AHSC 440 Chapter 2 - Beliefs, Values, and Health Study Guide

Core Beliefs and Values in Healthcare

• Desirable individual beliefs and values for healthcare providers:

  • Honesty and integrity

  • Personable demeanor

  • Unbiased attitude

  • Patient-centered care approach

  • Experience and expertise

  • Commitment to continuing education

  • Undivided attention to patients

  • Consideration for patient needs

• Significance of health beliefs and values for policymakers and managers:

  • Determining and monitoring the overall health status of a population.

  • Guiding the design, implementation, and focus of educational and preventive initiatives.

  • Establishing standard benchmarks and frameworks for evaluating healthcare organizations.

Basic Concepts and Views of Health

• Medical Model:

  • Defines health strictly as the absence of illness or disease.

  • Key operational focus areas:

  • Diagnosis of disease.

  • Relief of symptoms.

  • Limitation: Completely fails to account for disease prevention and proactive health promotion.

• World Health Organization (WHO) Definition:

  • Defines health as a state of complete physical, mental, and social well-being, rather than merely the absence of disease or infirmity.

• Holistic View of Health:

  • Emphasizes the complete well-being of every single aspect that makes a person whole.

  • Treats the person as an integrated whole across four distinct dimensions:

  • Physical health

  • Mental health

  • Social health

  • Spiritual health

  • Demonstrates a significant positive effect on overall health outcomes.

Quality of Life

• Definition: Refers to an individual's overall satisfaction with life and self-perceptions of health, as well as satisfaction with experiences while receiving healthcare.

• Key factors influencing healthcare quality of life:

  • Comfort factors

  • Respect from healthcare providers

  • Privacy during care and treatment

  • Personal security

  • Involvement in decision-making processes

  • Attention paid to personal preferences

Risk Factors and Disease Classifications

• The Triad of Health Risk Factors:

  • Host

  • Agent / Disease

  • Environment

  • Interaction: All three elements serve as risk factors that increase the overall likelihood of developing a particular disease or health condition.

• Population Prevalence of Behavioral Risk Factors:

  • Alcohol use (individuals 12 years and older): $52.7\%$ (2014)

  • Marijuana use (individuals 12 years and older): $8.4\%$ (2014)

  • Cocaine use among 12th graders: $1.0\%$ (2014)

  • Cocaine use among 10th graders: $0.6\%$ (2014)

  • Cocaine use among 8th graders: $0.5\%$ (2014)

  • Cigarette smoking (adults 18 years and older): $16.8\%$ (2014)

  • Hypertension (adults 20 years and older): $30.4\%$ (2011–2014)

  • Overweight and obese status (adults 20 years and older): $69.5\%$ (2011–2014)

  • High serum cholesterol (adults 20 years and older): $12.1\%$ (2011–2014)

• Disease Classifications by Severity and Duration:

  • Acute Conditions:

  • Short duration.

  • Highly treatable.

  • Typically subject to full recovery.

  • Subacute Conditions:

  • A less severe phase of an acute illness.

  • Requires continuing care once a patient is discharged from the hospital.

  • Chronic Conditions:

  • Persists over an extended period and is generally not severe in immediate presentation.

  • Associated with high medical costs and significant lost productivity.

  • Rates continue to rise continuously.

• Three Primary Drivers of Rising Chronic Conditions:

  1. Development of new diagnostic methods, specialized medical procedures, and advanced pharmaceuticals.

  2. Increased screening and early diagnosis.

  3. Lifestyle choices and behavioral risk factors.

Health Promotion, Disease Prevention, and Public Health

• Principles of Health Promotion and Disease Prevention Programs:

  1. Health risk appraisal to identify vulnerabilities.

  2. Interventions specifically targeting and counteracting key risk factors to foster healthier lifestyles.

  3. Provision of adequate public health and social services.

• Categories of Therapeutic Interventions:

  • Primary Prevention: Actions taken to prevent an illness or injury from occurring in the first place.

  • Secondary Prevention: Early detection and treatment of disease in its early stages to prevent progression.

  • Tertiary Prevention: Interventions focused on rehabilitation and preventing further disability or complications from established disease.

• Scope of Public Health:

  • Focuses on promoting optimal health for society as a whole.

