How are Healthy People 2020 standards used?

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Section B: Healthy People 2010

 

The Healthy People 2020 initiative is a national approach that identifies high priority health issues and establishes objectives to reduce the impact of these public health threats. To understand the significance of data on your own community, you have to be able to compare it to another standard. The questions in this section ask you about other standards that can be used.

 

 

Questions:

  1. How are Healthy People 2020 standards used? What are advantages and disadvantages to applying them at a local community level? (Note: you may use the Healthy People 2010 standards if the 2020 standards are not reported.)

 

  1. What other standards (national, state, or local) can be used?

 

 

 

 

 

 

 

Section C: Health Indicators

 

For this exercise, you will use an indicator approach to develop a community health assessment. A community health assessment involves three-step feedback loop.

 

The first step in such an assessment involves identifying important health indicators. The second step involves matching those indicators with available data. In the third step, standards such as those explored in Section B are applied to the data gathered in the first two steps to transform it into useful information about health needs of the population.

 

Health indicators are measurable health outcomes, such as death rate, insurance coverage measures, immunization rates, or other data items that are relevant to the health of a community. Indicators are thoughtfully selected data points that provide useful information about the health of a community.

 

Note that each indicator should be:

  1. An important health problem.
  2. Prevalent or common in the community of interest.
  3. Measurable on a community or population basis. There should be population data on a local level that is easily available—this cannot be collected from health facilities or providers because these data sources do not apply to the entire community.
  4. Ideally, because we want to use a limited number of indicators, the indicator should not be redundant—not measure the same thing—as another chosen indicator.

 

To organize indicators, it is helpful to identify major areas of focus. For this case, we will refer to these broad categories of public health concerns as domains. Please refer to Table 1 below for examples of domains. For each domain, an example of an indicator is provided.

 

 

 

 

 

Table 1: List of Domains to Assist Developing a Community Health Assessment

 

Domain: Example of an Indicator:
Communicable Diseases(including Sexually Transmitted Diseases) Incidence of Gonorrhea
Chronic Diseases (including Cancer) Incidence of Diabetes
Injury and Violence Homicide rate
Maternal and Child Health Childhood immunization rate
Environmental Health Rates of Lead Poisoning
Access to Health Care Rates of Uninsured

 

 

Question:

 

  1. How you would obtain data for these indicators. What sources might you use? Select 2 of the indicators above and provide specific sources of information on them (including URLs) for your own community or state.

 Community Health Assessment

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This Application Assignment asks you to consider the kinds of data you would use, and how you would obtain the data, for a community health assessment.

Read through the case exercise on Community Health Assessment, linked below, and complete all the questions. All the information you will need to complete this assessment exercise is provided in the Appendix at the end of the document. Save this Word document to your computer before you begin to fill out the form.

Community Health Assessment Exercise

Note: Assessment is a very involved process, and you could easily spend many hours exploring this case exercise alone. However, for the purposes of this assignment, you should limit yourself to spending no more than two hours to complete this Application.

Your name:
Date:

 

Week 4 Application: Community Health Assessment for Pitt County, North Carolina[*]
Community health assessment is key to understanding the health problems and priorities of a population. This Application Assignment outlines a process by which you can complete a health assessment of a community using indicator-based methods. You will construct a set of health indicators from a variety of domains, evaluate problems, and report on the health priorities for a community.

 

Sections A–C ask questions about assessment in general. Section D involves assessment of a particular county in North Carolina, information on which is provided in that section and in the Appendix.

 

 

Instructions: Save this document to your computer and complete all questions in Sections A–D below. Submit by the end of Week 4 following the submission instructions in the Week 4 Application section.

 

Section A: Community Health Assessment

 

The goal of public health is to improve the health of a population. Public health interventions such as safe water sources, immunization programs, and improved motor vehicle safety regulations account for the majority of years of life expectancy gained in the United States over the last 100 years.

 

A community health assessment involves obtaining and interpreting information to determine the health status of a specific community. Once community health needs are identified, public health interventions can be developed and their effectiveness evaluated using a similar approach.  Information necessary for performing a community health assessment, for example data on mortality rates or behavioral risk factors such as smoking, is available from various sources.

 

 

Questions:

  1. How do you define community?
  2. What stakeholders (groups/organizations) would you want to consult with for a community assessment?
  3. What types and sources of data would you use for a community assessment?

