Introduction to community medicne
1. Community medicine Definition of some terms : Community medicine is the sum of conditions of health and disease, the community as a whole is the subject of the study ( in difference from curative medicine where individuals are subjects of study and management ). According to WHO, health is the state of complete physical, mental and social wellbeing and not mere absence of disease.
2. Community medicine includes the following branches : 1. Epidemiology 2. Vital statistics ( health indicators ) 3. Environmental sanitation 4. Maternal health 5. Child health 6. Rural health 7. Urban health 8. Mental health 9. School health 10. Occupational health
3. Epidemiology is the systematic collection of data, their analysis and interpretation, with the objective to come out with conclusions. Vital statistics: The WHO definition of health is not measurable, hence indices such as population parameters (marriage, birth, morbidity and mortality rates ) are used as health indicators. Thus vital statistics is applied to the community life events. School health deals with the health of a certain age-group in the community. Its objective is the protection of children from communicable diseases through personal hygiene e.g. oral mouth hygiene, vaccination for booster doses and during outbreaks, cleanliness of place, water, skin and clothes, safe food provision, mental,psychological and physical wellbeing of children.
4. Maternal health : The health of females in the reproductive age years, to prevent pregnancy and labour complications. Child health : It starts since the intrauterine period ( antenatal care ) till the age of 14 years. Maternal and child health are dealt with together ( MCH ). Mental health : Psychiatry is a branch which deals with mental and psychological status of the human being. Neurosis is an illness due to unfavorable surroundings in the family, in the community or at work. One of the objectives of community medicine is to make the external environment favorable for the human being.
5. Environmental sanitation ( health ) is concerned with man external environment, to make it favorable for his wellbeing. Rural health is the healthcare provided to people living in rural areas, usually occupied in agriculture and animal breeding, more exposed to communicable diseases. Urban health is the healthcare provided to people living in urban areas. The problems of urbanization are multiple including the problems of adaptation to the new situation, stress-related diseases air pollution diseases, sewage-related diseases, etc. Occupational health is concerned with the health of people at the workplace, its main objective is to fit the worker to the work and to make the workplace suitable for the worker.
6. Importance of community medicine : Community medicine = public health = social and preventive medicine. Scope of community medicine, it includes 10 branches. Medicine includes two major branches, curative and preventive medicine. 85% of diseases are preventable. 20 medical schools network worldwide adopt community oriented medical education ( COME ). Difference between a clinician and a community physician, the clinician objective is to diagnose and treat a patient, while a community physician is to manage a health problem in a community.
7. Investigations in community medicine follow the sequence of : observation, hypothesis formulation, hypothesis testing, results interpretation and making conclusions. Example : Thalidomide given to pregnant women in the first trimester caused phocolemia among offspring, it has been stopped since the end of the 19th century. Another example is that, in 1980 at Los Anglos hospitals, 6 young males age-group years died because of pneumocystis carnii pneumonia, a disease encountered as a cause of death among immunocompromized groups such as elderly. A retrospective study among those deaths led to the discovery of AIDS.