COMMUNITY AND

PUBLIC HEALTH
FOR MEDICAL LABORATORY
SCIENCE

Mr. Raymund J. Capagas, RMT

 COURSE OUTLINE

LECTURE
WEEK TOPICS / CONCEPTS

WEEK 1 Introduction and Concepts of Community and Public Health

WEEK 2 Communicable and Noncommunicable Diseases
WEEK 3 Medical and Public Health Microbiology
WEEK 4 Medical and Public Health Parasitology
WEEK 5 Community Organizing/Building and Health Promotion Programming
WEEK 6 Public Health Nutrition
WEEK 7 MIDTERM EXAMINATION
WEEK 8 Environmental and Occupational Health
WEEK 9 Alcohol, Tobacco, and other Drugs: A community concern
WEEK 10 Introduction to Biostatistics
WEEK 11 Introduction to Epidemiology I
WEEK 12 Introduction to Epidemiology II
WEEK 13 FINAL EXAMINATION
 Introduction and
Concepts of
Community and Public
Health
Objectives:
1. Define the terms Health, community, community health,
population health, public health, public health system,
and global health.
2. List and discuss the factors that influence a community’s
health.
3. Identify the different determinants of health.
4. Understand the beginnings of public health in the
Philippines.
References:
An Introduction to Community & Public Health 9th Edition (2018),
McKenzie

Plenary Paper: A Century of Public Health in the Philippines, Tiglao

Health
■ The word health is derived from “hal’ which means ”hale, sound,
whole”

WHO (1946)
- states that “health is a state of complete physical, mental, and social
well-being and not merely the absence of disease and infirmity”.
- Health is a resource for everyday life, not the object of living , and is a
positive concept emphasizing social and personal resources as well as
physical capabilities.
Health
McKenzie (2018)
- a dynamic state or condition of the human organism that
is multidimensional in nature, a resource for living, and
results from a person’s interactions with and adaptations
to his or her environment; therefore, it can exist in varying
degrees and is specific to each individual and his or her
situation.
- “A person can have a disease or injury and still be healthy or at
least feel well ”.
Health Status Genetic Makeup

Education
Employment
Availability Income
Affordability Poverty
Accessibility Housing
Crime
Social cohesion

Su Phys D
bs ica iet n ts s
ta e
ag gent s
nc l ac i c a d
ab e u tivit Tox bial azar
u s se y cro lh
e an
d Mi ctura
u
Str
Community
- a collective body of individuals identified by common characteristics such as
geography, interests, experiences, concerns, or values.

Characterized by the following elements:

1. Membership - a sense of identity and belonging.
2. Common symbol systems—similar language, rituals, and ceremonies
3. Shared values and norms
4. Mutual influence—community members have influence and are influenced by each
other
5. Shared needs and commitment to meeting them
6. Shared emotional connection—members share common history, experiences, and
mutual support.
Community
Determination of a healthy community

a. Leadership - assess the needs and resources.

b. Public health support - public health and social

infrastructure and policies that supports health.

c. Health Service Delivery - equitable, affordable,

and available quality health care services.
Public Health Institute of Medicine (IOM),
"Public Health is ecological in 1988
perspective, multisectoral in scope
and collaborative in strategy. It aims
to improve the health of - what we as a society do
communities through an organized
community effort. collectively to assure the
Public health infrastructures need to
conditions in which people
reflect that it is an interdisciplinary can be healthy.
pursuit with a commitment to equity,
public participation, sustainable
development and freedom from war.
As such it is part of a global
commitment and strategy".
- Ilona Kickbush
Public Health System

- activities undertaken within the

formal structure of government and
the associated efforts of private and
voluntary organizations and
individuals.
Public Health System
Public Health System
Community Health Population Health

- the health status of a - the health outcomes of a

defined group of people and group of individuals, including
the actions and conditions to
promote, protect, and the distribution of such
preserve their health. outcomes within the group.
Global Health
- describes health problems, issues, and concerns that
transcend national boundaries, may be influenced by
circumstances or experiences in other countries, and are
best addressed by cooperative actions and solutions.
Personal Health VS. Community and Public
Health activities
Personal Health Activities Community and Public Health
- individual actions and decision-making Activities
that affect the health of an individual or
his or her immediate family members or - activities that are aimed at protecting or
friends.
improving the health of a population or
- Seldom directly affect the health of community.
others.
- Directly affect the health of the population.
- Individual/personal approach.
- Population approach.
Factors that affects the health of a community
Factors that affects the health of a community
Geography

Directly influenced by its altitude,

latitude, and climate.

