400 final community health

health promotion

focused on prevention- giving people tools and knowledge to make healthy choices

Health education

refers to programs on activities conducted to improve health literacy and navigating health system

steps to create and implement an effective health promotion program

- determine the purpose and scope of the needs assessment

- gather data

- analyze data

- identify the risk factors linked to problem

- identify the program focus

- validate the prioritized need

- set appropriate goals and objectives

- create an intervention

- implement the intervention

- evaluate results

health disparities

Differences in health outcomes between groups, often driven by social, economic, and environmental factors.

key contributors to health disparities

Social Determinants of Health (SDOH): Strongly linked to health outcomes. These include:

- Income & education level

- Employment & working conditions

- Access to healthcare

- Neighborhood safety

- Housing & transportation

cultural literacy

Understanding cultural influences on health beliefs and practices.

health literacy

The ability to understand and use health information to make decisions

Medicare

Federal health insurance program mainly for:

People 65 and older

People under 65 with certain disabilities

People with End-Stage Renal Disease (ESRD)

Part A

Hospital insurance-

Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health. DOES NOT cover custodial care (feeding/bathing)

Part B

Medical insurance-

Covers outpatient care, doctor visits, preventive services, and some home health care. 29% of spending

Part C

Medicare Advantage-

Offered by private companies. Includes Part A, B, and sometimes D; may offer extra benefits like vision, dental, etc. 23% of spending

Part D

Prescription drug coverage

medigap

a private insurance policy that pays the difference between the medical charge and the amount that Medicare pays

Medicad

Joint federal and state program that provides health coverage to:

- Low-income individuals and families

- Pregnant women, children, elderly adults, and people with disabilities

medicaid vital role

Provides essential healthcare for vulnerable populations

Medicaid Expansion (Virginia)

- Expanded under the Affordable Care Act (ACA)

- Covers more low-income adults who previously didn't qualify

- Includes adults aged 19-64 with income up to 138% of the federal poverty level

Children's Health Insurance Program (CHIP)

Means-tested program (based on income)

- Provides low-cost health coverage to children in families that earn too much to qualify for

- Medicaid, but can't afford private insurance.

entitlement programs

medicare, medicaid, public health service (rural vulnerable groups)

Private insurance

HMO's, PPO's, POS

cost share out of pocket

cost sharing/HSA

Employment based

group health insurance that employer offers to employees

military

TriCare and Veterans

1977 - Community Support Program (CSP)

Recognized chronic mental illness as a social welfare issue

Provided federal grants to communities for:

- Medication

- Transportation

- Counseling

- Other supportive services for individuals with psychiatric needs

2010 - Affordable Care Act (ACA)

- Expanded Medicaid to cover more people with mental health conditions

- Increased access to private insurance for low-income individuals without employer-based coverage

General Adaptation Syndrome (GAS)

a three-stage physiological response that appears regardless of the stressor that is encountered

1. alarm

2. resistance

3. exhaustion

PHQ-2

- Quick 2-question screening for initial detection of depression

- If positive → follow up with PHQ-9

PHQ-9

- 9-question tool to assess the severity of depression

- Helps guide diagnosis and treatment planning

Mental Health- Homelessness

About 25% of homeless individuals in the U.S. have a mental illness.

Maternal, Infant, and Child (MIC) Mortality

- U.S. MIC mortality has declined in recent decades

- U.S. has a higher infant mortality rate than other industrialized countries

Leading Causes of Infant Death

- Congenital abnormalities (birth defects)

- Preterm birth / Low birth weight

- SIDS (Sudden Infant Death Syndrome)

Maternal, Infant, and Child Health

- In the U.S., Black mothers and infants have higher mortality rates than White mothers and infants.

- Focusing on the mother's health and family support improves the child's chances for healthy development. IMPROVES CHILDS OUTCOME!

Preconception Health Care:

Medical care before pregnancy (for both men and women)

Goal: Promote health and prevent future issues

Prenatal Health Care:

Medical care during pregnancy (from conception to birth)

Goal: Monitor and support the health of mother and baby

WIC Program (Women, Infants, and Children)

Provides nutrition and health support to:

- Pregnant women

- Postpartum women

- Breastfeeding women

- Infants (up to age 1)

- Children (under age 5)

Services include:

Healthy foods

Nutrition education

Healthcare referrals

Among the many variables that impact adolescents and young adults, there are four that affect this demographic the most from the perspective of community health:

•Population.

•Living arrangements.

•Employment status.

•Access to health care.

"Greying of America" - Aging Population

- The U.S. population is getting older as more people live longer

- This shift increases demand for healthcare and aging services

Four Levels of Tasks That May Need Help

Instrumental tasks - managing home and money

Expressive tasks - emotional support and companionship

Cognitive tasks - decision-making, memory

Tasks of daily living (ADLs) - personal care

Six Instrumental Needs for All Ages (Can Change with Aging)

Income

Housing

Personal care

Health care

Transportation

Community facilities & services

What is Palliative Care/ Advanced Care Management---

Managing Chronic Pain That Affects Functioning

Definition of Palliative Care

means patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information, and choice.

Hospice Care

•Providing Quality of Life to a terminally ill patient

Medicare Hospice Certification Requirements:

Two physician certification that patient has disease prognosis of 6 months or less

**Patient must sign Medicare document indicating that they wish to receive care from an approved hospice**

Philosophy of care- hospice

that offers patients that are suffering with a life limiting illness a patient centered and multidisciplinary approach to care.

Location of hospice care:

"the place the patient calls home" (private residences, skilled nursing facilities, free-standing hospice facilities, hospitals.)

Environment-Public Health

•Health is affected by the quality of the environment, it Includes air we breathe, water we drink, food we eat, communities in which we live

Cholera:

Caused by the bacterium Vibrio cholerae, often spread through contaminated water sources.

Typhoid Fever

Caused by Salmonella typhi, commonly contracted through ingestion of contaminated water or food.

Dysentery

Inflammation of the intestines, spread by unclean water.

Nato Triage Categories for Disaster Victims:

Critical (RED)

•Injuries are life threatening but survivable with care

Urgent (YELLOW)

• Injuries are significant and require medical care

Minimal (GREEN)

•Injuries are minor and tx can be delayed (walking wounded)

Expectant (BLACK)

•Injuries are extreme, and survival is unlikely