PART I

PRELIMINARY

A. BACKGROUND

Health problems are one of the factors that play an important role in
realizing the quality of human resources. Through the development in the health
sector is expected to further increase the level of public health and health care can
be felt by all walks of life are adequate (Department of Health, 2007).
The success of health development is characterized by a conducive
environment, proactive community behavior to maintain and improve health and
prevent disease, health services successfully and efficiently spread evenly
throughout the region Indonesia.Akan but in fact, the health development in
Indonesia is still far from being expected. The problems of health is still a lot
going on. Some of them are: diseases such as dengue fever, avian flu, and so
increasingly widespread, cases of malnutrition is increasingly widespread,
especially in eastern Indonesia, a low health priority, as well as environmental
pollution levels are higher.
Most people argue that the government's policy was wrong, so that health
problems in Indonesia like there was no end. However, we can not just blame the
government alone in this regard. Because after all, the actual individual being a
decisive factor in determining health status. In other words, in addition to the
government there are many more factors or determinants that affect people's
health status.

B. FORMULATION OF THE PROBLEM

1. How Hendrik L Blum's theory?

2. How konsepHendrik L Blum that?
3. How is the health of it?
4. How taxonomic Hendrik L Blum that?

C. AIM

1. To find out what is the definition of the theory of Hendrik L Blum.

2. To find out how the concept of Hendrik L Blum.
3. To find out what level of health.
4. To find out how taxonomic from Hendrik L Blum.
CHAPTER II
DISCUSSION

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A. Hendrik theory L Blum
HLBlum healthy living concept is still relevant to be applied. Holistically
healthy condition not only healthy physically but also spiritually and socially in
society. To create healthy conditions like this requires a harmony in maintaining a
healthy body. HL Blum explained that there are four main factors that influence
the health of society. These four factors are a determinant factor health problems.
These four factors are composed of behavioral factors / lifestyle (life
style), environmental factors (social, economic, political, cultural), health service
factors (type of coverage and quality) and genetic (hereditary). These four factors
are interacting affecting individual health and the health of society. Among the
factors of human behavior factor is a determinant factor of the greatest and most
difficult to overcome, followed by environmental factors. This is due to
behavioral factors are more dominant than the environmental factors for the
human environment is also strongly influenced by the behavior of people.
In an age of increasingly advanced as it is today then our perspective on
health is also changing. When first we use the paradigm of ill health is only seen
as an attempt to heal the sick person where the intertwined relationship with the
patient's physician (doctor and patient). But now the concept used is the health
paradigm, where health efforts is seen as a measure to maintain and improve the
health of individuals and society (SKM and society).
Thus the concept of a healthy paradigm HL Blum looked healthy lifestyle
a person holistically and comprehensively. A healthy society is not viewed from
the standpoint of healing action but its continuous efforts in maintaining and
improving public health. Role Bachelor of Public Health in this regard than the
dominant role in control of the doctor. For the doctor-patient relationship was
limited to individuals with individuals not directly touch the wider community.
Plus competence in a more controlled memanagement graduate program resulting
in the development SKM SKM spearhead health programs in developed countries.
For developing countries like Indonesia precisely, the paradigm used pain.
Where government policies oriented to healing the patient so that the apparent
role of doctors, nurses and midwives as medical and paramedical personnel to
dominate. Though such efforts has long been abandoned due to financial terms to
the detriment of the State. The state budget for higher diIndonesiasemakin health
funding and are mostly used for treatment efforts such as the purchase of drugs,
health facilities and the construction of the building. Supposed to improve the
health status we must pay great attention to the root of the problem and then make
an effort to prevent it. For that reason, health efforts should focus on preventive
measures (prevention) rather than curative (treatment).
But what happened budgets to improve the health through promotion and
prevention program significantly reduced. The impact is the number of people
who are malnourished, rising drug costs for health centers, environmental

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 pollution control, and corruption askeskin use. The side effects that occur may
arise because our policy is wrong.

