Community Health Exam 3

minority health

the morbidity and mortality of American Indians/Alaska Natives, Asian Americans, Native Hawaiians and other Pacific Islanders, African Americans, and Hispanics in the United States

consumer/patient

the 1st party of the party system payment

health care provider

the 2nd party of the party payment system

government or private insurance

the 3rd party of the party payment system

health disparities

a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage

HP 2030 Goal

to eliminate disparities among racial and ethnic minority populations in six areas

• infant mortality

• cancer screening/management

• cardiovascular disease and stroke

• diabetes

• HIV/AIDS

• immunization

culture shock

the degree to which a person feels trauma related to being exposed to a new culture

phases of culture shock

• honeymoon phase

• frustration phase

• adjustment phase

• adaptation/acceptance phase

race

categorization of parts of a population based on physical appearance due to particular historical, social, and political forces

ethnicity

subcultural group within a multicultural society

hispanics

an ethnicity, largest minority group in U.S., lowest education, low income, and good health is seen as a matter of fortune from God for good behavior

african americans

2nd largest minority group in U.S., more than ½ live in southern states, lower graduation rates than average, lowest median income of any group, distrust government

asian americans

people who trace their roots to more than 20 different asian countries, higher than average education and income, and balance is related to health, and imbalance is related to disease

native hawaiian/other pacific islanders

peoples from hawaii, guam, samoa, or other pacific islands, lower education and income than average, and believe that healers should not get paid

american indians/alaska natives

relatively poor health status, many different tribal groups

indian health services (IHS)

responsible for federal health services to native americans and alaska natives, with the goal to raise health status to highest possible level

middle eastern and north african americans

not considered a unique racial group according to U.S. government

sexual orientation

an inherent enduring emotional, romantic, or sexual attraction to other people

gender identity

an individual’s innermost concept of self as male, female, a blend, or neither; how people perceive themselves and what they call themselves

gender expression

the outward or external appearance of an individual’s gender identity, usually expressed through behavior, clothing, appearance, which may or may not conform to socially defined behaviors and characteristics

intersectionality

how race, class, gender, and other individual characteristics “intersect” with one another and overlap

refugees

people who flee their homes due to danger

immigrants

people living in a country other than that of their birth

bias

prejudice in favor of or against one thing, person, or group compared with another; can be unconscious or implicit

seven steps to manage implicit bias

• acknowledge bias

• challenge current negative biases

• be empathetic

• see differences

• be an ally

• recognize this is stressful and painful

• engage in dialogue

ethnocentrism

the notion that one’s own culture, its customs and practices, are superior to those of another

mental illness

refers to all diagnosable mental disorders and the leading cause of disability in North America and Europe

mental health

state of successful performance of mental function

mental disorders

health conditions characterized by alterations in thinking, mood, or behavior associated with distress and/or impaired functioning

stress

one’s psychological and physiological response to stressors

diagnostic and statistical manual of mental disorders

a book about mental health that classifies disorders based on behavioral signs and symptoms

the moral treatment era

the era in which there was a belief that environmental changes can affect the mind and alter behavior

national mental health act of 1946

established a national institute of mental health to aid research and help treat neuropsychiatric disorders

deinstitutionalization

discharging of thousands of patients from state mental hospitals that began in 1950s

prevention of mental disorders

• primary - reduce incidence of mental illness and related problems

• secondary - reduces prevalence by shortening duration of episodes

• tertiary - treatment and rehabilitation

psychopharmacological therapy

treatment of mental disorders with medication

psychotherapy

treatment of mental disorders through verbal communication

cognitive-behavioral therapy

patient learns skills to modify thinking and behavior

self-help groups

concerned members of the community who are united by a shared interest, concern, or deficit not shared by other members of the community (examples: NAMI, AA, NA)

parity

concept of equality in healthcare coverage for people with mental illness and those with other medical issues or injuries

21st century cures act (2016)

provided funds for:

• suicide screening

• crisis intervention teams

• assisted outpatient treatment

• mental health courts

drug

a substance other than food or vitamins that when taken in small quantities, alters one’s physical, mental, or emotional state

psychoactive drugs

drugs that alter sensory perceptions, mood, thought process, or behavior

drug misuse

inappropriate use of prescription or nonprescription drugs

drug abuse

taking of a drug for a non-medically approved purpose

drug dependence

when one believes that a particular drug is necessary for normal functioning

dosage

the amount of drug that is administered

synergistic

the drug interaction where the effect of two drugs is greater than the sum of each drug (2+2=7)

antagonistic

the drug interaction where there is a complete or partial canceling effect (2+2=0 or 2 or 3)

risk factors

factors that increase the probability of drug use

protective factors

factors that lower the probability of drug use

legal drugs

drugs that can be bought and sold in the marketplace and that can be regulated or not regulated

controlled substances and illegal drugs

drugs regulated by the controlled substances act of 1970

alcohol

the number 1 drug problem in the U.S. of use, dollars spent, costs, injuries, and death

problem drinkers

those who experience personal, interpersonal, legal or financial problems because of alcohol use

alcoholism

physical dependence on alcohol with tolerance and withdrawal present

blood alcohol concentration (BAC)

percentage of concentration of alcohol in the blood (greater than or equal to 0.08% is considered intoxication in most states)

alcohol

#1 rape drug

fetal alcohol spectrum disorders

disorders that happen to the fetus of those who drink alcohol

nicotine

psychoactive and addictive drug present in tobacco products that produces tolerance and withdrawal

tobacco

the single most preventable cause of disease, disability, and death in U.S.

