Community as Client — A Multivariate Model for Analysis of Community and Aggregate Health Risk


Address correspondence to: Susan S. Rodgers, RN, MS, Monson Rd., Palmer, MA 01069.


Today's high-level technology has produced at least a twofold impact upon the current health-illness picture. Industrial, occupational, and environmental problems form the bases for many modern diseases, and thus shift the emphasis from a pattern of infection to one of stress and chronicity. Also, biochemical technology, currently dominating the illness industry in both method of analysis and modes of intervention and allocation of resources at the expense of health, is rapidly evolving into obsolescence. The increasing complexity of the structure of disease is no longer based on direct causality, but rather on the interrelationship of economic, social, psychologic, biologic, and ecologic factors.

The outcome of community assessment and analysis therefore presents an aggregate risk profile evolving from knowledge of such problems as unrelieved poverty, environmental abuse, inadequate housing, undernutrition and overnutrition, and occupational structure, and the factor of age distribution of a community. Thus risk profiles form the foundations of community health nursing diagnoses. This model is intended as a tool to assist nurses in meeting the challenge confronting us today and in the future to improve health care in collaboration with and independent of the illness industry.