INTRODUCTION TO PUBLIC HEALTH

HEALTH
• State of complete physical, mental, social well-being and not merely absence of disease of
infirmity (WHO)
• Health is a resource for everyday life, not the objective of daily living (Ottawa charter for health
promotion-1986)
• Health is right (Philippine constitution-1987)
• Health is a shared reality
DIMENSIONS OF HEALTH

• Physical
• Social
• Role
• Mental (emotional & intellectual)
• General perceptions of health status
COMPONENTS OF RIGHT TO HEALTH
• Availability
• Accessibility
• Acceptability
• Quality
AAAQ

• Availability- requires that operational public health and channels of service delivery, products
& services as well as programs be adequate for all
• Accessibility – entails that health services , facilities and goods must be made possible and
obtainable to everyone
4 intersecting features of accessibility:
a. Non-discriminatory
b. Physically accessible
c. Economically accessible
d. Information accessible
• Acceptability- corresponds to medical ethics, being culturally appropriate and gender-
sensitive. Need for health care centers, products, services and programs to be people-
centered, timely, equitable, integrated and efficient
PUBLIC HEALTH

• Interdisciplinary science and art of disease, disability, injury prevention and control in
human population (Holmes, 2009)
• Health status of a defined group of people and the governmental actions and conditions
to promote, protect and preserve their health (McKenzie, Ringer, Kotecki,2002)
• Is the science and art of preventing disease, prolonging life and promoting health
efficiency through organized community effort for:
 • The sanitation of environment
• The control of communicable disease
• The education of the individual in personal hygiene
• The organization of health services for early diagnosis and preventive treatment of
disease
• The development of social machinery to ensure everyone a standard of living
adequate for the maintenance of health

PUBLIC HEALTH DEALS WITH THE FOLLOWING:

1. Surveillance of emergence of diseases
2. Identification of diseases among community members
3. Investigating factors that contribute to existence of disease
4. Educating the community regarding ways that will prevent them from acquiring the disease
5. Creation of strategies that will ensure sustained well-being among community
6. Provision of health services to address community members who are already having the
disease or recuperating from complications of the disease
7. Institutionalize lessons learned through policies and structures that will prevent occurrence
of similar or other diseases
8. Monitoring health status of community and providing means that will ensure them of
sustaining their health and wellbeing
MISSION OF PUBLIC HEALTH

• The fulfillment of society’s interest in assuring the conditions in which people can be
healthy
• The substance of public health is “organized community efforts aimed at prevention of
disease and the promotion of health”
• Public health has the following three core functions:
1. Assessment- systematically collect, analyze and make available information on
healthy communities
2. Policy development- promote the use of scientific knowledge base on policy &
decision making
3. Assurance- ensure provision of services to those in need
THE TEN ESSENTIAL PUBLIC HEALTH SERVICES

• Assessment
1. Monitor health status to identify community health problems
2. Diagnose and investigate health problems and health hazards in the community
• Policy development
3. Inform, educate and empower people about health issues
4. Mobilize community partnerships to identify and solve health problems
5. Develop policies and plans that support individual and community health efforts
• Assurance
6. Enforce laws and regulations that protect health and ensure safety
7. Link people to needed personal health services and assure the provision of health care
when otherwise unavailable
8. Assure a competent public health and personal healthcare workforce
 9. Evaluate effectiveness, accessibility, and quality of personal and population-based
health services

• Serving All Functions

10. Research for new insights and innovative solutions to health problems

COMMUNITY HEALTH

• is a subset of Public Health

• is the study and improvement of health characteristics of a community
• dealing with community health means dealing with both “supply side” and “demand
side”
COMMUNITY

• a person thrives better if he/she is part of a community he/she identifies with

5 CORE ELEMENTS OF A COMMUNITY

1. Locus – implies a sense of place, locale, geographical boundary. Refers to specific area
such as neighborhood, village, city or a country
2. Sharing- existence of “shared perspective and common interest” that would contribute to
a sense of community
- Values, ideologies, vision, activities, passions, opinions, etc.
3. Joint Action- source of community cohesion and identity
- A community is seen as emerging from joint actions of people through socializing,
hanging out, conversing, volunteering together, praying together, working together and
getting things done together.

