importance of community health essay

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What Is Community Health and Why Is It Important?

By Ashley Brooks on 03/04/2019

The community you live in is part of who you are. Even if you don’t see your neighbors every day, you recognize that the decisions you make impact those around you. You’re all in it together, and you wouldn’t have it any other way!

Improving your community and helping others is often at the top of your mind. So when the phrase “community health” crossed your radar, you had to know more. What is community health? And how does it affect the lives of those in your area?

Community health is the intersection of healthcare, economics and social interaction. Unfortunately, many people are unaware of the role this type of healthcare plays in their everyday lives. Join us as we explore the impact of community health on your neighborhood—and what you can do to improve it.

What is community health?

Community health is a medical specialty that focuses on the physical and mental well-being of the people in a specific geographic region. This important subsection of public health includes initiatives to help community members maintain and improve their health, prevent the spread of infectious diseases and prepare for natural disasters.

“Working at the community level promotes healthy living, helps prevent chronic diseases and brings the greatest health benefits to the greatest number of people in need,” reports the Centers for Disease Control and Prevention (CDC) . 1

Strong community health requires residents to look beyond themselves and take “collective responsibility,” says Caleb Backe, health and wellness expert at Maple Holistics . “It’s not just about the healthcare system, but focuses on the importance of leading a generally healthy lifestyle in order to protect the community as a whole.”

Community health is inextricably tied to individual wellness. “Good community health equates to healthy people, as a community is the ecosystem or environment in which people live,” says Thomas G. Bognanno, president and CEO of Community Health Charities . “It’s difficult to be healthy personally if your community is unhealthy.”

The far-reaching impact of community health

Community health flips the script on the old adage, “You take care of you; I’ll take care of me.” Instead, public health experts agree that the health of a community can have far-reaching—and sometimes surprising—impacts on individual health and beyond.

“Community health impacts everything—educational achievement, safety and crime, people’s ability to work and be financially healthy, life expectancy, happiness and more,” Bognanno says. “Health impacts every other facet of life, from a child’s ability to learn to an adult’s ability to work, so health is critical for education and financial well-being.”

The effect of health on quality of life can also impact the desire to participate in civic duties like voting, social functions and leisure activities, according to Healthy People 2020 , an initiative of the Office of Disease Prevention and Health Promotion. 2

Communities that are attentive to public health can even reduce inequality among their residents. “[Community health] also helps to reduce health gaps caused by differences in race and ethnicity, location, social status, income and other factors that can affect health,” reports the CDC . 1

The consequences of neglecting community health

A lack of focus on community health can lead to a range of complex problems that aren’t easy to correct. For example, crime and safety issues that result from neglected community health can quickly becoming a self-perpetuating cycle. “Repeated exposure to crime and violence may be linked to an increase in negative health outcomes. Children exposed to violence may show increased signs of aggression starting in upper-elementary school,” reports Healthy People 2020 . 2

Chronic diseases, such as diabetes and heart disease, can also increase if a community’s overall well-being is suffering. “An unhealthy community tends to be obese and struggle more from chronic diseases and other health challenges,” Bognanno says.

Chronic diseases like these not only reduce life expectancy, they have a dramatic effect on the economy. The CDC reports that 90 percent of the nation’s annual healthcare expenses are for people with chronic health conditions. 3

Curbing the spread of infectious disease is also a priority of community health programs. Without them, communities may find themselves battling outbreaks of illnesses that put vulnerable populations like the elderly at higher risk.

“If a community has to recover from an emergency event, such as a natural disaster, reducing the spread of disease becomes a crucial part of the recovery process,” Backe says.

Factors that improve community health

Improving community health is a huge undertaking that involves cooperation between public health workers, local government, volunteers and average citizens alike—and the end products of their work can take a lot of forms. “Communities benefit from walking trails and bike paths, from access to healthy food and playgrounds, from accessible healthcare services, schools and places of employment, as well as affordable housing,” Bognanno says.

Education also plays a large role in maintaining community health. Health fairs and advertising campaigns that expose the dangers of risk factors like tobacco exposure, poor nutrition and physical inactivity can raise awareness about the importance of choosing a healthy lifestyle. The CDC has also focused on promoting nutrition guidelines in schools and increasing the amount of physical education children receive. 4

Individuals can step up to the plate for their community’s health by volunteering at health fairs or blood drives, petitioning local officials to develop more green space and walking trails and maintaining their own health. “The collective responsibilities that individuals have for their communal health can lead to positive interactions within the community as a whole,” Backe says.

Take a stand for community health

What is community health? Now you know that it’s a vital component of public health—and it’s something every individual can play a part in improving. To learn more about how public health workers are improving the health of people across the nation, take a look at these articles, “ 6 Invaluable Ways Community Health Workers Improve Our Lives .” and " What Can You Do With a Health & Wellness Degree?"

1 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Chronic Disease: A Significant Public Health Threat, [information accessed January 29, 2019] https://www.cdc.gov/nccdphp/dch/about/index.htm 2 Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Health-Related Quality of Life and Well-Being, [information accessed January 29, 2019] https://www.healthypeople.gov/2020/about/foundation-health-measures/Health-Related-Quality-of-Life-and-Well-Being 3 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Health and Economic Costs of Chronic Diseases, [information accessed January 29, 2019] https://www.cdc.gov/chronicdisease/about/costs/index.htm 4 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Partnerships to Improve Community Health, [information accessed January 29, 2019] https://www.cdc.gov/nccdphp/dch/programs/partnershipstoimprovecommunityhealth/index.html

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About the author

Ashley Brooks

Ashley is a freelance writer for Collegis education who writes student-focused articles on behalf of Rasmussen University. She believes in the power of words and knowledge and enjoys using both to encourage others on their learning journeys

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Why are community health workers important?

At least half of the world's population does not have access to the essential health services it needs. A combination of economic, social, and geographic barriers - compounded by a global shortage of health care workers - prevent people from accessing primary health care (PHC). 1 The shortage of health care workers, estimated at 7.2 million health workers today, is expected to widen to 18 million by 2030, according to the World Health Organization.

Community health workers (CHWs), as part of primary health care teams, can help fill this critical gap. CHWs can be trained much more quickly than doctors, nurses and other frontline health workers, allowing governments to ramp up services relatively quickly, to meet critical needs. Despite their narrower skill set, CHWs can provide PHC services that address some of the most important causes of maternal, child and neonatal mortality, improve sexual and reproductive health, and prevent and treat other communicable and non-communicable diseases. Critically, CHWs deliver care on the doorsteps and in the communities of those who need it most. By providing these services in otherwise overlooked or underserved communities, CHWs expand access to PHC services, improve health, and save lives, particularly in rural, remote, and vulnerable communities, and where there are cultural barriers to health care.

Even in geographies with a robust health workforce, CHWs can improve health outcomes by serving as effective health educators, increasing demand for health care and promoting healthy behaviors, such as exclusive breastfeeding, support for immunization, proper complementary feeding, and proper sanitation.

The power of CHWs

Investing in CHWs is a powerful way to increase access to PHC services, increase health-seeking behavior, and improve clinical outcomes because CHWs of the following:

Geographic proximity

CHWs reduce the travel time and cost needed to access medical care, making it more accessible and timely. Rural-focused programs have higher costs than programs that include urban CHWs. In general, cost per person served decreases as the scale of the program increases. Rural programs, however, are typically more effective because they reach populations with poor access to health care.

Trust from the community

As trusted members of the community they serve, CHWs can improve demand for services and accelerate behavior change. CHWs can sensitively address traditional customs and norms that undermine health. Their fluency with culturally appropriate language, and mechanisms for communicating health and hygiene best practices can ensure better competence with health instructions.

Frequency of contacts

Too often, remote communities' only contract with health systems is via intermittent campaigns. CHWs shift this paradigm by providing regular services that meaningfully extend the continuum of care. By virtue of living and working the community, they can monitor chronic health conditions or continually reinforce key health messages - such as the importance of exclusive breastfeeding or proper complementary feeding for infants - and readily identify unmet health needs.

Bridging community and health and welfare services

CHWs can serve as a bridge between the formal health system and vulnerable communities, helping their colleagues, such as nurses and doctors, better understand the patients they serve and prioritize their time addressing more complex medical problems. CHWs also help patients, who may have no previous experience with preventive care, better appreciate the benefits of and follow the unfamiliar protocols of preventive care. Likewise, they can link communities to other government social services that may impact health. Furthermore, CHWs can help patients navigate complex health systems and ensure they comply with recommended treatment and follow-up visits.

• 1 Tracking universal health coverage: 2017 global monitoring report. World Health Organization and International Bank for Reconstruction and Development / The World Bank; 2017. Licence: CC BY-NC-SA 3.0 IGO. https://apps.who.int/iris/bitstream/handle/10665/259817/9789241513555-eng.pdf?sequence=1.

