Concept of Healthy Community

DEFINITION:

A social group determined by geographic boundaries and/or common values and interests. Its members know and interact with each other. It function within a particular social structure and exhibits and creates norms, values and social institutions.

 CHARACTERISTICS

Environment physical, socio-cultural, educational and employment milieu 2. Population behavior or lifestyle self-responsibility, self-care competency 3. Human biology genetic characteristics of population 4. Systems of health care prevention, promotion, cure and rehabilitation
1.

 CLASSIFICATION

Urban high density, a socially heterogenous population and a complex structure, non-agricultural occupations; something different from an area characterized by complex interpersonal social relations 2. Rural usually small and the occupation of the people is usually farming, fishing and food gathering. It is peopled by simple folk characterized by primary group relations, well-knit and having a high degree of group feeling 3. Rurban
1.

1.

2.
3. 4. 5. 6.

Prompts its member to have high degree of awareness that we are community. Uses its natural resources while taking steps to conserve them for future generations. Openly recognizes the existence of sub-groups and welcomes their participation in community affairs. Prepared to meet crisis. Is a problem solving community, it identifies, analyzes and organize to meet its own needs. Has open channels communication that allows information to flow among all subgroups of its citizens and in all direction.

Seeks to make each of its systems resources available to all members of the community. 8. Has legitimate and effective ways to settle disputes and meet needs that arises within the community. 9. Encourage maximum citizen participation in decision making. 10. Promotes a high level wellness among its members.
7.

The CORE represents the people that make up the community, included in the community CORE are the demographics of the population as well as the values, beliefs and history of the people 2. EIGHT (8) subsystems of the community a. Housing - what type of housing facilities are there in the community; are there enough housing facilities available; are there housing laws/regulations governing the people? What are these? b. Education these include laws, regulation, facilities, activities affecting education, ratio of health educators to learners, distribution of educational facilities, who
1.

c.
d.

e.

f.

g. h.

Fire and safety fire protection facilities and fire prevention activities, distribution of these Politics and government political structure present in the community, decision-making process/pattern leadership style observed, etc. Health health facilities and activities; distribution, utilization, ratio of providers to clientele served; priorities in health, programs developed, etc. Communication systems, types of communication existing, forms of communication, be it formal or informal; etc. Economics occupation, types of economic activities, income, etc. Recreation recreational activities/facilities; types, consumers, appropriateness to consumers, etc.

1. 2. 3. 4. 5. 6.

People are partners in health care. People work together to attain good health condition. Physical environment promotes health, safety, order and cleanliness. Safe water and nutritious food. Families provide members with basic needs. Available, affordable health care.

1.

2.
3. 4. 5. 6.

Political Socio-economic Heredity/Genetic Environment Behaviour/Values Health Care Delivery system

Economi c Employme nt Education

Environment al

Housing

Public Health
Psychosoci al Behaviour al Transpor t

Community Contextual Health profile

Political

Medical

Government al

 Contextual Dimensions, Components,

and Indicators Potentially Related to Health

ECONOMIC DIMENSION
1.

A.
B. C.

D.
E. F.

Income Summary income measures Income components Disposable income Income distribution Geographic concentration of income Economic segregation

2. A. B. C. D. 3. A.

B.
4. A.

B.
C. D.

Wealth Geographic concentration of wealth Debt levels Savings rates Real estate ownership/values Poverty Geographic concentration of poverty Deprivation associated with poverty-level income Economic Development Productivity Industrial mix Business lending indicators Informal economy

5.
A. B. 6. A. B. C. 7. A. B.

Financial Services Availability of credit Availability of banking and check-cashing services Cost of Living Local cost of living indexes Spending/consumption patterns Income to spending ratios Redistribution Taxes Transfers

8. A. B.

C.
9. A.

B.
C.

Fiscal Capacity Property values Sales levels Income capacity Exploitation Ratio of wages to corporate profits Commuter taxes Commuting patterns

 EMPLOYMENT DIMENSION
1. A. B. 2. A. B.

