Community:
Community is a social group determined by geographical boundaries and/ or
common values and interest; community members know and interact with one another;
the community functions within a particular social structure and creates norms and
social institution (WHO, 1974)
Community is not easily or consistently defined entity. It is a nebulous, complex
concept can be defined in numerous ways depending on the application. It may be
defined as a “people, location, and social system” (Josten, 1989 in Hunts, 2001)
People: individual, Families, Culture
The variety of individual, families and cultural comprising a community
contributes to the overall complexion of that community. The simplest way to
understand a community is through its vital statistics and demographics (Hunt, 2005).
Vital statistics in the broad sense refers to the application of statistical methods and
techniques to study the vital facts such as births, deaths, population, illnesses,
marriage, divorce. In the narrow sense, the term refers to birth, deaths, and population.
Demographic refers to the characteristics of the population, such as: total population,
the percentage of age distribution, sex, topography, climate, health statistics, trends,
population density. These are the parameters that describe the population being served,
suggest their health risks and needs, growth and decline, who are potential to increase
exposure to communicable diseases and affects resources needed.
Culture contribute to overall character of a community and, in turn, its health
needs. Culture is the sum total of man’s experiences as he interacts with his
environments and fellowmen. The product is embodied in his thoughts, speech, actions,
beliefs, art, customs and traditions. Culture is learned, share and transmitted to
succeeding generations through the use of tools and language.
Health is affected by culture. Leininger observed that “health and illness state are
strongly influenced and often primarily determined by cultural background of an
individual”. The culture of the individual and family has an impact on the community’s
definition health and the service needs of that community.
Location: Community Boundaries
A community is defined by boundaries. Community boundaries are important
because they often determine the services are available to families living within a
particular geographic area. It is important to have a working knowledge of service
restriction for agencies in a geographic area, this information can assist you were to
refer services for health.
Social System
Another major feature of a community is the relationship that community
members form with each other. Community members fulfill the essential functions of
community by interacting with each other. Community members fulfill the essential
functions of community by interacting in groups. These functions provide socialization,
role fulfillment, goal achievement, and members support. Therefore, community is a
complex social system and its interacting members comprise various subsystems within
the community. Social system includes community economy, education, religion,
welfare, politics, recreations, legal system, health care, safety and transportation and
communication system. Depending on the infrastructure, these systems may have
beneficial or detrimental impact on the health of individuals living in a given community.
For instance, if recreational activities provide opportunities for health promotion
activities, then, the health of the citizens will be enhanced. If vaccines are available and
accessible to all children, the immunization rate is high and therefore a lower rate in
communicable disease.
Windshield Survey
Prior to conducting the actual community assessment, the nurse travel around the
neighborhood to identify objective data related to people, places and social system
that help define the community.
People:
● Are people seen in the street? What are they doing?
● How are they dressed?
● Who are the people living in the neighborhood? What is their age range (e.g.
preschoolers, young mothers or elderly?
● Do you notice residents who are nourished or malnourished?
● Is there any evidence of alcoholism, drug abuse, mental illness or presence of
communicable diseases? How did you come to this conclusion?
● Are there animal in the street? What kind?
Place/Boundaries:
● Where the community is located?
● Note any geoboundaries which tend which tend to separate the community
(e.g. zone)
● Natural boundaries?
● Human made boundaries?
Location of Health Services:
● Where are the major health institutions located?
● Health services (health centers, clinics, hospitals)
● Status- “Do you get an overall impression of a healthy or unhealthy
community?” State the Rationale: ______________________
● Are there geographic feature that may pose a threat?
Human made environment:
● Do you see industrial spaces with heavy industrial plants?
● Do the road allows easy access to health institutions?
● Note pave street, conditions.
Housing:
● What is the condition of housing (e.g. makeshift, made of strong or light
materials)?
● How old are these houses?
● Are there single-family or multiple family housing?
● Are their vacant dwellings? If so, explain.
Social System:
● Are there school in the area? How many, what condition?
● Are there alternative education system (e.g. Montessori schools)?
● What churches are located in the community?
● What schools, community centers, clinic or other services are provided by the
churches?
● Are there recreation and entertainment centers or parks?
● Does the community have public transportation? Does it provide accessible
services?
● What supermarkets and stores are available?
● Is there an evidence of police and fire protection in the area?
Population Focused
The central mission of public heath practice is to improve the health of population
groups. Community health nursing share essential feature: it is population focused,
meaning that it is concerned of population groups and their environment. Population
group may be scattered group with common characteristics, such as people with high
risk of developing heart disease or battered women or men.
EtTherehical Bases: The Greatest Good for the Greatest Number of People
Individualized care is important, but preventing of aggregate problems in the community
health nursing practice reflects more accurate philosophy and benefits more people.
Addressing health outcome for group of individuals defined by similarities (health
diagnosis, location, etc) rather than single patient.
