Community Health test 1 review

definition of health

state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (WHO 1946).

Health is also “the ever changing state that encompasses external and internal physical, emotional, spiritual and social function” and is viewed as a resource for everyday life, not the objective of living.

definition of community health

The effort that is organized by society to protect, promote and restore the health and quality of life of the people.” It focuses on groups rather than individuals.

Public health definition

The science and art of preventing disease, prolonging life, and promoting physical and mental efficiency through organized community effort…” and “the organization and application of public resources to prevent dependency which would otherwise result from disease or injury.” Public health is essentially “the people’s health.

Dental public health

is concerned with the diagnosis, prevention and control of dental diseases and the promotion of oral health through organized community efforts.

Dental public health serves the community rather than the individual through research, health promotion, education and group dental care programs

Roles of dental hygienists in public health: Clinician/service provider 

• Role: Provide preventive and therapeutic services in community settings (schools, public clinics, long‑term care, outreach programs).

Roles of dental hygienists in public health: Health educator

• Role: Design and deliver oral health education and health promotion programs for groups and communities.

Roles of dental hygienists in public health: Consultant

• Role: Advise agencies, schools, and community organizations on oral health policies and programs.

Roles of dental hygienists in public health: Consumer advocate/change agent  

• Role: Advocate for equitable access to oral health care, policy change, and reduction of disparities.

Roles of dental hygienists in public health: Researcher

• Role: Participate in or lead studies on oral disease prevalence, program effectiveness, and community needs.

Roles of dental hygienists in public health: Administrator/manager

• Role: Plan, implement, and evaluate public oral health programs; manage budgets and staff.

key functions of public health

• Prevent epidemics

• Protect against environmental hazards

• Prevent injuries

• Promote and encourage healthy behaviours

• Respond to disasters and assist communities in recovery

• Assure the quality and accessibility of health services

how does public health achieve the key functions

• Health education, research, administration of programs, policy development, surveillance, and community partnerships.

what is a publinc health problem

“a condition or situation that is a widespread actual or potential cause of morbidity or mortality”

Common criteria to identify a public health problem:

• Burden: High morbidity/mortality or disability.

• Prevalence of risk factors: Widespread behaviours or exposures that increase risk.

• Population impact: Ability to affect large groups or the whole population.

• Seriousness: Severity of outcomes (pain, disability, death).

• Economic/social impact: Costs to individuals, families, and systems.

• Public concern and political attention: Issue recognized and prioritized.

• Need for group action: Requires collective solutions, not just individual care.

• Availability of resources: Feasible interventions and funding.

• Cultural appropriateness: Solutions fit community values and norms.

• Effect on health equity: Degree to which it worsens or improves inequities.

Requirements for a public health solution

• Not hazardous to life or function.

• Effective in reducing or preventing the targeted disease/condition.

• Easily and efficiently implemented.

• Potency maintained for a substantial period.

• Accessible regardless of socioeconomic status or education.

• Effective immediately upon application or early in life.

• Inexpensive or within the means of the community.

examples of public health solutions

• Vaccination programs

• Community water fluoridation

• Seat‑belt laws and vehicle safety standards

• Workplace safety regulations

• Tobacco control policies

• Safe drinking water and sanitation

Why fluoride is ideal

• Meets solution criteria: Safe, effective, inexpensive, long‑lasting, and available to all who use the water supply.

• Not dependent on individual behaviour: Works regardless of whether people seek dental care or use other fluoride products.

• Reduces caries and treatment costs: “For every $1 invested in adding fluoride to the drinking water saves $38 in dental care…ROI = 3700%.”

Fluorosis

National surveys report that moderate/severe fluorosis is rare and “too low to permit reporting,” supporting safety.

optimal level of fluoride definition

controlled addition of fluoride to public water supply to bring the concentration to an optimal level to prevent caries

optimal level of fluoride

0.5-0.8 mg/L

health canada recommends 0.7 mg/L

population health definition

improves the health status of the population rather than that of the individual.

it studies health of populations using scientific approaches, health indicators & determinants of health then analyzes information and makes recommendations

Difference from public health

• Population health: Focuses on understanding health status, determinants, and trends; uses research and statistics to answer “What are the most important factors affecting health?” and “Why are some groups healthier than others?”

• Public health: Uses that information to design and implement programs, policies, and interventions—“Programming & Policy.”

Role of population health in community settings

• Identify health indicators (mortality, hospitalization, oral health indices, DMFT, edentulism, periodontal status).

• Analyze determinants of health (income, education, environment, behaviours, access to care).

• Monitor trends (e.g., changes in caries, periodontal disease, chronic disease prevalence).

• Inform planning of community programs, resource allocation, and policy decisions.

Key players in public health: Federal government

• Sets national policies, funds major programs, oversees surveillance (e.g., Health Canada, Public Health Agency of Canada, Chief Public Health Officer, Chief Dental Officer).

Key players in public health: Provincial/territorial governments

• Administer health care systems, public health units, and dental programs; implement legislation (e.g., Ontario Public Health Standards).