C.
D. 3.

A.
B. C.

Employment/Unemployment Rates Job security Labor market turnover Workforce Characteristics Racial/ethnic diversity Skill level Unionization Migrant workers Area Business Capacity Tax breaks offered Number and size of businesses Business space available

4. A. B. C.

D.
E. 5. A. B. 6.

A.
B. C.

D.

Job Access Geography of job growth Discrimination/affirmative action policies Distance travelled to work Transportation system Training/retraining Occupational Safety Laws, regulations, and company-specific policies Enforcement/number of violations Job Quality Compensation Ratio of CEO to worker earnings Family-friendly policies Demand/control characteristics

Job Characteristics A. Unionized employers/size and power of unions B. Skills needed by employers C. Full vs. part-time employment
7.

 EDUCATION DIMENSION
1. A. B.

C.
D. E. 2. A. B.

C.
D. E.

F.

Educational Attainment Graduation rates Dropout rates Literacy rates Test scores Rates of progression to post-secondary education Funding Teacher salaries Facilities Teacher training/support Fiscal capacity of school district Proportion of funds by source Corporate presence in schools

3.
A. B. 4. A. B. C. D. E.

Private Schools Number Enrolment School Characteristics Size of schools/classes Student/teacher ratios Teacher turnover Parental attitude/involvement in schools School segregation 1.Race/ethnicity 2.Economic status

F. Curriculum quality

1.Physical education requirements 2.Health education 3.Nutrition education 4.Sex education 5.Language requirements 6.Vocational education 7.Enrichment programs G. Preschool/Kindergarten/Early Intervention H. School-based clinics I. Physical environment of school/safety

J.

K.
5. A.

B.
C. D. E.

Disciplinary climate 1.Violence prevention programs 2.Police involvement School-based nutrition programs Community Climate Television viewing Radio stations Reading/reading to children Libraries Corporate-sponsored educational programs

 POLITICAL DIMENSION 1. Civic Participation A. Voting 1.Registration and voting rates 2.Ease of registration 3.Racial/ethnic representativeness of registered voters B. Political party membership C. Donations to parties and candidates 2. Political Structure A. Gender/racial/ethnic representation in elected office B. Percent of local budget for public health investments 3. Power Groups A. Community organizations B. Unions C. Advocacy Groups

 ENVIRONMENTAL DIMENSION
1. A.

B.
2. 3. A. B. C. D. E.

Air Quality Outdoor (exhaust, ozone, pollutants, particulate) Indoor (tobacco, insect, mold, dust) Water Quality (PCBs, dioxin) Environmental Hazards Hazardous waste Heavy metals Pesticides Climate extremes Noise

4.
A. B. C. D. E. 5. A. B. C.

Physical Safety Traffic Street repair Sidewalk availability/quality Street signs/lights Safety structures (e.g. guard rails) Land Use Public recreational space/number of parks Waste disposal/dumping/sanitation services Curbside recycling programs

 HOUSING DIMENSION
1. A.

B.
C. D. E. F. G.

Housing Stock Age Scarcity Value Characteristics Gentrification/gatedness Rental vs. owner occupied Safety violations

2.
A. B.

C.

D.
E. F. G. H.

Residential Patterns Homelessness Number of institutional facilities Segregation 1. Racial/ethnic 2. Economic Vacancy rates Crowded housing Population density Abandoned housing Social isolation

3.
A. B. C. 4. A. B.

C. D.

Regulation Zoning policies Industrial/residential segregation Housing policies (e.g. Section 8) Financial Issues Housing costs Low-income housing 1. Percent of total housing 2. Ratio of low-income units to low-income workers 3. Elderly housing Mortgage lending practices by race/ethnicity Community reinvestment initiatives

 MEDICAL DIMENSION
1. A.

