Community
- a group, population, or cluster of people who live, work, and play in an environment at a given time.
- share at least one common characteristic (geographic location, occupation, ethnicity) or share common values/concerns
- function in a social system that meets their needs within a larger social system such as an organization, a region, a province, or a nation…..OR a university
Goals for Community Health Nursing
- promotion of Social Justice and Equity
- Work upstream (midstream or downstream)
- primary health care - social justice and equity “health for all”
What do CHNs do to promote healthy communities?
utilize the philosophies of Primary Health Care to promote and support healthy communities
Primary Care
the first point of contact with the health care system. this could be physicians, NP, community nurse, school nurse
Primary Health Care
The foundation of Canada’s health system. Entry into the system and your continuity of care.
Primary Health Care Goals
- meant to achieve better care for all
- strong emphasis on health promotion and disease prevention
- more integrated approach that hits on the ideology of “health for all”
- an intersectoral approach
SDOH
“Social determinants of health refer to a specific group of social and economic factors within the broader determinants of health. These relate to an individual’s place in society, such as income, education or employment. Experiences of discrimination, racism and historical trauma are important
social determinants of health for certain groups such as Indigenous Peoples, LGBTQ and Black Canadians”
SDOH Examples
- income and social status
- Social support networks
- Education and literacy
- Employment and working conditions
- physical environments
- biological and genetic endowments
- individual health practices and coping skills
- healthy child development
- health services
- gender
- culture
- social environments
Physical Determinants Examples
- Natural environment, such as plants, weather, or climate change
- Built environment, such as buildings or transportation
- Worksites, schools, and recreational settings
- Housing, homes, and neighbourhoods
- Exposure to toxic substances and other physical hazards
- Physical barriers, especially for people with disabilities
- Aesthetic elements, such as good lighting, trees, or benches
Structural Violence
Refers to a form of violence where some social structure or social institution may harm people by preventing them from meeting their basic needs. it is avoidable impairment of fundamental human needs
Indigenous SDOH
- colonialism
- racism
- social exlusion
- repression of self determination (general society & health care)
Intersectionality
- how sources of discrimination overlap and reinforce each other
- also refers to the reality that we all have many identities that intersect to make us who we are
Social Justice
- rooted in social responsibility and fairness
- focus is on relative social advantage of individuals or groups over others
- examines root causes of inequities (and health disparities) and how to eliminate them
Health Equity
- refers to the absence of systemic disparities in health (those disparities that advantage or disadvantage)
- health inequity puts those disadvantaged at a further disadvantage (poverty being the most common root cause)
- reflects social justice and is critical and necessary to achieve health for all, with the concept that health is a human right
Equality
- Access to resources is there for all - equal rights under the law
Equity
- the fulfillment of each individual’s needs as well as their opportunity to reach full potential as a human being (everyone having the ability to reach the resources)
- more focus of fairness
Inequity
- unfair social arrangements (systematically unfair)
Pender
health promotion is directed towards increasing the level of well-being and self-actualization
and disease prevention is action to avoid or forestall illness/disease.
Ottawa Charter
regards health promotion as the over arching concept, the process of enabling people to increase control over, and improve, their health.
3 Levels of Disease Prevention
Primary: True avoidance of illness
Secondary: Early detection
Tertiary: limit disability
5 Broad Strategies identified in the Ottawa Charter for Health Promotion:
- Build healthy public policy
- Create supportive environments
- Strengthen community action
- Develop personal skills
- Reorient health services
Primary Health Care as Relevant to CHN
- provides essential health services in the community
- considers the determinants of health
- focus is on health promotion, disease prevention and protection
- includes therapeutic, curative and rehabilitation in care
- promotes coordination of care and inter-professional collaboration
- focus is on the client as an equal partner
Broader than disease prevention emphasizes:
- Participation
- Empowerment
- Equity
Downstream
Individual focus/treatment, cure, surgery, meds, rehab
