Population Health Test 3 Flashcards
vulnerable populations
risk for disparate healthcare access and outcomes because of economic, cultural, ethnic, or health characteristics
vulnerable population examples
racial or ethnic minorities, children, elderly, socioeconomically disadvantaged, underinsured, or those with certain medical conditions
vulnerable population subgroups
incarcerated, immigrants, Native Americans, LGBTQ individuals, veterans, homeless, and those with mental illness
Social Determinants of Health effect
unstable housing, low income, unsafe neighborhoods, poor access to care, unhealthy behaviors, and substandard educatiion
Department of Health and Human Services uses FPL to determine needs for these groups
- The National School Lunch Program
- The Low-Income Home
- Energy Assistance Program
- The Children’s Health
- Insurance Program
- Supplemental Nutritional
- Assistance Programs
- Women’s, Infants, & Children
- Headstart
Poor
living below the poverty level
Deep poverty
living at 1/2 of the poverty level
low income
living at twice the poverty level
neer poor
living slightly above the poverty level but inadequate income
United States Census Burea
issues public report calculating the Poverty Threshold
Poverty Threshold
calculates the level of poverty in the country
- estimated number of people that are poor living at the poverty level
- one-dimensional and does not consider the geographical difference in populations of the effectiveness of current programs
Supplemental Poverty Measure
(2010) uses cash resources and noncash benefits and subtracts necessary expenses
Global Multidimensional Poverty Index
(2010)
* Oxford Poverty & Human Development Initiative
* United Nations Development Program
uses health, education, and standard of living indicators to determine the degree of poverty experienced by a population
2030 end poverty and hunger everywhere
- combat inequalities within and amount countries
- build peaceful, just, and inclusive societies
- protect human rights and promote gender equality and the empowerment of women and girls
- ensure the lasting protection of the planet and its natural resources
* inclusive and sustained economic growth, shared prosperity, and decent work for all, taking into account different levels of national development and capacities
Johnson’s War on Poverty
- Kerner Commission 1967
1. intense rioting in communities leads to an investigation
2. untenable living conditions
3. institutional racism - racism and discrimination must be addressed
- social programs should be made more easily available
The Fair Housing Act 1968
prohibited discrimination on the basis of race, religion, or nationality
Clinton Administration 1993-2000
The lowest poverty rate of 11.3%
Factors Affecting Growing Number of Poor Persons in The United States
decreased earnings, increased unemployment rates, inadequate welfare benefits, weak enforcement of child support statutes, changes in the labor force, increase in female-headed households, dwindling Social Security payments of children, increased numbers of children born to single women, inadequate education and job skills, inadequate antipoverty programs, trade deficits, debts, involvement in wars, outsourcing of American jobs
Changing Face of Povertry
most affected?
- senior adults (.65)
- children (,18) have the highest poverty rate
- single mother households
* wage gap
* motherhood penalty - minorities
* African Americans (double of whites)
* Hispanics (current increase)
* American Indians
Children: Adverse Health and Development
low birth weight infant mortality language development chronic illness environmental exposure poor nutrition increased injury toxic stress
toxic stress
a condition characterized by excessive or prolonged activation of the physiologic stress response systems in the absence of the buffering protection afforded by stable, responsive relationships
Child poverty is associated with what?
life long hardship
American Academy of Pediatrics
- centered around government safety net programs
* additional programs which provide parental support and build resiliency in children
African Americans
- increase in chronic diseases
* diabetes, hypertension, cardiovascular disease, stroke, cancer, asthma, HIV/AIDS - increase in victims of homicide
- increase in premature death
American Indians
- high prevalence of suicide, obesity, teenage pregnancy, substance abuse, liver disease, SIDS
- homes lack adequate water purification and sewage systems
- lack of access to quality care if in a rural area
Hispanics
- cultural and language barriers, immigration status, lack of insurance
- preventative services are utilized less frequently
Homeless (Department of Housing and Urban Development)
individuals who lack fixed, regular, and nighttime residence
transitional homelessness
- most common
younger and generally enterr a shelter or temporary housing system for only one brief stay (catastrophic event)
Episodic homelessness
individuals who are currently homeless and have experienced at least 3 periods of homelessness in the previous year. (disabled, substance abuse, mental illness, medical problems)
Chronic Homelessness
*less common
older individuals with complex, long-term health issues and live on the street, in a car, park, or other location that is not suitable for human habitation
Hidden Homelessness
- unreported and undocumented
couch surfing
do not access homeless supports and services
Annual Homeless Assessment Report
HUD report in the U.S. Congress that provides nationwide estimates of homelessness (demographic characteristics, service use patterns, the capacity to house homeless persons)
Homeless Management Information Systems
data about persons who experience homelessness during a 12-month period
Point-in-time count
bi-annual, last 2 weeks fo January
required for HUD funding
* counts sheltered people (emergency shelters) and unsheltered people
Continuum Care Programs
region or local planning that coordinates housing and services
- relies on PIT counts to redirect funding, services, & resources
- manages services offering prevention and holes assistance programs
Factors Leading to Homelessness
- poverty
- lack of affordable housing
- Decrease in governmental support programs
- Domestic violence
- mental illness
- substance abuse
Who is homeless
- > 24
- male
- non-hispanic
- white
largest subsets
- children and youth
- LGBTQ
- veterans
- mentally ill
- battered women
Community Mental Health Centers Act
(1663)
creat outpatient community health centers which would be funded with assistance for the federal government
* unsuccessful and “put to rest” when President Regan took office
Omnibus Budget Reconciliation Act
(1981)
funds shifted to this act after the Community Mental Health Centers act was “put to rest”
*inadequate and those with severe mental disorders were neglected and unable to receive adequate care
Protection and Advocacy for Individuals with Mental Illness Act
(1986)
- funding of the Community Support Program
- provides grant money to states to develop comprehensive services for psychiatric discharged patients
American Disabilities Act
(1990)
* prohibit discrimination against those with mental and physical disabilities and promote equality in employment and access to public services
Mental Health Parity Act
(1996)
- passed and changed in 2008 to the Mental Health Parity and Addiction Equity Act
- insurers cover mental health issues (depression or substance use disorders), no more restrictively than diabetes or cancer patients
Affordable Care Act
(2010)
* prohibited discrimination in coverage for preexisting conditions and prohibited discontinuation of coverage because of illness
National Alliance for the Mentally Ill
largest consumer advocate mental health organization dedicated to building better lives for those affected by mental illness
- 1979 small families
- today 48 state organizations (Nebraska)
right to mental health services
least restrictive environment, consumer involvement in treatments, advocacy, and availability of rehabilitative and recovery services
mental illness prevalence
- 1-5 adults in the U.S. and even higher rates amongst children under 15 will experience a severe mental health issue.
- can lead to hypertension, stroke, and cardiovascular disease
- decreased life span by 25 years
- suicide is on the rise and top 10 leading cause of death by CDC
