Encyclopedia of Environmental Science and Engineering, Volume I and II

171

COMMUNITY HEALTH

GENERAL

Health is the ability to cope with activities of daily living,

ever a norm yet always relative.^1 Most people enjoy and

expect good health, boast of their abilities to perform but

resent being unhealthy. Health is valued most highly after it

has been impaired.

Health and sickness are two contrasting aspects of our

world’s life. Sickness is a deviation from normal healthy func-

tioning, much like any other system breakdown. Each attracts

a legion of helpers ready to aid ailing persons return to their

diverse pre-illness states. So it is with a community’s health.^2

Evaluations of community health must consider many

factors. In addition to specialized and general medical care,

variables include housing availability and ownership, trans-

portation adequacy for work or pleasure, entertainment and

recreation, severity of usual weather conditions, educational

opportunities, and social and religious factors, among others.

Whereas a plethora of medical and surgical options contrib-

ute to what are sometimes claimed as miraculous recoveries

from a personal illness, environmental engineering quietly

strives to create basic healthy living conditions and protect

communities from potential physical dangers, widely rang-

ing in severity and in size from small to large.

Environmental health of a community is rated by the

degrees of satisfaction that result from engineering works

and organized community efforts that improve the physi-

cal freedom, comfort, and efficiency of residents. Cities and

towns are judged on the numbers and quality of existing rec-

reation opportunities, schools and colleges, and transporta-

tion routes, and fiscal services. Yet, while the processes that

caused those amenities to be developed are important, the

systems and organizations that currently maintain growth or

stability must also be carefully noted and weighed. A com-

munity’s health is not static and must be cared for continu-

ally, much like the health of any resident.

For millennia, communities have depended on engineer-

ing skills to install, maintain and improve necessities and

amenities of life that contribute to the well being of citizens,

animals, and plant life. Ancient Crete used conical terra

cotta pipes to keep sewage flowing, an early example of the

venturi principle, and for centuries massive aqueducts pro-

vided ample supplies of fresh water to Roman communities.

Excellent roads and transport brought foodstuffs from farms

to imperial cities and helped speed commerce and communi-

cations between businesses and governments. Cities around

the world before and after Rome have turned to engineers

to solve urban problems of drainage, flooding, and crowding

while at the same time pyramids and temples, cathedrals and

castles, universities and markets were being built, all designed

to maintain good health and integrity of communities.

Today, efficient land, sea, and air rapid transport net-

works help deliver farm products promptly to processors,

relying heavily on refrigeration to maintain freshness and

nutritional quality. Water supplies, a vital element in human

health as well as a basic unit of industry, no longer depend on

insanitary streams or cisterns but are collected behind large

dams, delivered over great distances through well-engineered

conduits to filtration plants and there purified, chlorinated

and fluoridated for safe consumption. Epidemic diseases like

typhoid fever and cholera, amoebiasis, malaria and yellow

fever no longer threaten communities in developed nations,

thanks to engineering that provides potable water, free from

harmful parasites and available for human waste disposal.

Evaluation of any community’s health is both quan-

titative and qualitative. Planners need to know how many

hospitals exist within the city limits, where they are in rela-

tion to centers of population, and whether transportation for

patients, staffs, and visitors is adequate. Numbers of primary

and secondary schools, technical training centers and uni-

versities, each with details of the students being served are

important data in judging community ambience. Local gov-

ernments want to know how many of the people who work

in a city actually reside there, how many residents rent apart-

ments or own their own homes and in what direction these

numbers are changing, measures of migration in and out of

the jurisdiction.

Businesses and factories that are seeking new locations

look closely at pertinent employment rates and skills of avail-

able workers that can support general manufacturing, or

contribute to growth or modification of an enterprise. Other

statistics reflect the fire safety of a community, like the num-

bers of residential or business fires, annual dollar losses due to

conflagrations, or the average response times of fire apparatus

to alarms. Law enforcement is rated by numbers and catego-

ries of crimes, numbers of crimes solved and the convictions

that result. Social health indices would include the numbers of

persons on public welfare or assistance, and the numbers and

rates of out-of-wedlock school-age pregnancies.

When a community’s ability to provide effective sickness

care is weighed, the ratios of total population to physicians

and other health professions, the number, size, accessibility,

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