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
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2
Q

population groups

A
  • racial and ethnic minorities
  • uninsured children
  • women
  • rural area
  • residents
  • homeless population
  • mentally and chronically ill
  • disabled
  • HIV/AIDS
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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
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4
Q

three vulnerable model characteristics

A
  • comprehensive
  • general
  • covergence
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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

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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
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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
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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)
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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)
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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
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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
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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*
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13
Q

migrant workers

A
  • community and migrant health centers

- rural health clinics act

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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
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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
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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
Q

children

A
  • 30% covered under medicaid, 60% covered under private insurance
  • up to to 20% of children have disabilities
  • developmental vulnerability
  • dependency
  • new morbidities
26
Q

women and AIDS/HIV

A

-women have half of the HIV/AIDS cases

27
Q

women and depression

A

-women are more likely to be depressed than men

28
Q

women and alzheimers

A

-substantially greater risk for women to get alzheimers

29
Q

6 areas of for attention in substance abuse and mental health services for women

A
  • 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
Q

women and US health care system

A
  • 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
Q

reasons for barrier in health care in homelessness

A
  • individual factors (competing needs, substance dependence, mental illness)
  • system factors (availability, cost, convenience)
32
Q

managed care

A
  • not overuse health care

- manage access and quality at a low cost

33
Q

mental health

A

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
Q

psychiatrists

A
  • physicians
  • postgraduate training in mental health
  • have power to prescribe prescriptions, and admit patients
35
Q

psychologist

A
  • usually have doctoral degree, some masters
  • interpret and change peoples behavior
  • cannot issue prescriptions
  • use psychotherapy and counseling
36
Q

risk factors of mental health

A
  • 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
Q

children: developmental vulnerability

A

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
Q

children: dependency

A

childrens circumstances that require adults to take responsibility for recognizing and responding to their health needs

39
Q

children: new morbidities

A

-drug, alcohol abuse, violence, emotional disorders, learning problems