Key players in public health: Municipal governments/public health units:

• Deliver local programs (school dental screening, immunization, community water fluoridation, health promotion).

Key players in public health: Health professionals

Dentists, dental hygienists, nurses, physicians, allied health staff who design and staff programs.

Key players in public health: Community organizations and NGOs

• CAPHD, CDA, CDHA, Red Cross, etc., which advocate, educate, and support initiatives.

Core functions of public health

assessment

policy development

assurence

public health assessment

• Regular and systematic collection, analysis, and dissemination of information on the health of the community.

• Examples: Surveillance of caries and periodontal disease, CHMS data collection, monitoring immunization rates, tracking chronic disease prevalence.

public health policy development

• Definition: Using scientific knowledge to develop public health policies; involves strategizing and using the political process.

• Examples: Fluoridation bylaws, tobacco control legislation, school nutrition policies, dental public health guidelines.

public health assurence

• Definition: Ensuring communities have access to services needed to meet health goals through regulation and/or direct delivery.

• Examples: Guaranteeing access to immunization, school dental screening, emergency dental programs for low‑income groups, inspection of water quality.

Examples of public health services today

• Immunization clinics

• Community water fluoridation

• School‑based oral health programs (screening, sealants)

• Tobacco cessation programs

• Nutrition and physical activity promotion

• STI and sexual health clinics

• Injury prevention (helmet, seat‑belt campaigns)

• Environmental health inspections (food safety, water safety)

what is the Illness–wellness continuum

shows movement from premature death (disability, symptoms, signs) through a neutral point to high‑level wellness

Medical model of health

• Health = absence of disease.

  • Focus on diagnosis and treatment of pathology; curative, physician‑centred, hospital‑based.

holistic model of health

• Considers all parts of the person—physical, mental, social, spiritual—

• focuses on positive aspects of health.

indigenous wholistic THEORY

Considers mental, physical, cultural, and spiritual well‑being of the individual and the entire community; emphasizes connection to land, spirit world, and community relationships.

wellness model of health

• Builds on medical and holistic models; sees health as a process that evolves toward improved future health.

• Emphasizes prevention, health promotion, lifestyle, and personal growth—most common in current health care climate.

Health Canada’s determinants

1. income and social status

2. employment and working conditions

3. education and literacy

4. childhood expriences

5. physical environments

6. social support and coping skills

7. healthy behaviours

8. access to health services

9. biology and genetics

10. gender

11. culture

12. race/racsim

Population size and growth

• Over 41.6 million by late 2025.

• 2022–2023 growth rate 2.9%, highest since 1957; growth concentrated in urban areas, driven largely by immigration.

Age distribution

• “Graying of the population”—about 8.1 million seniors; proportion of elderly rising from ~11% (1991) toward ~25% (2021+).

• More chronic conditions and higher demand for health and dental care; nearly 44% of seniors do not visit the dental office vs ~27% of adults 45–64.

Health status

• Infant mortality has declined but remains higher in areas with predominantly Indigenous populations.

• Among those 65+, 73% have at least one of 10 common chronic diseases (hypertension, ischemic heart disease, diabetes, osteoporosis, cancer, COPD, mood/anxiety disorders, etc.).

Racial and ethnic composition of canada

• Visible minorities ~26–27% nationally (2021), projected to reach ~1 in 3 by 2031.

• Major groups: South Asian, Chinese, Black, Filipino, Arab, West Asian, Latin American, etc.

• In Ontario and Durham Region, visible minority proportions are higher (Durham ~36.3% visible minority in 2021)

Geographic distribution of canada

Population concentrated in Ontario and Quebec; Alberta fastest growing; 96% of visible minorities live in cities.

Economic distribution of canada

Economic pressures (inflation, cost of living, deficits) challenge health spending, especially for older adults and high‑cost care.

need definition

• Professionally perceived requirement for care determined by clinicians based on disease, risk, and standards.

Example: A client with untreated caries and periodontal pockets has a high need for restorative and periodontal therapy, even if they do not seek care.

demand definition

• Occurs when individuals actively seek care in response to a perceived need; “the expression of a desire to receive dental care because of a perceived need.”

• Example: A person with tooth pain who calls a dentist is expressing demand; someone wanting cosmetic whitening also creates demand, even if clinical need is low.

utilization definition

The number of individuals in a given population who receive dental care services during a specific time, often expressed as the proportion who visited a dentist in the past year or average visits per person.

• Example: CHMS data show about 74% of Canadians had contact with a dental professional in the past 12 months; 17% avoided going due to cost; 16% avoided full recommended treatment due to cost; 12% report unmet dental needs.

Factors influencing who uses dental practices

• gender

• age

• SES

• race and ethnicity (minority and immigrant groups may face barriers)

• geographic loctaion (harder for people in rual areas to recieve care)

• general health ( Chronic illness can both increase need and complicate access)

• dental insurence

Typical dental user profile

Female college‑educated suburbanite with a higher income bracket, who enjoys good health and has dental insurance