Concepts of the Community: • It is the patterned series of interrelationships

existing between individuals, groups, &

institutions & forming a coherent whole.
Community – is a group of people who: • Its components that affect health include the
family, economic, educational,
• Have common interests or characteristics communication, political, legal, religious,
• Interact with one another recreational, & health systems.
• Have sense of unity or belonging • Types of Organizations:
• Function collectively within a defined social a. Formal – ex: government agency, bank,
structure to address common concerns. school
b. Information – ex: neighborhood friends,
volunteers in a barangay clean-up drive.
A. Types of Communities
1. Phenomenological – functional E. Roles and Activities of CHN
2. Geopolitical – territorial 1. Advocate – seeks to promote an
understanding of health problems; looks for
B. Characteristics of a Healthy Family beneficial public policy & stimulates the
1. A shared sense of being a community based emergence of a supportive community action
on history & values. for health.
2. A general feeling of empowerment & control 2. Care Manager – clients need help in making
over matters that affect the community as a decisions about appropriate health care
whole. services. Achieving service delivery
3. The ability to cope with change, solve integration & coordination is a major task of
problems, & manage conflicts within the the CHN.
community through acceptable means. 3. Case Finder – the CHN looks for clients at
4. Open channels of communication & risk among the population served.
cooperation among the members of the 4. Counselor – clients in the community health
community. setting frequently face difficult & complex
5. Equitable & efficient use of community health concerns & desire supportive &
resources with the view towards sustaining problem-solving assistance. They deal with
natural resources. stress related to health concerns.
5. Clinic Nurse – clinic services are
C. Components/Features of a Community increasingly expanding to meet the needs of
1. People aggregates at risk.
2. Location 6. Epidemiologist – the CHN uses the
3. Social system epidemiological method to study disease &
health among various population groups & to
D. Factors Affecting Health of the Community deal with community- wide health problems.
1. Characteristics of the Population 7. Group Leader – the CHN works in groups in
a. Size & Density – negative effects of practice
overcrowding include: (1) easy spread of 8. Health Planner – the CHN provides health
communicable disease, (2) increased programs for the community.
stress among members of the 9. Home Visitor – the CHN enters the client’s
community, (3) rapid degradation of setting. He/She assesses the environment &
housing facilities, & water, air, & soil works within it. He/She also gathers
pollution. information about how a family system
- Sparsely populated areas have functions within its own setting. The CHN
limited resources resulting in difficulty also provides direct care services with
in providing health services. clients.
b. Differences in population composition by 10. Occupational Health Nurse – the CHN is
age, sex, occupation, level of education also concerned with risks & problems in the
& other variables. work environment of the people.
c. Rapid growth or decline – usually results 11. Researcher – the CHN assists health care
from migration of a large number of professionals in reaching their goals through
people into the community & from research.
disturbances brought about 12. School Nurse – the CHN works with
circumstances. students in school.
d. Cultural characteristics of the community. 13. Teacher – the CHN facilitates change in
e. Level of education & social class. behavior among clients which is a basic
2. Location of the Community intervention strategy in community health.
a. Natural variables – such as geographics
features, climate, flora, & fauna. CHN Activities:
b. Man-made variables such as community 1. Health education
boundaries, presence of open spaces, 2. Actively participate in the training component
quality of the soil, air & water, & the of the service like in Food Handler’s class &
location of health facilities is influenced attend training/workshops related to
by human decisions & behavior. environmental health.
3. Social Systems within the Community

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 3. Assist in the deworming activities for the disease, which illustrate the changing structure
school children & targeted groups. of human populations.
4. Effectively & efficient coordinate programs/
projects/ activities with other government &
Sources of Data
non-government agencies.
5. Act as an advocate or facilitator to families in • Primary – is the original data collected for a
the community in matters of program/ specific purpose. Collecting primary data is
projects/ activities on environment health in expensive and time-consuming, and it usually is
coordination with other members of Rural undertaken only when secondary data is not
Health Unit (RHU) especially the Rural available.
Sanitary Inspectors. • Secondary – includes census, hospital data,
6. Actively participate in environmental vital registration system, health insurance,
sanitation campaigns & projects in the disease notification, school health program,
community. disease registries, downloadable data sets,
7. Be a role model for others in the community surveillance system & surveys (morbidity,
to emulate in terms of cleanliness in the demographic & health)
home & surrounding.
8. Participate in the research/studies to be Population Size
conducted in their respective area of
• The number of individuals in a population.
assignment.
• The current population in the Philippines is
9. Help in interpretation & implementation of PD
about 110 million people. The annual
856 commonly known as Sanitation Code of
population growth rate has decreased
the Philippines.
significantly since 1960 where it was 3.3% to
10. Assist in the Disaster Management, which
now where it is about 1.3%.
will be implemented at all levels.
• The fertility rate in the Philippines has also
decreased significantly over the years. In
1969, the fertility rate was 6.4 children per
Health Statistics and Epidemiology
woman. Today, the fertility rate is 2.1 children
• Health Statistics – (WHO) include both per woman. Part of the reason for this is the
empirical data and estimates related to increased use of contraceptives and modern
health, such as mortality, morbidity, risk family planning methods.
factors, health service coverage, and health • With about 2 million people added to the
systems. population ever year, the population is
• Epidemiology – originated from the Greek expected to double in about 40 years.
words epi, meaning “upon”, demos, meaning
“people”, and logos, meaning “study”. It is the Disease Notification – an integral part of disease
study of the distribution & determinants of surveillance.
health-related states or events in specified
populations, & the application of this study to Disease Registry – is a compilation of information
the prevention & control of health problems. about a particular disease.

