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1. Chap 1: Community Health -
Yesterday, Today, and Tomorrow
Malimu

2. Chap 1: Community Health
• 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
Chapter Objectives

3. Chap 1: Community Health
Chapter Objectives
• Briefly relate the history of
community/public health, including
the recent history of community and
public health in the twentieth-
century .
• Describe the status of efforts to
improve world health and list some
plans for the future.

4. Chap 1: Community Health
Chapter Objectives
• Describe the purpose of the Health
People 2010 goals and objectives as
they apply to the planning process
of the health of Tanzanians.

5. Chap 1: Community Health
Introduction
• Definitions, Concepts, & Principles
• Community Health vs. Personal
Health
• Brief History of Community Health
• American Health Concerns in the
90’s

6. Chap 1: Community Health
HEALTH
• A state 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.
Definitions

7. Chap 1: Community Health
Definitions
• COMMUNITY
Group 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. Chap 1: Community Health
• 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. Chap 1: Community Health
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. Chap 1: Community Health
Factors Affecting Community HealthFactors Affecting Community Health
HHEALTHEALTH
OF THEOF THE
CCOMMUNITYOMMUNITY
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

11. Chap 1: Community Health
Prehistory
7000+ BC
Egyptians
1500 -1050 BC
Greeks
400 BC
Romans
450 BC - 410 AD
Middle Ages
410 - 1500AD
Renaissance
1500 - 1700
Hammurabi
1750 BC
Enlightenment
1700s
19th Century
20th Century
21st Century

12. Chap 1: Community Health
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. Chap 1: Community Health
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. Chap 1: Community Health
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. Chap 1: Community Health
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. Chap 1: Community Health
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. Chap 1: Community Health
Health Resources
• BEGINNING OF TWENTIETH
CENTURY
– Life expectancy less than 50 years
– Communicable diseases leading causes of
death
– Children health concerns

18. Chap 1: Community Health
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. Chap 1: Community Health
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. Chap 1: Community Health
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. Chap 1: Community Health
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. Chap 1: Community Health
CCHAPTERHAPTER 11
CCOMMUNITYOMMUNITY HHEALTHEALTH --
YYESTERDAYESTERDAY, T, TODAYODAY,,
AANDND TTOMORROWOMORROW