Concept of Healthy Community

Concept of Healthy Community

CommunityDEFINITION:A social group determined by geographic boundaries and/or common values and interests. Its members know and interact with each other. It function within a particular social structure and exhibits and creates norms, values and social institutions.CHARACTERISTICSEnvironment physical, socio-cultural, educational and employment milieuPopulation behavior or lifestyle self-responsibility, self-care competencyHuman biology genetic characteristics of populationSystems of health care prevention, promotion, cure and rehabilitation

CLASSIFICATIONUrban high density, a socially heterogenous population and a complex structure, non-agricultural occupations; something different from an area characterized by complex interpersonal social relationsRural usually small and the occupation of the people is usually farming, fishing and food gathering. It is peopled by simple folk characterized by primary group relations, well-knit and having a high degree of group feelingRurban A Healthy Community....Prompts its member to have high degree of awareness that we are community.Uses its natural resources while taking steps to conserve them for future generations.Openly recognizes the existence of sub-groups and welcomes their participation in community affairs.Prepared to meet crisis.Is a problem solving community, it identifies, analyzes and organize to meet its own needs.Has open channels communication that allows information to flow among all subgroups of its citizens and in all direction.Seeks to make each of its systems resources available to all members of the community.Has legitimate and effective ways to settle disputes and meet needs that arises within the community.Encourage maximum citizen participation in decision making.Promotes a high level wellness among its members.

Components of a CommunityThe CORE represents the people that make up the community, included in the community CORE are the demographics of the population as well as the values, beliefs and history of the peopleEIGHT (8) subsystems of the communityHousing - what type of housing facilities are there in the community; are there enough housing facilities available; are there housing laws/regulations governing the people? What are these?Education these include laws, regulation, facilities, activities affecting education, ratio of health educators to learners, distribution of educational facilities, who utilizes these, what informal educational facilities and activities exist in the communityFire and safety fire protection facilities and fire prevention activities, distribution of thesePolitics and government political structure present in the community, decision-making process/pattern leadership style observed, etc.Health health facilities and activities; distribution, utilization, ratio of providers to clientele served; priorities in health, programs developed, etc.Communication systems, types of communication existing, forms of communication, be it formal or informal; etc.Economics occupation, types of economic activities, income, etc.Recreation recreational activities/facilities; types, consumers, appropriateness to consumers, etc. Elements of a Healthy CommunityPeople are partners in health care.People work together to attain good health condition.Physical environment promotes health, safety, order and cleanliness.Safe water and nutritious food.Families provide members with basic needs.Available, affordable health care.

Factors that Affect Community HealthPoliticalSocio-economicHeredity/GeneticEnvironmentBehaviour/ValuesHealth Care Delivery systemTwelve Dimensions of the Proposed Community Contextual Health ProfileCommunity Contextual Health profileEnvironmentalEconomicEducationEmploymentPoliticalHousingMedicalGovernmentalPublic HealthPsychosocialBehaviouralTransport Contextual Dimensions, Components, and Indicators Potentially Related to Health

ECONOMIC DIMENSIONIncomeSummary income measuresIncome componentsDisposable incomeIncome distributionGeographic concentration of incomeEconomic segregation

WealthGeographic concentration of wealthDebt levelsSavings ratesReal estate ownership/valuesPovertyGeographic concentration of povertyDeprivation associated with poverty-level incomeEconomic DevelopmentProductivityIndustrial mixBusiness lending indicatorsInformal economyFinancial ServicesAvailability of creditAvailability of banking and check-cashing servicesCost of LivingLocal cost of living indexesSpending/consumption patternsIncome to spending ratiosRedistributionTaxesTransfersFiscal CapacityProperty valuesSales levelsIncome capacityExploitationRatio of wages to corporate profitsCommuter taxesCommuting patternsEMPLOYMENT DIMENSIONEmployment/Unemployment RatesJob securityLabor market turnoverWorkforce CharacteristicsRacial/ethnic diversitySkill levelUnionizationMigrant workersArea Business CapacityTax breaks offeredNumber and size of businessesBusiness space available

