COMMUNITY AND

PUBLIC HEALTH
VISION
• USL is a global learning community recognized for science and
technology across all disciplines, strong research, and responsive
community engagement grounded on the CICM mission and identity
for a distinctive student experience.
MISSION
• USL sustains a Catholic academic community that nurtures persons
for community, church and society anchored on CICM’s Missio et
Excellentia.
EDUCATIONAL PHILOSOPHY AND
CORE VALUES
A. Christian Living. We are witnesses to the Gospel values as taught and lived by Christ thus
making God’s love known and experienced by all.
B. Excellence. We seek and maintain uncompromising standard of quality in teaching, learning,
service, and stewardship of school resources.
C. Professional Responsibility. We are committed to efficiently and responsibly apply the
learned principles, values and skills in the chosen field of discipline, taking initiative and
command responsibility in one’s professional advancement.
D. Social Awareness and Involvement. We engage ourselves with society by listening to the
prevailing issues and concerns in the society, thereby initiating and participating in
constructive and relevant social activities for the promotion of justice, peace and integrity of
creation and for people’s wellness and development consistent with the CICM charism.
E. Innovation, Creativity and Agility. We keep ourselves relevant and responsive to the changing
needs of our stakeholders by being flexible, solution oriented, and having cutting-edge
decisions and practices.
CLASSROOM DO’S AND DONT’S
1. BE RESPECTFUL
2. BE ATTENTIVE
3. UNIVERSAL PRECAUTION = APPLIED TO SUBJECTS
4. ATTENDANCE IS A MUST!!!
OBJECTIVES
• DEFINE TERMS RELATED TO PUBLIC HEALTH
• INTRODUCTION TO COMMUNITY AND PUBLIC HEALTH, ITS SCOPE
AND SERVICES, ITS IMPROVEMENT AND DEVELOPMENT AS A
DISCIPLINE IN THE PHILIPPINES.
• STUDENTS SHOULD BE ABLE TO EXPLAIN THE MEANING AND
SIGIFICANCE OF PUBLIC HEALTH
• TRACE THE HISTORY OF PUBLIC HEALTH IN THE COUNTRY
DEFINITION OF TERMS
• Assessment- collecting, analyzing, and using data to educate and
improve public health.
• Behavioral risk factors- risk factors in this category include behaviors
that are believed to cause, or to be contributing factors to most
accidents, injuries, disease, and death during youth and adolescence
as well as significant morbidity and mortality in later life.
• CDC- The Centers for Disease Control and Prevention (CDC) is part of
the Department of Health and Human Services. It provides federal
leadership and funding in the prevention andcontrol of diseases.
• Chronic disease- A disease that has one or more of the following
characteristics: it is permanent, leaves residual disability
• Demographic characteristics- measures of total population as well as percent
of total population by age group, gender, race and ethnicity, where these
populations and sub-populations are located, and the rate of change in
population density over time, due to births, deaths and migration patterns.
• Disease- A state of dysfunction of organs or organ systems that can result in
diminished quality of life
• Endemic- Prevalent in or peculiar to a particular locality or people
• Environmental Factor - an extrinsic factor (e.g., geology, climate, insects,
sanitation,health services, etc.) that affects the agent and the opportunity
for exposure.
• Epidemic- A group of cases of a specific disease or illness clearly in excess of
what one would normally expect in a particular geographic area.
• Epidemiology- the study of the distribution and determinants of health-
related states or events in specified populations, and the application of this
study to the control of health problems.
• Health indicator- A health indicator is a measure that reflects, or indicates,
the state of health in a defined population, such as the infant mortality rate.
• Indicator- In public health terms, an indicator variable helps to measure
changes directly or indirectly.
• Infant Mortality Rate- A death rate calculated by dividing the number of
infant deaths during a calendar year by the number of live births reported
in the same year. It is expressed as the number of infant deaths per 1,000
live births.
• Infectious- Capable of causing infection or disease by entrance of organisms
(e.g., bacteria, viruses, protozoan, fungi) into the body, which then grow
and multiply. Often used synonymously with “communicable”.
• Morbidity- Illness or lack of health caused by disease, disability, or injury
• Mortality- A measure of the incidence of deaths in a population.
• Outbreak- the occurrence of more cases of disease than would normally be
expected in a specific place or group of people over a given period of time
• Prevalence- the proportion of people in a population who have some
attribute or condition at a given point in time or during a specified time
period.
• Vulnerable populations- A group of people with certain characteristics that
cause them to be at greater risk of having poor health outcomes. These
characteristics include, but are not limited to, age, culture, disability,
education, ethnicity, health insurance, housing status, income, mental
health, and race.
• Vectors- it refers to animals or other living organisms that carry or transmit
diseases (e.g., rats, mosquitoes, foxes).
INTRODUCTION TO CPH
• collective well-being of community members
• “mainting wellness vs. treating illness”
• WHAT IS A COMMUNITY
1. BIOLOGY- an interaction of group of various species in a common location
2. SOCIOLOGY- A group of people with a high degre of interaction that shares a common
purpose, belief or set of behaviours
• WHAT IS PUBLIC HEALTH?
I. ECOLOGICAL IN PERSPECTIVE, MULTISECTORAL IN SCOPE, AND COLLABORATIVE IN
STRATEGY
II. IMPROVE HEALTH STANDARD OF THE COMMUNITY IN AN ORGANIZED COMMUNITY
EFFORT
INTRODUCTION TO COMMUNITY AND
PUBLIC HEALTH
WHAT IS HEALTH?
ACCORDING TO WORLD HEALTH ORGANIZATION(1978)
-A state of complete physical, mental, and social-wellbeing, and n not
merely the absence of illness/disease or infirmity
*health is a social phenomenom
*outcome of multi-casual theories of health and dse
*outcome or by-product of the interplay of societal factors (ecological,
economical)
DISEASE?
-generally the harmful deviation from the normal structural or
functional state of an organism, usualy associated with signs and
sympoms (WHO)
-the scientific paradigm of modern medicine, are abnormalities
in the function and/or structure of body organs and systems

