HLTH471 WOMEN S HEALTH Exam 1 8 31 2012 History of Women s Health 1 First Women s right convention held 1848 groups got together and talked about health 2 First training schools for nurses opened 1873 professional roles 3 First birth control clinic was established in 1916 Margaret Sanger 4 Women gain the right to vote 1920 5 The number of women employed in the US increased 50 during the 1940 s 6 Kinsey report on human sexuality was published in 1953 interviews about sexual history women s sex drive 7 FDA approves the birth control pill 1960 8 Our Bodies Ourselves published 1970 by and for women about sexuality and health along with stories by women 9 Roe vs Wade 1973 abortion legal 10 Global Gag Rule implemented in 1984 funding money 11 NIH Revitalization Act required that women and minorities be included as research subjects in 1993 12 Patient Protection and Affordable Care Act 2012 health care reform 9 5 2012 Efforts to improve people s knowledge and awareness about health Can focus on teaching individuals communities or population Can cover any health related topic Focuses on getting people to change their behavior Includes health education and policies Deals with lifestyle and chronic disease factors Health Education Health Promotion Prevention Primary Prevention prevention of disease or injury by reducing exposure to a risk factor that may lead too disease or injury giving out condoms Secondary Prevention Early detection and prompt treatment of disease Tertiary Prevention takes place once a disease has advanced involves alleviating pain providing comfort halting progression of an illness and limiting disability that may result from a disease Total number of people affected by a given condition at a point in time or during a period of time spread Prevalence number of cases total population at risk Prevalence Incidence New cases of a condition that occur during a specified period of time Incidence number of new cases total population at risk WHAT DETERMINES HEALTH OUTCOMES 1 Social characteristics and total ecology 75 2 Health behaviors and genes biology 25 3 Medical Care HEALTH OF THE WOMEN AROUND THE WORLD What are the major behavioral and environmental risk factors that contribute to death and disease worldwide Alcohol consumption High blood pressure number 1 High cholesterol Obesity Tobacco consumption 9 10 2012 9 12 2012 Social determinants of health The conditions in which people are born grow live work and age including the health system These circumstances are shaped by the distribution of money power and resources at global national and local levels Social gradient Stress Early life Social exclusion Work Unemployment Understanding the natural stress response flight or fight reaction When you encounter perceived threats your body releases a surge of hormones Adrenaline increases heart rate elevates your blood pressure and boosts energy including supplies Cortisol o Increases sugars in the bloodstream enhances your brain s use of glucose and increases the availability of substances that repair tissues o Curbs functions that would be nonessential or detrimental in flight or fight situation Immune system responses suppresses the digestive system the reproductive system and growth process Whitehall study 1970 s Large study of British civil servants o Everyone has jobs Why o Because of health care system o Because of lifestyle choices Conventional wisdom in the 1970 s was that business executives had high rates attacks they found the opposite Social gradient every step they go up in occupation the greater the life expectancy professional top unskilled bottom Work and employment high control less stress low control more stress Infant mortality stress levels jobs money whatever affects the mother affects the child Healthy lifestyle healthy baby Social Exclusion Absolute poverty vs Relative poverty Result from o Racism discrimination stigmatization hostility and unemployment Prevent people from participating in society are psychologically damaging costly and harmful to health 9 14 2012 PAYING FOR HEALTH CARE IN THE UNITED STATES Three groups with health insurance Employees patients Health care providers Insurance companies Risk pooling as a group we are pooling healthy people to balance out the sick people If an employer wants to give their employee a raise Worker who pays federal and state income taxes at a combined rate of 30 will receive 7 000 for every 10 000 his employer provides in gross salary But the same employee will receive 10 000 in benefits for every 10 000 his employer spends on health insurance a 43 improvement Health insurance coverage of non elderly Americans Employer sponsored health insurance own 31 9 Employer sponsored health insurance dependent 30 3 Individual insurance 6 8 Medicare 2 5 Medicaid 13 4 Tricare 2 7 Uninsured 17 9 Definitions 60 employer sponsored 7 individual Premium monthly payment to health insurance company for employer sponsored health insurance this cost is split between employer and employee Benefits covered services by health insurance companies Co insurance set percentage that patients must pay as part of their care costs usually 10 20 Co payments fixed amount of money patient is required to pay to receive health care services office visits prescriptions etc Deductible amount that a person must pay out of pocket before health benefit kicks in Network defined group or providers that health insurance company will allow patients Benefit cap limit to the amount of money a health insurance company will pay to see if patients see an out of network provider costs go up significantly Referral Authorization from Primary Care Physician to see specialist care Cost to patient to have employer sponsored health insurance Employee contribution to premium Employer contribution to premium Co pay Co insurance Types of insurance Private insurance o Employer sponsored HMO PPO HDHP o Individual coverage Public insurance o Medicare o Medicaid o Tricare HMO HDHP Patients pay the same premium every month Co payments and deductibles low Primary care physician as gatekeeper HMO Health Maintenance Organization Managed care plan Need referrals for specialist care Usually cheapest option for employer sponsored health insurance Out of network care is much more expensive High Deductible Health Plan Usually paired with a Health Saving Account High Deductible Gives patient flexibility and choice over how health care benefits are used 9 17 2012 PPO most common plan