What impact can CHWs have?

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Community Health Nursing Essay

A community health nurse (CHN) serves as a link between healthcare organizations and communities, who work together to achieve the promotion of a healthy lifestyle and increase the awareness of these communities about their health status. These practitioners are specialized in finding an appropriate solution for health issues within a particular group by combining their medical expertise with social skills. This practice has emerged in modern days from the disparity in access to healthcare services, the lack of knowledge, and negligence of disadvantaged communities, and involves a thorough examination of socioeconomic and cultural connotations (“The nurse’s role in community health,” 2017). Therefore, these nurses not only provide necessary healthcare but also work on the elimination of the indirect causes of diseases, educate people on healthy lifestyles, and work with healthcare organizations to alleviate disparities.

Community resources are a vital component in the process of improving the health of a population, whether local or global. They allow all stakeholders to achieve a better result for involved sides, increase equity in healthcare, and enable healthcare organizations to establish a connection with people (National Academies of Sciences, Engineering, and Medicine, 2017). A community health nurse can identify what resources are lacking within the target group, what adverse effects this fact introduces to the population, and how to fix this issue. World Health Organization (2017) states that community health nursing involves “the allocation of resources,” “addressing public issues,” and “group facilitation to build partnerships” (p. 24). Therefore, a CHN can involve religious, charity, and other community-focused organizations in his or her work to achieve more significant results by promoting health via multiple channels and using various sources to reach the target group.

National Academies of Sciences, Engineering, and Medicine. (2017). Communities in action: Pathways to health equity . The National Academies Press.

The nurse’s role in community health . (2017). Northeastern State University. Web.

World Health Organization. (2017). Enhancing the role of community health nursing for universal health coverage . Human Resources for Health Observer Series , 18 . Web.

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1. IvyPanda . "Community Health Nursing." March 1, 2022. https://ivypanda.com/essays/community-health-nursing/.

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A Healthy Community is a Prepared Community

What does a prepared community look like?

As communities look at how to prepare for the next emergency, they usually focus on stockpiling emergency supplies, having clear alert networks and ways to communicate with the public, and designating evacuation routes and shelter locations. While all of these are key aspects of emergency planning, one area of preparedness that is often overlooked is community health. Community Health is a term used to describe the state of health and how easy or difficult it is to be healthy where people live, learn, work and play. The health of a community, including ease of access to medical care and community resources available for exercise and encouraging healthy habits, is an important part of emergency planning that can have a positive impact on a community before, during, and after a public health emergency.

What is a Healthy Community?

How is a Healthy Community Better Prepared?

Unhealthy communities often have a large number of individuals that are more vulnerable before, during, and after a disaster. Factors that lead to poor health in communities such as high rates of chronic diseases like diabetes and heart disease, limited access to general medical care, and low levels of health education, can cause substantial difficulties for a community recovering from an emergency event. Gaps in medical care can increase significantly after a disaster due to physical damage to health care facilities or from a large increase in the number of people who need medical attention. People who already have poor health are usually more susceptible to disease during a public health emergency and cannot get the normal day-to-day medical care they need.

Make Your Community Healthy and Prepared

Help promote health in your community by becoming more engaged in your community. Encourage local community groups and government organizations to consider community health in their emergency preparedness plans. Take action to improve your community’s health now to ensure you are better prepared to remain healthy when an emergency occurs.

8 comments on “A Healthy Community is a Prepared Community”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy » .

Living a healthy lifestyle and maintaining healthy habits is disaster prepare kit in it self. Most people think and often we teach that preparing for an emergency it is essential have “emergency items” such as flashlights and blankets, and water. These items are very important as essential needs to sustain life include, nutrition, shelter and water. In the event of an emergency, having a healthy life style gives you an advantage to sustaining life as no one can truly predict exactly how an emergency event will affect them or their immediate environment. Elders are typically the most affected by disasters due to often their health status. Encouraging things such as eating nutritious meals so that your body has sufficient nutrient stores, and performing physical activities to promote physical health and limit the needs of medications and additional assistance that may be very limited in event of emergency is important. Having healthy habits builds a stronger you, building stronger immune systems and fighting infection that can rise to very high level during emergencies as many situations force persons to live in close quarters such as shelters. Helping yourself also helps others!

Vaccinations provide an important defense against disease and infection for both the young and the old. Additionally, a sound vaccination protocol helps protect the general public from a possible outbreak occurring. The possibility of an epidemic re-occurring is a real and legitimate concern, so continued vaccination of the general public is necessary. The health benefits that a proactive vaccination schedule provides for children and the society in which they live far outweighs the potential risk associated with vaccinations; therefore, childhood vaccinations should be administered to every child on a regular schedule.

I solely love the idea of a community coming together to prepare for and work through disease and infection epidemics, as well as injury or disaster incidences. The people are the heart of the community and working together to achieve the same purpose speaks volumes of the community’s residents. Disease prevention and health promotion are important aspects in maintaining the health of the community. Each individual resident plays a personal role in promoting community health. This is achieved when residents exercise 3-4 times a week, eat a nutritious and balanced diet, get adequate amounts of rest and sleep, and stay up-to-date on vaccinations and immunizations. Promoting and maintaining a healthy community is everybody’s business and the responsibility of every individual living in it.

Consuming healthy meals, vaccinating your children, and devising an exercise plan are all steps that can help in improving the health of the community. Vaccinations are necessary in order to protect the youth and the community as a whole. There are health clinics located in many communities to ensure that every child can be vaccinated or immunized no matter what their income is.

Great article. Couldn’t be write much better!

This was great! Can’t wait for your upcoming content! What have you got planned for us?

It is interesting to note that everyone in the population has a part to play in community health. The health of a community rests not only on the government and policy makers but also on the community workers. Healthy communities recover well because the roles and responsibilities of the community health worker are at play and well followed. The income,race,education or location of individuals is not a stumbling block to getting proper and good health services and resources.

it would be interesting to talk about active and healthy communities

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• The Importance of Community Health Nurses

The Importance of Community Health Nursing

Community health nurses are a vital link in the health and welfare of neighborhoods. These registered nurses focus on improving the lives of diverse communities of infants, children, adolescents, and adults through education, prevention, and treatment.

“They assist with equalizing health care in diverse populations, so that care is more equitable, affordable, and well-coordinated,” says Sheila Rucki , faculty member in the Purdue Global School of Nursing.

“Community health nurses look at the broader needs of a population, not just an individual,” says Jessica Gordon , associate dean. “The agenda is health promotion, disease prevention, and recognizing the needs of the community.”

Learn more about the role of community health nurses, what their future looks like, and how to become one.

What Is a Community Health Nurse?

Community health nurses start by building trust and relationships with individuals and local leaders. They also develop a strong understanding of people’s backgrounds, experiences, and the social factors that influence health, with the goal of practicing cultural humility with empathetic care.

Many members of the community who take advantage of these services might not otherwise have access to private physicians or testing services, among other medical necessities.

“Ethnically diverse and culturally diverse populations are the most underserved,” Rucki says. “Those are the individual groups that benefit most from this kind of health care."

Community health nurses often participate in mobile clinics to help underserved populations, she says.

“The homeless are hard to reach because they are mobile,” Rucki says. “They benefit greatly from the care provided by community-focused providers, particularly nurses.”

What Do Community Health Nurses Do and Where Do They Work?

Community health nurses work in a variety of settings from community-based centers to government agencies to shelters to vaccine distribution sites. They build coalitions, craft policies, educate the public, manage public health programs, and more.

Services Provided by Community Health Nurses

The American Public Health Association lists 10 essential public health services provided by community nurses and other front-line professionals:

• Assess and monitor population health
• Investigate, diagnose, and address health hazards and root causes
• Communicate effectively to inform and educate
• Strengthen, support, and mobilize communities and partnerships
• Create, champion, and implement policies, plans, and laws
• Utilize legal and regulatory actions
• Enable equitable access
• Build a diverse and skilled workforce
• Improve and innovate through evaluation, research, and quality improvement
• Build and maintain a strong organizational infrastructure for public health

“Community health nurses are this incredible file cabinet of resources. They can point people in the right direction for what they need at that time,” Gordon says. “They're dealing with the community, but they provide education on where the community can get the help they need for individualized attention.”

For example, if a community has a high diabetes rate, one of the focuses for that area might be diabetes prevention education.

“Every single community health nurse works based on the population and the needs of that population specifically,” Gordon says.

