47 Million

53.3% Whites

24.3%Hispanics

16.5% Blacks

35 Million-2010

55 Million-2020

70 Million-2030

Focus was on infectious diseases

Poorly trained physicians

Focus on clean water and sanitation to combat diseases

American Medical Association established

Flexnor Report

Standardized medical admissions and education

CDC

NIH

1950- cigarette smoke attributed to lung cancer

Public health and health promotion begins

1930-Roosevelt signed Social Security Act to provide health insurance for the retired

1940's employers began to offer health insurance to employees

" preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals"

The focus of public health intervention is to improve health and quality of life through the prevention and treatment of disease and other physical and mental health conditions, through surveillance of cases and the promotion of healthy behaviors

1960's

1965- Medicaid and Medicare signed into law

1964-1st Surgeon General's Report

Warning labels on cigaretter packs

Clinton signed HIPAA into law

FMLA

 SCHIP

HIPAA

Medicare part D was added to provide prescription coverage for the elderly

Health care Reforme with Obama

19%

in 2007-17.3% @ 2.5 trillion dollars

80 females

75 males

less freedom with traditionally less cost

tends to have gate keepers

Staff model hire providers to work at one location

Group model negotiats with a group of physicians to perform services exclusively

Network models is similar to a group model but physicans can see other patients

HMO models have gatekeepers

a group of independent physicians that contract with managed care plans for discounted rates

Patients are offered financial incentives to choose participant providers

through utilization management

• Retrospective Utilization Review
• Precertification
• Primary care gatekeepers
• Primary care case managers
• Demand management
• disease management

Employers pay premiums

Employees pay premiums, copays, deductibles and coinsurance

Health Plan-assumes the risk of paying the health member's healthcare

Provider-assumes little financial risk

Intention to treat on a short-term for an illness, may require specialist intervention

Focuses on redcucing the onset of a disease

A social insurance program administered by the government for people 65 years or older, signed into law in 1965

35 million Americans are enrolled

Parts A-Hospital insurance

Part B-supplemental health insurance

Part C-Medicare Advantage, designed like to move patients into HMOs and PPO's

Part D-Prescription Drug Benefit

Comprehensive healthcare for 2 million native Americans

includes 33 hospitals, 59 health centers and 50 health stations

Expert committee recommendations

Each translation provides a grade for the recommendation based on the strength of clinical evidence and overall net benefit

Translations also include background information and cost data when available as well as actionable strategies for employees including programmatic ideas and communication

Osteoporosis

Bladder cancer

oral cancer

prostate cancer

obesity

hypertension

Depression

Breastfeeding

• Home health care- $150K/ yr
• 60% of seniors > 85 living in nursing homes
• 80% of older Americans have one chronic disease
• There will be 71 million older adults in 2030 (20%0 of population

Economics of aging

cost of providing health care for older amercians is 3-5 times higher

By 2030 healthcare spendinf will increase by 20%

• Behavioral-smoking, diet and inactivity
• Pscyhological-fear of falling, self-efficacy, self acceptance, environmental control
• Physiological-low risk of disease, high cognitive and physical functioning

• Need to do a better job at managing chronic disease
• Need to be more aggressive with health and promotion
• Need to have societal discussion
• Engage in the conversation on medical limits

• Every American Needs health insurance
• Health Insurance should be affordable
• Promote prevention and wellness

TITLE IV

Prevention of Chronic disease and improving public health

(health Care Reform)

• Subtitle A-establish health prevention and promotion strategy
• Subtitle B-Increasing access to clinical prevention services to all, especially Medicare and Medicaid
• Subtitle B-Healthier Communities through community based programs and foor labeling in restaurant chains
• Subtitle D: support for Innovation on research and effectiveness of prevention and ph services with a focus on health disparities, workiste health and childhood obesity
• Subtitle E: Better scoring practices with NCQA

1. Recognizes the value of prevention
2. Provides credibility to the field
3. attempts to reach more of the population
4. requires evaluation on effectiveness

1. Eliminate preventable diseases
2. Acheive health equity , eliminate health disparities
3. Create social and physical environments that promote good health
4. Promote the development  and healthy behaviors at every stage of life

Policy/Intervention

Behavior

Social environment

physical environment

Individual

Biology

Map-it-mobilize, assess, plan, implement and track

interactive webite with toolkits

Adolescent Health

LGB

Older Health

Dementias

Global Health

Sleep Health

Health Care associate infections

Established in 1946

Four Goals:

Healthy People Stay Healthy

Preparing people for emerging health threats

positive international health

healthy people at all stages of life

1. Established in 1930
2. Primary agency for research toward preventing and curing diseases
3. 27 instiutes

Established in 1989

Mission to improve  the quality, safety, efficiency and effectiveness of health care for all

1. health care cost and utilization
2. Information technology
3. medication safety
4. healthcare consumerism

Established in 1906

ensures the safety of food, animal and veterinary products, biologic products, cosmetics, medical equipment electronic products

establishe in 1970

governs workplace environments to make sure that employees are safe and healthy while at work

SG provides info on how to improve the health of the US pop

6000 public health professionals to address disease prevention, eliminate health disparities and disaster preparedness

• Each translation provides a grade for the recommendation
• Translation also includes background information and cost date

A new health health system for the 21st century

• immediate access to a persons health history
• longitudinal data
• established system to provide decision support, quality and safety

More comprehensive reporting

analyze review of patient outcome

process restore data

improve operational efficiency

Consistency

funding

hardware support

training the staff

• Health education while patients wait
• Medical billing management
• biometric authentication technology
• scan patient insurance card

The moral foundation fro standards of conduct

right and wrong choices

• decisions made with regard to a patient's medical treatment
• Advanced directives are orders that the patient gives to not prolong life

• Concerned with the ethical implications of certain biologic and medical procedures and technologies, such as cloning

• inaccessibility to health care
• response to bioterrorism
• Research in developing countries
• health promotion and its infringement on individual lifestyle choices

• accessibility
• social support
• financial incentives convenience
• health care costs
• productivity
• convenience

• Rising Healthcare Cost
• Economic crisis
• Obesity epidemic
• Multigenerational workforce
• unsustainable health care
• productivity

• a systemic approach
• population perspective
• a sound informational infrastructure
• adequate impact on productivity
• strong outcomes

the science of helping people change their lifestyle to move to a state of optimal health

HP professionals:

enhance awareness

change behaviors

create environments that promote good health practices

organized community efforts aimed at prevention of disease and promotion of health

epidiologically driven

Engage a higher proportion of individuals

integrate and create seamless experience

Demonstrate the real costs of savings