Lecture 3/Chapter 11 Flashcards
1
Q
Underserved population
A
- certain groups at greater risk of poor physical, psychological, or social health
- underserved
- medically underserved
- medically disadvantaged
- underprivileged
- American underclasses
2
Q
population groups
A
- racial and ethnic minorities
- uninsured children
- women
- rural area
- residents
- homeless population
- mentally and chronically ill
- disabled
- HIV/AIDS
3
Q
vulnerability
A
- challenged populations
- predisposing conditions can make you vulnerable
- something inherent that you cant fix (ex. genetic disorders)
- enabling vulnerability - people surrounding you or the system
- need characteristics
4
Q
three vulnerable model characteristics
A
- comprehensive
- general
- covergence
5
Q
racial/ethnic minorities: asian americans
A
- in 2015, asians account for only 5.6% of the US population
- asian americans constitute one of the fastest growing US population segments
6
Q
racial/ethnic minorities: american indians and alaska natives
A
- incidence and prevalence of certain diseases in the AIAN population are a prime concern
- higher death rates from alcoholism, tuberculosis, diabetes, injuries, suicide, and homicide
- indian health care improvement act
- indian health service
7
Q
uninsured
A
- ethnic minorities are more likely than whites to lack health insurance -> bc of employment, poverty
- most of the uninsured population comprises young workers -> they are healthy
- uninsured persons are in poorer health than the general population
- ACA made progress in reducing the uninsured
- 11% of children are uninsured
- 46 million are uninsured
8
Q
children
A
- health insurance is a major determinant of access to and utilization of health care
- coverage rates vary across races and ethnicities
- unintentional injuries are the leading cause of death for children and adolescents
- asthma is a common childhood chronic disease
- depression has an impact on adolescent development
- childrens health has certain unique aspects -> developmental vulnerability and dependency (bones)
9
Q
children and the US health care system
A
- programs categorized into 3 sectors:
- personal medical and preventive services sector (primary and specialty care)
- population based community health services (immunization, abuse prevention, rehab, case management, referrals)
- health related support services (nutrition, rehab, family support)
10
Q
women
A
- office on womens health -> specific goals that span the spectrum of disease and disability
- women and the US health care system are at a disadvantage in obtaining employer based health insurance
- the leading provider of care in the nursing profession is women -> also in allopathic and osteopathic medicine, dentistry, optometry, and podiatry
- women in the US live 8 years longer than men, but suffer greater morbidity and have poorer health outcomes
- heart disease and stroke- account for a higher percentage of deaths among women than men at all stages of life: 42% of women with heart attack die within the year but only 24% of men do
- 38% of women have chronic conditions
11
Q
rural health
A
- national health service corps
- health professional shortage in areas
- health professions educational assistant act
- 3 types of HPSAs by geographic areas, population groups, and medical facilities
12
Q
rural health: medically underserved areas
A
- percentage of population below poverty income levels
- percentage of population 65 years of age and older
- infant mortality rates
- number of primary care practitioners per 1,000 population*
13
Q
migrant workers
A
- community and migrant health centers
- rural health clinics act
14
Q
rural health clinics act
A
- concern rural areas could not support a physician
- permitted PAs, NPs, and CNMs with rural clinics to practice without the direct supervision of a physician
- enabled rural health clinics to be reimbursed by medicare and medicaid
15
Q
homeless
A
- approximately 1 in 200 people become homeless in 2011
- adult population is 63% men and 37% women
- estimated 22.8% are children under age 18
- 35.8% are families with children
- 14% are veterans
- shortage of adequate low income housing
- barriers to health-> barrier to ambulatory (outpatient, transportation) services and high hospitalization rates
16
Q
mental health
A
- barriers to mental health care
- uninsured and mental health
- insured and mental health
- managed care (maintaining health and access at an affordable cost) and mental health
- mental health professionals
17
Q
chronically ill
A
- chronic diseases are the leading cause of death in the US
- results in limitations on daily life activities
