NUR/405 Healthy Communities: Theory And Practice
November 28th, 2011
Community health nursing has become a focal point in healthcare since the 1960s-70s when the civil right movement shifted the goal from a charitable concept to a political commitment in order to rectify racial injustices of the past (Stanhope and Lancaster, 2008). Many programs came about with the goal of addressing inequalities in the delivery of healthcare based upon social-economical status. Nurse practitioners then became an important factor in the delivery of healthcare, thereby affecting services offered in community health clinics which improved local accessibility to healthcare. (Stanhope and Lancaster, 2008). Many dynamic changes occurred since then with nurses making important contributions in disease prevention and health promotion in the community which countered the escalating costs of acute hospital care. The definition of a community, in simplicity, is a group of people who live in the same area, or the area in which they live. Unfortunately, this definition does not completely explain what a community is. A community would be individuals who share the same space and interact with each other either directly or indirectly via mechanisms or environment. A community is more than a cluster of individuals, it also will be constructed of families and aggregates (persons with many commonalities) that are interdependent or whose purpose is to fulfill a wide variety of the collective needs (Stanhope and Lancaster, 2008).Stepping back and looking at this description, you could imagine the complexity of interactions which would occur for its survival. Community health is everything in the process, including characteristics, environment and economics that promote the survival of its constituents. Stanhope and Lancaster (2008) define community health as, “the meeting of collective needs through the identification of problems and management of behaviors within the community itself and between the community and the larger society” (page 371). Emotional and social aspects of community health are reflected in mental health, crime rates and levels of social function. Community structure is determined by the level of services and resources available to the members. Community health may be improved with the formation of organizations whose goal is to promote the welfare of those who it serves. To go beyond the concept of community/community health and enter the realm of community as a client is very difficult place into practice as a nurse. Communities are more than their sum/aggregates. The focus for nursing is aimed at the improvement of health for the community as a whole rather than groups of individuals. One could describe community from the systems perspective in which there is a hierarchy (Stanhope and Lancaster, 2008). That being said, changes in one level will impact the others. For nursing, the goal is to create entire community changes with interventions via working with individuals/families. This could be seen in the example of smoking cessation programs which improve individual health and ultimately impact the overall health of the community. The Houston/ Harris county area encompasses an area of 1,778 square miles with a population of 4.1 million ("City-Data.com", 2010). Due to its large size and demographics, I have elected to perform my survey based on the zip code in which I live. In this area you could find a variety of obvious health related issues in addition, to many community support services/institutions. Unfortunately, this area has individuals selling drugs, drinking alcoholic beverages along with environments that promote the perpetuation of these behaviors. The Healthy People 2020 health indicator I have chosen is substance abuse. According to US Department of Health and Human Services (2011), the goal is to, “reduce substance abuse to protect the health,...