Other health issues that could affect a community include:

• Substance abuse
• Teen pregnancy

Where Community Health Nurses Are Needed

Community health nurses, like other registered nurses, often work in local hospitals, trauma centers, and clinics. Many work in locations more focused on underserved communities, such as:

• Aid organizations, such as Doctors Without Borders or the Red Cross, providing disaster relief along with other daily local needs
• Community health centers, treating and educating around such topics as family planning, sexual health, and other preventative care
• Correctional facilities, working to limit the spread of communicable disease, along with running educational programs for inmates and staff
• Government agencies, helping with health policy development and implementation to create change on a large scale
• Homeless shelters, focusing on preventative care through screenings and assessments, and helping people find social service assistance
• Schools, providing education about illness prevention and good health habits, along with managing existing health problems and intervening in cases of abuse or neglect

“A lot of the community-based care centers are in parts of town or areas of the country or state where access to care might be limited or not affordable,” Rucki says. “Being based directly in the community provides access opportunities that might otherwise not be available to diverse populations.”

What Does the Future Look Like for Community Health Nurses?

Community health nurses have a bright future, but some serious challenges remain ahead.

“We’re seeing an increased need because what we thought was the traditional way of delivering care is really no longer applicable,” Rucki says. “Community-based care is becoming the primary way for many people today.”

What Job Growth Looks Like

The national nursing shortage, which has been exacerbated by the pandemic, will continue to fuel a 9% job growth rate through 2030, according to the U.S. Bureau of Labor Statistics . The agency projects employers to add 276,800 RN positions from 2020–2030.*

Because of these growing needs, becoming a community health nurse has some advantages:

• Creating strong partnerships between nurses and clients and/or community population
• Enjoying collaborative nursing care working with clients in a nonhospital setting
• Having a variety of work settings
• Helping vulnerable communities
• Providing holistic and more individualized care
• Working a convenient schedule with little to no holiday or weekend hours

According to the U.S. Centers for Disease Control and Prevention, community health worker programs particularly need nurses trained in preventing and controlling infectious diseases, to deliver home-based care to low-income people.

What Challenges Remain Ahead

The National Institutes of Health indicate that public nurses face many challenges aside from the day-to-day demands of practice, including:

• Concerns for personal safety
• Frequent overtime
• Inadequate staffing levels
• Limited management support and supervision
• On-call duties
• Professional isolation
• Restricted opportunities for career development

However, Gordon says a greater challenge facing community nurses is resistance.

“This can happen whether you're in acute care or community health, but you often see a population as a whole resisting care,” she says. “It can be incredibly frustrating when you've provided quality education and care. But you persevere. The challenge is not being rejected, it's how you overcome it.”

“It may take time to build trust in populations,” Rucki says. “Once you build trust and build that ongoing relationship, you're more likely to see change, behavior changes in people’s health care practices.”

Who Would Make a Good Community Health Nurse?

You need certain qualities and qualifications if you’re interested in becoming an effective community health nurse.

The Qualifications You Need

At a minimum, you must earn an associate or bachelor’s degree in nursing and pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN). † Some may wish to complete a two-year master's degree program in nursing. Employers often prefer community health nurses who have one to two years of nursing experience.

“Because this is such an education-heavy job, there's a strong preference toward those with a bachelor's degree,” Gordon says.

Community health nurses also are strongly encouraged to have ties to the areas in which they wish to work. Participating in volunteer programs both before and after becoming a community health nurse is highly recommended.

Community health nurses should also consider certification. One exam, the Advanced Public Health Nurse certification exam, is being phased out.

“However, there are opportunities in interprofessional groups to demonstrate excellence and receive certifications,” Rucki says.

Currently, there is no certification specific to public health nursing at the generalist level. However, nurses with a bachelor’s degree and at least five years of public health experience can obtain the Certification in Public Health (CPH). Visit the National Board of Public Health Examiners for more information on the CPH.

The Qualities You Need

A panel convened by the National Institutes of Health agreed that a successful nurse needs such qualities as being analytical, communicative, cooperative, coordinating, disseminating knowledge, empathic, evidence driven, innovative, and introspective.

Community health nurses should also be connected to their community, open-minded to those different from them, sensitive to different opinions, and objective in their view of the communities they serve.

“An essential component to these roles is a passion for serving the communities that are around them,” Gordon says. “These nurses have a connection and they understand the populations. They want to see them thrive and do better.”

“What's really so rewarding for nurses is this long-term engagement with a population,” Rucki says. “In an acute care setting, you're engaged with the patient and family for a short period of time. But in the community, they're your patients for life. You see families grow and care for them over a number of years.

“That ability to connect and learn and know about the individuals that make up your community is so rewarding for nurses.”

How Purdue Global Can Help You Become a Community Health Nurse

“Community-based nurses are very strong force for change in a community,” Rucki says. Gordon says this theme is woven throughout all programs at Purdue Global.

Purdue Global’s online nursing programs can help you start on the road to becoming a community health nurse. ‡ Reach out for more information today .

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The Importance of Healthy Communities

The community’s health depends not only on the residents’ genetics but also on the environment in which the residents are located. As such, a person’s health is dependent on the environment in which they live. Hence, a healthy community can be described as one in which residents have access to aspects that promote healthy living, such as adequate health care, physical activity, nutrition, quality employment, transportation, education, and safe and comfortable homes. Unhealthy homes and communities can increase the chances of having chronic diseases such as heart diseases, cancer, and diabetes.

In today’s world, when chronic lifestyle diseases are on the rise as a result of unhealthy living caused by poorly planned communities, healthy communities are critical. Health communities are essential to the development of a region in which resources that would have been spent on preventing chronic diseases are instead used to improve sustainable communities (Lesorogol et al., 2019). Physical exercise is a known variant when it comes to maintaining a healthy living, thus, healthy communities encourage physical exercise in addition to growth. Physical activities are promoted by health professionals because they are important in preventing chronic diseases. Another important aspect of healthy communities is improved air quality. Many residents, particularly in urban regions, are exposed to harmful chemicals as a result of the numerous companies that exist there. These hazardous gases have a number of negative consequences that have a significant impact on the health of local residents. Fresh market food encourages a diet that is devoid of additives and preservatives. A healthy community relies on access to high-quality, low-cost healthcare. Quality health care is available to all residents in well-established communities.

Healthy communities are built in such a way that variables that influence healthy living are encouraged. As a result, various factors should be considered when developing such communities. Access to quality health care has been known to promote healthy communities. The Lincy Institute, 2021). It is critical to address the discrepancies in access to health care. Health care access is more difficult to get by in communities with lower per capita income. As a result, when creating regulations governing access to medical treatment, a community health system should address such considerations. Minimizing the expense of medical treatment, as well as building medical facilities and programs that promote access to high-quality care, are examples of such policies.

In addition to medical infrastructure, a health public policy should be implemented. The establishment of policies in non-health sectors, such as public transit, food policy, or rules guiding sustainable production, is referred to as public health policy. A well-managed health public policy aims to improve the population’s health. Because of the many elements that influence human health at the community level, public health policy is extremely significant. Transportation alternatives, neighborhood design, access to healthy food options, and recreation possibilities are all examples of things that happen in our communities.

Unsafe and substandard homes put persons at risk of ill health or accidents. Asthma is common among children who live in inadequate housing, according to studies. Poor ventilation, mildew from water leaks, and pest infestation are all factors that contribute to unhealthy dwellings (The Lincy Institute, 2021). Addressing the problem of dangerous housing in the neighborhood helps to create healthier communities. Investing in the community utilizing an asset-based strategy benefits both individuals and communities by concentrating on the individual’s or community’s skills, knowledge, and strengths. Traditional approaches have concentrated on flaws in the community approach that has not worked to address issues like obesity, poverty, and homelessness. As a result of this approach, specialists from outside the community have been brought in to deliver interventions. In contrast, the asset-based approach focuses on communities developing their own strengths, knowledge, and skills in order to form their own solutions.

The Lincy Institute. (2021). What is a Healthy Community? 

Lesorogol, C., Baumann, A. A., Eyler, A., Metzger, M. W., Reis, R. S., & Tabak, R. G. (2019). Building Healthy, Diverse, and Thriving Communities. Toward a Livable Life: A 21st Century Agenda for Social Work , 211. 

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Essay on Health for Students and Children

500+ words essay on health.

Essay on Health: Health was earlier said to be the ability of the body functioning well. However, as time evolved, the definition of health also evolved. It cannot be stressed enough that health is the primary thing after which everything else follows. When you maintain good health , everything else falls into place.

Similarly, maintaining good health is dependent on a lot of factors. It ranges from the air you breathe to the type of people you choose to spend your time with. Health has a lot of components that carry equal importance. If even one of them is missing, a person cannot be completely healthy.