ILLNESS?
-manifestations of imapairement, defefecs/pathology, or
disability
- concept realted to personal experience of disease
INTRODUCTION TO COMMUNITY AND
PUBLIC HEALTH
• WHAT IS A COMMUNITY AND PUBLIC HEALTH?
- according to AdventHealth University:
Public health focuses on the scientific process of preventing
infectious diseases, while community health focuses more on the
overall contributors to a population's physical and mental health.
• EPIDEMIOLOGY
1. Branch of medicine that deals with the incidence,
distribution,and possible control of dse and other factors
relating to health
INTRODUCTION TO COMMUNITY AND
PUBLIC HEALTH
• DEMOGRAPHY
1. DEMOS (PEOPLE, SOCIETY) AND GRAPHIA (WRITING)
2. Study of demographics, the social characterictics and statistics
of a human population.
3. Study that correlates the population size and composition
(age, race) to how they change through the interplay of
fertility(births), mortality(deaths), and migration.
The Community, Its Organization, and its
HealthThe Community, Its Organization, and
its Health
• What is a community - a group of people with common
characteristics, interest that live together in a territort or a
geographical (physical) bundaries

• world views on community:

1. Family, society, comunity
2. Contradictions/conflicts
3. Change
FAMILY, SOCIETY, AND COMMUNITY
AS CLIENT
1. INDIVIDUAL
i. Patient: an individual who is sick
ii. client: individual who is well/ not sick
2. FAMILY
i. Role/Relationship: Parents: bi-parenting (the foundation of civilization and its values)
- a mother is expected to have the ability to provide and care and takes the role of
keeping the family healthy “ilaw ng tahanan’
-father “haligi ng tahanana”
* ANYTHING THAT AFFECTS THE INDIVIDUAL, AFFECTS THE FAMILY, AFFECTS THE
COMMUNITY
The Community, Its Organization, and its
Health
• CONFLICTS/CONTRADICTIONS
- people in a community are always in a constant conflict
1. INDIVIDUAL: intrapersonal conflict
2. FAMILY: Interfamilial conflicts (conflicts within the family/interpersonal)
3. COMMUNITY: intercommunity (interfmilial)
4. SOCIETY: Intra-societal intra-societal conflicts (interccommunity conlicts)
NICE TO KNOW
• PEOPLE TEND TO HAVE A NEGATIVE PERSPECTIVE TO ONE ANOTHER
• In the PH, we have this negative regional stereotyping:
1. ilocanos- Kuripot (positive: resourceful)
2. kapampangans- Mayabang (assertive/artistic)
3. bicolanos- Malibog (loving)
4. visayans- aswang (mysterious)
5. mindanaoans- mamamtay tao (brave/courageous)

