Transcript Skin exam - Dynamics of Health Care in Society Mrs. Franek

Dynamics of
Care in Society
Public Health
&
Health Care Delivery
1
What Is Healthy People 2020?
 A national agenda that communicates a vision for
improving health and achieving health equity.
 A set of specific, measurable objectives with targets to
be achieved over the decade.
 These objectives are organized within distinct
Topic Areas.
(Activity: See handout)
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Identify the different forms of health care organizations
illustrating the complexity & diversity of the health care
delivery systems
Explain & discuss trends that contribute to the shaping of
the health care delivery systems
Describe the major responsibilities of the US Public Health
Department (do in Public Health)
Describe at least three services offered by non-profit
agencies
Identify the basic organization & types of voluntary
agencies
Analyze two types of government agencies
Identify 3 current trends in health care
THIS IS PUBLIC HEALTH
 protect
people from diseases and encourages them
to change harmful behaviors.
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Who gets certain diseases and why?
Can a common element be changed to prevent an illness
among an entire population?
Does that element require a change in behavior;
technology, or the health care delivery system?
How can we motivate individuals to change their
behavior?
Can the new technology be developed?
How should the health care delivery system be changed
to improve access and treatment?
Click here: TIPH_Poster-FINAL.pdf
http://www.youtube.com/watch?v=cvm7Fqbpqcg
Everybody - The music video! –
YouTube 4min
Public Health Achievements
Sample
Childhood
Immunization
Schedule
1.
Primary Prevention:
include activities that help AVOID a given
healthcare problem, it is the most costeffective
ex:
immunizations
promoting use of helmets, seatbelts…
health & safety educations (STD prevention,
dangers of substance abuse etc)
2. Secondary Prevention :
include activities that identify & treat
persons with known risk factors or early
indicators of disease but the symptoms are
not present or clinically apparent.
ex: check ups, screening tests, early
diagnosis
3. Tertiary Prevention :
include activities involved in the care of
established disease which attempt to restore
highest function, minimize negative effects of
disease and prevent disease-related
complications
ex: post op PT, routine foot exams for
patients with Diabetes
The 20th Century's Ten Great Public Health
Achievements in the United States
1. Vaccinations
Programs of population-wide vaccinations resulted in the
eradication of smallpox; elimination of polio in the Americas; and
control of measles, rubella, tetanus, diphtheria, Haemophilus
influenzae type b, and other infectious diseases in the United States
and other parts of the world.
The 20th Century's Ten Great Public Health
Achievements in the United States
2. Motor-vehicle safety
Improvements in motor-vehicle safety have contributed to large reductions in
motor-vehicle-related deaths. These improvements include engineering efforts to
make both vehicles and highways safer and successful efforts to change personal
behavior (e.g., increased use of safety belts, child safety seats, and motorcycle
helmets and decreased drinking and driving).
3. Safer workplaces
Work-related health problems, such as coal workers' pneumoconiosis (black lung),
and silicosis -- common at the beginning of the century -- have been significantly
reduced. Severe injuries and deaths related to mining, manufacturing, construction,
and transportation also have decreased; since 1980, safer workplaces have resulted in
a reduction of approximately 40% in the rate of fatal occupational injuries.
The 20th Century's Ten Great Public Health
Achievements in the United States
4. Control of infectious diseases
Control of infectious diseases has resulted from clean water and better sanitation.
Infections such as typhoid and cholera, major causes of illness and death early in
the 20th century, have been reduced dramatically by improved sanitation. In
addition, the discovery of antimicrobial therapy has been critical to successful
public health efforts to control infections such as tuberculosis and sexually
transmitted diseases (STDs).
5. Decline in deaths from coronary heart disease and stroke
Decline in deaths from coronary heart disease and stroke have resulted from riskfactor modification, such as smoking cessation and blood pressure control
coupled with improved access to early detection and better treatment. Since 1972,
death rates for coronary heart disease has decreased 51%.
The 20th Century's Ten Great Public Health
Achievements in the United States
6. Safer and healthier foods
Since 1900, safer and healthier foods have resulted from decreases in microbial
contamination and increases in nutritional content. Identifying essential
micronutrients and establishing food-fortification programs have almost
eliminated major nutritional deficiency diseases such as rickets, goiter, and pellagra
in the United States.
7. Healthier mothers and babies
Healthier mothers and babies are a result of better hygiene and nutrition,
availability of antibiotics, greater access to health care, and technologic advances in
maternal and neonatal medicine. Since 1900, infant mortality has decreased 90%,
and maternal mortality has decreased 99%.