4. Social Ties - Interpersonal relationships forming from the foundation of community

- Family, neighbors, friends, coworkers, etc.

5. Diversity- focus on larger social view of community

- Stratification among members, “communities within a community”
- Group brought about by variations in interaction among members.
ELEMENTS OF HEALTH FIELD

• Human biology
- Described as aspect of health both physical and mental which are developed within
the human body “as a consequence of basic biology of man and the organic make up
of the individual”
- Ex. Some people are genetically predisposed to develop certain type of diseases
• Environment
- Matters related to health which are external to human body and over which “the
individual has little or no control”
- Ex. Poor water and air quality increase the risk of those exposed, over-crowding is a
health hazard
• Lifestyle
 - Most of society’s effort in improving health have been focused on health care
organization
- Health care organization consists of quantity, quality, arrangement, nature and
relationships of people and resources in the provision of health care
- Synonymous with health care system

LEVELS OF HEALTH CARE

1. Primary Care
- Is devolved to the cities and municipalities
- Activities of services provided by health care professionals acting as first point of
contact or consultation
- Health care provided by center physician, public health nurses, rural health midwives,
barangay health workers, traditional healers
- Primary care services are usually available at RHU or barangay health stations
- Can also be provided in family clinics
- Primary care deals with preventive care, performing strategies and interventions that
will promote optimal health for the patient and wellbeing of the general public
- Health services include; maternal and child services (immunization, family planning,
ante natal and perinatal care)
- Can be largely community-based

2. Secondary Care
- Provided by medical specialist amd other medical professionals to whom a primary
care professional has referred to
- Associated with hospital-based care. Usually given in health facilities either privately
owned or government operated such as infirmaries, municipal and district hospitals.
- Serve as referral center for the primary health facilities
- Cases referred to this level usually requires a more specialized type of service
- Types of service provided are more complex in nature than in primary care such as
minor surgeries and simple laboratory examinations
3. TERTIARY CARE
- Is more specialized form of health care.
- Tertiary care is rendered by specialists in health facilities including medical centers as
well as regional & provincial hospitals & specialized hospitals such as Philippine Heart
Center, Lung Center of the Philippines, National Kidney & Transplant Institute.
- Services are far more advanced, medical cases referred to this level are far more
complex
- Number of patients catered are fewer that in primary and secondary care
- Medical cases are more difficult, diagnostic procedures are also more complicated and
advanced.
REFERRAL PROCESS
• Begins at home where patient experience some form of illness
• Patient, according to his/her understanding of illness, chooses to seek care from a health
professional, performs self-care or self-medication or seeks alternative routes of
treatment.
 • Promptness of deciding to seek care from a health professional may positively influence
the prognosis of the illness.
• Delay in seeking care is detrimental to patient’s condition. (First Delay)
SECOND DELAY
• Delay of transport of patient from one health facility to a higher level of care
THIRD DELAY

• Although brought to a hospital with higher level of care, due to unavailability of medical
specialist or inadequate medical supplies, equipments, patients may not be able to receive
urgent & appropriate care.
HISTORY OF PUBLIC HEALTH

• Pre-historic era- early civilization look at disease from a supernatural perspective

• no concept of public health

• pre-historic people adapted “healthy related practices” not for health reasons but more for
religious purposes
• health or disease seen as a divine act
• since disease is a supernatural event, only those gifted in explaining such phenomenon
can address the situation
• “Shamans or medicine men” became natural healers of the tribe
• Shamans were skilled in:
- The use of medicinal herbs
- The use of amulets, charms or spells that supposedly ward off evil spirits causing the
illness
- The conduct of ceremonies that would appease the gods or supernatural beings and
eventually revert the curse
- Giving advice to individuals on how to maintain an illness-free life
• Shamans were consulted by the tribe’s leader on how to conduct themselves living
according their prescribed way of life that would not displease the gods

• Limited evidences regarding pre-historic health practice

- Geophagy- ingestion of clay or earth as mode of treatment for certain illness
- Trepanning- drilling hole into human skull to release evil spirit causing illness
- as tribes grew and organization of communities became more complex, human beings
started developing skills such as hunting & farming
- living together became more difficult and challenging especially accessing food &
clean water, disposal of human waste and getting rid of the dead
- to address the issue, civilizations started building infrastructures
ANCIENT EGYPTIAN CIVILIZATION

• established rudimentary and toilets

• gave high regards to personal cleanliness due to religious reasons
• still believe in deities & spirits causing the illness
 • developed a form of writing & was able to keep records of how certain illness should be
cured or treated.
• Shamans have evolved and developed surgical skills, even inventing devices which were
prototypes of surgical instruments
• famous for mummification- a form of taking care of their dead.

