health challenges
20th Century Achievements
Vaccination
Motor vehicle safety
Control of infectious diseases
Decline of deaths from CHD 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
Earliest Civilizations
Many community health practices went unrecorded
Practices may have involved taboos, rites, and spiritual beliefs
Archeological evidence of community health activities dating back to 2000 B.C.
The Eighteenth Century
Characterized by industrial growth
Cities overcrowded, water supplies inadequate and unsanitary, problems with trash, workplaces unsafe
1796-Dr. Jenner demonstrated process of vaccination against smallpox
Average age at death: 29 years
First census taken: 1790
The Nineteenth Century
Better agriculture lead to improved nutrition
Federal government approach to health: laissez faire (noninterference)
Epidemic problems in major cities
Many scientific discoveries
1850: Shattuck report
1850: Modern Era of Public Health begins
The Twentieth Century
1900: life expectancy less than 50 years
Leading causes of death were communicable diseases
Vitamin deficiencies and poor dental health common in slums
Period of Social Engineering (1960-1973)
Federal government became active in health matters
1965 Medicare and Medicaid established
Improved standards in health facilities
Influx of federal dollars accelerated rate of increase of cost of health care
Health Resources Development Period
(1900-1960)
Growth of health care facilities and providers
Reform phase (1900-1920)
1920s
Great Depression and WWII
Postwar years
Period of Health Promotion (1974-present)
Identification that premature death traceable to lifestyle and health behaviors
Healthy People publication established
Community Health in the Early 2000s
Main Issues
Health care delivery
Environmental problems
Lifestyle diseases
Communicable diseases
Alcohol and other drug abuse
Health disparities
Disasters
Public health preparedness
Community Health in the 21st Century
World Planning
Previous goals not met, but progress made
Widening inequities
Most attention on less developed and poorer countries
United States Planning
Focused on 10 year blocks of time
Current plan outlines health agenda: Healthy People 2020
Healthy People 2020
Four overarching goals:
Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death
Achieve health equity, eliminate disparities, and improve the health of all groups
Create social and physical environments that promote good health for all
Promote quality of life, health development, and healthy behaviors across all life stages
Community Organizations
Classified in different ways
Sources of funding
Responsibilities
Organizational structure
Governmental status
Governmental Health Agencies
Part of governmental structure
Federal, state, or local
Funded primarily by tax dollars
Managed by government officials
Authority over some geographic area
Exist at four levels
International, national, state, local
International Health Agencies
World Health Organization (WHO) most widely recognized international governmental health organization
Headquartered in Geneva, Switzerland
Six regional offices around the world
Not oldest world health-related international agency, but largest
History of WHO
1945-charter of the United Nations; article calling for establishment of health agency with wide powers
1946-UN representatives created and ratified the constitution of WHO
1948-constitution went into force and WHO began work
Organization of WHO
Membership open to any nation that has ratified constitution and receives majority vote of World Health Assembly
World Health Assembly – delegates of member nations
Approves WHO programs and budget
193 member countries
WHO administered by different levels of staff
Purpose and Work of WHO
Primary objective: attainment by all peoples of the highest possible level of health
Has 22 core functions to achieve objective
Work financed by member nations
Most notable work-helping to eradicate smallpox
Work of WHO guided by 11th General Programme of Work and the UN’s Millennium Declaration (millennium development goals)
National Health Agencies
Each nation has department or agency within its government responsible for protection of health and welfare of its citizens
Department of Health and Human Services (HHS)
U.S. primary national health agency
Other federal agencies contribute to health – Dept. of Agriculture, EPA, OSHA, DHS
Department of Health and Human Services
Headed by Secretary of Health and Human Services
appointed by president; member of cabinet
~24% of federal budget; largest department in federal government
New health care reform law provides series of new duties and responsibilities for HHS
Organized into 11 operating agencies; 10 regional offices
Operating Agencies of the DHHS
Administration on Aging (AoA)
Administration for Children and Families (ACF)
Agency for Healthcare Research and Quality (AHRQ)
Agency for Toxic Substances and Disease Registry (ATSDR)
Food and Drug Administration (FDA)
Centers for Medicare and Medicaid Services (CMS)
Health Resources and Services Administration (HRSA)
Indian Health Services (IHS)
Substance Abuse and Mental Health Services Administration (SAMHSA)
National Institutes of Health (NIH)
27 Institutes and Centers under NIH
Centers for Disease Control and Prevention (CDC)
Operating Agencies of the DHHS (ctd)
State Health Agencies
All 50 states have their own state health departments
Purpose: to promote, protect, and maintain the health and welfare of their citizens
Usually headed by a medical director that is appointed by the governor
Purposes represented in “Core Functions of Public Health” (assessment, policy development, assurance)
Core Functions of Public Health
and 10 Essential Services
Public Health Functions Steering Committee, Members (July 1995). “Public Health in America.” Available at http://web.health.gov/phfunctions/public.htm.