The 20th Century's Ten Great Public Health
Achievements in the United States
8. Family planning
Access to family planning and contraceptive services has altered social and
economic roles of women. Family planning has provided health benefits such as
smaller family size and longer interval between the birth of children; increased
opportunities for preconceptional counseling and screening; fewer infant, child,
and maternal deaths; and the use of barrier contraceptives to prevent pregnancy
and transmission of human immunodeficiency virus and other STDs.
9. Fluoridation of drinking water
Fluoridation of drinking water began in 1945 and in 1999 reaches an estimated 144
million persons in the United States. Fluoridation safely and inexpensively benefits
both children and adults by effectively preventing tooth decay, regardless of
socioeconomic status or access to care. Fluoridation has played an important role
in the reductions in tooth decay (40%-70% in children) and of tooth loss in
adults (40%-60%).
The 20th Century's Ten Great Public Health
Achievements in the United States
10. Recognition of tobacco use as a health hazard
Recognition of tobacco use as a health hazard in 1964 has resulted in changes in the
promotion of cessation of use, and reduction of exposure to environmental
tobacco smoke. Since the initial Surgeon General's report on the health risks of
smoking, the prevalence of smoking among adults has decreased, and millions of
smoking-related deaths have been prevented.
National Goals & Agencies Involved
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National Health Goals:
1. increase span of health life for Americans
2. reduce disparities among Americans
3. achieve access to preventive services for all Americans
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USDHHS
◦ CDC
◦ NIH
◦ Departments of public health (town, state)
WHO
 FDA
 EPA
 OSHA
 VA
 Workmen’s comp
 AHCPR (agency for health care policy &
research est. 1990)
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NJ Department of Health
http://www.state.nj.us/health/
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http://www.hhs.gov/
The Department of Health and Human Services (HHS) is
the United States government’s principal agency for
protecting the health of all Americans and providing
essential human services, especially for those who are least
able to help themselves.
It is comprised of the Office of the Secretary (18 staff
divisions) and 11 operating divisions. The agencies perform a
wide variety of tasks and services, including research, public
health, food and drug safety, grants and other funding,
health insurance, and many others.
Operating Divisions Of Health and Human Services:
Administration for Children and Families (ACF)
Administration for Children, Youth and Families (ACYF)
Administration on Aging (AoA)
Agency for Healthcare Research and Quality (AHRQ)
Agency for Toxic Substances and Disease Registry (ATSDR)
Centers for Disease Control and Prevention (CDC)
Centers for Medicare and Medicaid Services
Food and Drug Administration (FDA)
Health Resources and Services Administration (HRSA)
Indian Health Service (IHS)
National Institutes of Health (NIH)
National Cancer Institute (NCI)
Office of the Inspector General (OIG)
Substance Abuse and Mental Health Services Administration
(SAMHSA)
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http://www.cdc.gov/
The Center for Disease Control & Prevention:
Mission is to collaborate to create the expertise,
information, and tools that people and communities
need to protect their health – through health
promotion, prevention of disease, injury and
disability, and preparedness for new health threats.
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http://www.fda.gov/default.htm
The Food and Drug Administration is responsible
for protecting the public health by assuring the
safety, efficacy, and security of human and
veterinary drugs, biological products, medical
devices, our nation’s food supply, cosmetics, and
products that emit radiation, and by regulating the
manufacture, marketing, and distribution of
tobacco products.
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http://www.nih.gov/
The National Institute of Health’s mission is to seek
fundamental knowledge about the nature and
behavior of living systems and the application of that
knowledge to enhance health, lengthen life, and
reduce the burdens of illness and disability.
NIH is made up of 27 Institutes and Centers, each
with a specific research agenda, often focusing on
particular diseases or body systems.
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http://www.who.int/en/
The World Health Organization is the directing and
coordinating authority for health within the United
Nations system.
It is responsible for providing leadership on global
health matters, shaping the health research agenda,
setting norms and standards, articulating evidencebased policy options, providing technical support to
countries and monitoring and assessing health
trends.
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http://www.epa.gov/
The Environmental Protection Agency’s mission is to
protect human health and the environment
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http://www.osha.gov/
The Occupational Safety and Health
Administration’s mission is to assure safe and
healthful workplaces by setting and enforcing
standards and by providing training, outreach,
education and assistance
established in 1971
The Veterans Administration (Veteran
Affairs)
http://www.va.gov/
Provides a medical benefits package to all enrolled
Veterans.
This comprehensive plan provides a full range of
preventive outpatient and inpatient services within VA
health care system, you can be seen at any VA facility
across the country.
New Jersey Workers' Compensation
Providing workers' comp information, news, facts, and
contact information for employees, employers,
insurers, and medical providers.
Find rules, statutes, forms, and professional help
relating to workplace injuries and disabilities in the
state of New Jersey.