synar amendment (1992)

prohibited sale of tobacco products to those under 18

tobacco 21 (T21)

a movement that led to new legislation prohibiting sale of tobacco products to those under 21

family smoking prevention and tobacco control act (2009)

an act that made it so the FDA has oversight over all tobacco products

over-the-counter-drugs

legal drugs other than alcohol and tobacco that can be purchased without a physician’s prescription and are regulated by the FDA

prescription drugs

drugs that can be purchased only with a prescription, because they can have serious side effects, also controlled by FDA

drug enforcement agency

the agency responsible for enforcing the controlled substances act

stimulants

drugs that increase the activity of the central nervous system and produce rapid tolerance and withdrawal (cocaine, amphetamines, methamphetamines)

formication

the sensation that bugs are crawling under the skin

hallucinogens

drugs that produce illusions and changes in perception and synesthesia - mixing of the senses (LSD, mescaline, psilocybin)

depressants

drugs that slow down the nervous system and can lower anxiety (alcohol, barbiturates, xanax)

club drugs (designer drugs)

illicit drugs, primarily synthetic, synthesized by amateur chemists in secret labs, most commonly encountered at nightclubs, bars, or parties (MDMA, rohypnol)

anabolic drugs

protein-building drugs like steroids, testosterone, or human growth hormone

inhalants

a collection of psychoactive breathable chemicals (paint solvents, motor fuel, glue, aerosol sprays)

• primary - prevention aimed at those who have never used

• secondary - aimed at those who have used, but not chronic abusers

• tertiary - drug abuse treatment and aftercare

levels of prevention for drug use

substance abuse and mental health services administration (SAMSHA)

the lead agency focused on providing services for those with substance abuse problems

national institute on drug abuse (NIDA)

the lead agency for federal research on drug abuse

food and drug administration (FDA)

the lead federal regulatory agency for legal drugs

almshouses

old local hospitals government run provision of food, shelter, and basic nursing

pesthouses

old local government run hospitals isolation centers for the sick

hospital survey and construction act (Hill-burton act)

an act that provided funds to build hospitals in 1946

health maintenance organization act (1973)

an act that allowed for the creation of organizations that provide both insurance and health care delivery

national health planning and resources development act (1974)

an act that created federal bureaucracy to help prevent building unnecessary facilities and purchasing unnecessary equipment

american health security act (1993)

an act that failed to pass that would have increased dramatically the involvement of the federal government in health insurance

medicare prescription drug, improvement, and modernization act (2003)

an act that was an expansion of medicare to cover prescription drugs

chip reauthorization act (2009)

an act that expanded chip by increasing taxes on tobacco

• public health practice

• medical practice

• long-term practice

• end-of-life practice

spectrum of healthcare delivery four levels of practice

• primary

  • clinical preventive services

• secondary

  • specialized attention and ongoing management

• tertiary

  • highly specialized and technological medical and surgical care

levels of medical care

restorative care

care provided after surgery or other treatment (rehab, therapy)

long-term care

care that helps with chronic illnesses and disabilities (nursing homes)

allopathic (M.D.)

doctor education that requires 4 years of med school and 3-5 years of residency; focuses on the provision of specific remedies including drugs, medication, and surgery

osteopathic (D.O.)

doctor education that requires 4 years of med school and 3-5 years of residency; have greater recognition of the interrelationship between the structure and function of the body in providing treatment

nonallopathic

education of professionals that is a complementary and alternative medicine and focuses on natural products, mind and body medicine, and therapy treatments (chiropractors, acupuncturists)

licensed practical nurse (LPN)

nurses with 1-2 years of education in a vocational program that have passed the licensure exam

registered nurse (RN)

nurses that have completed an accredited academic program and have passed the state licensure exam

advanced practice nurse (APN)

nurses with masters or doctoral degrees (CRNA, NP, CNS)

physician assistants

professionals who practice in many areas similar to physicians, but do not have MD or DO degrees and practice medicine with physician supervision

private hospitals

hospitals that make profit and are specialty hospitals

public hospitals

hospitals that are supported and managed by government jurisdictions

voluntary hospitals

hospitals that are not-for-profit; about half of U.S. hospitals