Comparison of Public and Community Health: Pertinent History and Available Resources The terms public health and community health are oftentimes mistaken to have the same definition; however, the terms although similar have different meanings, as well as implications in application as it applies to health.
Both public health and community health serve the health needs of individuals within communities; however, each service began with different approaches to achieve the goals.This paper will define and compare public and community health, the associated objectives, and explore the pertinent history of each service as well as available resources. The use of available resources at the county, state, and national levels will support and promote the health of America so that our nation can continue to promote the health and well-being of all people. Definitions To begin the comparison process, exploration of common terms must occur. Public Health and Community Health have a word that is common to both; health.
The World Health Organization (2003) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (Definition of health, para. 1). Therefore, one can assume that the terms public and community health relate to the “state of complete physical, mental and social well-being” (World Health Organization, 2003, para. 1) of individuals in the public or community. Although this is partially true, I will define each term, to understand further the differences between public and community health. Public HealthAccording to Stanhope and Lancaster (2008), the Institute of Medicine defined public health as “Organized community and multidisciplinary efforts, based on epidemiology, aimed at preventing disease and promoting health” (Definitions of selected terms, p. 48). Stanhope and Lancaster (2008) further report that the Institute of Medicine state that public health is “what we, as a society, do collectively to assure the conditions in which people can be healthy” (p.
6).These definitions provide a level of understanding that Public Health offers an organized approach toward the promotion of health and prevention of disease through tracking and trending conditions, diseases and behaviors that lead to disease. These activities also promote, educate and raise awareness within the public and communities to further prevent the spread of disease, and further decrease associated risks to ensure society remains healthy.Community Health Community health’s definition on the other hand, according to Stanhope and Lancaster (2008) is “the meeting of collective needs by identifying problems and managing behaviors within the community itself and between the community and the larger society” (p.347).This definition provides the level of understanding that Community Health refers to the problems and behaviors specific to a community that has the potential to affect others within society.
Health care entities plan and provide interventions or services that focus on decreasing the negative health effects on the community’s individuals, families, and groups. Comparison Public and Community Health Although the two definitions are similar, the theory and concepts behind each are different.Public health practice focuses on “promoting and preserving [the] health of populations” (Stanhope & Lancaster, 2008, p. 1), through looking at the health of the community in its entirety as well as available community resources. The provision of care under Public Health centers in “preventing disease and disability and promoting and protecting the health of the community as a whole” (Stanhope & Lancaster, 2008, p. 1). Community Health theory and concepts center in investigation of community problems that affect health.The community health status is monitored through health surveillance efforts “for the purposes of preventing disease and disability and promoting, protecting and maintaining ‘health’ in order to create conditions in which people can be healthy” (Stanhope & Lancaster, 2008, p.
1). Community Health services center in “the delivery of personal health care services to individuals, families, and groups” (Stanhope & Lancaster, 2008, p. 1) to positively affect the health of the community and includes the environment in which the population reside. Public and Community Health History and Resources.History of Public and Community Health Numerous health emergencies in our nation over the last several hundred years have lead to the formal development of Public and Community Health programs and services. The widespread devastation of the effects of disease within the population of the nation and an inadequate supply of health care delivery services led to the development of schools, agencies, and providers of care to assist with decreasing death and disability of the population and within vulnerable populations such as the poor and underserved.Understanding how infectious disease affects health and the environmental conditions in which disease spreads was at the center of the early public health establishment.
Diseases such as small pox, measles, cholera, diphtheria, pertussis, polio, meningitis, influenza and tuberculosis were rampant and caused many deaths. The spread of many of these diseases devastated whole communities and families and led the government to develop programs to track and stop the spread of disease.At the heart of the movement, those who cared for the sick saw the need for health care services and education to promote and raise awareness of behaviors and environmental risk factors associated with the spread of disease and injury. Thus, nursing began to provide the necessary services and Public Health nursing began.
“Public health nursing developed in the United States in the late nineteenth and early twentieth centuries [sic] largely because of the pioneering work of Lillian Wald” (Stanhope & Lancaster, 2008, p. 28).Lillian Wald was a nurse during the depression era and upon visiting a woman at her home in New York City, found her hemorrhaging from childbirth 2 days prior. Lillian Wald provided care to nurse the woman and her family back to health and saw the need for services within the community. Thus, Lillian Wald lobbied and received financial support and began a settlement house to provide nursing care to her neighbors. This led to the development of the Henry Street Settlement, which later became the Visiting Nurse Service of New York (Stanhope & Lancaster, 2008).
