We will take care of all your assignment needs. We are a leading online assignment help service provider. We provide assignment help in over 80 subjects. You can request for any type of assignment help from our highly qualified professional writers. All your academic needs will be taken care of as early as you need them. Place an Order The greater issues pondered here in these essays, about the psychiatric community and about the impact of the mental health and personality of He President, or anyone in a position of power, should be discussed, and discussed NOW Jul 26, · Thoa et al () also note that, based on their studies, when the level of government expenditure on health is high, then this has a positive influence on the quality of health care, compared with low income areas where out-of-pocket (OOP) expenditure on health care has significant negative economic effects on households
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That statement from a resident of Rochester, essays on health care reform, NY, has remained with me for several years because it so intuitively speaks to the connection between financial health and physical and mental health. Not surprisingly, adults with lower incomes experience financial stress more acutely, and those who experience high levels of stress related to their finances are more likely to cope by smoking, eating, drinking alcohol, and watching television in excess, all of which increase their risk for chronic conditions like diabetes and heart disease.
Groundbreaking research reviewed in a report from the American Academy of Pediatrics finds that childhood exposure to poverty and stress has both immediate and long-term effects on development, behavior, and health. In the face of mild-to-moderate, isolated and short-lived periods of stress, this response is quite adaptive. It helps us to focus the mental and physical resources necessary to either confront or escape threatening situations.
However, when there are multiple sources of severe or inescapable stress, the stress response essentially never turns off, and the body begins to break down. The immune system is compromised, inflammation increases, and the ability to adapt to future stress is disrupted.
These children are also more likely to take up risky behaviors as a means of coping in adolescence and adulthood, such as smoking, drug use, overeating, problem gambling, and unsafe sexual practices. When these young people become parents, the cycle often continues. Yet our health lags that of other wealthy nations. Even white, college-educated, high-income adults with health insurance have worse health outcomes than their similarly situated peers in other nations.
Simply providing more and better health care is unlikely to solve the problem of health disparities, essays on health care reform.
That means that even legislation hailed as the most momentous social policy in at least a generation, the Affordable Care Act ACAis not sufficient to the task of alleviating persistent health inequality.
Although the ACA gives significant nods to prevention and population health, its central provisions — expanding health insurance coverage to millions of Americans — are not expected to significantly change the outlook for health disparities, if evidence from similar reform in the State of Massachusetts is any indication. The landmark Whitehall Studies of British civil servants find a clear link between employment class or rank of civil servants and health.
Those in higher-status jobs enjoyed better health and longer lives than those lower down the employment scale. Even in a country with universal health care, health inequality remains. Under the best of circumstances, the ACA will not achieve universal coverage, and the decision of essays on health care reform Supreme Court to allow individual states to decide whether to expand Medicaid means that many disadvantaged adults will continue to go without insurance coverage.
Health essays on health care reform alone is not enough to change disparities, essays on health care reform, particularly in premature death, because its contribution to the explanation of such deaths is only 10 percent. That is because the contribution of medical care to the overall explanation of premature death in the United States is estimated at only 10 percent. The other 90 percent is a matter of lifestyle behaviors, genetics, social circumstances, and environmental exposures.
Thomas Frieden, director of the Centers for Disease Control and Prevention, has another way of describing the relative influence of different kinds of interventions on the health of the population. Source: Frieden TR. Am J Public Health ; 4 Figure 1. The Health Impact Pyramid. At the top of the pyramid are interventions that have the smallest total impact on population health, essays on health care reform.
These are familiar counseling and education activities, such as helping patients with diabetes monitor their blood glucose and eat a healthy diet. At the next level are interventions such as medications to control blood pressure and cholesterol, much of what we think of as at the heart of medical care. This set of activities still has a relatively small impact on population health.
The bigger impacts come from changes in the environment that make healthy decisions easier, such as adding fluoride to the water supply to prevent cavities or removing lead from paint.
These are interventions that protect people from potential threats to health without their having to exert much energy to benefit from them. At the very bottom of the pyramid are social and economic factors such as poverty, education, and adequate housing.
These most fundamental resources also have the largest overall impact on health. As Frieden notes, they are also the most politically difficult to address. Individualism is a guiding ethic in America, and it provides the lens through which many interpret societal outcomes.
Nothing delights the American public more than heroic efforts to assume such responsibility in the face of very difficult circumstances. The flipside of this giddy support for individual heroism is a tendency to very quickly blame individuals or groups who are struggling for essays on health care reform lack of personal responsibility, essays on health care reform.
In a nation in which nearly three-quarters of adults worry about money at least some of the time, essays on health care reform, where income and wealth inequality are at all-time highs, and where the rate of child poverty is among the highest in the developed world, it is fair to ask whether individual effort can be the total answer to what literally ails, and ultimately kills, Americans. For example, water is necessary but not sufficient for ice. No matter how much one may will or wish it to be otherwise, water will not become ice unless it is exposed to a temperature at or below 32 degrees Fahrenheit.
In a similar way, individual effort is necessary but not sufficient for what we commonly define as aspects of a successful life: completing education, holding a job, starting and sustaining a family, supporting oneself in retirement and throughout old age. Think of individual effort as the water in this scenario. The average person cannot hope to achieve any of these outcomes without a significant amount of effort, perseverance, and determination — all of which is absolutely necessary, but not sufficient.
Vaunted though meritocracy may be as an ideal, many people get their first and subsequent jobs through networks of connection rather than laboriously wading through job postings.
