ICC exam #2

What is the overall purpose of the Health Outcomes & Inclusion system approach?

Improve community health outcomes and advance inclusion through coordinated systemwide and regional initiatives.

What does the Inclusion team primarily work on?

Workflow redesign, triennial survey readiness, reporting optimization, improved data capture, and cultural observance planning.

Why are triennial visit materials updated?

To ensure compliance with revised operational standards across the system.

What does the 1557 initiative strengthen?

Internal reporting structures, data capture, and actionable goal-setting based on nondiscrimination standards.

What is the goal of the Inclusive Hair Care Product project?

Transition the pilot program into a scalable, systemwide initiative.

What is the inclusion role of New Employee Orientation?

Align orientation content with updated models and keep a consistent systemwide inclusion approach.

What does Measure of Success focus on?

Adjusting, enhancing, and standardizing data capture for an updated performance scorecard.

What is the purpose of the Cultural Observance model?

Create a standardized, restricted model with coordinated communication and regional champions for annual observances.

What system function does Community Affairs support?

Reviewing and approving inclusion-related sponsorships with a standardized system approach.

What is the goal of the annual HBCU Summit?

Strengthen academic partnerships and leadership pipelines by hosting at least one summit each year.

What does NAHSE support include?

Professional development, mentorship, structured membership sponsorship, and active member engagement.

What do System Councils work toward?

Aligning council initiatives with system strategy and establishing clear, actionable goals.

What is the objective of the Pediatric Strategy?

Identify top negative drivers of child health outcomes and recommend evidence-based interventions for Louisiana.

What does the Food Security Strategy prioritize?

SNAP expansion, food access programs, and Food as Medicine partnerships to improve community nutrition.

What is the focus of the Mississippi Strategy?

Evaluating drivers of poor outcomes and communicating evidence-based interventions to improve regional health.

What is the role of the Drive Team?

Support workgroups, oversee workflow development, and ensure accurate data capture for evaluating health outcomes.

What is the purpose of OXIHER?

Partner with Xavier and other HBCUs to address root causes of poor community health and expand research/career opportunities.

What does the Mar/Comms Strategy support?

Toolkits, education events, and broad public awareness campaigns promoting evidence-based state health priorities.

What do Chronic Disease workgroups address?

Access, affordability, cancer screening, hypertension/diabetes management, and smoking/vaping education.

What do Food Security & Nutrition workgroups provide?

SNAP enrollment expansion, mobile markets, summer meal sites, and employee cafeteria discounts.

What do Workforce & Economic Opportunity workgroups create?

Career pathways, workforce sustainability models, and expanded health professional training opportunities.

Which internal stakeholders sit on regional steering committees?

CEOs, executive teams, clinic leaders, marketing/communications, community affairs, and health outcomes leaders.

Who are common external partners for smoking/vaping initiatives?

ConnectLA, state health departments, and local school systems.

Who supports food security initiatives?

DCFS, Second Harvest, Morrisons, and K-12 school partners.

What is activation management responsible for?

Coordinating and managing execution of region-specific health outcome initiatives.

What federal act provides the current definition of homelessness?

The HEARTH Act of 2009 (updates the McKinney Act of 1987).

What qualifies as a primary nighttime residence for homelessness under HEARTH?

A place not meant for regular sleeping, an emergency shelter, transitional housing, or exiting an institution after ≤90 days.

Who is considered imminently homeless under HEARTH?

Individuals/families losing housing within 14 days with no resources or support to obtain permanent housing.

What population is included under fleeing/attempting to flee interpersonal violence?

Individuals or families escaping domestic or interpersonal violence with no safe alternative housing.

How is "chronically homeless" defined?

Homeless ≥1 year OR ≥4 episodes in 3 years plus a chronic disabling condition.

What are typical characteristics of chronically homeless individuals?

Mostly single men with high rates of mental illness, substance use, and major barriers to housing/employment.

What defines intermittent homelessness?

Multiple short, self-limited episodes, often preceded by staying with friends/family, with high risk of recurrence.

What is the prototypical intermittently homeless person?

Member of a financially struggling female-headed household.

What causes crisis homelessness?

A one-time economic, health-related, or natural disaster event (e.g., job loss, fire).

Who qualifies as unaccompanied youth experiencing homelessness?

Adolescents/young adults ≤25 living without parents, often fleeing abuse or family rejection related to sexual identity.

What high-risk behaviors are common in unaccompanied youth?

Substance use, survival sex, suicidality, and frequent transience across cities.

What major trend did the 2024 AHAR report show?

The highest single-night homelessness count ever recorded (771,480 people).

What group saw the largest single-year increase in homelessness?

Families with children.

How many children experienced homelessness in 2024 on a single night?

Nearly 150,000 (a 33% increase from 2023).

Which population was the only one to show decreased homelessness?

Veterans.

What proportion of people experiencing homelessness are age ≥55?

About 1 in 5.

How are Black individuals represented among the homeless population?

They are disproportionately represented despite not being more susceptible to addiction or mental illness.

What fraction of individuals experience chronic homelessness patterns?

About one in three.

What are key protective factors against homelessness?

Financial resources, stable employment, housing subsidies, strong social support.

What are major risk factors for homelessness?

Mental illness, substance use, chronic illness, IPV, pregnancy, dependent children, poverty, incarceration history.

What is the most essential vulnerability leading to homelessness?

Poverty—though not the only determinant.

What common childhood experiences increase adult homelessness risk?

Foster care placement, juvenile justice involvement, childhood homelessness, runaway/"throwaway" status.

What is the mortality pattern among homeless individuals?

3-4× higher mortality than housed peers; median age of death 40-47 years.