The association of Lillian Wald’s pioneering nursing services with the New York Board of Health, led to increasing awareness within the government of the need for public services. Nurses within the nation during the nineteenth and twentieth century’s saw a need to organize and address public health nursing services. This led to the development of the National Organization for Public Health Nursing (NOPHN). The NOPHN “sought to improve the educational and services standards of the public health nurse, and promote public understanding” (Stanhope & Lancaster, 2008, p. 30).
This organization focused on standardizing the education of public health nurses and provided additional education services through the assistance of funding from the American Red Cross (Stanhope & Lancaster, 2008). The rise in maternal and pediatric mortality and the spread of contagious diseases from schools to the home also led to the development of organized school nursing, which is a community health service. Early public and community health services such as school nurses were pivotal in educating about, providing and ensuring immunizations against preventable diseases to stop the spread of disease and prevent injuries.
Another important association pertinent to the development of Public Health nursing was the “American Public Health Association (APHA) which was established in 1872” (Stanhope & Lancaster, 2008, p. 30). This association focused on issues within the environment that affected the health of the public such as sanitation, and work environment injuries as well as diseases that were transmitted sexually (Stanhope & Lancaster, 2008). Environmental health became a focus with the spread of disease and injury. To assist the public and decrease the effects of disease, local health departments began.The provision of local health departments within urban cities to improve living conditions to limit the spread of disease led to continuing efforts in more rural settings. Eventually, the government saw the need for a broader entity to manage the smaller entities and the United States Public Health Services (USPHS) began in 1912.
The focus of the USPHS was to “investigate the causes and spread of diseases and the pollution and sanitation of navigable streams and lakes” (Stanhope & Lancaster, 2008, p. 31).Another important agency that assisted in the development of public and community health services is the American Red Cross, which began on May 21, 1881 (American Red Cross, n.
d. ). The American Red Cross began to provide services and relief between “members of the American armed forces and their families” (American Red Cross, n. d. , para.
3), as well as “providing national and international disaster relief and mitigation” (American Red Cross, n. d. , para. 3), With these efforts, the provision of “first aid, water safety, and public health nursing programs” (American Red Cross, n.d. , para. 4) began.
The American Red Cross assisted the public with providing funding and materials as well as recruiting and providing nurses to staff hospitals. These nurses provided nursing care during the “worldwide influenza epidemic of 1918” (American Red Cross, n. d. , para. 4),. Through the years, the American Red Cross has developed many programs to aid the nation and the world in times of war and peace and substantially contributed to the development of public health, as it is now.
The Encyclopedia of Public Health (2010) denotes that by the mid twentieth century, “the basic activities of public health had been widely recognized in the industrialized world. These components were: communicable diseases control, environmental sanitation, maternal and child health services, health education, occupational and industrial hygiene, nutrition, and, in most developed countries, the provision of medical care. In the United States, only medical care for the indigent, the aged, and for certain diseases (e.
g., tuberculosis) were considered within the purview of public health”.(The early twentieth century, para. 3). In July of 1946, the Communicable Disease Center (CDC) began under the realm of Public Health after acknowledging that that the Malaria Control in War areas “had successfully kept the southeastern states malaria-free during World War II and, for approximately one year, from murine typhus fever” (History of CDC, n.
d. , para. 1). The CDC’s focus was to provide assistance with controlling communicable diseases to the individual states using epidemiology.In 1949, the first disease surveillance program began and “became the cornerstone on which CDC’s mission of service to the states was built and, in time, changed the practice of public health” (History of CDC, n.
d. , para. 3).
The CDC was pivotal in determining the cause of an outbreak with poliomyelitis in children who received the Salk vaccine as well as mapping the course of an influenza epidemic, which led to the development of the influenza vaccine (History of CDC, n. d. ). The CDC’s public activities and services continued to expand, and thus the Communicable Disease Center changed its name to Center for Disease control in 1970.In 1981, The Center for Disease Control became the Centers for Disease Control to depict the many different categories it covered. In 1992, The Centers for Disease Control added and Prevention to depict the change in the organizational activities toward prevention of disease and injury; however, the abbreviation, CDC, remained the same (History of CDC, n. d.
). Many victories over diseases come from the accomplishments of the CDC’s efforts, such as the eradication of small pox in 1977, and the identification of the “cause of Legionnaires disease and toxic-shock syndrome”.(History of CDC, n.d. , para.