* AVOID NEGATIVE STEREOTYPING AND LOOK FOR THE SURCCE OF

CONFLICT AND TRY TO FIND A SOLUTION
CHANGE
• INEVITABLE IN A COMMUNITY (bc community is dynamic)

* the role of the commnity health care or publi health care is to

constantly assess the community to come up with approciate
interventions
WHAT IS COMMUNITY HEALTH?
• A part of paramedical and medical intevention or approach which is
concerned with the health of the whole populaion
• a discipline that concerns with the study and betterment of the health
characteristics of biologic communities.
• it aims to:
1. Health promotion
2. dse prevention
3. management of factors affecting health
COMMUNITY HEALTH
• PANDEMIC
-Widespread , epidemic over a wide geographic area and affecting a large
portion of the population

• EPIDEMIC
-spreading rapidly and extensively by infection and affecting many individuals in
an area or a population at the same time.
- an outbreak of a contagious dse that spreads rapidly and widely
PUBLIC HEALTH (DEFINITIONS)
• MAJOR CONCEPTS:
1. HEALTH PROMOTION AND DISEASE PREVENTION
2. People’s participation towards self-reliance; active and full
engagement with the people in the decision making process.
- assessment , planning, implementation, monitoring, and evaluation

* 3PS IN PUBLIC HEALTH (PROMOTION, PREVENTION, PROTECTION)

• Dr C E Winslow:
-the science and art of preventing diseases, prolonging life, promoting health
and efficiency through organized community effort

• HANLOM:
-it is dedicated to the common attainment of the highest level of physical,
mental, and social-wellbeing and longevity consistent with the available
knowledge and resources at a given time and place. it holds this goal as its
contribution to the most effective total development and life on the individual
and this society. (Holistic)
• PURDOM
- It prioritizes the survival of human species, the prevention of conditions which
lead to the destruction or retardation of human function and potential in early
years of life, the achievemet of human potenrial and prevention of the loss of
productivity of young adults and those in the middle period of life and the
improvement of the quality of life especially in later years.

• NIGHTINGALE
- The act of utilizing the environment of the patients to assist them in their
recovery. Any individual is capable of reparative process.
MODELS OF COMMUNITY HEALTH
• Health-Illness Continuum Models:
A. Dunn’s High-Level Wellness Grid
-describes a health grid in which a health axis and an environmental axis
intesect. The grid demonstrates the intersection of the environment with the
illness-wellness continuum.
-the axis extends from the peak wellness to death, and the environmental axis
extends from very favorable to very unfavorable. The intersection of the two
axes forms four quadrants of health and wellness.
1. High-level wellness in a favorable environment
- example is a person who implements healthy lifestyle behaviours and has the
biopsychosocial , spiritual, and economic resources to support this lifestyle.

2. Emergent high-level wellness is an unfavorable environment

- example is a woman who has the knowledge to implement healthy lfestyle
practices but does not implement adequate self-care practices bc of family
responsibilities, job demands, and other factors.
3. Protected poor health in a favorable environment
- example is a sick person whose needs are met by the health
care system and who has access to appropriate medications, diet and
health care instructions.