Constituents of Good Health

First, we have our physical health. This means being fit physically and in the absence of any kind of disease or illness . When you have good physical health, you will have a longer life span. One may maintain their physical health by having a balanced diet . Do not miss out on the essential nutrients; take each of them in appropriate quantities.

Secondly, you must exercise daily. It may be for ten minutes only but never miss it. It will help your body maintain physical fitness. Moreover, do not consume junk food all the time. Do not smoke or drink as it has serious harmful consequences. Lastly, try to take adequate sleep regularly instead of using your phone.

Next, we talk about our mental health . Mental health refers to the psychological and emotional well-being of a person. The mental health of a person impacts their feelings and way of handling situations. We must maintain our mental health by being positive and meditating.

Subsequently, social health and cognitive health are equally important for the overall well-being of a person. A person can maintain their social health when they effectively communicate well with others. Moreover, when a person us friendly and attends social gatherings, he will definitely have good social health. Similarly, our cognitive health refers to performing mental processes effectively. To do that well, one must always eat healthily and play brain games like Chess, puzzles and more to sharpen the brain.

Get the huge list of more than 500 Essay Topics and Ideas

Physical Health Alone is Not Everything

There is this stigma that surrounds mental health. People do not take mental illnesses seriously. To be completely fit, one must also be mentally fit. When people completely discredit mental illnesses, it creates a negative impact.

For instance, you never tell a person with cancer to get over it and that it’s all in their head in comparison to someone dealing with depression . Similarly, we should treat mental health the same as physical health.

Parents always take care of their children’s physical needs. They feed them with nutritious foods and always dress up their wounds immediately. However, they fail to notice the deteriorating mental health of their child. Mostly so, because they do not give it that much importance. It is due to a lack of awareness amongst people. Even amongst adults, you never know what a person is going through mentally.

Thus, we need to be able to recognize the signs of mental illnesses . A laughing person does not equal a happy person. We must not consider mental illnesses as a taboo and give it the attention it deserves to save people’s lives.

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Home — Essay Samples — Nursing & Health — Childhood Obesity — Importance Of Good Health

Importance of Good Health

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Performance Management and Quality Improvement: Definitions and Concepts

At a glance.

In the public health field, many initiatives and organizations focus on improving public health practice, using different terms. This page provides common definitions for public health performance management.

Definitions and concepts

There has been a rapidly growing interest in performance and quality improvement within the public health community, and different names and labels are often used to describe similar concepts or activities. Other sectors, such as industry and hospitals, have embraced a diverse and evolving set of terms but which generally have the same principles at heart (i.e., continuous quality improvement, quality improvement, performance improvement, six sigma, and total quality management).

In the public health field, an array of initiatives has set the stage for attention to improving public health practice, using assorted terms. The Turning Point Collaborative focused on performance management, the National Public Health Performance Standards Program created a framework to assess and improve public health systems, while the US Department of Health and Human Services has provided recommendations on how to achieve quality in healthcare . In 2011, the Public Health Accreditation Board launched a national voluntary accreditation program that catalyzes quality improvement but also acknowledges the importance of performance management within public health agencies. Regardless of the terminology, a common thread has emerged—one that focuses on continuous improvement and operational excellence within public health programs, agencies, and the public health system.

To anchor common thinking, below are links to some of the definitions that are frequently used throughout these pages.

Key definitions

• Riley et al, "Defining Quality Improvement in Public Health", JPHMP, 2010, 16(10), 5-7.
• Public Health Accreditation Board Acronyms and Glossary of Terms, Version 2022 [PDF]

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Importance of Health Essay

An essay is a piece of writing that revolves around a particular theme and contains the academic opinions of the person writing it. A basic essay mainly consists of three parts: Introduction, Body, and Conclusion.

Wealth matters but is not as important as health. Good health helps an individual to keep a positive attitude toward work and life in general. After going through this post, you will be able to understand the Importance of Health.

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Importance of Health Essay (1000+ Words)

Due to his highly developed brain, man has been able to control nature, which is his superiority over other creatures. However, it is crucial for man to maintain the health and fitness of both his mind and body, as a healthy man is considered wealthy. Regular exercise not only helps in physical fitness but also keeps the mind alert. A sound and healthy well-being ensure an active and agile mind. Conversely, a weak and unfit body negatively affects an individual’s psychological well-being, as an individual’s state of mind and emotions are reflected in their health.

Recent studies have indicated that the increased stress of a fast-paced life can lead to various medical conditions, mainly heart and neurological problems. Good health helps an individual maintain a positive attitude towards work and life in general.

Despite the obstacles and difficulties we encounter in life, it is meant to be positive and enjoyable. To relish and cherish the wonderful things in life, we need the energy and enthusiasm for life, which can only happen when the body is healthy enough to face life’s challenges.

Caring for good health begins right from childhood and depends on various factors such as the mother’s health during pregnancy, a balanced diet containing necessary nutrients, and the hygienic surroundings in which the baby and mother reside. These are the fundamental necessities for a feeding mother and baby. Some children suffer from severe illnesses like polio, diphtheria, typhoid, etc. Preventive care is of utmost importance to maintain children’s health.

Parents have a great desire for their children to be healthy, intelligent, and bright. They hold a special place in their hearts for their children and wish for their physical and mental well-being. While parents have the primary responsibility of child care, others in the community share the responsibility for ensuring that children are healthy, as they represent the future of the country and the hope of all.

It is often said that the child is the father of the man, meaning that a healthy child grows into a healthy adult. A person’s development in childhood lays the foundation for their future abilities and potential contributions to society. It is, therefore, beneficial for others to lend their services to help children maintain good health. Educators, neighbors, friends, athletes, physical and mental trainers, media, social workers, doctors, and gymnasts can all play a significant role in inspiring children to prioritize their health.

In addition to the responsibility of parents and community members, schools also play a role in a child’s physical and mental development. While good health has always been important, it is even more crucial in today’s fast-paced and competitive world, where modern requirements demand optimal physical and mental health.

As educational expectations and competitions increase, students are required to spend long hours in the classroom studying. Therefore, it is essential for educational institutions to prioritize physical exercise and recreational activities to promote good health and enhance academic performance.

The presence of ideal sports facilities and recreational programs in a school or educational institution helps to ensure a positive experience for students. Engaging in outdoor activities serves as a mental break from academic work and boosts mental resilience.

A strong academic record and good health are fundamental to achieving one’s goals in life, regardless of the career path chosen. Good health and education instill confidence and enable individuals to overcome challenges, leading to progress and success.

Both physical and mental health are equally crucial for optimal performance and results in any profession. It is crucial for individuals to prioritize their health to become successful and productive individuals.

Through the virtue of good health, even an untalented person can manage his job. Those who have good physical condition can be seen working on farms all day, putting in their energy to earn their bread and support their families. This brings them mental satisfaction and a night of peaceful sleep at night. Moreover, physically fit and mentally sharp people can provide better support to society and earn appreciation from people.

Several professions demand good health as a primary eligibility requirement. Armed forces, paramilitary, police, and similar forces require individuals who are physically strong and mentally fit. We have seen many personnel in these forces decorated with awards for their exceptional performance and heroism while fighting against enemies or showing courage in extremely adverse conditions.

A healthy person has various job options available to them. Even in the private sector, where professional skill is the primary criterion, a physically fit person with a robust appearance is highly sought after. Health holds immense importance everywhere and proves to be beneficial throughout a person’s life.

A person’s negative thoughts and malignancy reflect on their face, while positive thoughts emanating from a healthy mind bring radiance to the face. Since the mind and body are closely interconnected, they constantly influence each other. If not controlled, they can trigger a cycle of reactions.

Improving good health is important as it holds immense value. There are many areas where people are in dire need of healthcare centers as hospitals in several rural areas are operating without doctors and medicines. The lack of proper medical facilities is leading to a scenario where people with multiple diseases or injuries are not receiving the treatment they require. Those who are financially disadvantaged cannot afford the treatment available in big cities or private hospitals.

Merely having medical facilities available will not solve the issue. It is necessary to raise awareness among people regarding regular physical exercise to promote sound health and efficiency at work. People who prioritize their health join Gymnasiums and Yoga camps, and their example inspires others to follow suit, making them disease-free and leading them toward robust health.

By freeing the mind of negative thoughts like self-indulgence, a person can develop the will to improve his body, leading to a healthier lifestyle. This, in turn, frees him from most illnesses of psychological origin, leading to a superior state of mind as he continues to work towards good health.

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Institute of Medicine (US) Committee on Using Performance Monitoring to Improve Community Health; Durch JS, Bailey LA, Stoto MA, editors. Improving Health in the Community: A Role for Performance Monitoring. Washington (DC): National Academies Press (US); 1997.

Improving Health in the Community: A Role for Performance Monitoring.

