Résumé
Previous policies for prevention of functional disabilities leading to long-term care in Japan have mainly focused on an individual or a high-risk approach, which aim to prevent health problems by identifying high-risk individuals to target for education and intervention. However, since April 2015, the Japanese government has expanded the approach for preventive healthcare policies from a high-risk approach to a population-based community approach. Specifically, such policies aim to create an environment in which older individuals can easily participate in the society and enrich community- and individual-level social capital by participating in community places or groups. For example, older individuals living in a community area with high prevalence of participation in sports groups were less likely to be depressed or develop cognitive impairment, regardless if they actually participated of not. The purpose of this report is to describe how to administer the management cycle (e.g., plan-do-check-act cycle) to demonstrate the utility of community development in prevention of functional disabilities in older individuals. First, we visualize the issues faced by and resources available in local communities and determine the communities that require intervention on priority. After obtaining clues to the solution of community issues, the strategic deployment of intervention projects is needed. Subsequently, these interventions need to be evaluated for their effectiveness. Previous studies have reported that older individuals participating in such community groups were less likely to develop functional disability and cognitive impairment than those who did not participate. Future research must examine in detail the multi-faceted effect and efficacy of various community intervention programs.
Résumé
A partir del análisis de algunas estadísticas de morbilidad oral en Colombia que muestran cómo los problemas de salud oral (caries) siguen afectando a un número alto de la población, a pesar de haberse reducido el número de dientes afectados (índice COP-D), el autorplantea que para alcanzar salud es necesario cambiar de perspectiva. Se propone un paso del enfoque individual de riesgo a un enfoque poblacional de salud pública que enfaticelos determinantes de la salud, la promoción de la salud y la integración del odontólogo a un equipo más amplio de trabajo. El análisis se apoya en estudios epidemiológicos, documentosde la Organización Mundial de la Salud e investigaciones recientes en el tema de los determinantes de la salud, la promoción de la salud y las representaciones sociales delproceso salud-enfermedad oral...
Starting with the analysis of some oral morbidity indicators in Colombia that show how dental diseases (caries) still affect the population in high numbers in spite of the lower numbers of affected teeth (DFM-T Index), the author suggests a change in perspective. A shift from an individual risk-based approach to a population-based approach of publichealth emphasizing health determinants, health promotion, and dentist joining work teams is presented. The analysis is supported by epidemiology reports, documents from the World Health Organization, and research on health determinants, health promotion and socialrepresentations of the oral health-disease process...