Systems of health care delivery: Community setting

Abstract

This chapter examines the role of the community in delivering health care to people with intellectual and developmental disabilities. The unit of the community is a core element of the practice of public health and in many locales is an underutilized environment in which to conduct activities concerned with promoting health and preventing disease to protect populations. Persons with disabilities and their caregivers are a public health issue that warrants further research to improve their health outcomes. Efforts reviewed here include the role of person-centered planning and community integration of such arrangements. The importance of one’s connection to community is discussed as it relates to the influence of social capital in improving health. In addition, the potential for community health workers as innovative providers of care is examined. Challenges and recommendations are presented for partnerships between academia and people with disabilities who are engaging in community-based participatory research efforts aimed at addressing local public health issues. Lastly, the role of community in preventing secondary conditions in people with disabilities is discussed. As health professionals, we need to consider the living environment of people with disabilities and not just the physical structure they occupy but their social connectedness to their community. We need to put more effort into improving community-based public health systems to provide essential public health services to this special population. Efforts should be directed towards a community-based approach that will have the most beneficial impact with the limited financial and human resources present at the community level.