FOUNDATIONS OF COMMUNITY HEALTH

1 1 UNITONEFOUNDATIONS OF 9/11/07 12:12 PM Page 1 Jones and Bartlett Publishers. NOT FOR SALE OR 9/11/07 12:12 PM Page 2 Jones and Bartlett Publishers. NOT FOR SALE OR DISTRIBUTIONC hapter 1 COMMUNITY HEALTH :Yesterday, Today,and Tomorrow 3 chapter OutlineScenarioIntroductionDefinitions Factors That Affect the HEALTH of aCommunityA Brief History of COMMUNITY andPublic HealthEarliest Civilizations Middle Ages ( 500 1500) Renaissance and Exploration ( 1500 1700) The Eighteenth Century The Nineteenth Century The Twentieth CenturyOutlook for COMMUNITY HEALTH in theTwenty-First CenturyWorld Planning for the Twenty-First Century TheUnited States Planning for the Twenty-First CenturyChapter SummaryScenario: Analysis and ResponseReview QuestionsActivitiesCommunity HEALTH on the WebReferencesChapter ObjectivesAfter studying this chapter , you will be able to.

2 1 Accurately define the terms HEALTH , COMMUNITY , COMMUNITY HEALTH , population HEALTH , publichealth, andpublic HEALTH describe the five major determinants the difference between personal andcommunity HEALTH and discuss the factors that influence acommunity s relate the history of COMMUNITY /publichealth, including the recent history ofcommunity and public HEALTH in the a brief overview of the current healthstatus of the status of efforts to improve worldhealth and list some plans for the the purpose of the Healthy People 2010goals and objectives as they apply to the planningprocess of the HEALTH of describe the impact terrorism has oncommunity/public 9/11/07 12:12 PM Page 3 Jones and Bartlett Publishers.

3 NOT FOR SALE OR DISTRIBUTIONINTRODUCTIONIn reflecting on the twentieth century, it is easy to point to the tremendous progress thatwas made in the HEALTH and life expectancy of those in the United States (see Box ) andof many people of the world. Infant mortality dropped, many of the infectious diseaseshave been brought under control, and better family planning became available. However,there is still room for improvement! Individual HEALTH behaviors, such as the use of tobacco,poor diet, and physical inactivity, have given rise to an unacceptable number of cases of ill-ness and death from noninfectious diseases such as cancer, diabetes, and heart and emerging infectious diseases, such as pandemic influenza (also referred to as panflu and H5N1) and those caused by drug-resistant pathogens, are stretching resources avail-able to control them.

4 And the events stemming from the terrorist attacks on the UnitedStates on September 11, 2001 (referred to as 9/11), and the subsequent anthrax mailingshave caused us to refocus our events disturbed the sense of complacencymany people felt about the HEALTH and safety of their living conditions. 1In addition, thoseevents revealed the vulnerability of the United States ability to respond to such circum-stances and highlighted the need for improvements in emergency response and the infra-structure of the public HEALTH system.

5 Even with allthat has happened in recent years in theUnited States and around the world, the achievement of good HEALTH remains a worldwidegoal of the twenty-first century. Governments, private organizations, and individualsthroughout the world are working to improve HEALTH . Although individual actions toimprove one s own personal HEALTH certainly contribute to the overall HEALTH of the com-munity, organized COMMUNITY actions are often necessary when HEALTH problems exceedthe resources of any one individual.

6 When such actions are not taken, the HEALTH of theentire COMMUNITY is at chapter introduces the concepts and principles of COMMUNITY HEALTH , explains howcommunity HEALTH differs from personal HEALTH , and provides a brief history of communityhealth. Some of the key HEALTH problems facing Americans are also described, and an outlookfor the twenty-first century is UNITONEFOUNDATIONS OFCOMMUNITYHEALTHSCENARIOAmy and Eric are a young working couple who are easinginto a comfortable lifestyle. They have good-paying jobs,drive nice cars, are buying a home in a good neighbor-hood, and have two healthy preschool children.

7 WhenAmy picked her children up from day care earlier in theday she learned from the head teacher that anotherparent had reported that his child was diagnosed withhepatitis. This news frightened Amy and made her beginto question the quality of the day care center. Amy toldEric of this situation when he got home from work. Asthe couple discussed whether or not they should taketheir children to day care as usual the following day, theydiscovered that they have many unanswered serious is hepatitis? What is the likelihood that theirchildren will be at serious risk for getting the disease?

8 What steps are being taken to control the outbreak? Isany state or local agency responsible for standardizinghealth practices at private day care centers in the com-munity? Does the city, county, or state carry out any typeof inspection when they license these facilities? And, ifthe children do not attend day care, which parent willstay home with them? 9/11/07 12:12 PM Page 4 Jones and Bartlett Publishers. NOT FOR SALE OR DISTRIBUTIONCHAPTER1 COMMUNITYHEALTH: YESTERDAY, TODAY, ANDTOMORROW 5A LOOKBACK ON THETWENTIETHCENTURY IN the twentieth century came to a close, the overall healthstatus and life expectancy in the United States were at all-time highs.

9 Since 1900, the average lifespan of people inthe United States had lengthened by more than 30 years; 25of these years have been attributed to advances in were many public HEALTH achievements thatcan be linked to this gain in life expectancy, however. TheCenters for Disease Control and Prevention (CDC), government agency charged with protecting thepublic HEALTH of the nation, singled out the Ten GreatPublic HEALTH Achievements in the United States between1900 and 1999. Some of these achievements will be dis-cussed in greater detail in other chapters of this bookwhere they are more relevant to the content being pre-sented.

10 Here is the entire are now available to protectchildren and adults against 15 life-threatening ordebilitating diseases. Rates of all vaccine-preventablediseases are down more than 97% from peak levelsbefore vaccines were vehicle number of advances over theyears, including safety belts, air bags, safer cars androads, and enforcement of drunk driving and otherlaws, have saved many number of voluntary andmandatory practices in the workplace have created amuch safer work environment. In the early 1900s,the work-related death rate was about 21 per100,000.