How does the employer mandate help eliminate the problem of adverse selection?

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In an essay, address the following questions:

  • How does the employer mandate help eliminate the problem of adverse selection? Would a single-payer plan, in which everybody is insured through the government, further reduce the problem of adverse selection?
  • What do you think would happen to health care expenditures in the United States under either the ACA or a single-payer plan? Consider the following:
    • Market supply and demand
    • Economics of scale
    • Incentives facing health-care providers
    • That preventative medicine would be available to more citizens
    • Any moral hazard issues
    • Any bargaining issues
    • Porter’s Five Forces model
    • Any other issues from this course that come to mind

Explain your thoughts thoroughly using concepts from the related chapters and lectures

Writing Requirements (APA format)

  • 6-8 pages (approx. 300 words per page), not including title page or references page
  • 1-inch margins
  • Double spaced
  • 12-point Times New Roman font
  • Title page with topic and name of student
  • References page (minimum of 5 resources)
  • Affordable Care Act

    ECO 524 Week 1

    The Affordable Healthcare Act was rolled out in 2010. It has put a comprehensive health insurance reform in place that improves the quality of healthcare and lowers the costs to those in need.  This plan will roll out over a four-year plan and then beyond. By 2014 all Americans will have access to affordable healthcare insurance options, providing those who were previously uninsured with coverage. Businesses have to adjust their decisions based off the economic environment and as a result of the Affordable Care Act, these new regulations have effected business long term strategies. In addition, as far as the Affordable Care Act is concerned, there are some unintended behaviors that can be expected from the affected businesses. This paper will focus on the two aforementioned areas and will also propose some alternative regulations that may prevent some of the negative outlooks associated with this Act.

    The Affordable Care Act includes changes to the insurance market plans that small businesses must comply with. Small businesses are considered to have less than 500 employees and small business are known to employee over half the workforce and are a main contributor in job creation. “While 96{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119} of employers won’t pay additional taxes, there is an increase to the current Medicare part A tax, paid by 3{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119} of businesses and employees making over $200,000. There is also a requirement for employers with the equivalent of over 50 full-time equivalent employees to purchase health insurance for their workers or pay a penalty by 2015 / 2016. The Affordable Care Act offers incentives, such as tax breaks and tax credits via the SHOP Exchange, to small businesses with the equivalent of less than 25 full-time workers to help them provide health benefits to employees. 90{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119} of US firms have less than 20 full-time employees.” (ObamaCare) In this case, all health insurance plans are expected to, starting from 2014, guarantee not only the availability but also the renewal of the insurance cover regardless of health status. Young adults in this case may remain on their parents plan until they are 26 years old. The second regulation is about costs. The premium rating, whose basis is the health status, will as from 2014, be prohibited for new plans. Premiums allowed for new plans will only be different in relation to geographic location, policy type (family or individual), tobacco use and age.  Up to a thirty percent discount may be offered by the health plans as a way of rewarding those who take part in wellness programs. The third regulation that businesses have to comply with concerns the coverage.  The other regulation concerns the value. In this case, all plans will be expected to report the percentage of their income or proceeds from premiums that are used on quality improvement and medical care. In case this amount, also called Medical Loss Ratio is less than eighty percent, individuals enrolled in the plan as well as small businesses in the plan will get a rebate (Jones, 2013).

What strategies were used to insure the standards of ethical research?

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Essay: (max. 2500 words, plus tables and figures) Students choose TWO extended case studies and will write an essay comparing and critically evaluating their ethical challenges and the strategies used to minimize or guard against harmful results. The essay must address the following issues:

  1. What ethical principles are at issue in each case? Provide and justify specific examples.
  2. What strategies were used to insure the standards of ethical research?
  3. Were those strategies successful? How and why?
  4. What alternate strategies might also have been used to achieve the same or better results?
  5. Which case study represents a better implementation of research ethics? How and why?

The two studies should have something in common: A similar topic, the method, the same ethical principles or conflict. They should also differ in the way that they addressed the ethical issues in question. Be sure to make both the similarities and differences clear to the reader. Your essay will consist of a careful, point-by-point contrast of the two cases. It should link the cases to commonly held standards of research ethics and discuss the extent to which those were followed. You should discuss the ethical, practical, and political consequences of these cases for the researchers, participants, and the social groups represented therein. And you should connect these cases to other examples of social research and implementation we have discussed.

