Family Dynamics and Community Health: A Comprehensive Analysis

Posted on Dec 13, 2024 in Geography

The Family as a System

The family is a group or system composed of subsystems that are simultaneously members and integrated into a larger system, which is society. It is an open system that receives data from each of its members. The family is a unity, a wholeness, a collection of interactions. The link between its members is so narrow that the illness of one of them changes the life of the rest. The communication between its members allows for the balance of the family. There must be open and explicit communication, adapting to change.

Concept of Family

A solemn contract by which a man and a woman come together indissolubly for their current lifetime in order to live together, procreate, and help each other. It is a group of people living under one roof, organized in fixed roles, with or without blood ties, a mode of economic existence, and common health with feelings of affection that bind and agglutinate them.

Assessment of the Family

• Structure: This refers to forms of unions of couples, family size, kinship, and history.
• Life Cycle: Evolution.
• Family Functioning: Ways of relating, communication, distribution of roles, affection, cohesion, and adaptability.

Classification of the Family

According to the Number of Generations:

• Traditional or Expanded: Two or more generations.
• Nuclear: Two generations.

According to Parental Presence:

• Complete: Two-parent.
• Incomplete: The absence of one or two parents.
• Incomplete Disguise: Parents separate and then return.

Family Classification

According to Decision-Making:

• Patrifocal
• Matrifocal
• Bifocal

According to Compliance with Roles:

• Organized
• Disorganized

Depending on the Type of Link:

• Legal
• Non-legal

The Life Cycle of Family Life

Stages:

1. Training a partner and starting the family.
2. Initial fostering of children.
3. Family with preschool children.
4. Families with school children.
5. Family with teenagers.
6. Children leaving home.
7. Family in middle age.
8. Terminal stage of the family.

Functions of the Family

The family as a social group has basic functions:

1. Meeting Financial Needs:
   • Example: Housing, food
2. Meeting Educational Needs:
   • Example: Skills, abilities, knowledge
3. Meeting Biological Needs:
   • Example: Reproduction
4. Affective:
   • Example: Support, companionship, understanding
5. Spiritual:
   • Example: Religion
6. Social Studies:
   • Example: Interaction with more individuals, families, groups
7. Recreational

Roles in the Family

Role: A set of attitudes, behaviors, and tasks normalized and therefore expected by the other members of the family.

Role derived from the role of marriage: paternity

Husband-Wife Father Mother —

Secondary role of sex: Male Female

Family Health

Health centers and health teams are responsible for the healthcare of families and their members through a series of actions to solve health problems. This set of actions is the Family Health Plan.

Family Health Problems

Affect family functioning. Affect socio-economic problems. The appearance of individual physical or mental health always affects family functioning.

Family Problems

• Grief
• Teen behavioral problems
• Children playing
• Marriage
• Teenage pregnancy
• Unemployment, etc.

All may influence the health status of the family.

Participating Community Model as Applied to Families

Core Rating (Family Members):

• Family history
• Values, beliefs, and customs
• Housing characteristics
• Socioeconomic status
• Lifestyle
• Health problems
• Communication level

Model Applied to Families

Environment Rating: 8 Subsystems

1. Physical Environment: Housing, schools, etc.
2. Social and Health Services
3. Economy: Income, jobs, etc.
4. Safety and Transportation: Firefighters
5. Politics & Government: Neighborhood council
6. Communication: Newspapers, TV, mail, etc.
7. Education: Access to schools
8. Recreation: Resources

Model Applied to Families

Analysis: Identify Stressors and Degrees of Reaction

1. Intrafamilial Stressors: Example: Partner conflict, unemployment, role conflicts
2. Outside the Family: Example: Air pollution
3. Level Reaction: Crisis of the couple, i.e., marital breakdown, drug addiction in children

Family health diagnoses give direction to nursing interventions. It is formulated considering the degree of reaction produced by one or more stressors. Example: Risk of asphyxiation associated with the installation of a water heater in the bathroom.