B. CONCEPT BLUM
All countries in the world use Blum concept in the health of its citizens.
For developed countries are now focusing on improving the quality of human
resources. So that the food intake of their children so guarded in terms of nutrition
that will give birth to offspring that weighs. Opposite condition
dialamiIndonesiasebagai agricultural country, any government regulation on
health instead focus on tackling malnutrition society. Even dilematisnya many
masyarakatkotayang malnourished. In fact, from the research results prove
wilayahIndonesiapotensial as food and farming land because of the large
topography mendukung.Adaapa with the government ?.
In the concept there are 4 determinants Blum studied, each factor
interconnectedness following explanation:
1. public behavior
Behavior is the second factor that affects the health of society as healthy or
unhealthy it is environmental health of individuals, families and communities are
very dependent on human behavior itself. In addition, it is also influenced by the
customs, mores, customs, beliefs, education, social, economic, and other
behaviors that attached to him.
People's behavior in maintaining health plays an important role to achieve Healthy
Indonesia 2010. This is because the culture of clean and healthy living must be
generated from within the community to maintain their health. We need a
program to move the community toward the mission of Healthy Indonesia 2010.
As the motor power are people who have competence in moving the community
and understand the value of public health. Communities that a clean and healthy
living behavior will result in culture maintain a clean and healthy environment.
Adoption of healthy behavior should also be accompanied by guidance to
raise awareness in the community. Therefore, if an attempt to impose a sanction
only short term. Guidance can be started from the family, school, and community.
Community leaders as role models should be invited to participate in the success
of health programs.

2. Environment
The neighborhood has the largest influence and role followed behaviors,
health facilities and descent. The environment is very varied, generally classified
into three categories, namely dealing with the physical and social aspects.
Environment-related physical aspects eg garbage, water, air, soil, ilkim, housing,
and so on. While the social environment is the result of interaction between
people such as culture, education, economy, and so on.

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 Talking about the environment often our review of the physical condition.
Environments that have poor sanitary conditions can be a source of disease
progression. This is clearly endanger the health of our society. A buildup of waste
that can not be managed well, air pollution, water and soil can also be a cause.
Efforts to safeguard the environment is the responsibility of all parties to that need
for awareness of all parties.
PHC itself has environmental health program which plays a major role in the
measure, monitor, and maintain the health of the community. however
dilematisnya in the clinic number is very limited environmental health personnel
when many diseases that come from our environment, such as diarrhea, dengue
fever, malaria, tuberculosis, smallpox and so on.
Besides the physical environment there is also a social environment play a
role. As social beings we need the help of others, so that the individual interaction
with one another should be established. Poor social environmental conditions can
cause psychiatric problems.

3. Health services
Healthcare is the third factor that affects the health of society because of
the existence of health facilities are crucial in the restoration of health care,
disease prevention, treatment and nursing as well as groups and people who need
health care. Availability of facilities affected by the location, whether accessible
or not. The second is the provider of health personnel, information and motivation
of people to come to the facility in obtaining health care services and programs
itself is in accordance with the needs of the community in need.
Condition of health services also support the health of society. Quality
health care is needed. Society needs posyandu, health centers, hospitals and other
health services for help in getting treatment and health care. Especially for
primary health services that are much needed by the community. The quality and
quantity of human resources in the health sector should also be improved.
PHC as the frontline in a very large public health services perananya.
because in puskesmaslah will be handled people who need education and primary
care. Role Bachelor of Public Health as a manager with competence in the field of
health management needed to make health programs. The main programs of
preventive disease prevention so that people tidaka many who fall ill.
Many events are preventable mortality such as diarrhea, dengue fever,
malaria, and degenerative diseases that flourish today as karoner heart, stroke,
diabetes mellitus and others. The disease can be easily prevented as long as people
understand and carry out the advice in maintaining the environment and health.