8). As communicable diseases declined, a paradigm shift took place that focused on educating the public on ways to be healthier. This paradigm shift lead to the promotion of health and well-being as well as activities to control chronic disease and prevent injury. Public Health services and agencies such as the CDC, was pivotal in ensuring the public and healthcare providers were educated in ways to transition the focus of health.
The CDC was instrumental in developing programs to assist with immunizations, motor-vehicle safety, workplace safety, control of infectious diseases, declines in deaths from heart disease and stroke, safer and healthier foods, healthier mothers and babies, family planning, fluoridation of drinking water, and tobacco as a health hazard (Ten great public health achievements in the 20th century, n. d. , para. 2).
Public and Community Health Resources As public and community health are similar, many of the resources available cross into both realms. Resources are available at county, state and national levels.County Counties are a division of each state into territorial portions for the provision of administrative, judicial and political processes. Public and community health resources within each state’s counties vary greatly depending upon location, population, and economic status. Generally, each county has a County Health office which assists the State and the public in identifying and collecting information regarding the health of the local population, as well as providing services to decrease the negative effects of the populations overall health.
In Wyoming, Public Health is under not only the county level but also the state level. Services provided through Fremont County Government’s (n. d. ) Public Health program include adult health services such as “sexually transmitted disease testing, Hemoglobin A1c testing, diabetes education, Human immunodeficiency virus (HIV) testing and counseling, hepatitis testing, nursing home admission evaluation, and assessment for in-home services, influenza and child immunizations, maternal child health, and migrant health” (Public Health services, para.1). Other Fremont County Governement (n.
d. ) public health programs focus on environmental hazards such as “bio-terrorism, chemical emergencies, emergency planning and disease surveillance” (All Hazards, para. 1). Community Health services at the county level can include county hospitals, which provide necessary health services as well as Community Health centers. The federal government provides the county with a subsidy for Community Health centers in which low-cost or free services are available to the population.Another community health service that is available to many counties is services such as Planned Parenthood and the County Detoxification Center, which also provide services at low or no cost to the population. State Public and community health resources are also available at the state level.
Each State has a Department of Health, which oversees each county within the state and assists the public. The Wyoming Department of Health encompasses both Community and Public Health services.Programs available for resources through the Wyoming Department of Health (2008) include, (a) “Epidemiology, (b) Immunization program, (c) Maternal and Family Health, (d) Children’s Special Healthcare Services, (e) Family Planning, (f) Maternal High Risk and High Risk Newborn Program, (g) Perinatal Health/Best Beginnings/Home Visiting, (h) Oral Health Programs, (i) Public Health Nursing, (j) Women, Infants and Children (WIC) program, and (k) Safe Kids of Wyoming” (Community and Public Health Division Programs list, para.1). The development of each of these programs began through a public health needs assessment to provide the necessary resources to combat identified problems within the state.
National Numerous national public health and community resources are available to assist the public as well. Agencies such as the CDC, American Red Cross, Environmental Protection Agency, National Institute of Health, and the United States Department of Health and Human services provide assistance to each state as well as to the public at large.Many Associations also exist to provide public and community services, education and support such as American Cancer Society, American Diabetes Association, and the American Heart Association to name a few. Many of these associations have local chapters and are involved in many community and public health events. Another important National resource is the Healthy People campaign developed by the federal government in response to national declining health trends.The objectives of the Healthy People (n. d. ) campaign is to help people live healthier, and achieve higher quality of life through achieving “health equity, eliminating disparities, and promoting healthy development and healthy behaviors across all life stages” (Overaching goals, para.
1). The Healthy People campaign began in 1979 in response to a report about health promotion and disease prevention from the Surgeon General (History of Healthy People, n. d.
).The Healthy People campaign “provides science-based, 10-year national objectives for improving the health of Americans…[and] has established benchmarks and monitored progress over time in order to encourage collaborations across sectors, guide individuals toward making informed health decisions, [and] measures the impact of prevention activities” (About Healthy People, para. 1). Conclusion Public and community health appears to have a gray line separating them.While each focuses on preventing disease and injury and promoting health and well-being, the theories and concepts behind each are different. Public Health activities and programs promote, educate and raise awareness with the public and communities to further prevent the spread of disease and prevent injury and mortality. Community Health activities and programs provide population centered health care services to individuals, families, and groups that promote health and well-being based on the needs of the community and the environment.Major public and community health events throughout our nation’s history have led to the development of formal Public Health and Community Health services, which include numerous agencies and associations to assist with America’s public health needs.
Using available resources that support and promote the health of America, our nation can continue to promote health and well-being and affect positively the health of all people. References American Red Cross. (n. d. ).
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