GREEKS

• developed a form of writing & recording

• slowly digressed from perspective of supernatural as the cause of illness.
• Greek culture cultivated the desire for knowledge giving birth to prominent personalities
like Aristotle, Socrates & Pythagoras
• Hippocrates known as the father of medicine contributed largely to
“professionalization” of medicine divorcing it from religious rituals and supernatural.
• Hippocrates wrote De Aere Et Locis or Of Air, Water and Land, where he proposed that
diseases developed because of our environment & not due to divine acts
• established the Hippocratic School of Medicine & was the 1st to use terms like acute,
chronic, endemic, epidemic, paroxysm & exacerbation.
• Greeks also came up with the concept of four humors, phlegm, blood, yellow bile & black
bile.

ROMANS

• - Roman civilization conquered Europe & Asia and many of the concept in health today
has been influenced by Roman perspective
• More focused on preventing illness rather than curing them.
• Many of the Roman doctors came from Greece
• Romans built sewers & aqueducts
• Roman doctors learned much about health & medicine through wounded warriors or
gladiators
• Battlefields and arenas became learning halls for Roman doctors who preferred studying
on living persons rather than dissecting corpses
• Galen, Greek physician dissected monkeys which became foundation for the study of
human anatomy
• Romans believed that establishment of community sanitation contribute to the
maintenance of health & prevention of spread of disease (built public baths & hospitals)

MIDDLE AGES (DARK AGES)

• Landlords or serfs replaced monarchs and villages which were once part of huge city-states
conglomerated to form feudal system
• Landlords protected village & built forts which later evolved into castles to provide defense
from invaders
• Early Christian monks & philosophers preserved Roman & Greek ideologies through
monasteries. Monasteries became hospices that cater travelling pilgrims who got sick along
the way.
• The concept of sin was introduced & how illness was in fact a consequence of sin therefore
to restore one’s health, it was necessary to make amendments with God
• This regression into prehistoric perspective of health disregarded importance of public health
issues such as environmental sanitation leading to outbreaks of diseases such as the Black
Plague

• Bubonic plague decimated 1/3 of Europe’s population in 5 years. The disease was caused
by Yersinia pestis, transmitted through flea bites. Person infected would have swollen lymph
nodes, gangrene of extremities, high fever, hematemesis, aching limbs & pain
• Outbreak started in China and through trade routes, the disease was brought to Europe
through Genoese trading ships that sailed through the Black Sea docked at the port of Sicily
carrying bodies of dead seafarers. Because they were covered with black boils, the disease
was called Black Death.
• Due to this pandemic, scientists & religious leaders established interventions & initiatives to
stop the spread of disease. More hospices were built. More hospices became more
specialized such as leprosarias or leper house were people with Leprosy were isolated from
those who were healthy.
• This method of isolating affected people from healthy ones became the forerunners of method
of “quarantine”.
• In the earlier part of Medieval period, medical schools began to develop in Europe & Middle
East Asia
• Salerno Medical School also known as Schola Medicana Salernitana was the world’s 1st
medical school. Teachers of this school wrote the poem Regimen Sanitates Salernitanum
emphasizing personal hygiene, diet, exercise as methods to maintain health.
• Islamic medicine developed from the influence of Greek & Roman traditions.
• Al-Razi, a prominent Arabic scholar & physician was known as the Father of Pediatrics. He
wrote a book “Diseases of Children”.
• Persian Avicenna wrote “The Canon of Medicine” which became a reference book for
medical schools worldwide until the 16th century.
• One of the major contribution of Islam in medicine was the proliferation of female doctors

RENAISSANCE PERIOD

• Scholars Girolamo Fracastoro broadened the public’s understanding of how epidemics or

infections were spread.
• Fracastoro introduced the concept of fomite
• Andreas Vesalius wrote “On the Structure of Human Body” where he described a detailed
structure of human body.
• William Harvey did an intensive study of human circulatory system
• Anton Van Leeuwenhoek is known as Father of Microbiology through his observations of
microorganisms
• During the 15th century, Italian boards of health started institutionalizing a system of record
and register deaths especially due to infectious disease which was referred to as Bills of
Mortality.

