UNIT ONE CONCEPT OF HEALTH IN COMMUNITY HEALTH NURSING Learning Objectivities: On completion of this of this unit, students will be able to: • Discuss the basic concepts in community health nursing using various definitions • Describe the health – illness continuum • Explain the relation ship between community health perception of the community and related health problems • Analyze components of community health practices • Describe characteristics of community health practice 1.1 Introduction 1.2Broadly defined, a community is a collection of people who interact with one another and whose common interest or characteristics gives them a sense of unity and belonging. - A community is a group of people in defined geographical area with common goal and objective and the potential for interacting with one another (Dryer’s den). The function of any community includes its members’ sense of belonging and shared identity, values, norms, communication, and supporting behaviors. Some communities who may share almost everything, while other communities (large, scattered and composed of individuals) who may share only there common interests and involvement in certain goals. A community is often defined by its geographic boundaries and thus called a geographic community. Example, a city, town or neighborhood is a geographic community. A community demarcated by geographic boundaries becomes a clear target for analysis of health needs to form basis for planning health programs and a geographic community is also easily mobilized for action. Community can also be identified by a common interest or goal. A collection of people, although they are widely scattered geographically, can have an interest or goal that binds the members-together calledcommon interest community. (e.g., Disabled individual scattered through out a large city may emerge asa community through a common interest in their need for improved wheel chaired access or other handicapped facilities). The Three Features of a Community A community has three features, location, population and social system. Location: every physical community carries out its daily existence in a specific geographical location. The health of the community is affected by this location, including the placement of the service, the geographical features…Population: consists of specialized aggregates, but all of the diversed people who live with in the boundary of the community. Social system: the various parts of communities’ social system that interact and include the heath system, family system, economic system and educational system. 1.3 Health 1.4Health is defined as a state of physical, mental and social well being not merely the absence of disease or infirmity (WHO, 1948). Health, in its holistic philosophy differs greatly from that of the acute care settings. Physical health implies a mechanistic functioning of the body. Mental health means the ability to think clearly and coherently and has to do with your thinking and feeling and how you deal with your problem. A mentally healthy person has a capacity to live with other people, to understand their needs, and to achieve mutually satisfying relationships. Social health refers to the ability to: • Make and maintain relationship with others: • Interact well with people and the environment. Health designates the ability to adopt to changing environments to growing up and to aging, to healing when damaged, to suffering and to peaceful expectation of death (lllich 1975). The ability of a system (e.g. Cell, organism, family, society) to respond adaptively to a wide variety of environmental challenges (Brody and Sobel, 1981). Lamberton (1978) sees the opposite of health as being no health and the opposite of illness as being no disease. Furthermore, death is not viewed as the ultimate illness but as a natural part of growth and development. She also considers an individual’s interaction with ecology as being an important influenceon health and on illness. Health is also conceptualized as a source for every day living. It is a positive ideathat emphasizes social and personal resources and physical in abilities.1.3. Health and Wellness Health Each person has a personal perception of health. Some people describe their state of health as good even though they may actually have one or more diagnosed illness (es). That is because each person perceives health in relation to personal expectations and values The concept of health must allow for his individual variability. Health is a dynamic state in which the person is constantly adapting to changes in the internal and external environments. For example, a person may see himself/herself as healthy while experiencing a respiratory infection. Wellness Wellness is a life – style aimed at achieving physical, emotional, intellectual, spiritual and environmental well being. The use of wellness measures can increase stamina, energy and self – esteem, then enhance quality of life.The concept of wellness also allows for individual variability. Wellness can be thought of a balance of thephysical, emotional, psychological, social and spiritual aspects of a person’s life. This is a dynamic state. Each person would define wellness in relation to personal expectations. Wellness behaviors are those that promote healthy functioning and help prevent illness. These include, for example, stress management, nutritional awareness, and physical fitness. Models of Health There are various models of the concept of health. Some models are based narrowly on the presence or absence of definable illness. Others are based more conceptually on health beliefs, wellness and holism. A. Clinical Model (Dunn, 1961) In this model, health is interpreted as the absence of signs and symptoms of disease or injury; thus the opposite of health is disease. Dunn defined, in this model, “health as a relatively passive state of freedom from illness, and a condition of relative homeostasis.” Illness is therefore, something that happens to a person. Many health care providers focus on the belief of signs and symptoms of disease and conclude that when these are no longer present, the person is healthy. N.B. This model may not take into consideration person’s health beliefs or person life- styles.B. Host –Agent – Environment Model (Leavell, 1965) This model helps to identify the cause of an illness. In this model: Host: Refers to the person (or