Planning family intervention according to levels of primary, secondary, or tertiary education.

• Primary Prevention: If family health strengthens.
• Secondary Prevention: If a problem is researched within family health.
• Tertiary Prevention: If you avoid further damage.

Family

A healthy family is one that maintains a certain effectiveness and functionality. To be effective, it enables people to live together and raise children who are healthy and have qualities accepted as desirable for the community to which they belong and that affect them.

Rural Communities

They are communities with low population density, 10 to 20 inhabitants per km². Those who are scattered are specially devoted to primary activities. They are usually isolated communities, whose distance from the most populous town exceeds the time of the usual means of transport.

Housing

Of light material, usually wood, thatch, or adobe.

Basic Sanitation

Poor, there is no sewerage. Water for human consumption comes from wells or spring water wheels. Waste disposal is by burning and burial.

Schooling

• Average 8.1 years of study.
• Complete basic education predominates.
• Incomplete secondary education.
• Early youth join the workforce, which is generally agricultural and temporary.

Household

• Predominantly nuclear-type families.
• Stable and legal unions.
• Family relationships are close.
• Average number of children: 3.
• Family roles are set according to gender.

Health

• There are problems of contamination of land and water.
• Health problems are expressed in infectious, parasitic, and respiratory diseases.
• With increasing life expectancy, chronic diseases are observed, such as hypertension and diabetes mellitus.
• Increasing magnitude of accidents and occupational diseases, including acute and chronic poisoning, the use of pesticides, and mechanization of farming.
• The attitude of the population towards their health problems is passive, particularly targeting healing.
• Self-medication in rural areas is twice that of urban areas.
• Items are handled, and knowledge of traditional medicine is used.

Health Problems of the Rural Sector

Sanitation

• Water Spraying:
  • Rural reaches 25.4%
  • Urban reaches 97%
• Disposal of Excreta:
  • Rural: Between 60 and 80% use a black hole
• Garbage Collection:
  • Rural reaches 33%
  • Urban reaches 99%
• Environmental Pollution:
  • Untreated sewage pollutes rivers.
  • Wastes are burned or deposited in non-health areas.
  • Pesticide use.

High Infant Mortality Rates

• Cañete is 38.4%
• James East is from 6 to 7%

High Neonatal Mortality Rates

• Sectors such as Achao Mulchén reach 21 per 1,000 live births.
• In the country, about 7 per 1,000 live births.

Child Malnutrition

• In Maria Elena, 15.9%
• In Chile, generally 4.8%

Teen Pregnancy

Especially in the poorest areas.

Low Coverage of Pap Smears

Oral Health Problems

Low Coverage of Professional Attendance at Birth

Affects the coverage of BCG.

High Presence of Vectors

Like flies, triatomines, and rats.

High Presence of Alcohol Among Young People

Risks of Accidents and Illnesses

Including poisoning by pesticides.

Lack of or Inadequate Health Resources

For example, professional and technical staff. Rural clinics have an assigned population over 2,000 people (double what is technically acceptable).

Expanded Coverage of the Baja de Inmunizaciones (PAI)

Permanent Shortages and High Turnover of Trained Personnel

Inaccessibility and Dispersion of Population (End Zones)

Climatic and Geographical Factors

In the south and extreme south.

Severe Deficit of Ambulances and Other Vehicles

For the transport of personnel and users.

Communication Equipment Shortages

Half of rural clinics have no radio transmission.

Factors Conditioning the Health Status of the Rural Sector

Common to All Health Services:

• Poor sanitation
• Increasing threat of pollution of water and soil
• Inadequate communication systems
• Shortage and high turnover of trained personnel
• Deficit means of transportation
• Gaps in coverage in remote areas
• Poor management of local government and public

Service-Specific Factors

• Inaccessibility and dispersion of the population (end zones)
• Sociocultural characteristics (presence of indigenous population)
• Climatic and geographical factors

Health

Complete biopsychosocial welfare of the individual and not just the absence of disease.