Department of Labor and Workforce Development |
Workers' Compensation
Leading Causes of Death by Age
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Ages 15–24
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Unintentional injuries
Homicide
Suicide
Cancer
Heart disease
Congenital defects
HIV/AIDS
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Ages 25–44
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Unintentional injuries
Cancer
Heart disease
Suicide
HIV/AIDS
Homicide
Chronic liver disease
Leading Causes of Death Overall
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Heart disease
Cancer
Stroke
Chronic lower respiratory diseases (emphysema,
chronic bronchitis)
Unintentional injuries (accidents)
Diabetes
Take a few Self Tests…
CDC Features - Test Your Knowledge: Health and Safety Quizzes and Tools
View these slide shows…health screening for men & women
http://www.medicinenet.com/mens_health_screening_te
sts_pictures_slideshow/article.htm
http://www.medicinenet.com/disease_prevention_in_wo
men_pictures_slideshow/article.htm
Blood pressure screening. Starting at age 18, every woman
needs to have her blood pressure checked at least every two
years.
Cholesterol check. Women should have their cholesterol
checked at least every five years starting at about age 20.
Pap smears and pelvic exams. Beginning at age 21, or
earlier if you are sexually active, women need to have a
pelvic exam and Pap smear every two years to check for any
abnormalities in the reproductive system.
Mammograms and breast exams. Starting around age 20,
women should have a clinical breast exam at least every
three years until age 40, when this should be done annually,
according to most experts.
Bone density screen. Women should start getting
screened for osteoporosis with a bone density test at age 65.
Women with risk factors for osteoporosis, such as having a
slender frame or a fractured bone, should be screened
earlier.
Blood glucose tests. Women should get a blood glucose
test every three years starting at age 45 to test for diabetes
or pre-diabetes.
Colon cancer screening. Colon cancer screening tests for
women generally start at age 50.
Body mass index. A full yearly physical exam includes
measurements of your height and weight and a
calculation of your body mass index (BMI).
Skin examination. Women should examine their skin
every month starting at age 18, and by the time they’re 20,
a doctor or dermatologist should conduct the examination
during a routine check-up.
Dental check-up. Good dental health is important from
the moment your first baby tooth sprouts, and all adult
women need twice-yearly dental check-ups and cleanings.
Recommended immunizations, health
screenings, physicals, procedures & tests
For women between the ages of 20 and 39, the following
screenings are recommended:
Pelvic exam: every year.
Pap test: every year until three satisfactory tests have been
completed, and then at the doctor's discretion.
Breast: at least every three years.
Skin: at least every three years.
For women between the ages of 40 and 49, the
following health screenings are recommended:
Blood pressure: at least every two years
Cholesterol test: every five years
Skin exam: every year
Breast exam: every year
Pelvic exam: every year
Pap test: every year (or at the doctor's discretion)
Mammography: every one to two years (depending on risk)
Fasting plasma glucose test: to check for the possibility of
diabetes, every three years after age 45
After age 50, women should have the following screenings:
Blood pressure: at least every two years
Cholesterol: every 5 years (or every 3 years begin at age 65)
Skin exam: every year
Breast exam: every year
Mammogram: every year
Fecal occult blood test: every year
Pelvic exam: every year
Pap test: yearly (or at the doctor's discretion)
Bone mineral density test: once as a baseline
Fasting plasma glucose test: for diabetes, every 3years
Thyroid-stimulating hormone test: every 3-5 years begin age 65
Colorectal cancer test: every five to ten years
Read more: Health screening, Information about Health
screening http://www.faqs.org/health/topics/72/Healthscreening.html#ixzz1CBElER7D
Men’s Health Screenings
Blood pressure
checked every three years throughout life.
Cholesterol
Have a lipid panel test at least once every five years.
Diabetes
Have a fasting blood sugar test at least every three years if you are at
risk for diabetes.
Skin cancer
Have a full-body examination at least once every five years.
Colon and rectal cancer
Screening for colon and rectal cancer normally begins at 50.
Prostate cancer
Screening normally begins at 50. Men with strong family histories of
prostate cancer should consider seeking early screening in their 40s.
Abdominal aortic aneurysm
Consider an abdominal ultrasound at age 65 if you have ever smoked.
Osteoporosis check
Begin discussing with your doctor at age 60.
Testicular Self-Exam
A simple check of the testes to check for lumps, beginning in teens.