4. Poor health in an unfavorable environment

-example is a young child who is starving in a drought stricken
country.
* Requires the individual to maintain a continuum of balance and
purposeful direction with the environment

* involves progress towards a higher level of functioning, an open-

minded and even expanding challege to live at the fullest potential.
B. Travis’ Illness-Wellness Continuum
-ranges from high-level wellness to premature death. it
demonstrates two arrows pointing in opposite directions and joined at
a neutral point. Movement to the right of the netral point indicates
increasing levels of health and well-being for an individual that is
achieved in three steps:
i. Awareness
ii. Education
iii. Growth
* in contarst, movement to the left of the neutral point indicates
progressively decreasing levels of health and premature death.
• Degree of client wellness that exist at any point in time ranging from
optimal wellness condition, with the availability of energy at its
maximum, to death which represents total energy depletion

• a dynamic state that continously alters as a person adapts to changes

in the internal and external environments to maintain a state of
physical, mental/intellectual, social,developmental and spiritual well-
being (Holistic)
Variables affecting health status, beliefs, and
practices
1. Internal variables- include those which are usually non-modifiable
such as:
i. Biologic dimensions: genetic make up, sex, age, and
developmental level all sinifican to person’s health.
ii. Psychological dimensions: emotional factors that include mind-
body interactions and self-concept.
iii. Cognitive dimension: intellectual factors that include lifestyle
choices and spiritual and religious beliefs.
2. EXTERNAL VARIABLES- The macrosystems which includes:
i. Environment: geographical locations determine climate
(climate affects health); environmental hazards
ii. Economics: standards of living reflecting occupation, income
and education related to health, morbidity, mortality.
iii. family and cultural beliefs: the family passes on the life
patterns of daily living and lifestyles to offsprings (ex. physical and
emotioncal abuse). Cultural and special interactions also infleunce how
a person perceives, experiences, and copes w health and illness.
iv. Social suppor networks: Political/systems of social governance:
religion/church; mass media.
• in september 9, 1978 - UNICEF and WHO held the First International
Conference on Primary Health Care in Alma Ata, USSR

• PHC Goal: HEALTH FOR ALL by 2000 (bc of the high-level wellness
model in 1978)
• in 1994, modified goal to HEALTH FOR ALL by 2000 and Beyond
because the original goal cannot be acheived.
• LOI 949 was signed by PFM on Oct 19, 1979 making the Primary
Health Care the focus of the Department of Health.
• VISION: Health For All Filipinos was set by DOH Sec. Juan Favier

• Goal: Health for All Filipinos and Health in the Hands of the people by
the year 2020 (the 2nd phrase was suggested by the NGO: Bukluran
Para sa Kalusugan)

• Mission:
In partnership with the people, provide equity, access and quality health care
esp to the marginalized which brought about the Sentrong Sigla movement in
order to acheive it.
• RA 7160
The local government Code of 1991 which resulted in devolution, which
transferred the power and authority from the national to the local government
unit, aimed to build their capabilities for self-governing and develop them fully
as self-reliant communities
• C. Agen-Host-Environment Model:
- also called the ecologic model by Leavell and Clark refers to the interplay of
agent (causative/etiologic factor), host (intrinsic factor), and the environment
(extrinsic factors)

1. Etiologic factors
-Biologic agents: Virus, fungi, bacteria, helminthes, protozoa, ectoparasites
-Chemical elements: carcinogens, poisons, allergens, transfats
-Nutritive elements: excess or deficiencies (marasmus and kwashiorkor)
-Mechanical factors
- Physical: individual struck by lightning
-Psychological: stress
2. Host
-intrinsic factors (Exposure and response/reaction)
3. Environment
-Extrinsic factors
i. Natural boundaries
ii. Biological environment
iii. Socio-economic (political boundary)
D. HEALTH BELIEF MODEL
-Refers to the relationship between a persons belief and his
behaviour towards health. It pertains to three components of an
individual’s perception:
1. Susceptibility to Illness
2. Seriousness of an Illness
3. Benefits of taking the action
E. Evolutinary-based Model
- states that illness and death sometimes an evolutionary function.
Elements considered in the theory are:
i. Life events: developmental variables and variables associated w
changes such as accidents/relocation
ii. Lifestyle determinants
iii. Evolutionary vaibility with the social context: extent to which an
individual functions to promote survival and well-being
iv. Control perceptions: the extent to wc the person can influence
circumstances in life
v. Viability of emotions: affective reactions
vi. Health outcomes: physiological, behavioural and psychological
status
• F. HEALTH PROMOTION MODELS
- DIRECTED AT INCREASING CLIENT’S WELL-BEING
-Goal : Enhance level of wellness
The Health Field Concept

• MARC LALONDE- The New Perspective document (concept of health

and promotion)