Job AccessGeography of job growthDiscrimination/affirmative action policiesDistance travelled to workTransportation systemTraining/retraining Occupational SafetyLaws, regulations, and company-specific policiesEnforcement/number of violationsJob QualityCompensationRatio of CEO to worker earningsFamily-friendly policiesDemand/control characteristicsJob CharacteristicsUnionized employers/size and power of unionsSkills needed by employersFull vs. part-time employmentEDUCATION DIMENSIONEducational AttainmentGraduation ratesDropout ratesLiteracy ratesTest scoresRates of progression to post-secondary educationFundingTeacher salariesFacilitiesTeacher training/supportFiscal capacity of school districtProportion of funds by sourceCorporate presence in schoolsPrivate SchoolsNumberEnrolmentSchool CharacteristicsSize of schools/classesStudent/teacher ratiosTeacher turnoverParental attitude/involvement in schoolsSchool segregation1.Race/ethnicity2.Economic statusCurriculum quality1.Physical education requirements2.Health education3.Nutrition education4.Sex education5.Language requirements6.Vocational education7.Enrichment programsPreschool/Kindergarten/Early InterventionSchool-based clinicsPhysical environment of school/safetyDisciplinary climate1.Violence prevention programs2.Police involvementSchool-based nutrition programsCommunity ClimateTelevision viewingRadio stationsReading/reading to childrenLibrariesCorporate-sponsored educational programsPOLITICAL DIMENSIONCivic ParticipationVoting1.Registration and voting rates2.Ease of registration3.Racial/ethnic representativeness of registered votersPolitical party membershipDonations to parties and candidatesPolitical StructureGender/racial/ethnic representation in elected officePercent of local budget for public health investmentsPower GroupsCommunity organizationsUnionsAdvocacy GroupsENVIRONMENTAL DIMENSIONAir QualityOutdoor (exhaust, ozone, pollutants, particulate)Indoor (tobacco, insect, mold, dust)Water Quality(PCBs, dioxin)Environmental HazardsHazardous wasteHeavy metalsPesticidesClimate extremesNoisePhysical SafetyTrafficStreet repairSidewalk availability/qualityStreet signs/lightsSafety structures (e.g. guard rails)Land UsePublic recreational space/number of parksWaste disposal/dumping/sanitation servicesCurbside recycling programsHOUSING DIMENSIONHousing StockAgeScarcityValueCharacteristicsGentrification/gatednessRental vs. owner occupiedSafety violationsResidential PatternsHomelessnessNumber of institutional facilitiesSegregation1. Racial/ethnic2. EconomicVacancy ratesCrowded housingPopulation densityAbandoned housingSocial isolationRegulationZoning policiesIndustrial/residential segregationHousing policies (e.g. Section 8)Financial IssuesHousing costsLow-income housing1. Percent of total housing2. Ratio of low-income units to low-income workers3. Elderly housingMortgage lending practices by race/ethnicityCommunity reinvestment initiativesMEDICAL DIMENSIONPrimary CareNumber of providersProvider training/competence/certificationRates of ambulatory care sensitive hospitalizationsMedicaid reimbursement levelsSpecialty CareNumber of providersProvider training/competence/certificationEmergency ServicesHome Health Care ServicesMental Health CareLong-Term CareOral Health CareAccess to/Utilization of CareInsurance coverageRace/ethnic staff to population ratiosProvision of indigent careCosts of careRates of ambulatory care sensitive hospitalizationsCultural competence among providers and institutionsAlternative Care

GOVERNMENTAL DIMENSIONFundingRevenue1. Intergovernmental2. Taxes3. LotteryDebtPolicy/LegislationObstacles to unionizationLiving wage/minimum wage ordinancesEmployer requirements to provide health benefitsServicesPrivatizationLocal safety net resourcesMunicipal Fragmentation (number of subunit governments within)PUBLIC HEALTH DIMENSIONProgramsScreeningNutritionFamily planningChronic disease controlHome visitingOutreachSchool-based clinics/educationSubstance abuse preventionDomestic violence preventionMental health servicesImmunizationRegulation/EnforcementSanitationHealth/food inspectionHealth violationsLegislative effortsFundingBudget allocationsPrivate sector provision of public health servicesPSYCHOSOCIAL DIMENSIONPoliticalContributions to parties, candidatesWomen in elected officeNumber of registered votersVoter registration proceduresVolunteer OrganizationsTypes/functionsNumber of membersUnion ParticipationCharitable GivingJailsExpendituresIncarceration ratesCrimeLawsuitsCivil lawsuitsSmall claims court casesLawsuits against businessesProtective ServicesGovernment servicesHousehold systemsBEHAVIORAL DIMENSIONTobacco UseSmoking ratesCessation programsSmoking preventionWorkplace/public space smoking restrictionsCost/accessibility of cigarettesAdvertisingPhysical ActivityPhysical activity levelsPhysical education requirements in schoolsPublic and private recreational facilitiesTelevision viewing patternsWorkplace exercise programs/facilitiesParticipation in local sports/recreational activitiesVideo game sales/useDiet/ObesityFresh fruit and vegetable consumptionHigh fat, high sugar food consumptionFood quality/availability/costNumber of fast food establishmentsSchool nutrition1. Regulation of subcontracting to vendors2. Nutrition education3. Breakfast/lunch programsAlcohol and Illicit Drug UseNumber of liquor storesDrug and alcohol treatment servicesSyringe laws/exchange programsLiquor marketing lawsAdvertisingViolenceGuns1. Availability2. Gun Shows3. LicensingExposure to violencePolice protectionGang activityTRANSPORT DIMENSIONSafetySeat belts/child restraintsHelmetsAge curfews/graduated driver's license programDriving while intoxicated laws/enforcementSpeed restriction/enforcementInfrastructureRoads1. Quantity2. Quality3. Speed bumps4. Buffers from pedestriansSidewalksBike lanes1. Quantity2. Mandating legislationTraffic PatternsSpatial location of jobsTraffic volumeCar poolingVehiclesNumber of heavy/diesel vehiclesCars per capitaTypes and ages of vehiclesPublic TransportationAvailability/density/efficiencyTypes of public transportation availableCohesiveness/integrationReliability/qualityGeographic equityEnvironmental soundnessTransportation for special needs groupsEmployer promotion of public transportationEconomic IssuesExpendituresSpending on local roads vs. alternative transportationPercent of transit revenue from faresInsurance rates