  • Encompasses health protection and environmental health functions overseen by agencies like the CDC (e.g., preventing disease spread through water, air, and food).

  • Manages global pandemic health protection through international cooperation (e.g., implementation of travel bans during COVID-19).

  • Challenges in global response: Inadequate response times by international bodies like the WHO can leave hospitals unprepared with critical medical equipment and supplies.

• Bioterrorism Threats and Historical Examples:

  • 1984 Salmonella Attack: Intentional biological attack in Oregon where a religious cult contaminated restaurant salad bars.

  • 2001 Anthrax Attack: Intentional distribution of anthrax spores through the U.S. postal system in September 2001.

• Health Protection, Disaster Preparedness, and Health Security:

  • Requires comprehensive, large-scale preparations including specialized tools and training for medical healthcare workers.

  • Establishment of surge capacity in emergency care settings.

  • Coordination across civil defense agencies at federal, state, and local levels.

  • Analysis of Post-9/11 Preparedness: Ongoing evaluation of systemic measures implemented to cope with natural and human-made disasters following September 11, 2001.

  • Systemic Failures Exposed by COVID-19:

  • Longstanding lack of structural emphasis on public health infrastructure.

  • Persistent underinvestment in population health and overall well-being.

  • Deep-seated socioeconomic and health inequities.

  • Uneven global impact: Several Asian countries faced severely high initial risk, triggering strict responses including travel bans, rigorous quarantine, contact tracing, and widespread testing.

Leading Causes of Mortality and Physical Health Metrics

• Leading Causes of Death in the United States:

  • All Causes Combined: $2{,}626{,}418$ total deaths ($100.0\%$)

  • Diseases of the heart: $614{,}348$ deaths ($23.4\%$)

  • Malignant neoplasms (Cancer): $591{,}699$ deaths ($22.5\%$)

  • Chronic lower respiratory diseases: $147{,}101$ deaths ($5.6\%$)

  • Unintentional injuries: $136{,}053$ deaths ($5.2\%$)

  • Cerebrovascular diseases: $133{,}103$ deaths ($5.1\%$)

  • Alzheimer's disease: $93{,}541$ deaths ($3.6\%$)

  • Diabetes mellitus: $76{,}488$ deaths ($2.9\%$)

  • Influenza and pneumonia: $55{,}227$ deaths ($2.1\%$)

  • Nephritis, nephrotic syndrome, and nephrosis: $48{,}146$ deaths ($1.8\%$)

  • Suicide: $42{,}773$ deaths ($1.6\%$)

• Primary Physical Health Measurement Categories:

  • Morbidity: Measurement of disease and disability levels within a population.

  • Population at risk: The specific demographic subset susceptible to a disease.

  • Incidence: The number of new cases arising in a population over a given period.

  • Prevalence: The total number of existing cases in a population at a specific point in time.

  • Mortality: Measurement of death rates.

  • Crude Rates: Total death rate in an unadjusted population.

  • Age-Specific Mortality Rates: Death rates calculated within defined age brackets.

  • Infant Mortality Rate: Death rate of infants under one year of age.

  • Demographic Changes:

  • Births: Total count of live babies born.

  • Migration: Geographic movement of human populations between distinct regions.

  • Fertility Rates: Measure of childbearing performance in a population.

  • Functional Disability Measures:

  • Activities of Daily Living (ADLs): Measures a person's ability to perform fundamental personal care functions independently.

  • Instrumental Activities of Daily Living (IADLs): Measures a person's ability to perform complex activities necessary for independent living within a community.

• U.S. Life Expectancy Data and Trends:

  • General Trajectory: Basic measure of population health status representing predicted lifespan.

  • 2014 Overall Baseline: $78.8\text{ years}$

  • Projected 2050 Baseline: $84.1\text{ years}$

  • Historical Life Expectancy Table ($2002$–$2014$):

  • Year 2002:

    • Total Population: $77.0\text{ years}$ (Male: $74.4$, Female: $79.6$)

    • White Demographic: $77.5\text{ years}$ (Male: $74.9$, Female: $80.1$)

    • Black Demographic: $72.2\text{ years}$ (Male: $68.7$, Female: $75.4$)

  • Year 2007:

    • Total Population: $78.1\text{ years}$ (Male: $75.5$, Female: $80.6$)