Industrial
Development
Environment
Increased resources.
Directly related to the
Increased health quality of environment.
risks.

Community Size

The size of community is directly

related to the size of health
problems and resources.
Factors that affects the health of a community
Beliefs, Tradition, and Prejudices

Influence health-related policy

development and implementation.

Social Norms and Socio- Economy and Politics

economic status
Directly proportional to
Social practices. health and social services.

Strong correlation between Participation and

SES and health status. involvement in health
With independent effects on service delivery.
on health.

Religion

Position on health care and health

behavior.
Factors that affects the health of a community

- The way in which a community is - The behavior of the individual community

able to organize its resources directly members contributes to the health of the entire
influences its ability to intervene and community.
solve problems, including health
problems. - It takes the concerted effort of many—if not
most—of the individuals in a community to make
Community organizing the process by a program work .
which community groups are helped
to identify common problems or Herd immunity the resistance of a population to
change targets, mobilize resources, the spread of an infectious agent based on the
and develop and implement immunity of a high proportion of individuals.
strategies for reaching their collective
goals.
SOCIAL DETERMINANTS OF HEALTH
Healthy People 2020
- the social determinants of health “are the conditions
in the social, physical, and economic environment in
which people are born, live, work, and age. They
consist of policies, programs, and institutions, and
other aspects of the social structure (including the
government and private sectors), as well as
community factors.”
SOCIAL DETERMINANTS OF HEALTH
- Are the conditions in the environment that affects a
wide range of health, functioning, and quality of life
outcomes and risks.
- Conditions, patterns of social engagement, sense of
security and well-being affect the “place” where
people live.
SOCIAL DETERMINANTS OF HEALTH
- Resources
- e.g., safe and affordable housing, access to
education, public safety, availability of food, and local
health services.
- Can enhance the quality of life of the “place” will
significantly influence the population health outcomes.
SOCIAL DETERMINANTS OF HEALTH
- Understanding the relationship between how the
population experience the place and the impact of the
place on health is basic to social and physical
determinants of health.
EXAMPLES OF SOCIAL DETERMINANTS OF
HEALTH
INCOME AND SOCIAL UNEMPLOYMENT AND
EDUCATION
PROTECTION JOB INSECURITY

HOUSING, BASIC
WORKING LIFE FOOD INSECURITY AMENITIES AND THE
CONDITIONS
ENVIRONMENT

SOCIAL INCLUSION
EARLY CHILDHOOD STRUCTURAL
AND NON-
DEVELOPMENT CONFLICT
DISCRIMINATION

ACCESS TO AFFORDABLE AND QUALITY

HEALTH SERVICES
 Economic Stability

Education
SIX (6) KEY
AREAS OF Social and community context
SOCIAL
Health and Health care
DETERMINANTS
Neighborhood and built environment

Food
SOCIAL DETERMINANTS OF HEALTH
HISTORY OF PUBLIC
HEALTH IN THE
PHILIPPINES
PRE-AMERICAN OCCUPATION
üPublic health work during the Spanish regime began
at the portera of the old Franciscan convent in
Intramuros where indigents in Manila was treated.
üEventually became the “San Juan De Dios Hospital”
PRE-AMERICAN OCCUPATION
FIVE GENERAL HOSPITALS FOUR CONTAGIOUS HOSPITALS
Ø San Juan De Dios Ø San Lazaro Hospital (1577)
Hospital (1659) Ø Hospital de Palestina in
Ø Chinese General Hospital Camarines Sur
(1891) Ø Hospital de Leprosos in
Ø Hospicio de San Jose in Cebu
Cavite (1611) Ø Hospital de Argentina in
Ø Casa de Caridad in Cebu Manila for smallpox and
Ø Infirmaries de Sta. Cruz in cholera
Laguna (1870)
PRE-AMERICAN OCCUPATION
TWO MILITARY HOSPITALS OTHER HOSPITALS/ASYLUM