- treatment accounts for 86% of US health costs
- disability:
- categorized as mental, physical, or social
- disability tests
18
Q
HIV/AIDS
A
- number of AIDS cases reported:
- increased between 1987 and 1993
- decreased between 1994 and 1999
- increased between 200 and 2004
- decreased since 2005
- HIV infection in rural communities
- HIV in children
- HIV in women
- Cost of HIV/AIDs
- HIV/AIDS- related issues:
- need for research
- public health concerns
- discrimination
- provider training
19
Q
AIDS and the US health care system
A
- AIDS is characterized by a gradual decline in physical, cognitive, and emotional function
- as HIV disease progresses, many people become disabled and rely on public entitlements
20
Q
summary
A
- challenges and barriers in accessing health care services for certain population groups
- health needs of these population groups vary
- gaps exist between population groups and the rest of the population
21
Q
recession
A
- 2000-2006
- people lost jobs and health insurance
- black population mortality rates increased
22
Q
smoking
A
- male are more likely to be smokers
- associated with many chronic and diseases
23
Q
underinsured
A
- catastrophic insurance- high deductible, insurance only kicks in after you spend $10,000
- not everything is covered (dental)
24
Q
uninsured/underinsured
A
- tend to be:
- less educated, poor
- working in part time jobs and/or employed by small firms
- younger 25-40
- medically uninsured are employed but not covered due to:
- employer doe snot offer health
- employee does not qualify, too few hours worked
- cant afford
- uncompensated care costs covered by medicaid, federal grants to nonprofit hospitals and charitable organizations
25
children
- 30% covered under medicaid, 60% covered under private insurance
- up to to 20% of children have disabilities
- developmental vulnerability
- dependency
- new morbidities
26
women and AIDS/HIV
-women have half of the HIV/AIDS cases
27
women and depression
-women are more likely to be depressed than men
28
women and alzheimers
-substantially greater risk for women to get alzheimers
29
6 areas of for attention in substance abuse and mental health services for women
- physical and sexual abuse of women
- women as caregivers
- women with mental and addictive disorders
- women with HIV/AIDS
- sexually transmitted disease or tuberculosis
- older women
- women detained in the criminal justice system
30
women and US health care system
- women are the principle users for health care system for themselves and as the family care coordinator
- work more part time jobs then men -> receiving lower wages -> higher risk to be uninsured -> more likely to be covered as dependents under their husbands plans
- women are twice as likely to be covered under medicaid because the program is linked to aid to families with dependent children (AFDC)
31
reasons for barrier in health care in homelessness
- individual factors (competing needs, substance dependence, mental illness)
- system factors (availability, cost, convenience)
32
managed care
- not overuse health care
| - manage access and quality at a low cost
33
mental health
1 in 4 have mental disorder in any given year
- industry plagued with disparities in availability and access
- hinges on financial status
- tear down the stigma, fear and the hopelessness
- medicaid is the single largest payer
- state had strong emphasis on inpatient care
- depression is the most common illness among primary care pateitns -> affect approx 14.8 million adults in the US
34
psychiatrists
- physicians
- postgraduate training in mental health
- have power to prescribe prescriptions, and admit patients
35
psychologist
- usually have doctoral degree, some masters
- interpret and change peoples behavior
- cannot issue prescriptions
- use psychotherapy and counseling
36
risk factors of mental health
- history of depression
- family history
- stressful life events
- lack of social support
- history of anxiety
- postpartum period
- substance abuse
- medical comorbidity ** -> goes along with a physical sickness usually
- being single
- old age
- low socioeconomic status
- female gender
37
children: developmental vulnerability
the rapid and cumulative physical and emotional changes that characterize childhood, and the potential impact that illness, injury, or disruptive family and social circumstances can have on a childs life course trajectory
38
children: dependency
childrens circumstances that require adults to take responsibility for recognizing and responding to their health needs
39
children: new morbidities
-drug, alcohol abuse, violence, emotional disorders, learning problems
