Over the past two decades, countries in the Latin America and the Caribbean (LAC) Region have experienced significant demographic, epidemiological and social changes including those in population age structures spurred on by mortality and fertility levels transitioning from high to low. Overall, under-five child mortality and maternal mortality have significantly fallen in the region, though disparities within and between countries remain. There is lower fertility and an increase in life expectancy. However, while people are living longer, they are not necessarily living healthier or enjoying an improved quality of life.
Rapid shifts in population settings from rural areas to urban cities (this Region being the most urbanized in the world) give rise to new health challenges. Migration transitions affect almost all communities breaking up historical patterns of power, shared values, norms, and social capital. The emergence of new diseases and health challenges with global spread (such as Zika, Chikungunya, and avian flu) exist alongside existing communicable disease outbreaks (such as the current yellow fever outbreak in Brazil). Non-communicable diseases, chronic disease, and mental health issues are increasing, along with the persistence of common infectious diseases across the life course.
Simultaneously, region-wide economic growth and technological innovation, such as interconnectivity and Web 2.0 platforms (user-generated context in a virtual community), including social networking and social media, offer new opportunities to address the multi-culturalism and dynamic changes affecting communities and how we work and communicate with them.
As we all know, the meaning of "community" has changed and evolved over time. The definition also changes in different contexts. Community work is also diverse as some view it as working directly with hospitals, while others view it as working directly with people of specific communities.
Considering these changes that the region is experiencing and the important relationship between the health of individuals and their community, FGL/HL took the initiative to start a dialogue within PAHO regarding the definition and scope of community health in the 21st century. The purpose of this dialogue was to better understand where PAHO stood in terms of defining community and community health, as well as gathering information on ongoing efforts that are being implemented in this area of work.
FGL/HL was able to successfully do this through interviews with 25 experts on the evolving nature of "community" and "community health". The results showed that the majority of PAHO's experts think it is an opportune time to strengthen Community Health within the Organization. This is also an opportune time to update our definition of Community and apply new principles to the way we approach community, community health, and community work, with the determination of achieving organizational goals within PAHO -- given the demographic, epidemiological and social changes, as well as the new challenges that the Region is experiencing today.
As a next step, FGL/HL organized a two and a half day consultation to discuss the definition of community and community health, as well as look at some of the new specific challenges that countries are facing. The meeting concluded with the identification of concrete inputs and next steps for PAHO/WHO to take action and support the Region to maximize the role of community and community health towards the achievement of regional and country-level health goals.