COLONIAL PERIOD

• Spanish explorers brought with them the smallpox virus to other places like New World
• Syphilis was also brought to Europe, they thought that it was due to contaminated water.
• New remedies to diseases were also introduced. Discovery of Quinine from South America.
• Quina-quina tress became the first medicine against Malaria.
• Botanist Carl Linnaeus called the tree “Cinchona” in honor of Spanish Countess of
Chinchon

1800
• People had little understanding about disease referred to as “bad air”
• Charles Louis Laveran, a French surgeon discovered parasites in blood of patients suffering
from symptoms of Malaria
• Ronald Ross discover that malarial parasites can be transmitted by mosquitoes
• Innovations in Public Health focused on control of infectious diseases.
• Dr Edward Jenner also known as the Father of Immunology pioneered the process of
vaccination or immunization. He discovered the vaccine against smallpox. He coined the term
“vaccine” from the word “vacca” or cow.
INDUSTRIALIZATION
• Saw not only the development of highly urbanized centers but also public health challenges
such as sanitation & overcrowding.
• Edwin Chadwick, secretary of England’s Poor Law Commission, wrote Report on the Inquiry
into Sanitary Conditions of the Laboring Population of Great Britain which reveals results of
prevalence & causation of preventable diseases which was considered as one of the most
important document of modern public health.
In 1831, Cholera outbreak killed more people in England than the Black Plague

• Dr. John Snow elucidate how Cholera was transmitted by tracing the source, which was the
water pump. His work earned him the title Father of Epidemiology.
• Florence Nightingale helped push professionalization of nurses
• Lilian Wald introduced the concept of public health nursing
• Robert Koch & his “Koch’s Postulate” developed the field of bacteriology
• Louis Pasteur challenged the concept of spontaneous generation, introduced pasteurization
& inoculation of vaccine against rabies

20TH CENTURY- saw the rise of many developments in pubic health

• Early 1900’s was still predominated by infectious diseases such as Polio & Yellow Fever.
Boards and councils for health were established in various country regulating quarantine
activities
In the Philippines, Board of Health for the Philippine Islands was established which was later
replaced by Bureau of Health. This was renamed as Department of Health & Welfare, which was
later on became DOH. The 1st secretary was Dr. Jose Fabella.

• The Spaniards already established Public Health even before the arrival of Americans
• The 1st hospital was a dispensary organized by Fr. Juan Clemente which later became San
Juan De Dios Hospital
• UST became the 1st medical school in the country.
After WWII, WHO was established in 1948. Center for Disease Control and Prevention was
established in Atlanta USA.
Other developments in medical technology:
• Development of Penicillin & Polio vaccine by Jonas Salk & Albert Sabin
• Small Pox was eradicated in 1977
• In 1978, Declaration of Alma-Ata in Kazakhstan on Primary Health Care came out. This
declaration made clear that health is a human right. Also defined Primary Health Care and
pushed for “Health for All” by year 2000.
• A year after the declaration, Health and Population Development Conference was held in
Italy where Selective Primary Health care was introduced.
• In 1982, UNICEF came up with Growth Monitoring, Oral Rehydration, Breastfeeding &
Immunization (GOBI) strategy. Later they added FFF (GOBI-FFF), Family Planning, Food
Supplementation, Female Literacy.
• Emerging diseases such as AIDS highlighted the latter years of 20th century.
• In 2003, there was an outbreak of Severe Acute Respiratory Syndrome (SARS) in Southern
part of China, particularly HK, spreading to 37 other countries including Philippines where 14
cases were reported and 2 deaths.
• 1998, outbreak of Swine Flu caused by H1N1
• 1997, outbreak of flu virus (H5N1) affecting poultry workers in HK. This Avian Flu spread in
other countries in 2003 & 2004
• 1976, microbiologist Peter Piot discovered Ebola Virus while investigating mysterious illness
in Congo. In 2014, parts of west Africa re-experienced sudden outbreak of Ebola.