What infectious diseases are more common in homeless populations?

TB, HIV, and viral hepatitis (due to poor living conditions and higher rates of injection drug use).

What health risks are higher for homeless women?

Pregnancy complications, poor contraception access, high unintended pregnancy rates, and increased physical/sexual assault.

What health issues are more common in homeless children?

More infections, nutritional disorders, asthma, and developmental delay.

What percentage of homeless adults smoke?

About 75%.

What chronic conditions are common in homeless adults ≥50?

Cognitive impairment, functional decline, diabetes, hypertension, CAD, COPD—often undiagnosed or untreated.

What percentage of homeless individuals have a mental health problem?

57% lifetime; 39% currently.

What percentage have substance use problems?

~25% current drug use issue; 60% lifetime drug use disorder.

What percentage have at least one of mental illness, alcohol use disorder, or drug use disorder?

86% lifetime; many have ≥2 simultaneously.

Why do homeless individuals experience more hospitalizations?

Delayed care access, poor outpatient follow-up feasibility, and lower admission thresholds for safety reasons.

Where do most homeless individuals receive their care?

The safety-net system—community clinics, public hospitals, VA hospitals.

How has the ACA changed health care access for homeless individuals?

Expanded Medicaid eligibility has improved access to ambulatory care.

What is the medical model of disability?

Views disability as a problem caused by disease or injury requiring medical treatment.

What is the social model of disability?

Views disability as the result of societal barriers rather than individual impairment.

What framework integrates both medical and social models?

The WHO International Classification of Functioning, Disability, and Health (ICF).

What does the ICF define as "disability"?

An umbrella term for impairments, activity limitations, and participation restrictions.

What should clinicians avoid assuming when treating patients with disabilities?

That the disability is always the reason for the visit.

What is the most common cause of adult physical disability?

Arthritis.

What are common causes of sensory disability?

Cataracts, glaucoma, presbyopia (vision); presbycusis (hearing).

What federal programs support individuals unable to work due to disability?

Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

What medical evidence is required for SSDI/SSI?

Documentation that the patient cannot perform substantial gainful activity due to impairment.

What does the ADA prohibit?

Discrimination in employment, public entities, and public accommodations—including healthcare settings.

How does the ADA define disability?

A physical or mental impairment limiting one or more major life activities, a record of such impairment, or being regarded as such.

What is a common pitfall among healthcare providers?

Lack of training, improper use of assistive devices, and assuming functional ability without assessment.

What is the Get Up and Go Test used for?

Assessing gait and fall risk; >30 sec suggests dependence/high fall risk.

When are physical therapy referrals appropriate?

For new disability, balance/gait problems, strength/range deficits, or mobility aid assessment.

When are occupational therapy referrals appropriate?

When patients need help with ADLs/IADLs, safety judgment, home modifications, or adaptive equipment.

What is the role of canes?

Provide balance support or offload weight when used correctly and at proper height.

What distinguishes crutches from canes?

Crutches can support full body weight and require strong upper extremity strength.

What is Healthy People 2030?

A national initiative establishing 10-year goals to improve health, eliminate disparities, and promote well-being.

What are the overarching goals of Healthy People 2030?

Healthy thriving lives, elimination of disparities, health equity, supportive environments, healthy development, and multisector engagement.

What does a "health disparity" mean?

A worse health outcome experienced disproportionately by socially disadvantaged groups.

What does a "healthcare disparity" mean?

Differences in insurance coverage, access, utilization, or quality of care across population groups.

What factors most strongly drive disparities?

Race, ethnicity, socioeconomic status, geography, and gender.

What has research shown about racial concordance?

Black patients experience poorer communication and less participation with non-Black clinicians.

How do Hispanics compare in representation?

~16.7% of U.S. population but <6% of physicians and ~3% of PAs.

How do African Americans compare in representation?

~13.4% of population but ~6% of physicians and ~3% of PAs.

How many U.S. adults have limited English proficiency?

About 24 million.

Why does geography matter in health disparities?

Regional variation in chronic disease, policies, infrastructure, and healthcare access shapes outcomes.

What does the "Place Matters" concept highlight?

Environmental conditions—schools, transportation, parks, pollution, food access—directly influence health.

What disparities affect LGBTQ+ populations?

Higher rates of anxiety, depression, suicidality, substance use, STIs, and select cancers.

What are key risk factors for LGBTQ+ disparities?

Stigma, discrimination, harassment, poor access to affirming care, and minority stress.

What does the 2025 National Overview show about disparities?

Black, Hispanic, and low-income groups face the strongest barriers to high-quality healthcare.

What is avoidable mortality like for Black individuals?

About 2× higher than white individuals in most states.

What does the 2025 affordability crisis refer to?

Millions of adults who cannot afford needed care or medications ("cost desperate").

What are major LGBTQ+ youth mental health findings?

68% report anxiety; 47% report suicidal thoughts.

What is a major source of disparities in the health workforce?

Underrepresentation of minority clinicians contributing to poorer communication and trust.

What do social drivers of health refer to?

Non-medical factors like housing, education, income, food access, and transportation influencing outcomes.

What is the role of community engagement in equity?

Builds trust, improves cultural relevance, and aligns interventions with local needs.

What is the importance of culturally competent care?

Enhances communication, satisfaction, and quality of care for diverse populations.

What is a key policy strategy for reducing disparities?

Expanding access to affordable, high-quality care through inclusive legislation.

What does investment in underserved areas accomplish?

Improves social opportunities, reduces structural barriers, and supports long-term health equity.

What is the purpose of the National Healthcare Quality & Disparities Report?

To assess U.S. health system performance and monitor disparities in access and quality.