A young first-time mother receives at-home nurse visits as part of a community outreach program. A weekly clinic targeting high diabetes rates helps a struggling man with diabetes gain nutritional control and reduce symptoms. These success stories illustrate how improving quality of life in communities is an essential part of public health.
The public health worker’s goal in community-focused care is to enhance healthcare services and patient outcomes in targeted populations. By applying public health theory on a local, personalized level, community health providers can cater services to a specific demographic and bring a sense of wellness to communities that would otherwise lack proper access to care.
Community health programs address disparities by ensuring equitable access to health resources. Such disparities include living in an isolated rural area with limited healthcare providers or being unable to afford health insurance. Community health centers often serve as the primary care provider in communities where health equity is limited by socioeconomic factors.
Those seeking to apply public health principles to address a local population’s needs must understand the area’s unique characteristics. This allows them to interact dynamically with community members and create a lasting positive impact on the population.
What Is Community Health?
Community health is the collective well-being of community members. In addition to living in the same neighborhood or region, these populations often share health characteristics, ethnicities, and socioeconomic conditions.
For instance, some low-income communities might experience high obesity rates due to limited availability of nutritious foods in local grocery stores. This places them in an area commonly known as a food desert.
In addition, a population might be exposed to contaminants from a nearby plant or waste facility. Community health programs improve access to preventive health care services, engage citizens in care decisions, and seek out lower medical costs.
Community Health Elements
Public health professionals engaged in community health identify how variables related to socioeconomic status — such as income levels, nutrition, crime, and transportation resources — impact people. They also determine how the community’s medical and educational resources contribute to residents’ lifestyles and what improvements are called for. Key elements of community health include:
- Identifying top public health concerns within the specific geographic area, such as environmental and social factors that affect healthy life choices.
- Developing an intervention plan to address resource gaps in the community, such as establishing community health centers, mobile clinics, and outreach programs.
- Educating residents on the benefits of preventive care and healthy behaviors to facilitate life changes.
- Providing essential services such as screenings, social support, and counseling.
- Helping residents gain access to resources such as affordable medical, dental, and mental health care services; insurance (Medicare or Medicaid enrollment); translation and transportation services; or housing, food, and education.
- Reducing the need for expensive emergency care and hospitalizations.
- Advocating for improved care for at-risk populations to state and federal policymakers.
- Working with other community agencies to address the area’s mental, physical, cultural, and social characteristics, including nutrition, housing, and transportation.
Community Health Goals
The goal of a community health provider is to offer comprehensive services that grant communities direct and immediate access to essential resources, including medical, dental, pharmacy, and mental health care. By educating area residents on what resources are available and giving them the tools to access care, public health workers empower people to take control of their own health.
Community public health initiatives focus on identifying specific geographic areas with high levels of need and helping those communities overcome barriers to living healthier lives. Community members’ average lifespans can differ by 20 to 30 years based on inequities that restrict access to healthy food, affordable health care, and mental health support, according to the American Public Health Association.
Community health professionals form strong bonds with citizens, as well as area health care and social services providers. This enables them to complete essential tasks, such as uncovering regional health risks, educating local residents on healthy behaviors, or establishing community health resources to close gaps in care.
Community health differs from the similar concept of population health management, which considers a population’s health outcomes based on a wider range of factors beyond just geography. Hospitals use population health management tactics to improve chronic disease management or to avoid readmissions.
Why Community Health Is Important
About half of Americans suffer from chronic health conditions. Many do not get proper care due to socioeconomic factors beyond their control. An elderly diabetic without a driver’s license and no family nearby, a pregnant woman with toxemia living more than 50 miles from a hospital—both are at high risk in a medical emergency. This makes community health resources all the more important.
Addressing Health Disparities
Healthcare disparities can be especially prevalent in rural and low-income communities where hospitals have closed down and physician shortages exist. More than 7,000 primary care, 6,000 dental, and 5,500 mental health shortage areas currently exist in the U.S., according to the Health Resources & Services Administration (HRSA).