State Health Departments
Most organized into divisions or bureaus
Play many different roles
Can establish health regulations
Provide link between federal and local health agencies
Serve as conduits for federal funds aimed at local health departments
Have laboratory services available for local health departments
Local Health Departments
Responsibility of city or county governments
Jurisdiction often depends on size of population
State mandated services provided locally:
restaurants, public buildings, and public transportation inspections; detection and reporting of certain diseases; collection of vital statistics
Approximately 2,700 in the United States
Organization of Local Health Departments
Coordinated School Health Programs
Schools funded by tax dollars; under supervision of elected school board
Schools have great potential for impacting community health
CSHP essential components
Health education, healthy school environment, health services
Face many barriers
Quasi-Governmental Health Organizations
Some official health responsibilities; operate more like voluntary health organizations
Operate independently of government supervision
Derive some funding and work from government
Examples: National Academy of Sciences, National Science Foundation, American Red Cross
The American Red Cross
Official duties
Provide relief to victims of natural disasters
Serve as liaison between members of armed forces and their families during emergencies
Nongovernmental services
Blood drives, safety services, community volunteer services, international services
Part of international movements
Nongovernmental Health Agencies
Funded by private donations or membership dues
Arose due to unmet health need
Operate free from governmental interference
Meet specific IRS guidelines with tax status
Thousands present in the U.S.; many types
Voluntary, professional, religious, social, philanthropic, corporate, service, etc.
Voluntary Health Agencies
Created by one or more concerned citizens that felt a specific health need was not being met by governmental agencies
Most exist at national, state, and local levels
National often focused on research, state links national with local offices, local often carry out programming
Usually combination of paid staff and volunteers
Purpose of Voluntary Health Agencies
Four basic objectives
Raise money to fund programs and/or research
Provide education to professionals and the public
Provide services to those afflicted
Advocacy
Fund-raising is a primary activity
Examples, ACS, AHA, March of Dimes, MDA
Professional Health Organizations
Made up of health professionals who have completed specialized training and have met standards of registration/certification or licensure for their fields
Mission: to promote high standards of professional practice
Funded primarily by membership dues
Examples: American Medical Association, American Public Health Association
Philanthropic Foundations
Endowed institutions that donate money for the good of humankind
Fund programs and research on prevention, control, and treatment of many diseases
Some have broad support, others very specific
Examples: Bill and Melinda Gates Foundation, Commonwealth Fund, Robert Wood Johnson Foundation, local Community Foundations
Social, Service, and Religious Organizations
Many do not have health as primary mission, but make significant health-related contributions
Examples: Kiwanis, Elks, Shriners, Lions, FOP
Contributions of religious groups to community health substantial
History of volunteerism, influence families, donation of space, sponsorship of programs (food banks, shelters)
Corporate Involvement in Community Health
Biggest role is provision of health care benefits
Worksite health promotion programs aimed at lowering health care costs and reducing absenteeism
Safety, counseling, education courses, physical fitness centers
Other measures
Use of natural resources, discharge of wastes, safety of work environment
Discussion Questions
How do you define health?
How can understanding the history of community health efforts better help today’s planning?
How can Healthy People documents affect health outcomes?
What role does the United States play in world health planning?
Discussion Questions
How have voluntary health organizations impacted health outcomes?
How does the Department of Health and Human Services impact individuals?
How can the World Health Organization overcome the obstacles they face?