• DETERMINANTS OF HEALTH:
1. HUMAN BIOLOGY
2. LIFESTYLE
3. ENVIRONMENT
4. HEALTH CARE ORGANIZATION
HEALTH DETERMINANTS
1. HUMAN BIOLOGY - aspects of physical and mental health as a result
of oragni make-up
2. LIFESTYLE- persons decisions and risks over the individual has
control
3. ENVIRONMENT- Aspects of physical and social environment over
which individial has little or no control
4. HEALTH ORGANIZATIONS- institutional arrangements governig the
provision of health services; access and quality
ADVENT OF PUBLIC HEALTH IN THE
PHILIPPINES
• 1577- earliest concept of public health was introduced by Franciscas
Friars
• 1888- spaniards institutued the Superior Board of Health and Charity
• Americas helped to establish a more formal health system thru:
-Act 1507 of the Philippine Commission in 1901 setting up the Board of Health
of the Philippine Islands
-Act 307 through 309, which provided provincial and municipal boards for
health

*In 1941, the Philippines independently created its own health care
system, where the Department of Health was separated from the
Department of Health and Public Welfare.
• POST WORLD WAR II - the Philippine Independence
-Completion of a research on Dichlorodiphenyltrichloroethane
(DDT) saw dust as larvicide and DDT residual spraying of
houses in the control of malaria.
-Construction of the National Chest Center-for control case
registry for TB, mass immunization with BCG.
-Creation of central Health laboratory in the Philippines
-Manila was selected as Headquarters for the WHO Western
pacific Office.
• Executive Order 288 : Reorganization of DOH - Creation of several
offices
1. Dental health services
2. Malaria Education services
3. Disease Intelligence Center
4. Food and Drug Administration
5.National Schistosomiasis Control Commission
6.National Nutrition Program
• DECENTRALIZED - health systems
have been tailor-fitted for the
specific situation for each
country
*Provincial Government:
Provincial and District hosp
*Munical Government: RHUS
and BHS
*City Government: City hosp,
health centers, and Barangay health
stations (BHS)
*INITIATION OF PROGRAM WITH MULTILATERAL ASSISTANCE:
1. WHO and UNICEF assisted TB and BCG
programs
2. TB control program as basic service of RHU
3. TB sputum case finding by microscopy
4. Serum and vaccine production in Alabang
5. Expanded MCH and Mental Health Program
6. Training programs for Midwives
7. Strengthened graduate health programs at the
UP-CPH
• Development of family Planning Movement
• Launching of programs in cooperation with private sectors- top
provide services to periphery ( indigents, minority groups)
MARCOS ADMINISTRATION
• Prioritizes health maintenance
• 1975 to mid-1980s, four specialty hospitals:
1.The Philippine Heart Center was established (February 14, 1975)
-Dr. Avelino Aventura as director.
2. The Philippine Children's Medical Center was built (1979).
3. The National Kidney and Transplant Institute (1983).
4. The Lung Center of the Philippines
-Health Minister Dr. Enrique Garcia.
MARTIAL LAW ERA
• MARTIAL ERA - DOH was renamed as MINISTRY OF HEALTH (June 2, 1978):
-Dr. Clemente S. Gatmaitan as the first health minister
- Implementation of restructure Health care delivery system (primary,
secondary,
tertiary)
- Construction of tertiary hospitals (Philippine heart center, Lung center,
Kidney
center,Lunsod ng kabataan/ PCMC)
2. Adaptation of the Primary Health Care
- Promotive and preventive rather than curative care
- Philippines was the first country to implement PHC
3. Launching of Operation Timbang and Mothercraft
- Nationwide program providing supplementary food for infants and
preschool
children
4. Birth of integrated Provincial Health Office (IPHO)
5. Oral rehydration Therapy for the National Control of Diarrheal Diseases
6. Community-based health programs
7. Progress in Public Health research
- Nutrition council of the Philippines- to address problems on malnutrition
- RITM- for infectious and tropical diseases
- PCHRD- mandated to lead, direct and coordinate science and technology
activities in health and nutrition.
* EDSA REVOLUTION - MINISTRY OF HEALTH renamed to DOH
-April 13, 1987
-Dr. Alfredo R. A. Bengzon as secretary of health.
AQUINO’S ADMINISTRATION
AQUINO ADMINISTRATION-
-1987 constitution – more provision on health making comprehensive
health care available
• Active participation of private sector and NGO
• Major activities influencing public health during this period
1. Milk code- EO51- required the marketing of breast milk substitute
2. Universal child and mother immunization
3. International safe and motherhood initiative was launched to
reduced
maternal mortality rate.
-4. Act prohibiting discrimination against women (RA6725)
5. National Epidemic Surveillance System (NESS)- this was made to track
down the occurrence of 14 diseases with potential causing outbreaks.
6. National drug policy and Generic Act- ensure the availability of safe,
effective and affordable quality drugs (RA6675)
7. Local government code- from national government to governors and
mayors (RA7160)