Terms Surveillance System – were developed for

monitoring high burden diseases, detecting disease
• Study – includes surveillance, observation, outbreaks that could escalate into epidemic
hypothesis testing, analytic research & proportions, & monitoring progress toward
experiments. attainment of targets for the control, elimination, or
• Distribution – refers to analysis by time, eradication of a specific diseases.
places, & classes of people affected.
• Determinants – include all the biological, a) Active Surveillance – is a system in which
chemical, physical, social, cultural, public health staff members actively &
economic, genetic, & behavioral factors that regularly contact health care providers or the
influence health. population to obtain information about the
• Health-related States or Events – refer to disease of interest.
disease, causes of death, behaviors such as b) Passive Surveillance – is a system by
the use of tobacco, positive health states, which public health staff receives reports
reactions to preventive regimens & provision from hospitals, clinics, public health units, or
& use of health services. other sources.
• Specified Populations – include those with c) Population Size – influences the number &
identifiable characteristics such as size of health care institutions. Knowing
occupational groups. community size provides important
• Application to Prevention & Control – the information for planning.
aim of public health – to promote, protect & d) Composition
restore good health. e) Distribution

Tools 2. Health Indicators – are quantitative measures,

1. Demography – the study of statistics such as usually expressed as rates, ratios, or
births, deaths, income, or the incidence of

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 proportions, that describe & summarize various f. General Fertility Rate (GFR) – this is more
aspects of the health status of the population. specific rate than the CBR since births are
related to the segment of the population deemed
• Rate – shows the relationship between a vital to be capable of giving birth, that is, the women
event & those persons exposed to the in the reproductive age groups.
occurrence of said event, within a given area No. of registered live births in a year
& during a specified unit of time. It is evident GFR =
Midyear population of women 15 − 44y. o
× 1000
that the person experiencing the event (the
numerator) must come from the total
population exposed to the risk of same event g. Maternal Mortality Rate (MMR) – defined as
(the denominator). “death of a female from any cause related to or
• Ratio – used to describe the relationship aggravated by pregnancy or its managing during
between two (2) numerical quantities or pregnancy & childbirth or within 42 days of
measures of events without taking particular termination of pregnancy, irrespective of the
considerations to the time or place. duration & the site of the pregnancy.” Number of
• Crude or General Rates – these rates deaths due to pregnancy, delivery, puerperium in
referred to the total living population. It must a calendar year.
be presumed that the total population was
No. of maternal death in a year
exposed to the risk of the occurrence of the MMR = × 1000
No. of live births in the same year
event.
• Specific Rate – the relationship for a specific h. Specific Rates of Mortality:
population class or group. It limits the
occurrence of the event to the portion of the i. Specific Death Rate (SDR) – describes
population. more accurately the risk of exposure of
certain classes or groups to particular
diseases.
a. Crude Birth Rate (CBR) – a measure of one No. of deaths from a specified class
SDR = × 100000
characteristic of the natural growth or increase of Midyear population in same specified class
a population.
No. of registered live birth in a year
CBR =
Midyear population
× 1000 ii. Age Specific Death Rate (ASDR)
No. of death in a specified age group
ASDR = × 100000
Midyear population of specified age group
b. Crude Death Rate (CDR) – a measure of one
mortality from all causes which may result in a
decrease of population. iii. Sex Specific Death Rate (SSDR)
Total No. of registered deaths in a year No. of death in a specified sex group
CDR = × 1000 SSDR = × 100000
Estimated population as of July 1 (same year) Midyear population of specific sex group

c. Infant Mortality Rate (IMR) – measures the risk i. Incidence Rate (IR) – measures the number of
of dying during the 1st year of life. It is a good new cases, episodes, or events occurring over a
index of the general health condition of a specified period of time, commonly a year, within
community since it reflects the changes in the a specified population at risk. The best measure
environment & medical condition of a community. to use for evaluating the effectiveness of heath
interventions.
Deaths under 1y. o of age registered in a year
IMR = × 1000
Number of live births in the same year No. of new cases of disease in a specified period
IR = × 100000
Population at risk

d. Neonatal Mortality Rate (NMR) – measures

pregnancy wastage. Death of the product of j. Prevalence Rate (PR) – measures the total
conception occurs prior to its complete number of existing cases of a disease at a
expulsion, irrespective of duration of pregnancy. particular point in time divided by the number of
people at that point of time.
No. of deaths under 28 days of age in a year
NMR = × 1000
No. of live births in the same year No. of existing cases of disease in a specified time
PR = × 100
No. of people examined in a specified time

e. Post-neonatal Mortality Rate (PMR) –

measures the risk of dying the 1st month of life. It k. Attack Rate (AR) – a more accurate measure of
serves as an index of the effects of prenatal care the risk of exposure
& obstetrical management of the newborn. No. of people acquiring a disease in a year
AR = × 100
1 year of age in a year No. of expose to same disease in same year
PMR = × 1000
No. of live births in the same year

• Leading causes of morbidity

• Life expectancy