Introduction to Public Health November 7, 2004. Community Assessment with Health Disparities Groups Judith Bradford, Ph.D. Community Health Research Initiative Survey and Evaluation Research Lab [email protected] Defining the Population. Communities.
Overarching purpose: promoting health and preventing illness, disability, and premature death
... grounded in science, built through public consensus, and designed to measure progress
Two overarching goals:
Format: 467 objectives to improve health, organized into 28 focus areas.
Differences that occur by….
HP2010 Goal: Ensure that ... health agencies have the infrastructure to provide essential public health services effectively
Arthritis, osteoporosis, and chronic back conditions
Chronic kidney disease
Disability and secondary conditions
Educational and community-based programs
Health communicationFocus Areas - 1
Immunization and infectious diseases
Injury and violence prevention
Maternal, infant, and child health
Medical product safety
Mental health and mental disorders
Nutrition and overweight
Occupational safety and health
Oral healthFocus Areas - 2
Public health infrastructure
Sexually transmitted diseases
Vision and hearingFocus Areas - 3
are not always easy to find
are sometimes difficult to define (and therefore to count)
may be poorly understood by the “system”
may have low political/social priority
may even be considered less valuable or otherwise inconvenientLimitations of Current System forHP2010 Community Assessment
What’s the question?
Who is in the community?
On a scale of 1 - 10….
How complete are available data?
How difficult to obtain currently unavailable data?
Which sampling strategies are most effective?
How to determine the distribution of identified cases in a geographic area defined by Census tracts?
(using same-sex HH data from 1990 & 2000; difficulty 2)
No existing federal data system contains directly relevant data.
No existing federal data system will do this.
…the nature of human relationships – the degree to which an individual is interconnected and embedded in a community – is vital to an individual’s health and well-being as well as to the health and vitality of entire populations.
Berkman LF, Glass T. Social integration, social networks, social support and health, in Social Epidemiology, Berkman LF and Kawachi I, Eds. New York: Oxford University Press, 2000.
McElroy KR, Bibeau D, Steckler A, Glanz . An ecological perspective on health promotion programs. Health Education Quarterly 15:351-377, 1988.
Interpersonal: assessments?family, friends, peers that provide social identity, support and identity
Individual: awareness, knowledge, attitudes, beliefs, values, preferences
Public Policy: local, state and federal government policies, regulations, and laws
Community: social networks, standards and practices among organizations
Institutional/Organ-izational: rules, policies, procedures, environment, and informal structures within an organization or system
Minkler M, Wallerstein N (Eds.). Community Based Participatory Research for Health. San Francisco: Jossey-Bass & Co., 2003.