UW-Madison SOCWORK 453 - Public Health and Health Disparities (10 pages)

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Public Health and Health Disparities

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Public Health and Health Disparities


A lecture about what the public health perspective is and how health disparities exist.

Lecture number:
Lecture Note
University of Wisconsin, Madison
Socwork 453 - Alcohol and Other Drug Abuse
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Soc Work 453 Edition 1nd Lecture 19 Outline of Last Lecture I Overview II Announcements III Comorbidity IV Dual Diagnosis V Treatment Implications VI Family Issues VII Guest Speaker Outline of Current Lecture II Announcements III Prevention as a drug policy a Prevention paradox IV Drug and alcohol related injuries V Types of prevention in public health VI Defining goals and evaluating outcomes VII Montana Meth Project VIII Social Influence Model IX Health disparities health equity X IClicker Question and notes XI Contextual factors Current Lecture Announcements Exam info The exam is not cumulative We just have to study what we have learned since the 2 nd exam The test is in 3 weeks Goals Understand what the public health perspective is and how health disparities exist and to become familiar with them Prevention as a drug policy Effective supply reduction techniques e g increase cost limit availability clearly reduces drug use But as long as there is demand there is supply Drugs will never disappear Supply reduction has unintended consequences Prevention and treatment programs can reduce demand From a public health perspective we should look at the health of a city health of a state or health of a whole nation Looking at it from those perspectives the stakeholders are different The more drugs cost the less people will be able to afford them so then less people use them Knowing that supply control will not be effective in total we need to do other things And one of these things is prevention and treatment programs Prevention paradox The large number of people at small risk contribute more harm costs than the smaller number of people who are individually at greater risk or the people who use drugs at a harmful and high risk are more harmful than the people who have severe dependence or have substance use disorder People with less severe problems contribute more to the cost of the nation than those with more severe problems When we move away from the chronic disease perspective that really concentrates on those with the highest problems we start looking at what is the whole nation is like and what the consequences of use are People who have the most severe problems who are the most severely addicted they contribute to the least amount of the nations suffering from the consequences of drugs and alcohol This is because there are so few people who are addicted severely This is the top of the pyramid this is also where substance use disorder is located The vast majority of people who use substances use them at low levels or at high or risky levels The top of the pyramid has a small number of people at great risk The middle part is a large amount of people who are individually at a smaller risk There are far more aggregate costs injuries years of life lost etc If we really want to make a difference for the nation we have to change the middle part of the pyramid The bottom of the pyramid is low risk and abstinence and this is not a problem area either Drug and alcohol related injuries Saturday night in a Dallas Emergency Room Many people are in the hospital for drug or alcohol related reasons Some of the people in this video could have been severely addicted or at the top of the pyramid But the video shows that it isn t that someone has a chronic addiction the most cost to society is that intoxication and the injuries that occur during that You don t have to be drinking everyday to experience the harms that can occur from being intoxicated It really is a lot of life lost when you compare alcohol or drugs to young people when compared to older people and their diseases Types of prevention in public health Primary Prevention Prevent use before it starts Aimed primarily at younger people This is because typically drug and alcohol use is among young people Primary Prevention is trying to prevent it before it starts to be useful Secondary Prevention Curtail further problematic or risky use Prevent addiction and disorder Aimed at persons who have used substances People who have experimented and tried but are not yet severely addicted This could be college students or other people who started using but have not become severely addicted Tertiary Prevention Intervention treatment recovery Aimed at people who have developed addiction problems This is aimed at people who are already addicted These are treatment programs to reduce addiction etc This is trying to take care of the problem after it already happens The younger you are the lower prevention you will probably receive Defining goals and evaluating outcomes Goal of presenting negative information about drugs to youth prevention Programs should be evaluated according to rates of substance use among those who attended the program Until recently most drug prevention programs were not evaluated Some are still not evaluated today For youth primary prevention will send messages that have to do with the negative consequences of use the programs will probably talk to people about beliefs about use and change attitudes about using drugs To evaluate programs you have to think of what population are they targeting and what outcomes are most useful to that population An example would be DARE which made people feel good because they thought something was being done about drugs But because it wasn t evaluated there was no information about what was really going on And once it was evaluated it seems like it doesn t really work Montana Meth Project Large scale exercise in prevention aimed at significantly reducing Meth use in Montana View methamphetamine as a consumer products marketing problem Meth is a readily available affordably priced consumer product Perceived as attractive with little risks This is the root of the problem Goal was to increase knowledge about meth so Montana youth could make a better informed decision To manufacture this drug it creates a lot of toxic waste and you need a lot of chemicals Most people to make this drug would go to a rural area away from people and manufacture it This state is a really rural state so meth is used frequently These tactics were informed by people s hypotheses of why people use meth For this program they wanted to convince youth that the drug is really risky They use scare tactics they tried to scare kids to not use meth Montana Meth Messaging Campaign High impact advertising that graphically communicates risks of meth use TV radio billboards newspapers internet Statewide targeting youths age 12 17 Reach

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