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IUB SPEA-H 124 - Final Exam Study Guide

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SPEA-H 124 1nd EditionEXAM 6 STUDY GUIDEChapter 11: Public Health and the Role of the Government in Health Care Defined: Public Health: “Efforts made by communities to cope with health problems arising from people living in groups..the need to control the transmission of disease, maintain a sanitary environment,provide safe water and food, and sustain people with disabilities and low income population.” Morbidity: the incidence and prevalence of a disease or disease in a population (“illness”) Mortality: the incidence of death in a population (“death”) Incidence: how many new cases of a disease or illness in a given time period Prevalence: how many current cases of a disease or illness exist at any given point in timeConcepts in Public Health- Current knowledge of the nature and causes of diseases- Practices of disease control and treatment - Dominant social ideologies of communities - Health problems of people living in close proximity **Disease control exam: John Snow disease mapping in London 1854; “The Broad Street Pump”produces cholera in certain communities with the street pump**History of Public Health - Poverty, illness, disability commons - Elizabethan Poor law of 1601 in England o “Lame, impotent, old, blind unable to work”- recognition of the government’s responsibility for these people - Poor law Commission (1834) of England: motivated by economic interests; Edwin Chadwick used data to link population conditions, environmental conditons and incidences of disease; used to address common public health problems- 1848: Public health Act and General Board of Health established England as the world leader in public health philosophy and practice- American Public Health- Public health in America heavily influenced by the British o NY poor law in 1788: established almshouses;o Recognition that the government has a responsibility for public health - Sanitary Commission Report: first ignored, but now the most influential document in evolution of U.S. Public Health - Monroe County Public Health Department: can test water, set rules for garbage, etc. US Chronology - Late 1700s: marine hospitals - 1870s: Marine hospital system reorganized; “surgeon general” o Government is responsible for caring for marines, but towns they went into not responsible lead to establishment of marine hospitals - 1912: Marine Hospital Service became U.S Public Health Service o U.S Public Health Service remains one of the largest federal departments for healthcare today- 1935: Social Security Act, Title VI; creates public health agencies - 1953: Public Health Services joined the new Department of Health, Education and Welfare- 1970s: HEW renamed Health and Human Services (HHS)o 11 operating divisions o 2nd most costly executive branch o NIH (uses grant money for government; important to move forward, FDA, CDC, CMS most important - Veterans Administration is NOT public health; federally owned government system; It is a provider of health care, so it is not considered public health - 1960s: federal spending dried up; began declining through the 80s and funding remains where it was left in the 80so Public Health has been strangled out because of our fascination with high tech medicine Health People Objectives- Health People 2000 failed because of a lack of people to oversee specific objectives - Not funded well enough o Success in occupational health and safety - Now: Health People 2020- Good upper paying public health jobs are in academia, not in the community leadership positions - MDs in public health are mostly administrative o Less than 1% of federal spending is used on public health o Referred to as the “neglected stepchild” of the US health care system Medicine is to individuals as public health is to populations**The interests of the people must be represented; cost effectiveness must be addressed and howpeople will respond -Medical care vs. public health: hospitals have the mission to serve the


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IUB SPEA-H 124 - Final Exam Study Guide

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