• Hardcopy Version at National Academies Press

2 Understanding Health and Its Determinants

W hat is health? Multiple definitions of health exist, ranging from a precise biomedical or physical definition such as the absence of negative biologic circumstances (altered DNA, abnormal physiologic states, abnormal anatomy, disease, disability, or death) to the broad definition of the World Health Organization: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (WHO, 1994). The former definition offers the advantages of easy measurement and relatively clarity of the causal connections between the medical and public health care systems and the measured outcomes. The latter definition views health more broadly but risks assigning to the "health" system full responsibility for the economic and social welfare of members of society. Neither definition explicitly takes account of how individuals experience disease. Individuals can feel ill in the absence of disease and vary dramatically in their responses to a disease. Indeed, what matters to individuals is not simply the absence of disease, disability, or death, but also their responses to symptoms or diagnoses; their capacity to participate in work, family, and community; and their sense of well-being in many spheres (e.g., physical, psychosocial, spiritual).

• A Broader Definition of Health

The successful implementation of initiatives to improve community health requires an understanding of the complex and diverse processes that produce health in communities. For both individuals and populations, health can be seen to depend not only on medical care, but also on other factors including individual behavior and genetic makeup, and social and economic conditions. The committee has adopted a broad definition of health, echoing a WHO (1986) health promotion perspective, that acknowledges multiple possible goals for the health system and underscores the important contributions to health that occur outside the formal medical care and public health systems. The committee definition allows improvement efforts to target not only the reduction of disease, disability, or death, but also an improvement in individuals' response to and perceptions of their illnesses; their functional capacity both now and in the future; and their overall sense of physical, emotional, and social well-being. The value of a broad measure thus rests in part upon the value attached to it by the population. Working within a definition of health that explicitly relies, in some measure, on community values is particularly important in a context of decision making for the allocation of limited resources.

Committee definition of health: Health is a state of well-being and the capability to function in the face of changing circumstances. Health is, therefore, a positive concept emphasizing social and personal resources as well as physical capabilities. Improving health is a shared responsibility of health care providers, public health officials, and a variety of other actors in the community who can contribute to the well-being of individuals and populations.

As Syme (1996) notes, viewing health as a biomedical construct has limited our ability to integrate processes that produce health and to address the underlying causes of disease. Death, disability, and disease incidence—ascertained by using traditional biologic or epidemiologic measures—are all important and valid indicators of the health of a population. A broader definition, however, allows efforts to measure community health to go beyond traditional public health measures, incorporating measures of functional status and general health perceptions. Communities embarking on health improvement initiatives should consider carefully their definition of health and ground their work in an evidence-based conceptual model of the determinants of health. Three arguments supporting such action are discussed below.

The origins of good health are multiple and cross-sectorial . Origins of good health include factors such as genetic makeup, environmental conditions, nutrition and exercise, access to health care, social support systems, and many others. Some of the factors, such as genetic makeup, are nearly impossible to alter whereas others are amenable to change. In addition, some of the factors influence a variety of health outcomes (e.g., on a population basis, dietary habits and education are known to influence multiple health outcomes). Careful consideration of what is known about the determinants of health highlights the tension between factors that are easily measurable now (e.g., hospitalization rates) and factors that may be equally or more important in the long run (e.g., teenagers' perception of their future) but are much more difficult to measure and monitor. Grounding community health improvement in a broad model of the determinants of health can remind communities to consider multiple and cross-sectorial influences when selecting health issues to target and when designing possible interventions.

A focus on the origins of health emphasizes the need for cross-sectorial assumptions of responsibilities . For various stakeholders to be accountable, the roles of those stakeholders in producing illness or health must be defined. A broad conceptual model of the determinants of health includes the full spectrum of possible influences on health. Such a model provides a valuable framework for communities to use as they consider the roles (and potential contributions) of the various stakeholders and thus each stakeholder's responsibility for health improvement in the community.

A focus on the origins of health creates multiple options for intervention . A conceptual model of the determinants of health can serve as the starting point for communities to identify what is known about issues they wish to address. Options for intervening can reflect the unique characteristics of the community vis-à-vis available resources, cultural norms, and target populations. Performance measures can then be developed as the basis for strategic actions.

The rationale for adopting a broad definition of health lies not only in its value to the population served by the health system and its usefulness in identifying measures of the origins of health. A broad definition of health also is appropriate for the changing nature of the "health care system," reflects the interconnectedness of health and social systems, and is consistent with current scientific evidence about how health is produced in communities (Aguirre-Molina, 1996; Warden, 1996).

Changing Nature of the "Health Care System"

Many Americans view health as a simple biomedical construct in which health is determined by the provision of health care (Lamarche, 1995). This perspective on health developed during this century, beginning in the 1930s with well-baby clinics and services for "crippled children" and expanding in the 1950s with national investments in biomedical research facilities such as the National Institutes of Health and construction and funding of hospitals through the Hill-Burton program (Guyer, 1990). With advances in medical science and increases in the number of hospitals, policymakers and health care providers became concerned about differential access to health care resources, especially for underserved and hard-to-reach populations. Poverty and geography were viewed as barriers to health care and thus to good health.

Beginning in the 1960s, programs designed to improve access to health services were created, including Medicare and Medicaid. These programs markedly reduced financial barriers for the poor and elderly, and they also ensured a supply of well-trained physicians by providing funds for medical school and residency training programs.

The biomedical model of health has fostered the development of a personal health care system centered around technologically advanced hospitals and highly trained medical specialists. However, the high cost of maintaining these resources is the subject of current public debate. In addition, questions have been raised about the overall contribution of the biomedical model to improvements in health status. Although important, health care has probably been overemphasized as a determinant of health. Of the 30-year increase in the life expectancy achieved this century, only 5 years can be attributed to health care services (Bunker et al., 1995).

The roles of the public sector in managing the health care system and in providing clinical and personal preventive care services as well as public health services are undergoing dramatic changes. Historically, public health departments have provided population-based services and, together with public hospitals and community health centers, have delivered clinical and personal preventive services to poor and uninsured populations. For many public health departments located in the South and in large metropolitan areas, the delivery of clinical and personal preventive services is a primary focus. In the late 1980s, however, the activities of public health departments were reexamined, and the Institute of Medicine (IOM, 1988) recommended a focus on three core functions—assessment, policy development, and assurance. In this framework, the direct provision of clinical and personal preventive services is only a small portion of the assurance function of public health departments. In many states, this transition is in progress. Public hospitals and community health clinics, however, remain important providers of these services.

Currently, most local public health departments do not play a significant role in assuring the quality of personal health care services that they do not purchase or provide. the quality assurance roles of state agencies have also been limited. Private-sector organizations, however, have developed complex and sophisticated quality assurance systems, often more in response to market forces than to demands of the public sector. As more public health departments become involved in quality assurance activities, providers and health plans can be expected to experience the influence of more public-sector demands via standard setting and licensure requirements as well as market forces.

The recent surge in the growth of managed care organizations has taken place in an environment that seeks to continue the delivery of high-quality clinical and personal preventive health services while constraining the costs of care. Managed care organizations are viewed as more capable of responding to the demands of third-party payers for performance and accountability than are clinicians practicing independently. Market forces, which spurred the recent growth of managed care organizations, have influenced the structure of the health care system (Rodwin, 1996). The experience of the Pacific Business Group on Health illustrates the changing relationships in the health system vis-à-vis new roles for purchasers and providers (see Box 2-1 ).

THE PACIFIC BUSINESS GROUP ON HEALTH. The experience of the Pacific Business Group on Health, a private-sector employer purchasing coalition based in the San Francisco Bay Area, demonstrates how "purchasers can shift the focus of the health care system (more...)

Interconnectedness of Health and Social Systems

It has long been recognized that the health of a community has a tremendous impact on the function of its social systems and that the condition of the social and economic systems has a significant impact on the health of all who live in a community (Patrick and Wickizer, 1995). For example, a healthy workforce is more productive, a healthy student body can master lessons more readily, and a healthy population is better able to make progress toward societal goals. Working conditions, economic well-being, school environments, the safety of neighborhoods, the educational level of residents, and a variety of other social conditions have a profound impact on health. Only recently, however, has substantial attention been devoted to understanding and acting upon the interdependence of health and social systems (Ashton and Seymour, 1988).

Health is a growing concern of employers, community-based organizations, schools, faith organizations, the media, local governmental bodies, and community residents, even though their roles are not viewed as part of the traditional domain of "health activities." As communities try to address their health issues in a comprehensive manner, all parties will have to sort out their roles and responsibilities. By reaching out to new partners in the community, traditional partners in health can ensure that all relevant sectors are engaged in efforts to improve health. A recent IOM report on primary care (IOM, 1996) also emphasizes the need for better collaboration among the diverse groups that can influence health. The Health Care and Community Services Project in Escondido, California, illustrates this kind of collaboration among diverse groups and the interconnectedness of health and social systems (see Box 2-2 ).

