Community Health Programs
Community health programs are locally based education and treatment programs available typically to individuals who are living in poverty and/or do not have health insurance coverage. Community health programs are usually non-profit and seek funding through health department programs, donations, and government grants. Community-based health programs are typically found in communities where the services are needed the most, and the services are tailored to the populations of residents.
Community health programs and clinics provide treatment, special clinics, education, and media campaigns that target a variety of issues affecting the health of a community. Many poor populations would have no other options for treatment without such neighborhood clinics and community health programs. Typical services include testing and treatment of sexually transmitted diseases; gynecological and obstetrical services; well-baby checks and immunizations; treatment of chronic diseases such as diabetes and high blood pressure; substance abuse programs; and general health promotion of good nutrition and weight management.
Community-based programs will continue to be in demand to serve all populations from newborns to the elderly. Such programs are likely to become increasingly necessary to serve the growing number of immigrants moving to and living in the United States, the aging of the baby boomer generation, and the overall expansion of the population.
In the 21st century, the United States is expected to become increasingly diverse as the proportion of immigrants grows. In the next 25 years, the number of non- Hispanic white people living in the United States is expected to decrease from 72% to 62% due mostly to the increase in Hispanic populations.
Immigration also affects fertility rates because women in some immigrant populations tend to have more children. The need for reproductive health care and pregnancy prevention services are expected to increase at the community level.
The demand for services for the elderly will also increase as baby boomers age. As the health status of the elderly population improves, older adults are increasingly choosing to stay in their own homes and live independently. Senior citizens who live on a fixed income or who have limited health care coverage may be hard- pressed to pay for medications, monitoring, and treatment of age-related, chronic conditions such as diabetes, high blood pressure, declining eye sight, hearing loss, and heart disease.
One point of debate within community health programs is the maximum income a person may earn and still be eligible for community health benefits. With limited funding, these agencies must follow guidelines for whom to offer services. In addition to those clearly living in poverty, the working poor and those with fixed
The American Public Health Association (APHA) emphasizes that health care for all individuals is a basic human right. Every individual should be able to participate in his or her own health and wellbeing, and it is every citizen's responsibility to contribute to the wellbeing of all. Community-based health programs offers the opportunity to empower the community to enable all citizens to have access to optimum health. Community health directors can take the lead to promote these ends.
In collaboration with the APHA, the American Medical Association (AMA) has implemented seven goals, known as the Medicine/Public Health Initiative. They include: working to change the attitude within academic health centers; community health programs, insurance companies, and other heath care delivery providers having a more health-centered approach; creating inter- disciplinary teams to establish research-based programs that focus on relevant health problems; expanding the public's understanding of medicine, and, in turn, helping those in medicine understand public health; developing a common research agenda for public health; and developing a framework for integrating health promotion into clinical and community settings.
The AMA emphasizes that the success of health education and promotion lies with many disciplines collaborating and working cooperatively. Health care professionals, such as physicians, social workers, nurses, health educators, environmental health engineers, and behavioral health professionals, have their own unique training, skills, and tools. Public health is a multidisciplinary field. By contributing a population-based perspective on health and disease, public health practitioners can collaborate with medical professionals to optimize resources and ideas and contribute more effectively to improving the health of the community. Community-based health clinics and centers are in need of professionals who can lobby legislators to support funding for programs, in addition to lobbyists who can work with government agencies such as the Health Care Financing Administration (HCFA), which over- sees Medicaid funding.
Maxcy, Kenneth Fuller, M.J. Rosenau, John M. Last, et. al., eds. Public Health and Preventive Medicine. McGraw- Hill Professional Publishing, 1998.
Swanson, Janice M., Mary A. Nies, and Ilde Rader Albrecht, eds. Community Health Nursing: Promoting the Health of Aggregates, 2nd ed. Philadelphia: WB Saunders, 1996.
American Public Health Association. 800 I Street, NW, Washington, D.C. 20001. (202) 777-2742. <http://www.apha.org>.
The Center for Community-Based Health Strategies. 1825 Connecticut Ave., NW, Washington, D.C. 20009. (202) 884-8862. <http://www.healthstrategies.org>.
U.S. Department of Health and Human Services, Offices of Disease Prevention and Health Promotion. 200 Independence Ave., SW, Washington, D.C. 20201. (202) 401-6295. <http://odphp.osophs.dhhs.gov>.
Meghan M. Gourley