Advocacy and Policy

Question 1

Review: Incidence vs. Prevalence

Answer 1

• Incidence: rate of a new disease within a given period of time
• Prevalence: total number of people living with a disease

Question 2

3 Core Functions of PH

Answer 2

Assessment
Policy Development
Assurance

Question 3

What is at the center of all core functions of PH?

Answer 3

Equity

Question 4

4/10 of the Essential Services that regard Policy Development

Answer 4

• Communicate effectively to inform and educate
• Strengthen, support, & mobilize communities & partnerships
• Create, champion, & implement policies, plans, & laws
• Utilize legal & regulatory action

Question 5

Policy

Answer 5

• The authoritative decisions made in the legislative, executive, or judicial branches of government
• Enacted at all 3 levels of government (local, state, federal)
• Intended to influence the actions, behaviors or decision of citizens

Question 6

• Public policy

Answer 6

crafted by governments
- Health Policy
- Social Policy

Question 7

Health Policy

Answer 7

Health Policy is when the intent of public policy is to influence health or health care

Question 8

Social Policy

Answer 8

Social policy identifies course of action to deal with social problems – typically addressing the social determinants of health

Question 9

Private Policy

Answer 9

crafted by nongovernmental entities – health care organizations, insurers, or others

Question 10

Big P

Answer 10

governmental policies

Question 11

Little P

Answer 11

policies crafted by non-governmental organizations

Question 12

Public Health Policy

Answer 12

• Directed toward influencing actions, behaviors, or decisions influencing population health
• Intrinsically connected to the health care system, values, and philosophies about the place of government
• Grounded in the health planning process
• Should be based on evidence and support determinants of health

Question 13

Upstream Factors

Answer 13

• Broad range of issues – other than health care that influence health and wellbeing.
• Social Determinants of Health – Health is determined in a large part by the conditions where people live, work, and play
• To date …the focus on reducing disparities has been health policy addressing access, coverage, cost, & quality once the individual ENTERS the health care system
• Focus must shift to addressing upstream factors in and outside of health care systems

Question 14

Two types of Public Policy

Answer 14

Allocative
Regulatory

Question 15

Allocative Policy

Answer 15

Provides benefits for a distinct group of individuals or organizations (at the expense of others) to achieve a public objective (may be redistribution of wealth) What we are funding and how we are funding it

Question 16

Regulatory Policy

Answer 16

Influence actions, behaviors, and decisions of individuals or groups to ensure that a public objective is met

Question 17

_____- itself is policy!

Answer 17

Funding
(how we choose to lay out our dollars)

Question 18

Nursing and Policy

Answer 18

• Health policy affects every nurse’s practice
• Health policy determines who gets what type of health care – when, how, from whom & at what cost

Question 19

Why do nurses participate in policy?

Answer 19

• To advance a healthier society
• To promote a safer healthcare system
• To support nursing’s ability to care for people with equity & skill

Question 20

The Triple Aim

Answer 20

Developed by the Institute for Healthcare Improvement (IHI)
• Improving population health
• Improving the patient experience of care
• Reducing per capita costs

Question 21

Goal of The Triple Aim

Answer 21

creating a high-performing health care system

Question 22

The Triple Aim requires HC providers to…

Answer 22

to broaden focus from individuals to populations

Question 23

Triple Aim may be Quadruple aim now:

Answer 23

Improving the work life of clinicians and staff OR Achieving health equity

Question 24

Health Care Finance

Answer 24

Public Health Finance
Funding and Access to Care

Question 25

Public Health Finance

Answer 25

Complex system determines how public health infrastructure, services, etc. are financed

Question 26

Public Health Funding Needs (fix 21-6 from book)

Answer 26

1. Core funding for public health - at the federal, state, and local levels -should be increased
2. First dollars of core PH funding should be used to a assure all Americans are protected by a set of foundational PH capabilities and services no matter where they live
3. Funding should be considered strategically, so funds are used efficiently to maximize effectiveness and lowering disease rates and improving health
4. The Prevention Fund, identified as part of the Affordable Care Act, should be implemented quickly and strategically to effectively and efficiently reduce rates of disease
5. Stable, sufficient, dedicated funding should be provided to support public health emergencies and major disease outbreaks – so the country is not caught up and unprepared for threats ranging from Ebola to an act of bioterrorism – and is better equipped to reduce ongoing threats such as flu, foodborne illness, and the measles
6. Accountability should be a corner stone of public health funding. Americans deserve to know how effectively their tax dollars are used, and the government’s use of funds should be transparent and clearly communicated with the public

Question 27

3 branches of government

Answer 27

Legislative—Makes laws (Congress, comprised of the House of Representatives and Senate)

Executive—Carries out laws (president, vice president, Cabinet, most federal agencies)

Judicial—Evaluates laws (Supreme Court and other courts)

Question 28

3 levels of government

Answer 28

Federal
State
Local

Question 29

Criteria to Evaluate Public Health Policy - Effectiveness

Answer 29

likelihood of achieving the goals and objectives of the policy or demonstrated achievement of them

Limits to use: estimates involve uncertain projection of future events

Question 30

Criteria to Evaluate Public Health Policy - Efficiency

Answer 30

achievement of policy goals relative to cost. Least cost for a given benefit or that largest benefit for a given cost

Limits to use: measuring all costs and benefits is not always possible.

Question 31

Criteria to Evaluate Public Health Policy - Equity

Answer 31

fairness or justice in the distribution of a policy’s costs benefits, and risks across population subgroups

Limits to use: difficulty in finding techniques to measure equity; disagreement over whether equity means a fair process or equal outcomes

Question 32

Criteria to Evaluate Public Health Policy - Liberty/Freedom

Answer 32

Extent to which public policy extends or restricts privacy and individual rights and choices

Limits to use: Assessment of impacts on freedom is often clouded by ideological beliefs about the role of the government

Question 33

Criteria to Evaluate Public Health Policy - Political Feasibility

Answer 33

The extent to which elected officials accept and support a policy proposal

Limits to use: Difficult to determine. Depends on perceptions of the issues and changing economic and political conditions

Question 34

Criteria to Evaluate Public Health Policy - Social Acceptability

Answer 34

The extent to which the public will accept and support a policy proposal

Limits to use: Difficult to determine even the public support can be measured. Depends on saliency of the issues and level of public awareness

Question 35

Criteria to Evaluate Public Health Policy - Administrative Feasibility

Answer 35

The likelihood that a department or agency can implement the policy well

Limits to use: Involves projection of available resources and agency behavior that can be difficult to estimate

Question 36

Criteria to Evaluate Public Health Policy - Technical Feasibility

Answer 36

The availability and reliability of technology needed to policy implementation

Limits to use: Often difficult to anticipate technological changes that would alter feasibility