ESCONDIDO HEALTH CARE AND COMMUNITY SERVICES PROJECT. The Escondido Health Care and Community Services Project aims to reduce the harmful effects of alcohol and other drug use in the community of Escondido, California (population, 120,000; county population, (more...)

• A Model of the Determinants of Health

A resurgence of interest in broader definitions of health and its determinants is, in part, a response to the growing realization that investments in clinical care and personal preventive health services were not leading to commensurate gains in the health of populations (Evans and Stoddart, 1994). In the early 1970s, an ecologic or systems theory approach to understanding health and its determinants generated a multidimensional perspective. Some grouped the factors influencing health into four principal forces: (1) environment, (2) heredity, (3) lifestyles, and (4) health care services (Blum, 1981). A Canadian government white paper, often referred to as the Lalonde Report (Lalonde, 1974), brought wider attention to this "force-field" paradigm.

Initial responses tended to focus on individual behavior as the target of both responsibility and clinical and policy interventions. In the United States as well, the broadened emphasis on health promotion was aimed primarily at modifications of individual behavior that could be, and often were, undertaken as clinical and community interventions (USDHHS, 1991).

Responding, in part, to this focus on individuals largely to the exclusion of the communities in which they live. Evans and Stoddart (1994) proposed an expanded version of this model, illustrated in Figure 2-1 , that identifies both the major influences on health and well-being and the dynamic relationships among them. In developing a model that is consistent with current knowledge about the determinants of health, they identified nine components of interest:

A model of the determinants of health. Source: Reprinted from R.G. Evans and G.L. Stoddart, 1990, Producing Health, Consuming Health Care, Social Science and Medicine 31:1347–1363, with permission from Elsevier Science Ltd, Kidlington, UK.

social environment,

physical environment,

genetic endowment,

individual response (behavior and biology),

health care,

health and function,

well-being, and

prosperity.

Unlike a biomedical model that views health as the absence of disease, this dynamic framework includes functional capacity and well-being as health outcomes of interest. It also presents the behavioral and biologic responses of individuals as factors that influence health but are themselves influenced by social, physical, and genetic factors that are beyond the control of the individual. The model emphasizes general factors that affect many diseases or the health of large segments of the population, rather than specific factors accounting for small changes in health at the individual level. It takes a multidisciplinary approach, uniting biomedical sciences, public health, psychology, statistics and epidemiology, economics, sociology, education, and other disciplines. Social, environmental, economic, and genetic factors are seen as contributing to differences in health status and, therefore, as presenting opportunities to intervene. It is important to note, as Evans and Stoddart (1994) have done, that each component of the model represents complex sets of factors that can be examined in greater detail (see Evans et al., 1994).

The committee found the model proposed by Evans and Stoddart—which is referred to in this report as the field model —broad enough to encompass its vision. Although not yet widely tested, the model has been adapted for health policy and community planning in several Canadian provinces (Roos et al., 1995). Several features of the model were important to the committee. The model

• emphasizes the importance of considering the origins of health and the underlying causes of disease in individuals and populations;
• encourages explicit hypothesizing about the production of health in the community;
• underscores the interdisciplinary and multisectorial efforts often required to achieve health improvement in communities;
• makes explicit the possible trade-offs and benefits that occur across sectors; and
• encourages communities to identify possible performance and outcome measures from all of the categories.

In selecting indicators for performance monitoring, the determinants of health approach is useful in expanding the potential universe of indicators that should be considered. In addition to these practical reasons for adopting a model of the determinants of health such as that proposed by Evans and Stoddart, the field model provides an accurate representation of the complex contributions of physical environment, social environment, individual behavior, genetics, and health services to the well-being of communities.

Components of the Field Model: Some Examples

The components of the field model were discussed at the committee's second workshop. 1 the material below has been drawn from the summary of that workshop (see Appendix D ).

Social Environment and Prosperity

Among the elements of the social environment that have been linked to health are family structure, the educational system, social networks, social class, work setting, and level of prosperity.

Family structure, for example, is known to affect children's physical and mental health. On average, children in single-parent families do not do as well on measures of development, performance, and mental health as children in two-parent families. Children's relationships with their parents, social support, nurturance, and sense of self-efficacy have been shown to be related to their mental and physical health and even to their future economic productivity (Schor and Menaghan, 1995).

Education has an effect on health status separate from its influence on income. Years of formal education are strongly related to age-adjusted mortality in countries as disparate as Hungary, Norway, and England and Wales (Valkonen, 1989). Although most research is based on years of formal schooling, evidence suggests a broader relationship that includes the preschool period. An assessment at age 19 of participants in the Perry Pre-school Study, which randomized children into a Head Start-like program, showed that participation in the preschool program was correlated with better school performance, attending college, and avoiding involvement with the criminal justice system (Weikart, 1989). Critical periods for education, particularly at young ages, may prove to be important in determining health. In addition, studies show that maternal educational attainment is a key determinant of child welfare and survival (Zill and Brim, 1983).

"Social networks" is a term that refers to an individual's integration into a self-defined community and the degree of connectedness to other individuals and to institutions. There is a strong inverse correlation between the number and frequency of close contacts and mortality from all causes, with odds ratios of 2:1 or higher and a clear "dose-response" relationship (Berkman and Syme, 1979). Other aspects of physical and mental functioning also appear to be influenced by the quantity and quality of social connections (Seaman, 1996). Although it is possible to see the impact of social networks on health, the pathways responsible for those effects are not yet known.

Social class is another well-described determinant of health, independent of income. Major studies have been done in Britain, where social class is defined more explicitly than in the United States. In the Whitehall study of British civil servants, Marmot and colleagues (1987) demonstrated a clear relationship between social class (based on job classification) and mortality. The relationship persists throughout the social hierarchy and is unchanged after adjusting for income and smoking. The effect of social class may raise uncomfortable issues in the United States but is important to consider in dealing with issues of health and equity.

The health effects of work-related factors are seen in studies of job decision latitude, autonomy, and cardiovascular mortality (Karasek and Theorell, 1990). Involuntary unemployment negatively affects both mental and physical health. Economic prosperity is also correlated with better health. Throughout history, the poor have, on average, died at younger ages than the rich. The relationship between prosperity and health holds across the economic spectrum. For every decile, quintile, or quartile of income, from lowest to highest, there is a decline in overall age-adjusted mortality. In international comparisons by the Organization for Economic Cooperation and Development, the difference in income between the highest and lowest deciles of income shows a stronger relationship with overall mortality rates than does median income (Wilkinson, 1992, 1994).

Physical Environment

The physical environment has long been recognized as an important determinant of health. The public health movement of 1840–1870 emphasized environmental changes as a successful strategy for reducing the epidemic rates of infectious diseases, which flourished in the overcrowded housing with poor sanitation in industrial cities in Europe and North America (Ashton and Seymour, 1988).

The physical environment affects health and disease in diverse ways. Examples include exposures to toxic substances, which can produce disorders such as lung disease or cancers; safety at home and work, which influences injury rates; the design of vehicles and roadways, which can alter crash survival rates; poor housing conditions and overcrowding, which can increase the likelihood of violence, transmission of infectious diseases, and mental health problems; and urban-rural differences in cancer rates.

Genetic Endowment

The contribution of genetic makeup to the health of an individual is a new and emerging area of scientific inquiry. As scientific knowledge about genetics increases, this component of the field model is likely to become increasingly important.

For the most part, genetic factors are currently understood as contributing to a greater or lesser risk for health outcomes, rather than determining them with certainty. One area of particular interest is the link seen between genetics and behavior. Studies of twins separated at birth demonstrate a high concordance rate in alcoholism, schizophrenia, and affective disorders (Baird, 1994). Even so-called voluntary behaviors such as smoking and eating habits may be subject to genetic predispositions (e.g., Carmelli et al., 1992; de Castro, 1993; Falciglia and Norton, 1994). Health behaviors are complex, and the influences that determine them are likely to be extremely complex.

Genetic factors also interact with social and environmental factors to influence health and disease. It will be important to understand these interactions to learn why certain individuals with similar environmental exposures develop diseases whereas others do not (e.g., why most smokers do not develop lung cancer).

In the field model framework, behavior is seen as a response to other factors and can be treated as an intermediate determinant of health. Rather than a voluntary act only amenable to direct intervention, behavior is shaped by multiple forces, particularly the social and physical environments and genetic endowment. At the same time, behavior change remains a goal. Behaviors related to health care, such as adherence to treatment regimens, are influenced by these forces as are behaviors directly influencing health, such as smoking.