These populations may be exposed to higher levels of poverty, homelessness, substance abuse, and other risk factors. When a community health system that takes the community’s unique characteristics into account is put into place to address unmet needs, the community’s overall quality of care can be vastly improved.
Lowering Healthcare Costs
Community health is an important element of health reform efforts that aim to lower national healthcare expenses. The cost of healthcare in the U.S. represents more than 17 percent of GDP, a much higher percentage than in any other industrialized nation, according to the Organisation for Economic Co-Operation and Development. About one-third of this spending goes toward hospital care, so costs might drop if the U.S. model of care shifts toward more affordable outpatient care facilities such as community health clinics.
Community health providers operate under a patient-centered care model, involving patients in care decisions. This model allows providers to steer patients away from costly trips to the emergency room and help them avoid relapses.
Enacting Public Health Initiatives
Community health resources have become essential assets in public health initiatives such as combating the opioid crisis and stemming the HIV epidemic. Opioid deaths in the U.S. have surpassed homicides and traffic fatalities, and community health centers are on the front line of federal efforts to reduce preventable drug overdose deaths.
These clinics are also working to decrease the estimated 38,000 preventable HIV infections that occur in the U.S. each year. The holistic model of community care allows practitioners to treat and prevent a multitude of conditions simultaneously.
Community Health Services and Resources
Community health services providers want to change the model of care from treating illness to maintaining wellness. This challenge is addressed by tackling patients’ well-being in a comprehensive way and not just band-aiding ailments that will soon resurface without proper preventive and maintenance care.
By combining medical, oral health, mental health, substance abuse, and pharmacy care with support services including health education, transportation to appointments, and bilingual staff, community health resource providers make sure that access to care is not restricted by geographic, economic, or cultural barriers, according to the HRSA.
Community Health Centers
Federally funded community health centers (CHCs) provide affordable healthcare options to more than 28 million people in towns and cities across the U.S. The clinics are designed to improve access to primary care services regardless of whether patients have insurance, speak languages other than English, or live in remote areas.
These centers often target groups facing health disparities and limited care resources, including patients living in poverty, rural residents, veterans, and the homeless. Clinics typically use a sliding scale for fees and provide care even when patients cannot pay.
Typical services include:
- Preventive and primary care services (including medical and dental checkups and condition management)
- Disease prevention (vaccinations, anti-smoking programs, and obesity screenings)
- Patient education (nutritional counseling, injury prevention, and disease information)
- Mental health services (screenings and counseling)
- Substance abuse treatment
By providing comprehensive preventive care and helping patients monitor chronic conditions, CHCs serve to lower medical costs by reducing expensive emergency department visits and hospital stays. Many of these clinics operate as patient-centered medical homes (PCMHs). According to the National Association of Community Health Centers, some 1,400 CHC organizations (operating 12,000 sites) generate $24 billion in savings for the U.S. healthcare system each year.
Most CHCs receive federal grant funding under the Health Center Program, which aims to improve health care for vulnerable populations. Many CHCs also receive funding and operational support from state agencies and nonprofit charitable organizations.
Public Outreach Programs
Public outreach campaigns include direct medical care programs along with educational materials, advertisements, and social media posts that encourage healthy lifestyles. Some organizations operate mobile and pop-up clinics that offer disease prevention programs within the community. To extend public education into all aspects of the community, health workers will often partner with local political systems, social work agencies, and schools.
Community Mental Health Centers
What is community mental health? In the U.S., mental health disorders often go untreated. Community health centers are providing frontline services in the behavioral health arena. The demand for behavioral health-focused community clinics is strong. Substance-abuse treatment centers are also being established at a growing rate as many regions across the nation struggle to reduce overdose deaths.
A Medicare-designated community mental health center is defined as providing screening, outpatient therapy, rehabilitation, day treatment, and 24-hour emergency services to chronically ill patients or those recently discharged from inpatient care. States also oversee mental health resources.
Careers in Community Health
Public health workers are engaged in a broad scope of activities, including research, education, program development, program management, medical care, and charitable aid. Roles can range from leadership positions to frontline caregivers. Professionals seeking careers in community health might work in medical, educational, government, corporate, or nonprofit settings.