IMPORTANCE OF HEALTH DETERMINANTS

• “Common diseases have roots in lifestyle, social factors and environment, and successful
health promotion depends upon a population-based strategy of prevention.”
• As health professionals, training and reimbursement systems emphasize diagnostic and
treatment services to individuals.
• We need to focus on those factors (DETERMINANTS) which have the most influence on the
health of the population.
DRIVERS/DETERMINANTS OF HEALTH AND DISEASE
• BIOLOGY/GENETICS
• BEHAVIOR
• PHYSICAL ENVIRONMENT
• HEALTH SERVICES
• SOCIAL FACTORS
• POLICYMAKING

BIOLOGY/GENETICS

• Is an individual’s genetic make up, family history, physical & mental health problems
developed in the course of life
• Inheritance plays a part in determining lifespan, healthiness and the likelihood of developing
certain illnesses. Personal behavior and coping skills – balanced eating, keeping active,
smoking, drinking, and how we deal with life’s stresses and challenges all affect health
• Inherited condition: sickle cell anemia, hemophilia, cystic fibrosis
• Age: older adults are biologically prone to being in poorer health than adolescents due to the
physical and cognitive effects of aging
• Sex: your gender makes you prone to certain diseases at different ages
• Genetic carrier: BRCA1/2 increases risk for breast/ovarian CA

BEHAVIOR (LIFESTYLE CHOICES)

• individual responses to internal stimuli & external conditions.

• Affects individual and population health outcomes
• E.g. smoking, physical activity, diet
• Play a significant role in an individual’s health status:
- Dietary patterns , Level of physical activity , Alcohol, tobacco, and other drug use,
Hand washing behavior, Sexual behavior, Inadequate relief of chronic stress
PHYSICAL ENVIRONMENT

• Is what is experienced by the senses.

• May affect health negatively or positively
• Inclusive of physical & built environment
• Individual’s school, work or home environment

HEALTH SERVICES
• Access to health care & quality of care that impact health
• Access and use of services that prevent and treat disease influences health
• E.g. Immunization, family welfare, ante & perinatal care, family planning
• Must be available, accessible, acceptable & affordable
• Barriers to access include; lack of availability, lack of insurance coverage, high costs, and/or
limited language access
SOCIAL FACTORS

• Reflect the social, personal, and economic factors and physical conditions of the environment
in which people are born, live, learn, play, work, worship, and age.
• Include interactions and relationships with family, friends, coworkers, & others in the
community
• Social institutions such as law enforcement, religious communities, schools and government
agencies are all part of social environment
• Culture - customs and traditions, and the beliefs of the family and community all affect health.
• E.g. education, income, safe neighborhood, transportation, housing

POLICY MAKING
• Local and state policies affect individual and population health
• Can have a profound effect on health of individuals, groups and communities
• E.g. national budget on health, education, etc.
• E.g. UHC, policies against smoking (increasing taxes on tobacco), use of seatbelt, safety laws
regulating standards on vehicle & highway.

PUBLIC HEALTH VS. MEDICAL CARE

PUBLIC HEALTH

• The community is its patient trying to improve the health of the population
• Focuses on preventing illness
• In carrying out its core functions- assesses the health of a population, diagnose problems,
seeks the causes of those problems, devices strategies to cure them
• Assessment- diagnostic function (public agency collects, assembles, analyze & makes
available information on health of population)
• Policy development- involves use of scientific knowledge to develop a strategic approach to
improve community’s health
• Assurance- assuring that the services needed for the protection of public health in community
are available & accessible to everyone

MEDICAL CARE

• Concerned with individual patients

• Focuses on healing
• Work with patient, assess, diagnose, develop treatment plan & implement the treatment plan
DISCIPLINE OF PUBLIC HEALTH IS DIVIDE INTO 6 AREAS

• Epidemiology- the basic science of public health, backbone of disease prevention