Health Care

Health care is an essential determinant of health. In the United States, however, its contribution has probably been over-emphasized. As noted above, about 5 years of the 30-year increase in life expectancy achieved in this century can be attributed to health care (Bunker et al., 1995). The greatest share of this gain can be attributed to diagnosis and treatment of coronary heart disease, which contributes 1 to 2 of these additional years of life.

Linking the Determinants

The committee was impressed by several implications of the field model's theoretical perspective. First, the model clearly reinforces the interrelatedness of many factors. Health outcomes are the product of complex interactions of factors rather than of individual factors operating in isolation. Indeed, these interactions are probably as important as the actions of any single factor. Currently incomplete, however, are descriptions of mechanisms underlying the linkages among the various determinants and full characterizations of the interactions among factors. The committee encourages the continued research needed to gain a better understanding of these mechanisms.

Second, not all of the determinants, viewed as causes, act simultaneously. The effects of some determinants, in fact, may be necessary antecedents to others, and some may have their primary influence by modifying the effects of others. Some may also differ in their relationship to health according to when they are present in the life cycle. Evidence suggests that there are certain times in the human life cycle that are critical for future health and well-being. During infancy and early childhood, crucial neurologic, cognitive, and psychosocial patterns are established (Carnegie Task Force on Meeting the Needs of Young Children, 1994; Entwisle, 1995). Experiences in childhood and adolescence may also have a critical influence on adult health risk factors such as weight and smoking (Dietz, 1994; IOM, 1994).

Another Perspective

Patrick and Wickizer (1995) have extended the field model framework by focusing on factors in the social and physical environments that operate at the community rather than the individual level. These two components are seen as affected by cultural, political, policy, and economic systems. In turn, they influence elements such as community response, activation, and social support, and ultimately community outcomes including social behaviors, community health, and quality of life. For example, establishing a smoke-free workplace policy exerts an influence on exposure to tobacco smoke separate from the smoking practices of individuals. This perspective points both to the influence of community-level factors and to the opportunities for community-level interventions.

• Interventions to Improve Health

Many factors can influence the impact of interventions to improve health. It is possible to target various determinants of health to produce change at an individual level, a community level, or both. All aspects of each broad determinant of health are not equally amenable to intervention, however. For example, the social environment of isolated senior citizens can be improved by increasing contact with others, but their genetic makeup is not amenable to change.

Time frames for measuring health changes vary widely, from days to decades. Some successful interventions will produce observable results within a year or two, but others may be followed by long latency periods before significant changes in health status can be observed. The impact of an intervention may also be influenced by when it reaches an individual because, as noted above, there appear to be "critical periods" in human development. Certain interventions in childhood may have long-delayed yet long-lasting results. In addition, the population effects of interventions are also important to consider. Small changes at the individual level may have important ramifications when applied to a whole community (Rose, 1992).

The traditional targets for intervention have been specific diseases or behaviors, and categorical funding streams for both research and the delivery of services encourage this approach. The field model of the determinants of health encourages consideration of a wider array of targets. For example, if adolescents' sense of well-being can be improved by reducing their feelings of alienation and hopelessness, can unintended pregnancies, alcohol and other drug use, crime, and the school dropout rate all be reduced? A multidimensional approach would be required, focusing on education, social and community involvement, family preservation, and improved social networks for teens and their parents. Community-level interventions might include after-school programs, athletics (e.g., midnight basketball), and church-based programs.

Whether focused on individuals or the community as a whole, health improvement efforts should be targeted at specific causal pathways or should employ interventions that have been proven effective. There is an obvious tension between what is now known and what we need to know to improve health. For example, the biologic pathways through which poverty or low social class influence health have not been adequately elucidated. A tension also exists between what is now measurable with valid and reliable indicators and what is not measurable, but may be important.

The multidimensional approach may be unfamiliar to health professionals because it is new and relies on partnerships with people from fields beyond those traditionally encompassed by a medical model. It is, however, consistent with the field model and may provide expanded opportunities for performance monitoring and improving the community's health.

• Implications for Communities

An examination of the field model points to the importance of considering both individual- and community-level data. Performance monitoring should include measures of inputs, process, and outcomes for health and health improvement activities. It may prove useful to monitor some key determinants, regardless of whether they are amenable to change at the local level, so that communities can understand the range of important factors. In addition, qualitative data may contribute important information about community needs. For example, information on social support, perceived barriers to service utilization, and attitudes toward the community and its resources are all relevant to performance monitoring and can be obtained from community surveys.

Performance monitoring provides an opportunity for a community to define and articulate expectations for organizations' contributions to the population's health. Although organizations might disagree with the appropriateness of the expectations, a useful dialogue may ensue. Communities may want to focus special attention on expectations regarding managed care organizations (MCOs) and the business sector. MCOs, for example, have generally defined "community" as their enrollees and not considered the entire community or public health as their area of concern. A community expectation that the health of the entire local population is part of an MCO's corporate and social responsibility could lead to their broader involvement in public health activities. Businesses, including MCOs, that have strong ties with a city or region may have a history of interest in local health issues. As corporations expand to multiple regions, however, they may require added encouragement to become involved and accountable in the local communities where they have a presence.

• Conclusions

Contributing to the interest in health improvement and performance monitoring is a wider recognition that health embraces well-being as well as the absence of illness. For both individuals and populations, health can be seen to depend not only on medical care but also on other factors, including individual behavior and genetic makeup, and social and economic conditions for individuals and communities. The field model, as described by Evans and Stoddart (1994), presents these multiple determinants of health in a dynamic relationship. The model's feedback loops link social environment, physical environment, genetic endowment, an individual's behavioral and biologic responses, health care, disease, health and function, well-being, and prosperity. The committee found this model to be an effective basis for its work.

This multidimensional perspective reinforces the value of public health's traditional emphasis on a population-based approach to health issues. It also provides a basis for looking to segments of the community beyond those traditionally associated with health to address factors affecting health and well-being. Some of the additional parties who can be brought to the table as interested stakeholders and accountable partners include, among many others, schools, employers, community-based organizations, the media, foundations, and public safety agencies. A performance monitoring program can promote the articulation of roles and responsibilities among these participants.

The committee has concluded that entities engaged in performance monitoring for community health improvement should

• adopt a broad definition of health;
• adopt a comprehensive and conceptual model of the way in which health is produced within the community; the field model, as elaborated by Evans and Stoddart, is a good starting point; and
• develop a concrete and specific hypothesis of how the multiple sectors of the community and individual stakeholders in each sector can contribute to the solution of a health problem.

In addition, federal agencies and foundations should provide support for further research on the determinants of health to clarify pathways, to develop reliable and valid measures useful for performance monitoring related to these pathways, and to identify community programs and clinical and public health interventions that are successful in addressing the underlying causes of ill health in communities.

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The workshop discussion was based on a presentation by Jonathan Fielding.

• Cite this Page Institute of Medicine (US) Committee on Using Performance Monitoring to Improve Community Health; Durch JS, Bailey LA, Stoto MA, editors. Improving Health in the Community: A Role for Performance Monitoring. Washington (DC): National Academies Press (US); 1997. 2, Understanding Health and Its Determinants.
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Mental Health Awareness Month: UK, Talkspace encourage students to 'Talk it Out'

LEXINGTON, Ky. (May 16, 2024) — Highlighting the importance of mental wellness and fostering a supportive environment for students, the University of Kentucky joins the global community in observing Mental Health Awareness Month this May. 

This annual observance aims to raise awareness about mental health issues, reduce stigma and promote access to resources and services.

Mental Health Awareness Month traces its roots to Mental Health America (MHA), formerly known as the National Mental Health Association, which initiated the observance as Mental Health Week in 1949. Over the years, it has evolved into a month-long campaign — engaging communities, organizations and institutions worldwide in conversations and initiatives to prioritize mental well-being.

For college students, mental health plays a pivotal role in their overall academic success and personal growth. The university experience often brings about unique challenges — from academic pressures to social transitions — that can impact mental wellness. Recognizing these challenges, the university is committed to providing comprehensive support and resources.

"As an institution dedicated to the holistic development of our students, we recognize the profound impact of mental health on their well-being and academic journey,” David Beach, acting assistant vice president for well-being with the  Office for Student Success , said. “This month, we reaffirm our commitment to fostering a campus culture that prioritizes mental wellness and provides accessible resources for all students.”

Through Student Success, UK offers a range of mental health resources and services including: counseling and psychological services, mental health awareness workshops, peer support programs, and partnerships with community mental health organizations. These efforts are complemented by a campuswide commitment to promote mental health literacy, reduce stigma and encourage open dialogue about mental wellness.