8. Organ Donation Act of 1991 (RA7170)- Legalizing donation of all or

body parts after death for specified purpose.
• RAMOS ADMINISTRAION
“Health in the Hands of People” and “Lets DOH it”- by the Sec. Juan
Flavier
• Continue to adopt PHC as a strategy
• Memorable initiative during the leadership of Flavier:
1. National Immunization Day – BCG, DPT, OPV, MMR
2. Mother and Friendly Hospital Initiative
3. This strategy ensures the survival and health of children through breast
feeding
4. Promotion of Philippine Traditional medicine- DOH and DOST
5. Hospital as Center of Wellness- transformed 45 government hospitals
from disease places to centers of wellness
6. Yosi Kadiri- Anti smoking campaign
• 7. Araw ng Sangkap ponoy- aimed to prevent vitamin A, iron and
iodine
• deficiency
• 8. Voluntary Blood Donation Program
• 9. Kung Sila’y Mahal mo Magplano- Family planning program
• 10.Doctors to the Barrio
LAWS
1.RA 7394- Consumer Act of the Philippines- an act providing penalties for
manufacture, distribution and sales of adulterated foods, drugs and cosmetics
2. RA 7610- Special protection of Children against child abuse, exploitation and
discrimination
3. EO 39- which created the Philippines National AIDS Council as a national policy
and advisory body in the prevention and control of HIV-AIDS
4. RA 7432- Senior Citizen’s Act- which grant benefits and special privileges in order
to maximize the contributions of senior citizen to nation building
5. RA 7719- The National Blood Services Act of 1994 which was passed to promote
voluntary blood donation
6. RA 8172- An Act of Salt Iodization Nationwide (ASIN)- providing salt iodization
nationwide approved in 1996 and renamed FIDEL _fortified for Iodine Elimination)
REODICA’S SEVEN STRATEGY
PROGRAM
• Carmencita Noriega-Reodica as the first woman Secretary of Health in
March 1996.
1. Expanded Program on Immunization (Oplan Alis Disease)-
to eliminate polio, measles and neonatal tetanus
2. Nutrition- vitamin A, iron and iodine utilization ( araw ng
Sangkap pinoy)
3. Family Planning
4. Tuberculosis prevention (Target, Stop TB)
5. Environmental sanitation (TKO)
6. STD-AIDS awareness prevention
7. Healthy Lifestyle program
• 2008 - MAJOR changes took effect to the country’s PHCS
-The universal access to cheaper and quality medicines
-FOURmula One for Health – a strategic framework for
health reforms formulated by DOH using four pillars (Service
Delivery, Health Care Financing, Health Governance and Health
Regulation) in attaining the National Objectives for Health and the
Millennium Development Goals for Health
-PFEP (Ph Facility Enhancement Program)

* PHILIPPINE 1987 CONSTITUTION

-HEALTH IS BASIC HUMAN RIGHT
DOH SEVEN AREAS OF PRIORITY
-The Seven Healthy Habits is part of DOH's Health Promotion Framework
Strategy 2021 to 2030, which serves as a basis for population-wide solutions to
the seven priority areas of health:
(1) Move More Eat Right
(2) Get Vaccinated
(3) Care for Yourself, Care for Others
(4) Practice Safe Sex
(5) Be Clean, Live Sustainably(6) Don’t Smoke, Avoid Alcohol, Say No to Drugs;
(7) Do No Harm, Put Safety First.