Transcript Health communication, management and policy

Health communication,
management and policy (政策)
William W. Au, Ph.D.
[email protected]
Topics to be covered in lecture
• What is health communication,
management and policy?
• Who are involved?
• What skills are needed?
• Case presentations
Health communication,
management and policy
• Informing and motivating (激励)
individual, institutional (机构), and
public audiences about important health
information.
Health management
• Promote (促进) health, prevent disease
and enhance quality of life through self
effort and/or external contributions
• Provide high quality of care with
reasonable cost
• Provide preventive and emergency care
Health policy and regulation
• Policy: rules to guide decisions to reach
desirable (beneficial) outcomes and to
avoid negative effects, e.g. university
policy, ?
• Regulation: a legal process that creates,
limits or constraint a right, creates or
limits a duty, or allocates a responsibility;
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Who and what skills are involved?
• Who: self, doctors, nurses, health care
managers, public health services,
insurance agencies, regulatory agencies,
charitable (慈善) organizations and
communities.
• Skill: communication, management,
public health, medicine, sociology,
economic, policy and psychology
(心理学).
Strategy
• Identify the problem
• Conduct research to understand the
problem and the population, cost and
benefits, what to do, implementation
• Design strategy: communication,
intervention, outcome measures
• Implementation and evaluation
Identify problems
Communication
Public meeting, announcement in
television and internet, posters,
promotions and policies, etc.;
Involvement of stakeholders
(利益相关者).
Healthy People 2010: focus areas
• Access to quality health services
• Arthritis, osteoporosis, & chronic
back conditions
• Cancer
• Chronic kidney disease
• Diabetes
• Disability & 2nd conditions
• Educational & community-based
programs
• Environmental Health
• Family planning
• Food safety
• Health communication
• Heart disease & stroke
• HIV
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Immunization & infect. diseases
Injury & violent prevention
Maternal, infant & child health
Medical product safety
Mental health & mental disorders
Nutrition & overweight
Occupational Safety & health
Oral health
Physical activities & fitness
Public health infrastructure
Respiratory diseases
Sexually transmitted diseases
Substance abuse
Tobacco use
Vision & hearing
Short and attractive statements
for easy memory and action
• Fasten your seat belt
• Eat more fruit
• Pull over to use your
cell phone
• Don't litter
• Get a mammogram
• Smoking causes
cancer
• Don’t drink and
drive
• Talk to your doctor
• Just say no (to drugs)
Problem with cigarette
smoking in china
• 300 million smokers, the largest in the world
• Most will die early with smoke-related
illnesses
• Manufacture and sale of cigarettes are
owned by the central government
• Little regulation of the smoking problem
Communicate
with the problem of smoking
(scary or friendly?)
Who participates in cigarette
smoking controls?
• Citizens, cigarette manufacturers
• Legislators: city, provinces and central
government
• Regulators: enforcement of policy or law
Management of the
cigarette smoking problem
• Education and public awareness
(warning) campaign
• Ban advertisement and sponsorship
• Ban of smoking in public places
• Provide alternatives to smoking
• Monitor and evaluate success
Why is smoking such an
uncontrolled problem in China?
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Management?
Policy and regulation?
Smokers’ right?
Lack of knowledge about harm? What
types of exposure?
• Social conditions?
Group discussion on hypertension
• What is hypertension?
• What are the clinical indications for
hypertension?
• What are the risk factors for hypertension?
• What are the health complications for
hypertension?
• What can we do to reduce the risk?
• How can we get people to do the work?
• Have you heard of “health risk calculator?
A case study: hypertension
• High blood pressure: it is dangerous
because it can lead to strokes, heart
attacks, heart failure and kidney diseases,
etc.
• Incidence among Chinese adults is about
20%; dominant in men older than 45 and
women older than 50.
