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NATIONAL AND STATE INIATIATIVES

NATIONAL AND STATE INIATIATIVES. CULTURAL BELIEFS AND VALUES. BELIEF IN SCIENCE LED TO THE APPLICATION OF THE SCIENTIFIC METHOD TO MEDICINE THE MEDICAL MODEL OF HEALTH CARE DELIVERY IS FOUNDED ON ADVANCES IN SCIENCE AND TECHNOLOGY.

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NATIONAL AND STATE INIATIATIVES

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  1. NATIONAL AND STATE INIATIATIVES

  2. CULTURAL BELIEFS AND VALUES

  3. BELIEF IN SCIENCE LED TO THE APPLICATION OF THE SCIENTIFIC METHOD TO MEDICINE • THE MEDICAL MODEL OF HEALTH CARE DELIVERY IS FOUNDED ON ADVANCES IN SCIENCE AND TECHNOLOGY. • THE MEDICAL MODEL HAS FUELED THE TREMENDOUS GROWTH IN MEDICAL SCIENCE AND TECHNOLOGY INNOVATION. • THE U.S. HAS BEEN LEADING THE WORLD IN NEW MEDICAL BREAKTHROUGHS.

  4. THESE DEVELOPMENTS HAVE HAD NUMEROUS IMPLICATIONS FOR HEALTH SERVICES DELIVERY.

  5. THEY INCREASE THE DEMAND FOR THE LATEST TREATMENT AND RAISE PATIENTS’ EXPECTATIONS OF FINDING A CURE. • MEDICAL PROFESSIONALS HAVE BEEN PREOCCUPIED ALMOST EXCLUSIVELY WITH CLINICAL INTERVENTIONS, WHEREAS THE HOLISTIC ASPECTS OF HEALTH AND USE OF ALTERNATIVE THERAPIES HAVE BEEN DEEMPHASIZED. • HEALTH CARE PROFESSIONALS HAVE BEEN TRAINED TO FOCUS ON PHYSICAL SYMPTOMS.

  6. FEW ATTEMPTS HAVE BEEN MADE TO INTEGRATE DIAGNOSIS AND TREATMENT WITH HEALTH EDUCATION AND DISEASE PREVENTION. • THE CONCERN WITH NONHEALTH HAS FUNNELED MOST RESEARCH EFFORTS AWAY FROM THE PURSUIT OF HEALTH INTO DEVELOPMENT OF SOPHISTICATED MEDICAL TECHNOLOGY. COMMITMENT OF RESOURES TO THE PRESERVATION AND ENHANCEMENT OF HEALTH AND WELL-BEING LAGGED FAR BEHIND.

  7. MEDICAL SPECIALISTS WHO USE THE LATEST TECHNOLOGY HAVE BEEN HELD IN HIGHER ESTEEM AND HAVE EARNED HIGHER INCOMES THAN GENERAL PRACTITIONERS AND HEALTH EDUCATORS. • THE DESIRABILITY OF HEALTH CARE DELIVERY INSTITUTIONS, SUCH AS HOSPITALS, IS OFTEN EVALUATED BY THEIR ACQUISITION OF ADVANCED TECHNOLOGY.

  8. WHILE BIOMEDICINE HAS TAKEN CENTRAL STAGE, DIAGNOSIS AND TREATMENT OF MENTAL HEALTH HAVE BEEN RELEGATED TO A LESSER STATUS, BUT DIFFICULITIES IN IDENTIFYING CERTAIN BEHAVIORS TO BE INDICATIVE OF MENTAL HEALTH DISORDERS HAVE BEEN AT LEAST PARTICALLY RESPONSIBLE FOR THE SECONDARY STATUS OF MENTAL HEALTH SERVICES IN THE HEALTH CARE DELIVERY SYSTEM. • THE BIOMEDICAL MODEL HAS ALSO ISOLATED THE SOCIAL AND SPIRITUAL ELEMENTS OF HEALTH.

  9. AMERICA HAS BEEN A CHAMPION OF CAPITALISM. DUE TO A STRONG BELIEF IN CAPITALISM, HEALTH CARE HAS LARGELY BEEN VIEWED AS AN ECONOMIC GOOD, NOT AS A PUBLIC RESOURCE.

  10. A CULTURE OF CAPITALISM PROMOTES ENTREPRENEURIAL SPIRIT AND SELF-DETERMINATION. • INDIVIDUAL CAPABILITIES TO OBTAIN HEALTH SERVICES HAVE LARGELY DETERMINED THE PRODUCTION AND CONSUMPTION OF HEALTH CARE - WHAT SERVICES WILL BE PRODUCED, WHERE, AND IN WHAT QUANTITY, AND WHO WILL HAVE ACCESS TO THOSE SERVICES.