In an effort to expand mental health resources for students, last year, UK partnered with  Talkspace . The confidential and secure online text and video chat therapy platform offers access to mental health clinicians. With a network of thousands of credentialed clinicians, Talkspace is used by more than one million people, matching them with a licensed therapist that best suits their needs.

This May, Talkspace is celebrating the power of talking to a licensed therapist to overcome challenges and build mental resilence. "When you open up to a therapist you don’t know quite what to expect, or which feelings and discoveries therapy will bring up for you on a given day," Talkspace said in a description of its "Talk it Out" campaign. "However, one thing’s certain: If you keep talking, you’ll gain insights and uncover truths that you can only find in therapy."

Beach looks at Talkspace as a way to supplement the wide number of resources that already exist at UK and likens it to the Swiss cheese analogy.

"Each resource has holes," he explained. "However, if we layer the resources, each and every student has access to mental health support in a way that works for them."

How Talkspace works: 

• Answer a few simple questions to get started — it takes less than two minutes.
• The Talkspace team will match you with a provider (typically within 48 hours).
• Connect with your provider and begin your mental health journey, including unlimited messaging and two phone or video sessions each month.

All currently enrolled students have access to Talkspace, free of charge. To learn more, visit:  www.Talkspace.com/uky .

For additional mental health resources at UK, students can utilize  TRACS (Triage, Referral, Assistance and Crisis Support) . The physical and virtual one-stop shop offers a quick referral to support services and direct clinical support for a range of mental health needs.

Services are offered in-person and virtually, 8 a.m.-5 p.m. Monday-Friday. For more information on TRACS, visit  go.uky.edu/tracs . 

To learn more about mental health resources available to staff and faculty, please visit the UK HR website .

At the University of Kentucky, students are at the center of all that we do. From the moment you become a Wildcat through graduation and beyond, the Office for Student Success is committed to supporting you. Comprised of five areas and 25 units, together, they have one vision — to help students live a life of meaning. Student Success works through an equitable, holistic and inclusive lens to design and deliver unparalleled services and support a diverse community of learners in achieving their wildest ambitions. In the Office for Student Success this is what we do — this is who we are. You can explore resources available to you  here . If you have additional questions, you can reach a Student Success team member by calling the helpline 859-218-YouK (9685).

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Why writing by hand beats typing for thinking and learning

Jonathan Lambert

If you're like many digitally savvy Americans, it has likely been a while since you've spent much time writing by hand.

The laborious process of tracing out our thoughts, letter by letter, on the page is becoming a relic of the past in our screen-dominated world, where text messages and thumb-typed grocery lists have replaced handwritten letters and sticky notes. Electronic keyboards offer obvious efficiency benefits that have undoubtedly boosted our productivity — imagine having to write all your emails longhand.

To keep up, many schools are introducing computers as early as preschool, meaning some kids may learn the basics of typing before writing by hand.

But giving up this slower, more tactile way of expressing ourselves may come at a significant cost, according to a growing body of research that's uncovering the surprising cognitive benefits of taking pen to paper, or even stylus to iPad — for both children and adults.

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In kids, studies show that tracing out ABCs, as opposed to typing them, leads to better and longer-lasting recognition and understanding of letters. Writing by hand also improves memory and recall of words, laying down the foundations of literacy and learning. In adults, taking notes by hand during a lecture, instead of typing, can lead to better conceptual understanding of material.

"There's actually some very important things going on during the embodied experience of writing by hand," says Ramesh Balasubramaniam , a neuroscientist at the University of California, Merced. "It has important cognitive benefits."

While those benefits have long been recognized by some (for instance, many authors, including Jennifer Egan and Neil Gaiman , draft their stories by hand to stoke creativity), scientists have only recently started investigating why writing by hand has these effects.

A slew of recent brain imaging research suggests handwriting's power stems from the relative complexity of the process and how it forces different brain systems to work together to reproduce the shapes of letters in our heads onto the page.

Your brain on handwriting

Both handwriting and typing involve moving our hands and fingers to create words on a page. But handwriting, it turns out, requires a lot more fine-tuned coordination between the motor and visual systems. This seems to more deeply engage the brain in ways that support learning.

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"Handwriting is probably among the most complex motor skills that the brain is capable of," says Marieke Longcamp , a cognitive neuroscientist at Aix-Marseille Université.

Gripping a pen nimbly enough to write is a complicated task, as it requires your brain to continuously monitor the pressure that each finger exerts on the pen. Then, your motor system has to delicately modify that pressure to re-create each letter of the words in your head on the page.

"Your fingers have to each do something different to produce a recognizable letter," says Sophia Vinci-Booher , an educational neuroscientist at Vanderbilt University. Adding to the complexity, your visual system must continuously process that letter as it's formed. With each stroke, your brain compares the unfolding script with mental models of the letters and words, making adjustments to fingers in real time to create the letters' shapes, says Vinci-Booher.

That's not true for typing.

To type "tap" your fingers don't have to trace out the form of the letters — they just make three relatively simple and uniform movements. In comparison, it takes a lot more brainpower, as well as cross-talk between brain areas, to write than type.

Recent brain imaging studies bolster this idea. A study published in January found that when students write by hand, brain areas involved in motor and visual information processing " sync up " with areas crucial to memory formation, firing at frequencies associated with learning.

"We don't see that [synchronized activity] in typewriting at all," says Audrey van der Meer , a psychologist and study co-author at the Norwegian University of Science and Technology. She suggests that writing by hand is a neurobiologically richer process and that this richness may confer some cognitive benefits.

Other experts agree. "There seems to be something fundamental about engaging your body to produce these shapes," says Robert Wiley , a cognitive psychologist at the University of North Carolina, Greensboro. "It lets you make associations between your body and what you're seeing and hearing," he says, which might give the mind more footholds for accessing a given concept or idea.

Those extra footholds are especially important for learning in kids, but they may give adults a leg up too. Wiley and others worry that ditching handwriting for typing could have serious consequences for how we all learn and think.

What might be lost as handwriting wanes

The clearest consequence of screens and keyboards replacing pen and paper might be on kids' ability to learn the building blocks of literacy — letters.

"Letter recognition in early childhood is actually one of the best predictors of later reading and math attainment," says Vinci-Booher. Her work suggests the process of learning to write letters by hand is crucial for learning to read them.

"When kids write letters, they're just messy," she says. As kids practice writing "A," each iteration is different, and that variability helps solidify their conceptual understanding of the letter.

Research suggests kids learn to recognize letters better when seeing variable handwritten examples, compared with uniform typed examples.

This helps develop areas of the brain used during reading in older children and adults, Vinci-Booher found.

"This could be one of the ways that early experiences actually translate to long-term life outcomes," she says. "These visually demanding, fine motor actions bake in neural communication patterns that are really important for learning later on."

Ditching handwriting instruction could mean that those skills don't get developed as well, which could impair kids' ability to learn down the road.

"If young children are not receiving any handwriting training, which is very good brain stimulation, then their brains simply won't reach their full potential," says van der Meer. "It's scary to think of the potential consequences."

Many states are trying to avoid these risks by mandating cursive instruction. This year, California started requiring elementary school students to learn cursive , and similar bills are moving through state legislatures in several states, including Indiana, Kentucky, South Carolina and Wisconsin. (So far, evidence suggests that it's the writing by hand that matters, not whether it's print or cursive.)

Slowing down and processing information

For adults, one of the main benefits of writing by hand is that it simply forces us to slow down.

During a meeting or lecture, it's possible to type what you're hearing verbatim. But often, "you're not actually processing that information — you're just typing in the blind," says van der Meer. "If you take notes by hand, you can't write everything down," she says.

The relative slowness of the medium forces you to process the information, writing key words or phrases and using drawing or arrows to work through ideas, she says. "You make the information your own," she says, which helps it stick in the brain.

Such connections and integration are still possible when typing, but they need to be made more intentionally. And sometimes, efficiency wins out. "When you're writing a long essay, it's obviously much more practical to use a keyboard," says van der Meer.

Still, given our long history of using our hands to mark meaning in the world, some scientists worry about the more diffuse consequences of offloading our thinking to computers.

"We're foisting a lot of our knowledge, extending our cognition, to other devices, so it's only natural that we've started using these other agents to do our writing for us," says Balasubramaniam.

It's possible that this might free up our minds to do other kinds of hard thinking, he says. Or we might be sacrificing a fundamental process that's crucial for the kinds of immersive cognitive experiences that enable us to learn and think at our full potential.

Balasubramaniam stresses, however, that we don't have to ditch digital tools to harness the power of handwriting. So far, research suggests that scribbling with a stylus on a screen activates the same brain pathways as etching ink on paper. It's the movement that counts, he says, not its final form.

Jonathan Lambert is a Washington, D.C.-based freelance journalist who covers science, health and policy.

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