 - Study of occurrences & distribution of diseases & determinants of health states or
events in a specified population.
- Focuses on human populations, usually starting with an outbreak of disease in
community.
- Epidemiologist look for common exposures or other shared characteristics in the
people who are sick of seeking care, the causative factor.
- Epidemiologist are concerned not only with deaths, illness & disabilities but also with
positive health states & means to improve health.
• Statistics- depends heavily on collection of data (births & deaths, causes of death,
outbreaks of communicable diseases, etc.). The science of statistics is used to calculate
risks from exposure to environmental chemicals, for example.
- Refers to system of obtaining, organizing & analyzing numerical facts so that
conclusion maybe drawn from them.
- Statistical analysis is an integral part of any epidemiologic study seeking the cause of
a disease or a clinical study testing the effectiveness of a new drug.

DISCIPLINE OF PUBLIC HEALTH IS DIVIDE INTO 6 AREAS

• Biomedical Sciences-A major proportion of human disease is caused by microorganisms.

• Prevention and control of these diseases in a population require an understanding of how
these infectious agents are spread and how they affect the human body.
• Environmental Health Science- is concerned with preventing the spread of disease through
water, air, and food.
• Social Science- deals with social factors and its association with disease in a population
• Behavioral Science- deals with human behavior and practices and its association with disease

OTHER PARTNERS IN PUBLIC HEALTH

• Media
- Vehicle for public discourse
- Health education and promotion
- Health communication
- Social media as catalyst
• Employers and Businesses
- Employer-sponsored health insurance programs
- Wellness initiatives and benefits
- Healthy workplaces and communities
• Government agencies
- City planning
- Education
- Health in all policies
• Academia
- Education
- Training
- Research
• Public service

PREVENTION AND INTERVENTION

PREVENTION
Public health’s approach to health problems in a community has been described as a five-step
process:

1. Define the health problem.

2. Identify the risk factors associated with the problem.
3. Develop and test community-level interventions to control or prevent the cause of the
problem.
4. Implement interventions to improve the health of the population.
5. Monitor those interventions to assess their effectiveness

• The main task of prevention is to develop interventions designed to prevent specific problems
that have been identified either through an assessment process initiated by a public health
agency or through community concern raised by an unusual course of events.

INTERVENTION
• Public health has developed systematic ways of thinking about such problems that facilitate
the process of designing interventions that prevent undesirable health outcomes. One
approach is to think of prevention on three levels:

• PRIMARY PREVENTION
- Prevents an illness or injury from occurring by preventing exposure to risk factors
- E.g. handwashing, healthy lifestyle, health teachings, vaccination, avoiding tobacco &
alcohol, oral health

• SECONDARY PREVENTION
- Seeks to minimize the severity of the illness of the damage due to an injury-causing
event once the event has occurred.
- E.g. screening tests (mammogram, pap smear, colonoscopy), contact tracing of
infected people with HIV, detection & treatment of asymptomatic hypertension

• TERTIARY PREVENTION
- Seeks to minimize disability by providing medical care and rehabilitation services.
- E.g. Rehabilitation programs that focus on regaining optimal functionality such as
physical therapy, use of prostheses, support groups, etc., Interventions intended to
minimize complications of active medical condition (early treatment of diabetic
nephropathy, percutaneous transluminal coronary angioplasty)

COMMUNITY HEALTH

Definition of Community
• A group of people with the potential for interaction
• Members have shared values & norms of behavior
• Has “ sense of community” can be a key factor in gaining support for the program & for
maximizing the health effects of some program
• Shared emotional connections

Local Factors that Affect Health of Community As

Cited From WHO’ Community Needs Assessment

• Physical environment in which people live,

• Social Environment
• Poverty
• Behavior & lifestyle
• Family genetics & individual biology

DATA FOR COMMUNITY PROFILING

❑ Work & levels of employment and underemployment in a community

✓ Occupational diseases
✓ Income levels
✓ Self Worth

❑ Poverty & income d

❑ Environment
✓ Pollution
✓ Good Sanitation
✓ The lack of home
✓ Transport system

✓ Social support
✓ Family & friendship network
✓ Migration
✓ Marginal groups
✓ Opportunities for non-work social activities

WHO identifies destabilizing factors that can affect the health status of community.
✓ War
✓ Economic
✓ Recession
✓ Natural disaster (earthquake, floods or drought)

- These factors affect health indirectly by reducing the resources available for health
services, increasing poverty & lowering the social & economic wellbeing of a
population.
- They may radically lower population numbers increase fear & mental illness.