    • White Demographic: $78.5\text{ years}$ (Male: $76.0$, Female: $80.9$)

    • Black Demographic: $73.8\text{ years}$ (Male: $70.3$, Female: $77.0$)

  • Year 2014:

    • Total Population: $78.8\text{ years}$ (Male: $76.4$, Female: $81.2$)

    • White Demographic: $79.0\text{ years}$ (Male: $76.7$, Female: $81.4$)

    • Black Demographic: $75.6\text{ years}$ (Male: $72.5$, Female: $78.4$)

Determinants of Health Models

• Blum's Model of Health Determinants (Ordered by Level of Importance):

  • Socioeconomic and political context

  • Governance structures

  • Policy framework (Macroeconomic, Social, and Health policies)

  • Cultural and societal norms and values

  • Social position (comprising Education, Occupation, Income, Gender, and Ethnicity/Race)

  • Material circumstances

  • Social cohesion

  • Psychosocial factors

  • Behaviors

  • Biological factors

  • Health Care System attributes

  • Overall distribution of health and well-being

• Contemporary Models of Health Determinants:

  • Identifies fixed personal factors: Age, Sex, and Genetic makeup.

  • Categorizes non-fixed determinants into four major functional groups:

  1. Social determinants

  2. Health care system attributes

  3. Disease-inducing behaviors

  4. Health outcomes

Equitable Distribution of Healthcare: Market Justice vs. Social Justice

• Market Justice Principle:

  • Key Characteristics:

  • Views healthcare strictly as an economic good.

  • Assumes standard free-market conditions for health services delivery.

  • Assumes market forces are inherently more efficient at allocating health resources equitably.

  • Determines production and distribution of healthcare via market-based demand.

  • Distributes medical care strictly based on individual ability to pay.

  • Views access to medical care as an economic reward derived from personal effort and achievement.

  • Key Implications:

  • Assigns individual responsibility for personal health.

  • Allocates healthcare benefits based directly on individual purchasing power.

  • Imposes limited obligation toward the collective public good.

  • Emphasizes individual well-being over society.

  • Encourages private solutions for broader social problems.

  • Results in health care rationing based on financial ability to pay.

• Social Justice Principle:

  • Key Characteristics:

  • Views healthcare fundamentally as a social resource.

  • Requires active, direct government involvement in health services delivery.

  • Assumes central government planning is more efficient at allocating resources equitably.

  • Allocates medical resources according to central planning mechanisms.

  • Treats individual ability to pay as inconsequential for receiving medical care.

  • Views equal access to medical services as a basic human right.

  • Key Implications:

  • Establishes collective societal responsibility for health.

  • Entitles every citizen to a standardized basic package of benefits.

  • Enforces a strong obligation toward the collective good.

  • Prioritizes overall community well-being over individual preference.

  • Applies public, governmental solutions to social problems.

  • Implements planned, administrative rationing of healthcare resources.

• Justice Dynamics in the U.S. Healthcare System:

  • Operating System: The U.S. healthcare delivery system represents a mixture of market justice and social justice dynamics.

  • Major Limitation: Reliance on market justice principles leaves uninsured individuals without consistent or guaranteed access to necessary care.

National Health Objectives: Healthy People Initiatives

• Healthy People 2020 Framework:

  • Identifies key nationwide health improvement priorities.

  • Increases public awareness and deepens understanding of the determinants of health, disease, and disability.

  • Provides concrete, measurable objectives and targets applicable across national, state, and local levels.

  • Engages multiple societal sectors to take actions grounded in the best available evidence and research.

  • Pinpoints critical gaps in research and data collection needed for public health advancement.

• Healthy People 2030 Framework:

  • Vision: A society in which all people can achieve their full potential for health and well-being across the entire lifespan.

  • Mission: To promote, strengthen, and evaluate national efforts to improve the health and well-being of all people.

  • Overarching Goals:

  1. Attain healthy, thriving lives and well-being, completely free of preventable disease, disability, injury, and premature death.

  2. Eliminate systemic health disparities, achieve health equity, and attain widespread health literacy.

  3. Create physical, social, and economic environments that actively promote reaching full health potential.

  4. Promote healthy development across all life stages.

  5. Engage leadership, key constituents, and the public across multiple sectors to take concerted action.