There are fundamental differences between public and community health. “Public health nursing focuses on populations. It is not about the setting where care is delivered. It is first and foremost a philosophy applied in any setting where populations exist” (Stanhope & Lancaster, 2008, p. 191). Public health is designed to help improve the health, safety and welfare of the general public looking at the long term, prospective health of the entire public. Public health involves the health of the county, state and nation. Public health protects the health of every citizen.
It must work to help predict the potential outbreaks of epidemics from other parts of the world which may have a direct impact of the United States as a whole. Public health looks at health from a global perspective and is concerned with health care issues on a more pandemic level for example the “Spanish flue of 1918 and or the H1N1 virus of 2009. Public health generally provides free services to the public to encourage positive healthcare outcomes. Community health incorporates a diverse multidisciplinary perspective of healthcare.
It utilizes healthcare professionals such as doctors and nurses that work to specifically tailor medical-based interventions with the specific needs of the community in mind. They serve on the front lines of the community healthcare system. Community health nurses function on a grass roots level within the neighborhood. They visit patients in their homes where they treat those patients who would not normally be able to care for themselves or be in a position to travel to a healthcare facility on their own.
Unlike public health workers, the community based health care professional does not need to plan ahead for possible epidemics but must work hard to treat medical issues which the community faces on a daily basis. Modern infectious such as SARS and AIDS still pose a huge challenge to the public health on a global scale. Public health is often considered to be a relatively modern concept; however, it actually has its origins going back to ancient times. Clean drinking water was always considered to be sacred and essential to good health since ancient people discovered that dirty or polluted water would usually make them ill.
Religions such as Judaism passed strict religious guidelines with respect to the preparation of food and even the types of foods which were permissible to consume. Other religions created mandates regarding alcohol and even sexual relations in an attempt to create a society where the health of the public was not necessarily placed in jeopardy. The Romans were well aware that in urban areas the issue of public waste disposal was critical if the public was to be safeguarded against sickness.
During the middle ages when the so-called “plagues” were prevalent, many cities realized that the proper disposal of dead bodies and the burning of vermin infested buildings helped alleviate the spread of disease to some extent. In the early 1800’s, Edward Jenner was credited with helping to usher in the era of vaccination and in the 1850’s, John Snow was known for his worker as an early pioneer in the field of epidemiology. The modern age of public health probably had its genesis when the production of artificial vaccines began and the modern germ theory was developed primarily through the work of Louis Pasteur during the 1880’s.
Throughout the 20th century, the focus of public health research to cure chronic infectious diseases such as smallpox, yellow fever and polio was combined with searching for cures for non-infectious health issues such as heart disease and various forms of cancer. At the end of the 20th century and just after the 911 terrorist attacks, public health agencies began to devote their time and resources to issues relating to bioterrorism, waste disposal issues and other threatening environmental issues.
Public health nurses at the federal, state and local levels were very much involved in helping to cope with the post 911 anthrax threat by helping to create and maintain medication distribution clinics while, at the same time, trying to educate the public and the media as to how to deal with these threats. Nurses have also become more involved in governmental policy making decisions designed to prevent as well as to respond to potential and actual bioterrorism issues as well as to vaccine shortages for such illnesses as influenza and SARS. (CDC,1999).
The resources which form the very essence of county, state and public health are the public health agencies which form a partnership whose ultimate goal is work together to develop and implement comprehensive solutions to improve the health of the community. Federal public health agencies in collaboration with Congress work to create and implement federal regulations to help fund state and local health care agencies whose goal is to improve the general health of the public. Monitoring the country’s health status as well as coordinating interstate health activities is the basic responsibility of federal public health agencies.
Some examples of federal public health agencies are the U. S. Department of Health and Human Services (USDHHS) which includes the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) as well as the Environmental Protection Agency (EPA). On the state level, each state as well as territory of the United States maintains a state public health agency that is run by a state health commissioner who may or may not be a licensed medical doctor depending on the particular requirements of the state.
In some states, public health nurses have, in fact, been appointed as state public health commissioners. The state healthcare agencies are responsible to distribute and allocate both state and federal funds to community based healthcare organizations. These local or community based agencies provide basic yet essential public heath care assistance in the form of programs and treatment to members of the local neighborhoods. This may include drug treatment and education programs as well as programs which help deal with teenage pregnancy.