In general, there are 3 broad factors that affect the health of a community:
✓ Physical factors (geography, environment, community size, industrial development)
✓ Social & Cultural factors (traditions, norms, beliefs, politics, income, livelihood, economy)
✓ Individual factors (behavior)

Community Organizing
- the process by which community groups are helped to identify common problems or
goals, mobilize resources & in other ways develop & implement strategies for reaching
the goals they collectively have set.
- important in health education & social involvement.

CATEGORIES OF COMMUNITY ORGANIZATION

1. Locality Development
- process-oriented, creating a consensus & sense of cooperation
2. Social Planning
- task-oriented, emphasizing rational-empirical problem-solving
3. Social Action
- both task & process-oriented.

STEPS IN COMMUNITY ORGANIZING

1. Problem identification
2. Interface with community
3. People organization
4. Community profile & assessment
5. Goal-setting & formulation of strategies
6. Implementation of agreed strategies or solutions
7. Monitoring & evaluation
8. Sustaining gains, addressing emerging problems.

❖ In the process involved in maintaining Community Health, understanding population &

community health data is a necessity.
❖ Gathering & analyzing these health data is part of epidemiological study that can be conducted
in the community.

❖ EPIDEMIOLOGY is the study of distribution & determinant of diseases & injuries in human
populations.
❖ The goal of epidemiology is to limit disease, injury & death in a community by intervening to
prevent or limit outbreaks or epidemics of disease & injury.
❖ This is accomplished by describing outbreaks & designing studies to analyze them and to
validate new approaches to prevention, control & treatment. Through these practices,
epidemiologists contribute to our knowledge of how diseases begin & spread through population
& how they can be prevented, controlled & treated.

USES OF EPIDEMIOLOGY
1. Study the history of health population & the rise & fall of diseases & changes in their character
2. Diagnose the health of the community & the condition of people to measure the distribution &
dimension of illness in terms of incidence, prevalence, disability & mortality, to set health
problems in perspective & to define their relative importance & to identify groups needing
special attention
3. Study the work of health services with a view of improving them
4. Estimate the risk of disease, accident, defects & the chances of avoiding them
5. Identify syndromes by describing the distribution & association of clinical phenomena in the
population
6. Complete the clinical picture of chronic disease & describe their natural history
7. Search for causes of health & disease by comparing the experience of groups that are clearly
defined by their composition, inheritance, experience, behavior & environment.

ESSENTIAL DATA FOR EPIDEMIOLOGISTS

RATES
• Is the number of events in a given population over a specified period or at a given point
in time.
• Birth Rate- is the average annual number of births during a year per 1,000
persons in the population. Also known as CRUDE BIRTH RATE. This is usually
the dominant factor in determining the rate of population growth.
• Crude Death Rate- a measure of mortality from all causes which may result in
a decrease of population.
• Incidence Rate- the number of new cases of a disease in a population at risk
in a given time period.
• Prevalence Rate- the total number of cases (existing cases) of disease in a
population
• Case Fatality Rate- the percentage of cases that result in death. It measures
the severity of disease & is proportionate to the virulence of a disease agent.
ESSENTIAL DATA FOR EPIDEMIOLOGISTS
RATES

• Infant Mortality Rate- measures the risk of dying during the 1st year of life . It is a good
index of general health condition of a community since it reflects the changes in the
environment & medical condition of a community.
• Maternal Mortality Rate- measures the risk of dying from causes related to pregnancy,
childbirth & puerperium. It is an index of the obstetrical care needed & received by
women in a community.
• Fetal Death Rate- measures pregnancy wastage. Death of the product of conception
occurs prior to complete expulsion, irrespective of duration of pregnancy
• Neonatal Death Rate- measures the risk of dying during the 1st month of life. Serves
as the index of the effects of prenatal care & obstetrical management of the newborn