B.
C. D. 2. A. B. 3. 4. 5.

Primary Care Number of providers Provider training/competence/certification Rates of ambulatory care sensitive hospitalizations Medicaid reimbursement levels Specialty Care Number of providers Provider training/competence/certification Emergency Services Home Health Care Services Mental Health Care

6.
7. 8.

A.
B. C.

D.
E. F. 9.

Long-Term Care Oral Health Care Access to/Utilization of Care Insurance coverage Race/ethnic staff to population ratios Provision of indigent care Costs of care Rates of ambulatory care sensitive hospitalizations Cultural competence among providers and institutions Alternative Care

 GOVERNMENTAL DIMENSION 1. Funding A. Revenue 1. Intergovernmental 2. Taxes 3. Lottery B. Debt 2. Policy/Legislation A. Obstacles to unionization B. Living wage/minimum wage ordinances C. Employer requirements to provide health benefits 3. Services A. Privatization B. Local safety net resources 4. Municipal Fragmentation (number of subunit governments within)

 PUBLIC HEALTH DIMENSION

1. A. B. C. D. E. F. G. H.

I.
J. K.

Programs Screening Nutrition Family planning Chronic disease control Home visiting Outreach School-based clinics/education Substance abuse prevention Domestic violence prevention Mental health services Immunization

2.
A. B. C. D. 3. A. B.

Regulation/Enforcement Sanitation Health/food inspection Health violations Legislative efforts Funding Budget allocations Private sector provision of public health services

 PSYCHOSOCIAL DIMENSION
1. A. B. C. D. 2. A. B. 3. 4.

Political Contributions to parties, candidates Women in elected office Number of registered voters Voter registration procedures Volunteer Organizations Types/functions Number of members Union Participation Charitable Giving

5.
A. B.

C.
6. A.

B.
C. 7. A. B.

Jails Expenditures Incarceration rates Crime Lawsuits Civil lawsuits Small claims court cases Lawsuits against businesses Protective Services Government services Household systems

 BEHAVIORAL DIMENSION
1. A.

B.
C. D.

E.
F.

Tobacco Use Smoking rates Cessation programs Smoking prevention Workplace/public space smoking restrictions Cost/accessibility of cigarettes Advertising

2.
A. B. C. D. E. F. G.

Physical Activity Physical activity levels Physical education requirements in schools Public and private recreational facilities Television viewing patterns Workplace exercise programs/facilities Participation in local sports/recreational activities Video game sales/use

3.
A. B. C. D. E.

Diet/Obesity Fresh fruit and vegetable consumption High fat, high sugar food consumption Food quality/availability/cost Number of fast food establishments School nutrition 1. Regulation of subcontracting to vendors 2. Nutrition education 3. Breakfast/lunch programs

4. A. B. C.

D.
E. 5. A.

B.
C. D.

Alcohol and Illicit Drug Use Number of liquor stores Drug and alcohol treatment services Syringe laws/exchange programs Liquor marketing laws Advertising Violence Guns 1. Availability 2. Gun Shows 3. Licensing Exposure to violence Police protection Gang activity

 TRANSPORT DIMENSION
1. A.

B.
C. D. E.

Safety Seat belts/child restraints Helmets Age curfews/graduated driver's license program Driving while intoxicated laws/enforcement Speed restriction/enforcement

Infrastructure A. Roads 1. Quantity 2. Quality 3. Speed bumps 4. Buffers from pedestrians B. Sidewalks C. Bike lanes 1. Quantity 2. Mandating legislation
2.

3. A. B.

C.
4. A.

B.
C.

Traffic Patterns Spatial location of jobs Traffic volume Car pooling Vehicles Number of heavy/diesel vehicles Cars per capita Types and ages of vehicles

5.

A.
B. C.

D.
E. F. G. H. 6. A.

B.
C. D.

Public Transportation Availability/density/efficiency Types of public transportation available Cohesiveness/integration Reliability/quality Geographic equity Environmental soundness Transportation for special needs groups Employer promotion of public transportation Economic Issues Expenditures Spending on local roads vs. alternative transportation Percent of transit revenue from fares Insurance rates