And a whole host of policies prop up the economic well-being of the relatively well-to-do, from home mortgage deductions to tax-deferred college and retirement savings accounts. Despite stacks of studies showing that financial health and physical and mental health essays on health care reform connected and that the conditions in which we live also affect how well and how long we can expect to live, the description above of how individual effort interacts with environment and resources to produce life outcomes remains a tough sell in the current political climate.
Even providing health insurance to more Americans is controversial, in part, because it suggests that government is doing what individuals ought essays on health care reform be doing on their own.
Either we continue down an unhealthy and ultimately untenable path of ever-increasing health care expenditures for suboptimal and unequal outcomes, or we somehow change the trajectory by changing the way we deliver the message. The latter of these alternatives is the path of a growing number of public health professionals who are convinced by the data supporting the power of the social determinants of health, but also aware that the public and policymakers may not be.
In fact, they may not even be aware that the relationships between factors such as household financial status, education, and health are as strong as they are, and that is not their fault. Academics and public health and medical professionals are pretty adept at talking to one another, but their efforts to communicate information clearly and convincingly to the lay public often leave much to be desired. New models are needed for translating information about the social and economic determinants of health for decision makers from parents to politicians.
This was the argument made in a paper in the Annual Review of Public Health in early Steven Woolf and his team at the Center on Society and Health at Virginia Commonwealth University and my team and I at Washington University in St.
Louis offered a framework that includes rigorous research as its basis, but also places emphasis on strategic forms of communication, a thorough understanding of the decision-making context, particularly for policymakers, and thoughtful engagement with key stakeholders.
We use as examples of essays on health care reform framework the Education and Health Initiative, a national project led by Dr, essays on health care reform. Louis called For the Sake of All. Although developed separately, each initiative uses the full arsenal of modern communications, from policy briefs and reports to websites, YouTube videos, essays on health care reform, Twitter feeds, and blog posts to tell the story of how social and economic factors are affecting the health of ordinary individuals.
We have some early evidence that the approach is working, or at least that people are talking and thinking in new ways about these issues. The response as measured by web traffic, social media mentions, and local, national, and even international media coverage suggests that this work has hit a nerve.
Whether that can translate to changes in policy remains to be seen. That was not because any of the speakers including myself and Dr. Woolf had a bias against medicine or truly life-saving scientific discoveries made every day. Rather, it was because the speakers recognized the wisdom of that simple statement by the man from Rochester.
If we want to help people to live full and healthy lives, we must attend essays on health care reform their livelihoods ; to the resources that make life possible from the very earliest stages of development to the waning days of old age. We must invest in interventions that address such things as high-quality early childhood development and that provide support for families at all income levels to accumulate and preserve assets.
We must redouble our efforts to ensure that all children receive excellent elementary and secondary education and that essays on health care reform most vulnerable children receive the mental and physical health, social, and other services to help them succeed. Those children will also need support in completing postsecondary education and finding jobs with wages that will sustain them and their families, along with a set of benefits such as family and sick leave, retirement savings, and yes, affordable health insurance.
And we must not only invest in individuals. We know that poverty, violence, and inadequate resources, services, and amenities affect the health of communities as well. We must find creative ways of making health promotion a central part of community and economic development. In these and many other ways, the inextricable, often stress-laden link between financial well-being and physical essays on health care reform mental health must become the centerpiece of public understanding and public policy.
Both our economic health as a nation and the very lives of the American people depend on it. Jason Q. Purnell is an Assistant Professor in the George Warren Brown School of Social Work, Faculty Scholar in the Institute for Public Health and Faculty Director for community engagement in the Center for Social Development at Washington University in St. Trained in applied psychology and public health, he studies socioeconomic factors contributing to… Read more. Toggle navigation.
Topics Experts The Book About Insights. Explore the Essays:. Where We Are. Why It Matters. Who Is Affected. What To Do Next. Financial Health is Public Health Written by Jason Q. PurnellWashington University in St. Jack P. Shonkoff, Andrew S. In fact, a recent report from the Institute of Medicine found that the U. National Research Council and Institute of Medicine.
Health essays on health care reform International Perspective: Shorter Lives, Poorer Health, essays on health care reform.
Panel on Understanding Cross-National Health Differences Among High-Income Countries, Steven H. Woolf and Laudan Eron, essays on health care reform, Eds. Committee on Population, Division of Behavioral and Social Sciences essays on health care reform Education, essays on health care reform, and Board on Population Health and Public Health Practice, Institute of Medicine.
Washington, DC: The National Academies Press. Danny McCormick et al. Thomas R. Steven H. Woolf et al. About the Author Jason Q, essays on health care reform.
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Jul 26, · Thoa et al () also note that, based on their studies, when the level of government expenditure on health is high, then this has a positive influence on the quality of health care, compared with low income areas where out-of-pocket (OOP) expenditure on health care has significant negative economic effects on households Danny McCormick et al., “Effect of Massachusetts Healthcare Reform on Racial and Ethnic Disparities in Admissions to Hospital for Ambulatory Care Sensitive Conditions: Retrospective Analysis of Hospital Episode Statistics,” BMJ () h; Brian D. Smedley, “Moving beyond Access: Achieving Equity in State Health Care Reform The greater issues pondered here in these essays, about the psychiatric community and about the impact of the mental health and personality of He President, or anyone in a position of power, should be discussed, and discussed NOW
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