Ø Hospital Militar de Manila Ø Hospicio de San Pascual

Ø Hospital Militar de Baylon in Manila
Ø Asylum of St. Vincent de
Zamboanga Paul in Manila for poor
girls (1885)
TWO NAVAL HOSPITALS Ø Founding Hospital of San
Jose for orphaned
Ø Hospital dela Marie in children and mentally ill
Canacao Cavite (1782)
Ø Hospital de Basilan in
Basilan
PRE-AMERICAN OCCUPATION
An era for the construction of:
ØFirst medical school – UST (1872)
ØSchool of midwifery in 1879
ØPublic health laboratory in 1883
ØForensic medicine in 1892
AMERICAN MILITARY GOVERNMENT (1895-1907)

Ø During the early occupation of the Americans witnessed

the control of epidemics:
- Cholera, smallpox, plagues
Ø Fight communicable diseases such as:
- Leprosy, diarrhea, malaria, beri-beri (vit. B1 deficiency)
Ø Establishments of health organizations and administration
and general sanitation.
AMERICAN MILITARY GOVERNMENT (1895-1907)
Ø establishment of garbage crematory (1899)
Ø First sanitary ordinance and rat control (1901)
Ø Established that contaminated water and unclean vegetables are factors in the control of
amoebic dysentery
Ø Anopheles minimus as causative of malaria (1904)
Ø Cholera vaccine was tried as compulsory vaccination to school children
Ø Confirmation that plagues in man comes from infected rats.
Ø Opened the leper colony in Culion and compulsory detection of leprosy
Ø Founding of Manila Medical Society
Ø Founding of Philippine Island Medical Association
Ø Opened the UP College of Medicine (1907)
Ø Establishment of Bureau of Science in 1905
PHILIPPINE ASSEMBLY (1907 – 1916)
Ø Period of several first
- First institution of the search for germ carriers (1908)
- First time to use general chemical disinfection as emergency measures against cholera.
- Inclusion of Hygiene and Physiology in the curriculum of public elementary schools
(1909)
- Start of anti-tuberculosis campaign
- Dissemination of the results of first nutrition survey
- Organization of the Philippine Tuberculosis Society (1910)
- Opening of Pasteur Prophylaxis treatment against rabies
- Opening of the Philippine General Hospital (PGH)
- First eradication of Beri-beri among scout by change of diet.
PHILIPPINE ASSEMBLY (1907 – 1916)
- First use of dry vaccine against smallpox
- First offering of graduate courses in hygiene and tropical medicine at the UP
College of Medicine (1913)
- Manufacture and distribution of Tiki-Tiki for treatment of beri-beri
THE JONES LAW (1916 – 1936)
- Health administration is retrogression rather then progress.
- Increase Crude death rate and infant mortality rate.
- Increased death caused by smallpox, cholera, typhoid, malaria, beri-beri, and
tuberculosis.
- A Committee to study the prevalence of typhoid fever was launched
- Schick Test was first used to determine the susceptibility of Filipino children to
diphtheria
- Start of leadership of Dr. Jose Fabella, the first secretary of Health.
- Campaign against hookworm was launched
- Mechanism in the transmission of Aedes aegypti of Dengue Fever was studies
successfully.
- BS in Education major in health education was offered in U.P
THE COMMONWEALTH (1936 – 1942)
- Establishment of UP School of Public Health
- Death rate remained high
- Tuberculosis remained uncontrolled
- Malaria, beri-beri, and intestinal diseases remained undiminished
- Maternal and Child Health, School Health, Health education of the public, Public
Health Nursing, Public Health Dentistry, Hospital and Laboratory services were
all strengthened.
THE END
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