Causes for hypertension
• Increasing longevity and prevalence of
contributing factors such as obesity
• Other factors include inactivity, smoking
and alcohol consumption and stressful
lifestyle
Classification of blood pressure
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Normal blood pressure: less than 120/80
Prehypertension: 120-139/80-89
Hypertension: greater than 140/90
Stage 1 Hypertension:140-159/90-99
Stage 2 Hypertension: 160 or greater/100
or greater
Problems with hypertension
• “Three highs”： high morbidity, high
mortality, high rate of disability
• “Three lows”: low awareness rate ,
low treatment rate , low control rate.
Morbidity and mortality
• The rate of hypertension in Chinese
adults is about 20%.
• One in five adults has hypertension
• Death from cardiovascular diseases
accounts for 41% of total deaths/year.
• A patient with hypertension, if untreated,
can only live for 19 years on average,
shortened by 20 years
Communication and awareness
• via a series of educational promotions
and behavioral intervention
• Public meeting, announcement in
television and internet, posters,
promotions and policies, etc.
Conduct a blood pressure
awareness activity
Planning, training, announcement,
brochures, conduct activities, evaluation,
follow-up
Decisions based
on blood pressure
Conduct an awareness and
intervention study
• Identify 100 people with hypertension, ,
aged from 40 to 60
• Provide education and training to reduce
blood pressure
• Support and evaluate monthly for 6
months
• Evaluate 6 months later for self
maintenance
Management of hypertension
• The goal is to lower high blood pressure
and protect important organs, like the
brain, heart, and kidneys from damage.
• Good management (treatment) has been
associated with reductions in stroke
(reduced an average of 35%-40%), heart
attack (20%-25%), and heart failure
(more than 50%), according to research.
Management options
• Patients with blood pressure > 120/80 are
to make lifestyle modifications, such as
eating a healthier diet, quitting smoking,
and getting more exercise.
• Treatment with medication to lower
blood pressure to less than 140/90.
• Patients who have diabetes or chronic
kidney disease the recommended blood
pressure is less than 130/80.
Self help management
• Lose weight if overweight
• Quit smoking.
• Eat a healthy diet (more fruits and vegetables,
low fat dairy products, less saturated and total
fat).
• Reduce sodium (< 1,500 milligram or 1
teaspoon/day)
• Get regular aerobic exercise
• 2 alcohol drinks/day for men, 1 for women.
Food guideline
Treatment and follow-up
• See a doctor for treatment of high blood
pressure (> 140/90)
• See the doctor monthly until the pressure
is reduced to < 140/90
• See doctor yearly to monitor pressure
and medication
• Check up on health conditions of heart,
kidneys, etc.
A case study – vision health
• About 30% primary school students
suffer from myopia
• Myopia reduces learning among students
and is harmful to their health (falls,
fatigue, glaucoma and cataract)
Myopia problem
Vision care is still needed after having
eye glasses
Conduct a public awareness
and intervention program
• Identify problem and intervention
approaches
• Develop strategy
• Train staff and get support from
optometrist and/or ophthalmologist
• Contact primary schools for action
Activities
• Conduct questionnaires among students,
(parents and teachers) regarding their
eye problems and knowledge on eye care
• Conduct on-site educational program on
eye care and protection (good and bad
habits)
• Conduct on-site activities such as vision
contest, eye examination
• Engage parents and teachers
Bad habits
• Reading books or play computers for a
long time without relaxation
• Reading with insufficient light and from
incorrect distance
• Reading from a small screen and with
small prints
• Reading in bed
Follow-up and evaluation
• Follow-up interviews on eye care and
protection
• Provide yearly eye examination
• Evaluate support from parents and
teachers
New technologies for health
management and disease prevention
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Sensors (..)
Remote monitoring (…)
On-time and on-site tests
Health informatics
Early warning for health problems
Better communication, management and
policy for health and disease
Conclusion
• Better understanding of causation and disease
process
• Education and development of real solutions to
disease problems
• Better management based on interactions
between public health, clinicians and the public
• Clear and enforceable policy for better health