4. Genetic / Descent (heriditas)

Like what the younger generation descendant ??? desired. That question is
key in knowing the expectations that will come. The fate of a nation is determined

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 by the quality of young people. Therefore we must continue to improve the
quality of our young people so that they are able to compete and have high
creativity in building the nation.
In this case we must consider the nutritional status of children because this
is when brain development of children who are our future assets. But still many
nutritional status anakIndonesiayang less even worse. The potential
alamIndonesiacukup support. because that malnutrition prevention program and
an increase in the nutritional status of the people are still needed. Primarily IHC
program normally undertaken at the RT / RW. With the passage of this program it
will be detected early and rapid nutritional status can be addressed.
Supplementary feeding programs in posyandu still need to continue to run,
especially daeraha poor and low education level of society. Weight measurement
in accordance with kms toddlers should be routinely performed. It is for the early
detection of nutritional status of children. Not only the lack of nutrition obese
condition also needs to be avoided. How is the quality of the next generation will
determine the quality of Indonesian Bangas.

C. Public Health degree

According to Hendrik L.Blum (1974), there are four major factors that can
affect the health of society, namely: the environment, human behavior, health, and
offspring. These four factors are interrelated with several other factors, namely
natural resources, ecological balance, mental health, cultural systems, and the
population as a whole. Environment has the most influence on the health of
society (Gumilar, 2004). Figure 1 illustrates the relationship between
environmental factors, human behavior, health services, and the descent to the
health of society.
In addition Hendrik L Blum also mentions 12 indicators related to health
status, namely:
1) Life spam: the length of time for the life expectancy of people, or it can also be seen
as the degree of public death was not due to die of old age.
2) Disease or infirmity: the sickness or disability of physiological and anatomical of
society.
3) Discomfort or ilness: the pains of the public about the state of somatic,
psychological and social of himself.
4) Disability or incapacity: the inability of a person in the community to do the job and
run a social role because of illness.
5) Participation in health care: the ability and willingness of people to participate in
keeping themselves to be in good health.
6) Health behavior: that is a real human behavior from members of the public directly
associated with health problems.
7) Ecologic behavior: the behavior of people on the environment, other species, natural
resources and ecosystems.

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8) Social behavior: the behavior of community members against each other, family,
community and nation.
9) Interpersonal relationship: the communication quality community members against
one another.
10) Reserve or positive health: the endurance of community members to the disease or
the capacity of community members in the face of pressures somatic,
psychological, and social.
11) External satisfaction: the sense of satisfaction of members of the public to the
social environment includes houses, schools, work, recreation, transportation.
12) Internal satisfaction: the satisfaction of members of the public on all aspects of life
itself.

D. Factors that affect the degree of public health

According to Hendrik L. Bloom, there are four factors that affect the
health status of society: environment, behavior, health care and descent.
Of these parts can be seen that the factors that most influence the health of
environmental factors, followed by health care and behavioral factors last descent.
Description of factors - these factors are:
1. Living environment
a) Physical: garbage, water, air, housing etc.
b) Social: culture, education, economy (human interaction)
c) Biology: animal, Remik bodies, vegetation.

2. behavior
a) A custom or habit of the people.
b) Families' health and environment dependent behavior.

3. Health services
The role of the health service are:
a) Determining the restoration of health care, disease prevention treatment, and health
care.
b) Influenced by the location or distance to a health human resources, information
appropriateness of health care programs to the needs of the community.

4. ancestry
Heredity is a factor that has existed in man innate. For example: diabetes mellitus,
asthma, epilepsy, mental retardation, hypertension, etc. color blind.

