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UMass Amherst PUBHLTH 129 - Final Exam Study Guide

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Final Exam Study GuideUndeserved PopulationsWhat are health and health care disparities?Refer to differences in health and health care between population groupsDisparities matter because limits continued improvement in overall quality of care and population health and have unnecessary costsHispanics, Blacks, American Indians/ Alaskan Natives less likely to be insured, also low income individuals relative to whites and higher incomeMinorities have increased barriers to access care, receive poorer quality of care and ultimately experience worse health outcomesVulnerable populationsRacial and ethnic minoritiesOver 30% of US populations is minoritiesDisabledHave psychological problemsEnabling CharacteristicsInsurance status (uninsured)Poor and less educated, work at part-time jobs, younger (25-40), minoritiesHomelessness3.5 million experience itSocioeconomic statusIndividual assets (human capitals)Mediating factors are associated with the use of health care services (e.g. health insurance, access to quality of health care)Federal Initiatives to Eliminate socioeconomic disparitiesPrograms that have helped eliminate socioeconomic differences:Community Health Center ProgramNational Health Service CorpsHealth care for the Homeless ProgramNeed CharacteristicsMental healthRanks second as a nationwide burden on health and productivityChronic illness/disabilityResponsible for 7 out of 10 deathsHIV/AIDSCDC estimates 1 million in US are living with HIV, average cost of ART $15,000 a yearHealth Care for All, Canada Health Care SystemNational Health ServiceHealth care is provided and financed by the government through tax paymentsMany hospitals and clinics owned by the government, some doctors are govt. employeesEngland, Spain, new Zealand,Social Health InsuranceUses health insurance system (insurers called sickness funds) usually financed jointly by employees and employersSingle player systemHas elements of the two above, but uses private sector providers but payment comes from govt-run program that every citizen pays intoCanada, Taiwan, South KoreaNo profit, no marketing, tend to be cheaperThe Out of Pocket ModelMarket driven health care. Most of the nations that are poor and disorganized to provide national health careUS Health Care System of SystemsMaintains so many separate systems for separate classes of peopleMedicareMedicaidEmployment based health insuranceVeteransNative AmericansMilitaryUninsured—reduced by the ACA, subsidized private health insurance and states that have choose to go with Medicaid expansionCanada Government and PoliticsConsists of 10 providences and 3 territoriesLargest providence in population is Ontario (12.8 million), then Quebec (7.9 million)Bicameral national legislature, Capital in OttawaSenate, Appointed by Governor GeneralHouse of CommonsSupreme Court of Canada9 judges appointed by the governor generalCanada Health Care SystemGovernment RoleRegionally administered universal public health insurance program called MedicarePublic System FinancingTerritorial/Provincial/federal tax revenue; less than 25% comes form the central governmentPrivate Insurance Role67% buy coverage for non-covered benefitsThere are no caps on cost-sharingCanada Health Act, 1984Canada and US Health Indicators, 2011PopulationCanada—34.5 million, US—311 millionPercentage of population over 65CA—14.7%, US—13.2%Health Spending GDPCA—11.2%, US—17.7%Out of pocket HC per capitaCA—$600, US—$987Length of Stay for Acute daysCA—7.7; US—5.4Future of the US Health Care SystemDemographicsAging, DiversitySoon will be a minority majority populationTend to be a much younger populationTechnologyMajor contributor to costPeople really like the status quo if they’re benefiting from itWill opposition if there is real fundamental changeChronic DiseaseObesityBeat out cigarettes at highest preventable deathAccessMinorities, undocumented individualsFragmentation of delivery of careNot well coordinated, always been a problem“There is no political agreement about the obligation to provide health care for all, and one the political parties rejects that idea.”(Public opinion can be the opposite, the role that legislature and money and how the influences things) – why should we care about those populations who should be able to care for themselves, or cant afford it)Its very easy to influence and kill bills, there’s committees and subcommittees that influence these decisions, which is why it can be so hard to pass anything in Congress.Public Health 129 1st Edition Final Exam Study Guide Undeserved Populations What are health and health care disparities?- Refer to differences in health and health care between population groups- Disparities matter because limits continued improvement in overall quality of care and population health and have unnecessary costs- Hispanics, Blacks, American Indians/ Alaskan Natives less likely to be insured, also low income individuals relative to whites and higher income- Minorities have increased barriers to access care, receive poorer quality of care and ultimately experience worse health outcomes Vulnerable populations- Racial and ethnic minoritieso Over 30% of US populations is minorities- Disabled- Have psychological problems Enabling Characteristics - Insurance status (uninsured)o Poor and less educated, work at part-time jobs, younger (25-40), minorities- Homelessnesso 3.5 million experience it - Socioeconomic status- Individual assets (human capitals)- Mediating factors are associated with the use of health care services (e.g. health insurance, access to quality of health care)- Federal Initiatives to Eliminate socioeconomic disparitieso Programs that have helped eliminate socioeconomic differences: Community Health Center Program National Health Service Corps Health care for the Homeless Program  Need Characteristics- Mental healtho Ranks second as a nationwide burden on health and productivity o Chronic illness/disability Responsible for 7 out of 10 deaths HIV/AIDS CDC estimates 1 million in US are living with HIV, average cost of ART $15,000 a year Health Care for All, Canada Health Care System- National Health Serviceo Health care is provided and financed by the government through tax payments Many hospitals and clinics owned by the government, some doctors are govt. employees England, Spain, new Zealand,o Social Health Insurance Uses health insurance system (insurers called sickness funds)


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