Community Health Worker
A community health worker is defined by the U.S. Bureau of Labor Statistics (BLS) as someone who assists communities and individuals in adopting healthy behaviors. Job duties include outreach on behalf of medical organizations and implementing community health programs. Community health workers are also involved in basic medical screenings or care; informal counseling; research; and health education and advocacy.
Community health professionals serve as a bridge between community members and medical and social service providers, and often live in the community. To promote healthy behaviors, a community health worker might focus on helping people get better access to not only medical resources but also to transportation, housing, and nutrition, as well.
In addition, a community health worker develops cultural sensitivity and establishes relationships with local residents to create trust. Such workers also need to balance activities in client advocacy, public education, and medical service provision.
The occupational category of health educators and community health workers is expected to grow 11 percent between 2018 and 2028, according to the BLS. This is faster than the average of all occupations.
The BLS also reports the median annual salary of a community health worker is about $44,000. Other job titles for this role might include outreach educator, peer health promoter, and community health representative, advisor, or advocate, according to the National Institutes of Health.
Program Director
The program director or clinical director of a community health program or community health center takes overall responsibility for the organization’s goals and accomplishments. A director improves access to care in the community, identifying and filling gaps in care services, and reducing emergency medical care through preventive measures.
Skills that foster establishing rapport with community members are especially important for program directors. Program directors must have strong leadership, communication, and management skills, in addition to a foundation in public health advocacy.
Research Analyst
A researcher career in the community health field entails gathering information about health issues and risks for specific geographic areas or populations. Researchers collect essential information on socioeconomic conditions, health disparities, and community health resources’ effectiveness through data evaluation and direct interaction with local residents.
A researcher might investigate environmental hazards, infectious disease risks, or other regional threats. Community research analysts provide statistical reports and environmental evaluations to help administrators create innovative health advocacy and improvement programs.
Medical Professional
An education or early career in community health sciences can form a solid foundation for a career in medicine as a physician, psychiatrist, or nurse practitioner, and might even lead the health professional to practice in an at-risk geographic area. A community health worker might also go on to become a hospital administrator or government health official.
Earn a Master of Public Health Degree and Help Communities Grow
Establishing public health programs that cater to targeted populations enables public health professionals to improve the quality of care for all communities. In order to develop effective community health programs, professionals must develop strong competencies in evaluating health environments, understanding local cultures, identifying disparities, strategizing interventions, and creating trusting relationships with local residents and officials. Such skills require a high level of dedication and tenacity.
Pursuing an Online Master of Public Health (MPH) degree from Tulane University’s School of Public Health and Tropical Medicine emboldens students to apply transformative health equity principles and innovative solution-building skills to empower communities in need. MPH students gain a passion for equality and the drive to enact change for vulnerable populations. By covering topics including physical health, mental health, disease management, biostatistics, leadership, and social justice, the MPH program enables graduates to cultivate healthier communities around the globe.
Recommended Readings
What Is Environmental Justice? An Introduction to Fair Treatment
Healthcare Analytics: A New Frontier for Public Health
Advocating for LGBTQ Health Access
Sources
American Public Health Organization, Healthiest Cities & Counties Challenge
Centers for Disease Control and Prevention, Chronic Disease: A Significant Public Health Threat
Centers for Medicare & Medicaid Services, “National Health Expenditures 2018 Highlights”
Health Resources & Services Administration, Health Workforce Shortage Areas
Health Resources & Services Administration, “HRSA Health Center Program 2019 Fact Sheet”
HIV.gov, U.S. Statistics, Fast Facts
Louisiana Department of Health, Community Mental Health Center
Louisiana Department of Health, Office of Behavioral Health — Mental Health Services
National Association of Community Health Centers, What Is a Community Health Center
National Institutes of Health, Role of Community Health Workers
Office of Disease Prevention and Health Promotion, Stories From the Field
Organisation for Economic Co-Operation and Development, Health Expenditure
Tulane University, Community Health Sciences