  11. FINANCING OF HEALTH CARE THROUGH INDIVIDUAL HEALTH INSURANCE COVERAGE HAS MADE ACCESS TO HEALTH CARE A SOCIAL PRIVILEGE. • A CLEAR DISTINCTION EXISTS IN THE TYPES OF SERVICES BETWEEN POOR AND AFFLUENT COMMUNITIES, AND BETWEEN RURAL AND URBAN LOCATIONS. • THE CULTURE OF INDIVIDUALISM EMPHASIZES INDIVIDUAL HEALTH RATHER THAN POPULATION HEALTH. MEDICAL PRACTICE HAS BEEN DIRECTED AT KEEPING THE INDIVIDUAL HEALTHY RATHER THAN THE ENTIRE COMMUNITY HEALTHY.

  12. PRINCIPLES OF FREE ENTERPRISE AND A GENERAL DISTRUST OF BIG GOVERNMENT HAVE KEPT THE DELIVERY OF HEALTH CARE LARGELY IN PRIVATE HANDS. • A SEPARATION EXISTS BETWEEN PUBLIC HEALTH FUNCTIONS AND THE PRIVATE PRACTICE OF MEDICINE.

  13. Medical Model • Delivery of health care that places its primary emphasis on the treatment of disease and relief of symptoms instead of prevention and promotion of optimum health

  14. WHAT IS “HEALTHY PEOPLE?’’

  15. Healthy People 2010 is the prevention agenda for the Nation.

  16. It is a statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats.

  17. Healthy People 2010 builds on initiatives pursued over the past two decades.

  18. The 1979 Surgeon General’s Report, Healthy People, and Healthy People 2000: National Health, Promotion and Disease Prevention Objectives, both established national health objectives and served as the basis for the development of state and community plans.

  19. Healthy People 2010 offers a simple but powerful idea: provide the objectives in a format that enables diverse groups to combine their efforts and work as a team.

  20. It is a roadmap to better health for all and can be used by many different people.

  21. DEVELOPMENT OF HEALTHY PEOPLE 2010 OBJECTIVES

  22. The 28 focus areas of Healthy People 2010 have been developed by leading Federal agencies with the most relevant scientific expertise.

  23. The development process was informed by the Health People Consortium – an alliance of more than 350 national membership organizations and 250 State health, mental health, substance abuse, and environmental agencies.

  24. HEALTHY PEOPLE 2010 IS ABOUT IMPROVING HEALTH – THE HEALTH OF COMMUNITIES, AND THE HEALTH OF THE NATION.

  25. GOAL 1: INCREASE QUALITY OF YEARS OF HEALTHY LIFE

  26. Life Expectancy • Life expectancy is the average number of years people born in a given year are expected to live based on a set of age-specific death rates. At the beginning of the 20th Century. Life expectancy at birth was 43.7 years. Today the average life expectancy is nearly 77 years. Projected to be 79.2 years.

  27. Life expectancy for persons at every age group also has increased during the past century. Based on today’s age-specific death rates, individuals age 65 years can be expected to live an average of 18 years more years. Those aged 75 years can be expected to live 11 more years.

  28. Women outlive men by 6 years.

  29. QUALITY OF LIFE • Quality of life reflects a general sense of happiness and satisfaction with our lives and environment.

  30. Health Related quality of life reflects a personal sense of physical and mental health and the ability to react to factors in the physical and social environment.

  31. Global assessments, in which a person rates his or her health as “poor,” “fair,” “good,” “very good,” or “excellent” can be reliable indicators of one’s perceived health.

  32. ACHIEVING A LONGER AND HEALTHIER LIFE – THE HEALTH PEOPLE PERSPECTIVE.

  33. Healthy People 2010 seeks to increase life expectancy and quality of life over the next 10 years by helping individuals gain the knowledge, motivation, and opportunities they need to make informed decisions about their health.

  34. GOAL 2: ELIMINATE HEALTH DISPARITIES • Gender: Overall, men have a life expectancy which is 6 years less than that of women, and have higher death rates for each of the 10 leading causes of death.

  35. Race • Even though the Nation’s infant mortality rate is down, the infant death rate among African-Americans is still more than double that of whites.

  36. Heart disease death rates are more than 40 % higher for African-Americans than for whites. • The death rate for all cancers is 30% higher for African Americans than for whites.

  37. INCOME AND EDUCATION

  38. Inequalities in income and education underlie many health disparities in the United States. • In general, population groups that suffer the worst health status also are those that have the highest poverty rates and the least education.

  39. Overall, those with higher incomes tend to fare better than those with lower incomes. • Among white men aged 65 years and over, those in the highest income families could expect to live 3 years longer than the lowest income families.

  40. For women, the amount of education achieved is a key determinant of the welfare and survival of their children.

  41. GEOGRAPHIC LOCATION

  42. Twenty-five percent of Americans live in rural areas. Injury-related death rates are 40 percent high in rural populations than in urban populations. Heart disease, cancer, and diabetes rates exceed those for urban areas. • Timely access to emergency services and specialty care are issues to this population.

  43. Determinants of Health

  44. Biology • Biology refers to the individual’s genetic makeup, family history, and the physical and mental health problems acquired during life.

  45. Behaviors • Behaviors are individual responses or reactions to internal stimuli and external conditions.

  46. Social Environment • Social environment includes interactions with family, friends, coworkers, and others in the community.

  47. Physical Environment • Physical environment can be thought of as that which can be seen, touched, heard, smelled, and tasted.

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