Preface We enter the new millennium, the opportunities and challenges in nursing are boundless and ever-changing. New biotechnologies offer opportunities not experienced before: women can give birth to eight living babies in one delivery; multiple defective organs can be replaced; and through genomic typing we soon will be able to anticipate the anomalies that lead to illness.

However, challenges abound: millions of people die each year from conflicts resulting in wars, drought, and starvation; from preventable ancient, new, and reemerging infectious diseases; and from unhealthy lifestyle choices.

Community health The communities in which we live and work have a profound influence on our collective health and well-being. Here are examples: both smoking and passive exposure to tobacco smoke are directly associated with premature mortality among more than 1 billion smokers worldwide

A community that achieves a high level of wellness is composed of healthy citizens, functioning in an environment that protects and promotes health.

Community health, as a field of practice, seeks to provide organization structure, a broad set of resources, and the collaborative activities needed to accomplish the goal of an optimally healthy community.

Many different professionals work in community health to form complex team ?!!

The city planners becomes involved in community health. The social workers providing counseling about child abuse. A physician treating clients effected by a sudden outbreak of hepatitis.

The professional nurse is an integrated member of this team. Their duties range from teaching elderly stroke victims, to carrying out epidemiologic research or engaging in health policy analysis and decision-making.

Community health nursing is a specialized practice Community health nursing is a specialized practice. It combines all of the basic elements of clinical nursing with public/community health practice.

Definition: Community health or public health: is an organized community efforts aimed at the promotion, protection, and reservation of the public's health.

Or: is the science and art of preventing disease, prolonging life, and promoting health and efficiency through organized community efforts.

The concept of community A community is a collection of people who interact with one another and whose common interests or characteristics form the basis for a sense of unity or belonging. e.g., (citizens of a town); (a prison community). (4th-year nursing students at IUG)

The function of any community is to promote the members’ collective sense of belonging and their shared identity, values, norms, communication, and common interests and concerns.

Population The concept of population has a different meaning. It refers to all of the people occupying an area, or to all of those who share one or more characteristics. In contrast to a community, a population is made up of people who do not necessarily interact with one another and do not necessarily share a sense of belonging to that group.

e.g., The elderly population Children below 7 years old in Gaza strip Pregnant women in Gaza

Wellness-illness Continuum: Yet wellness is a relative concept, not an absolute, and illness is a state of being relatively unhealthy. Because health involves a range of degrees from optimal health at one end to total disability or death at the other (Fig.1-2), it often is described as a continuum. This health continuum applies not only to individuals but also to families and communities.

Health as a holistic: Health involves the total person or community. All of the dimensions of life, including physical, psychological, spiritual, economic, and socio-cultural experiences must be considered when dealing with the health of an individual or community. The approach should be holistic.

Subjective and objective dimensions of health Health involves both subjective and objective dimensions; that is, it involves both how people feel (subjective) and how well they can function in their environment (objective).

Continuous and episodic health care needs Continuous needs: For populations in all age groups with birth-to-death developmental health care needs. E.g., MCH

Episodic needs: one-time, specific, negative health events, such as an illness or injury, that are not an expected part of life. e.g., a head injury from an automobile accident.

Components of community Health practice 1. Promotion of health Health promotion includes all efforts that move people closer to optimal well-being or higher levels of wellness.

2. Prevention of health problems Prevention means stopping or discovering problems as early as possible to minimize potential disability and impairment. It is practiced on three levels in community health: (a) primary prevention, (b) secondary prevention, and (c) tertiary prevention.

Primary prevention prevents the occurrence of a health problem; it includes measures taken to keep illness or in-juries from occurring. Examples: - vaccination, - teaching young adults healthy lifestyle behaviors

b. Secondary prevention involves efforts to detect and treat existing health problems at the earliest possible stage when disease or impairment already exist. Hypertension and cholesterol screening programs to identify high-risk individuals and encourage early treatment to prevent heart attacks or stroke.

c. Tertiary prevention attempts to reduce the extent and severity of a health problem to its lowest possible level, so as to minimize disability and restore or preserve function.

Examples: Rehabilitation of handicapped people (e. g Examples: Rehabilitation of handicapped people (e.g., stroke, heart condition, amputation, mental illness) can be helped to regain some measure of lost function or to develop new compensating skills.

3. Treatment of Disorders The third component of community health practice is treatment of disorders. It focuses on the illness end of the continuum.

4. Evaluation Evaluation, the forth component of community health practice, is the process by with that practice is analyzed, judged, and improved according to established goals and standards. 6. Research Research, the fifth component of community health practice, is systematic investigation to discover facts affecting community health and community health practice, solve problems, and explore improved methods of health service.

Eight characteristics of community heath nursing are : Characteristics of community nursing Eight characteristics of community heath nursing are : (1) it is a field of nursing; (2) it combines public health with nursing; (3) it is population focused; (4) it emphasizes prevention, health promotion, and wellness; (5) it promotes client responsibility and self-care; (6) it uses aggregate measurement and analysis; (7) it uses principles of organizational theory; and (8) it involves interprofessional collaboration.