Here is a list of the extended case studies for you to choose your two studies from. You should get the complete article for each study (go to library or use PsychInfo) so you will have detailed and complete information to address each of the five issues listed above.

NOTE: Milgram’s notorious Obedience to Authority experiments are hereby officially banned from this assignment because they have been used so extensively throughout this and many other discussions on this topic. Part of this assignment is to show understanding of the principles in this course well enough to apply them to new research studies.

The Tea-Room Trade (Humphreys 1975)

Humphreys took a participant-observer role as “watch queen” in order to study anonymous male homosexual activities in St. Louis’s Forest Park public restrooms. He followed the “Johns” to their cars and recorded their license numbers. Humphreys then posed as a market researcher to obtain their addresses from police registers.

About a year later, he disguised himself and gained entry to their homes by pretending to do a health survey – including questions about sexual activity. Participants were never informed of their participation in a study or given the opportunity to withdraw.

Tuskegee Syphilis Studies (various authors, 1930s – 1970s)

In 1932, the US Public Health Service began a longitudinal study that came to be called the “Tuskegee Study of Untreated Syphilis in the Negro Male.” Black men in Macon County, Alabama were recruited by circulating word in the community that they could receive free tests for “bad blood” at the teaching hospital of the Tuskegee Institute.

616 men (412 diagnosed with syphilis and 204 disease-free controls) eventually participated. At the start of the study, syphilis was poorly understood and untreatable, but penicillin became widely available as an effective cure for the disease in 1943. Nevertheless, participants were not informed of their disease, not treated, and actively encouraged n o t to go elsewhere once viable treatments were known.

The medical community was aware of the study through numerous scholarly publications, but no one formally objected to the study until 1965. The PHS convened an ethical review panel in 1969 that found no ethical violations and recommended the study continue. It was not halted until 1972, when an Associated Press expose appeared, causing widespread public furor.

The Bell Curve (Herrnstein and Murray, 1994)

The authors argue that cognitive ability is largely inherited, and that there are meaningful differences in intelligence between culturally recognized racial and ethnic groups. They assert that cognitive ability is now the strongest force stratifying educational and occupational access and performance, as well as mating decisions.

In blunt terms, smarter people tend to get more and better education, get better jobs and more promotions, and marry other smarter people – thus transferring greater cognitive stratification into the next generation – and those smarter people tend to overwhelmingly be white or Asian. In their minds, this explains continuing racial differences in life chances, particularly between white and black Americans.

As a consequence they argue that social, educational, and other ameliorative programs cannot overcome these advantages and are effectively a waste of public funding and effort. Their findings are almost universally discredited by other researchers due to methodological flaws, and yet their book significantly contributed to the public perception that “race” is a real biological category and that those “races” are irrevocably unequal.

Regqrdless of one’s political views, is there anything inherently unethical about Herrnstein and Murray’s research?

‘Zimbardo Prison Experiment’ (Zimbardo 1972, 1973; Zimbardo, et. al. 1973, 1974)

Male students, testing psychologically “normal,” were divided randomly into “prisoners” and “guards.” Prisoners were given plain uniforms, numbers, and had all personal effects removed. Guards were given military-style uniforms, nightsticks, and mirrored sunglasses. Prisoners were incarcerated in cells and had to maintain their roles around the clock. Guards were given eight-hour shifts and told simply to maintain a “reasonable degree of order” without inflicting physical harm.

The prisoners soon began antagonizing the guards and the guards rapidly resorted to mental and physical abuse to maintain order among the prisoners. Though the experiment was scheduled for two weeks, conditions became so dangerous that it was called on the sixth day.

Middletown studies (Lynd and Lynd 1929, 1937; Vidich and Bensman 1968; Vidich 1999; and others)

Though the Lynds promised confidentiality and followed the standard convention of changing names and locations, it soon became common knowledge that “Middletown” was Muncie, IN. Once that was known, it was also easy to recognize individuals in what was then a community of only twenty thousand. Of course, many of those portrayals were unflattering and related private information, causing some participants to feel as if they had been betrayed.

Project Camelot (Horowitz 1965)

Study sponsored by the CIA, ostensibly to test W. I. Thomas’ idea of the “self-fulfilling prophecy”. A research team from several prestigious American universities was assembled that gained access to several remote South American villages, but failed to disclose their funding source or true purpose.