the community in health and illness

The Community in Health and Illness

The community has a strong influence on the health promotion and illness prevention of its individuals and families. Just as the family has risk factor for the health of individual members, so does the community have risk factors involving resources, economics, and service. Nursing assessments and interventions would not be comprehensive and individualized if the community influence were not also considered.

Risk Factors
It is not within the scope of this book to discuss community health nursing as a whole. However, because the community provides the environment affecting health and illness, it is important to discuss environmental factors influencing the safety and security if the individuals within that community. The following are examples of community factors affecting health:
Number and availability if healthcare institutions and service
Housing codes and police and fire departments
Nutritional services for low-income infants, mothers, school lunch programs, and older people
Zoning regulations separating residential and industrial areas
]waste disposal service and locations
Air and water pollutions regulations
Food sanitation guidelines
Health education services and dissemination
Recreational opportunities
Prevalence of violent crimes or drug use
To illustrate how the community can affect individual and family needs, consider the following examples :
Maria age 20, lives in an inner city, two room apartment with her 6 month-old baby girl. The apartment lacks adequate heat and plumbing. Maria has no family living nearby, and her husband has left her. Maria rarely leaves her apartment because she fears the street gangs and drug addicts. She has never taken her baby to al local clinic for checkups because she does not want to ask her neighbor for direction.
Anne, age 22, lives in a small house in a rural area. She is married and has a 2 year old son. Her husband works at a local factory, and Anne works part time at a clothing store. Both Anne and her husband have family members who live nearby and they see them often. Anne, her husband and her son all have regular health assessments.
The two different examples are given to demonstrate than the community plays a major role in the health of the people who live within it. Maria and her infant are at much greater risk for illness than are Anne and family. Even if the two women had identical health needs, a plan of care would reflect different interventions because of their community environments.

Risk factors for alterations in family health based on family developmental level
Couple and childbearing couple
Inadequate knowledge about contraception and family planning
Inadequate knowledge about sexual and marital roles
Lack of knowledge about child health and safety
Unsafe home environment
Inadequate resources for child care if working
Child abuse or neglect
First pregnancy before age 16
Inadequate nutrient, obesity
Abuse of nicotine, drugs, alcohol
Low socioeconomic status
Sexuality transmitted diseases
Rubella

Family with adolescents
Racial and ethnic family of origin
Family values of aggressiveness, dependence on social welfare
Low socioeconomic status
Inadequate knowledge to teach problem-solving skills
Conflict between parents and children
Sexual abuse
Use of nicotine, drugs, and/ or alcohol
Sexually transmitted diseases

Family with middle adults
Diet high in fat, sugar, salt
Obesity
Use of nicotine and alcohol
Physical inactivity
Depression
Environmental exposure to sunlight, radiation, asbestos and pollution

Family with older aduls
Increasing age with loss of physicalo function
Depression
Chronic illness
Poor nutrition
Lack of exercise
Death of spouse
Limited income
Past lifestyle

by : mulyadi, fundamental of nursing