Public health efforts

1. promotive

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 Effort is aimed at improving health, including efforts to improve the nutrition,
personal health maintenance, maintenance of environmental health, regular
exercise and adequate rest so that it can achieve optimal health status.
2. preventive
Is an effort aimed at preventing the occurrence of the disease include the efforts of
immunization (infants, children, pregnant women). Periodic medical examinations
to detect the disease early.
3. Curative
Is nusaha yangditujuikan to the ill person to be treated appropriately and
adequately so that health recovered.
4. rehabilitative
Nusaha is directed against the patient who is recovering from the disease,
to improve mental and social physical weakness patients as a result of the disease
include pisioterafi programmed exercises.

E. taxonomic BLOOM
Taxonomy is derived from the Greek Language tassein means for
classifying and nomos which means the rules. The taxonomic classification
berhirarkhi meaning of something or the principles underlying the classification.
All things move, stationary objects, places, and events-up thinking skills can be
classified according to some taxonomic scheme. Bloom's Taxonomy concept was
developed in 1956 by Benjamin Bloom, a psychologist education. This concept
classifies educational objectives in three domains, namely cognitive, affective and
psychomotor.
Cognitive domain includes functionality to process information,
knowledge and expertise mentality. Affective includes functions related to the
attitudes and feelings. While the psychomotor domain associated with the
manipulative function and physical abilities. Classify and sort your cognitive
thinking skills that describes the expected goals. The thought process expresses
the stages of ability to be students to master so it can show the ability to process
thought to be able to apply theory into action. Turn theory into terbaiknyasehinggi
skills to produce something new as a product innovation mind.
The concept has improved along with the development and progress of
time and technology. One of the students named Lorin Anderson Bloom
Taxonomy revise in 1990. The improvement results published in 2001 under the
name Revised Bloom's Taxonomy. No changes in this revision keyword, category
of nouns into verbs. Each category is sorted hierarchically, from the lowest order
to a higher one. In the cognitive ability to think of analysis and synthesis
integrated into any analysis. Of the total six categories on the previous concept
has not changed in number as Lorin enter a new category of creating that
previously did not exist.

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 CHAPTER III
COVER

A. CONCLUSION

To achieve good health status, whether physical, mental and social well-
being, every individual or group must be able to identify any aspirations, to satisfy
needs, and to change or to anticipate the circumstances for the better. Health, as a
source of everyday life, not just the purpose of life. Positifyang health is a concept
that emphasizes on social resources and personal. With this Blum theory we can
improve poor environmental conditions, and also things that can affect health
status. As a way to improve health determinants four main aspects, namely
genetic, environmental, behavioral and health services.

B. SUGGESTION

Seeing the condition of health and public awareness of health, it is

necessary active role of all parties in addressing public health issues. Health care
providers, communities, governments and companies need to spell out the road
map of public health development in an integrated and sustainable. Considering
the area of Indonesia is very wide, it takes cooperation in formulating and
developing public health programs suits the characteristics of the local area so that
the pace of change towards a healthy society in the management of public health
be part of awareness and knowledge of the community and in the end has self
belonging that health is the property and responsibility. Moreover, the pattern of
refreshment, guidance, empowerment and strengthening the organizational
network health centers, village health post, IHC, UKS / UKGS and PMR is
important in developing a public health system with the aim towards a healthy
society and in line with community involvement as much as possible. With as
much as possible the participation of organizations active in the community as
volunteers of Posyandu, PKK, Youth Work, Scout, Bachelor of Rural movers and
other organizations, and supported by MUSPIDA set

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 REFERENCES

Slamet, July Soemirat. 2002. Environmental Health. Yogyakarta: Gadjah

Mada University Press.
Effendy, Nasrul. 1998. Fundamentals of Public Health Nursing. Jakarta: EGC.
Ekasari, Mia Fatma, et al. 2008. Community Nursing Society's independence
efforts for Healthy Living. Jakarta: Trans Media Info.
Go Nursing. 2008. An Introduction to Family Nursing.
http://ilmukeperawatan.wordpress.com/2008/04/07/keperawatan-keluarga-sebuah-
pengantar/. 09-10-2010.