Diagnosis of the Health Status of a Community

Determined by the interaction of man and the environment and the impact of health services on man and the environment.

Indicators for Diagnosis of the Health Situation of the Community Refer To:

1. Health state of people of a certain area
2. External conditions affecting the health of people
3. Services and activities designed to improve health conditions

Indicators

Indicators used are:

1. Infant mortality rates and general
2. Life expectancy at birth
3. Incidence of communicable diseases

Measurement Systems

1. Absolute Figures:
   • Number of births and deaths
2. Fees:
   • Number of times an event occurs in relation to the exposed population.
   • Example: Infant mortality rate = Number of children under one year of age who die per 1000 live births
3. Reasons:
   • Relate the frequency of two different events that do not include the population.
   • Example: Compare 10,400 cancer deaths with 74,000 deaths from all causes; the ratio is 0.14, i.e., 14% of these deaths occurred from cancer.
4. Index:
   • We compare two such charges or reasons.
   • Example: Risk of death from lung cancer in heavy smokers; the rate is 166 per 100,000. In non-smokers, whose rate is 7 per 100,000, the ratio is 23.7. Therefore, the risk of death is 7.23 times greater for a heavy smoker than for a non-smoker.

Health Risk

Concentrate resources on the groups that most need them to achieve a greater impact on health. Define their problems, who are the groups most at risk for certain diseases, and act on them preventively.

Health Team

The heterogeneity of its members gives us the strength and potential, together with their experience, allowing a comprehensive approach to problems. The health team is a group of people working in the same institution, sharing and serving a common purpose. So, the health team consists of all individuals working in health regardless of their origin (administration, social sciences, biological, etc.).

Intersectoral

Health problems are multifactorial, i.e., the whole society is influencing the solution of problems.

Public Health

It is the science and art of preventing disease, prolonging life, promoting physical and mental health, and efficiency through organized community efforts towards achieving a healthy environment.

Actions:

1. Control of communicable diseases in the community.
2. The education of the individual in self-care principles.
3. The organization of medical and nursing services for the early diagnosis and treatment of disease.
4. The development of social machinery to ensure every individual a standard of living adequate for health maintenance.

Community Nursing

It is a service discipline that aims to contribute individually and in collaboration with others to promote an optimal functional level of the user through education and care provision.

Emphasis on disease prevention and health promotion.

There are three levels:

1. Primary Prevention: Promotion and protection activities such as specified education for self-immunization.
2. Secondary Prevention: Early diagnosis and treatment.
3. Tertiary Prevention: Rehabilitation.

Community Development

It is a process whereby community members, individually and collectively, accept responsibility to assess their needs and health problems, to plan and decide their solutions, to create and maintain organizations that support these goals, objectives, and programs.

Community Intervention

Community involvement is a process of interference or influence that seeks a change or modification in a particular direction. It focuses on problems and needs identified in the social system where the community is inserted.

Intervention should put emphasis on human development and the reduction of psychosocial problems that impede or limit it. Certain changes may require intervention in the opposite direction to the expected one to achieve a given effect, as might be amplified or escalate a conflict to resolve it. This could be useful, for example, to deal with conflicts or disagreements involving complicating the work of a team but have not been spelled out.

Nursing Community Intervention

The concepts of human beings themselves have implications for nursing roles both at work with individual clients, as well as families, groups, and larger social systems, since each of these is made up of individuals.

A Competent Community is One in Which its Members:

a) Are able to collaborate on the problems and needs of the community.

b) Work with goals and priorities.

c) Agree on how to implement the goals and collaborate on actions required.

Social Participation

The participation of organized groups in the deliberations, decision-making, control, and responsibility for healthcare. All stakeholders participate in a geographical area, identify health problems, and design, test, and implement solutions.

Appropriate Technology

Involves the application of technology according to environmental conditions, with a sound scientific basis acceptable to the whole community, which supplies real needs of families and provides a reasonable solution to the problems.