For men between the ages of 20 and 39, the following
screenings are recommended:
•Blood pressure: at least every two years
•Cholesterol: every five years
•Skin exam: every three years
•Testicular exams monthly
For men between the ages of 40 and 49, the
following screenings are recommended:
•Blood pressure: at least every two years
•Cholesterol: every five years
•Skin exam: every year
•Fasting plasma glucose test: to check for diabetes, every 3
years after age 45
Men who are 50 years or older should have the
following screenings:
•Blood pressure: at least every two years
•Cholesterol: every five years(or every three years starting
at age 65)
•Skin exam: every year
•Digital rectal exam: (to check for prostate cancer) every
year
•Prostate specific antigen (PSA) test: every year
•Fasting plasma glucose test: (for diabetes) every three
years
•Colorectal cancer test: every five to ten years
Guidelines
for the
Early
Detection
of
Cancer
For
Women:
breast
cervical
For Men:
prostate
testicular
For Both:
colorectal,
skin
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Defined as: A nonprofit organization is formed for
the purpose of serving a public or mutual benefit.
They are private as opposed to governmental, not for
profit, self-governing, voluntary and for public
benefit.
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Examples: March of Dimes, Easter Seals, Cancer
Care, American Heart Association…
(see handout & assignment)
Self-help groups, AKA mutual aid, or
support groups, are groups of people who
provide mutual support for each other.
In a self-help group, the members share
a common problem, often a common
disease or addiction.
Their mutual goal is to help each other to
deal with, if possible to heal or to recover
from, this problem.
Group helping
sufferers to cut
free the chains of
OCD
New Jersey Self Help Group
Clearinghouse
1-800-367-6274 or
1-800-FOR-M.A.S.H.
(Mutual Aid Self-Help)
Types of Support
groups
 Addictions
 Adult
Children
 Bereavement
 Caregivers
 Cultural
 Disability
 Disease specific
 Economic/financial
 Faith-Based
 Family
 Men
or Women Only
 Mental Health
 Online Groups
 Older Adults
 Parenting
 Siblings
 Wellness & Recovery
(mental health)
 Youth
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2.
3.
4.
5.
6.
7.
8.
9.
10.
Confidentiality first. What is said in the group, stays in the
group.
Share feelings and experiences, but not advice.
Accept each other without making judgments.
Listen to each other. Give everyone an opportunity to share.
Avoid interrupting or having side conversations.
No offensive language, no cell phones, no headphones…
Be honest.
Have a positive attitude, be supportive and encouraging
Be on time.
Be respectful and sensitive to others.
Support Group\Creating and Facilitating Peer Support Groups.mht
go to section - How do you facilitate a peer support group?
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YOUR NAME
Rate your experience in the group today
1-5 (5 = best)
Which topic that came up in group today, do
you wish you could continue to discuss at your
next meeting
Name the facilitator that emerged (N/A if none)
Best moment
Worst moment
4 Current Trends in health care
Cost Containment
Home Health Care
Geriatric Care
Wellness
Between doctor/NP/PA
and patient
Face-to-face
Between patient and care
team
Multiple methods
Problem-initiated and
focused
Topics are clinician’s
concerns and treatment
Ends with a prescription
Based on care plan:
“planned visit”
Collaborative problem list,
goals and plan
Ends with a shared plan
of care
What one word describes the change in
approaches to health care & public health:
Complementary and Alternative Medicine
Pretest:
Do you know the difference between acupressure
and acupuncture? Take the alternative medicine
quiz! : Discovery Channel
Conventional (allopathic or Western) medicine
is practiced by holders of M.D. and D.O. degrees and
by allied health professionals, such as physical
therapists, psychologists, and registered nurses.
Alternative (sometimes Eastern) medicine
refers to use of healing arts not taught in traditional
Western medical schools, in place of conventional
medicine.
Complementary (integrative)
medicine
refers to use of alternative medicine
together with conventional
medicine
“Western” Medicine
or Biomedical Health Care
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Based on the cause of disease & eliminating, treating, or
preventing those causes
Providers receive training and are licensed to practice as
professionals
Beliefs of this system include:
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Encouraging patients to learn about their illness
Teaching self-care
Using medications and technology to treat illness
Teaching preventive care
Most people use CAM therapies in addition to
conventional medical treatment
Considerations:
Safety, Effectiveness, Timing, Cost
Traditional Indigenous Systems
Complementary and Alternative Medicine (CAM)
Alternative Health Care Methods
◦ Nutritional/biological methods – organic, herbs,
vitamins, special diets, shark cartilage…
◦ Mind and body control methods – meditation,
hypnotherapy, biofeedback, dance therapy, prayer…
◦ Energy therapy –magnets, cupping, therapeutic touch,
Reiki…
◦ Manipulative body based methods - chiropractic, yoga,
tai chi, osteopathic, massage, reflexology…
◦ Spiritual methods – faith healing
◦ Homeopathy, an unconventional Western medical
system –remedies are derived from substances that come
from plants, minerals, or animals
National Center for Complementary
& Alternative Medicine | NCCAM