WorldWideScience

Sample records for health plan population

  1. Public Health Planning for Vulnerable Populations and Pandemic Influenza

    National Research Council Canada - National Science Library

    Cameron, Wendy K

    2008-01-01

    This thesis addresses planning for vulnerable populations, those segments of each community that are normally independent but that may require special assistance during a health emergency such as an influenza pandemic...

  2. Real estate planning for population health.

    Science.gov (United States)

    McHugh, Margie

    2014-11-01

    Factors that health systems should consider when performing strategic assessments of their portfolios of ambulatory facilities include: Inventory. Location Facility condition. Service mix. Space use and capacity. Occupancy metrics. Strategic and economic opportunities.

  3. Strategic Planning in Population Health and Public Health Practice: A Call to Action for Higher Education

    Science.gov (United States)

    PHELPS, CHARLES; RAPPUOLI, RINO; LEVIN, SCOTT; SHORTLIFFE, EDWARD; COLWELL, RITA

    2016-01-01

    Policy Points: Scarce resources, especially in population health and public health practice, underlie the importance of strategic planning.Public health agencies’ current planning and priority setting efforts are often narrow, at times opaque, and focused on single metrics such as cost‐effectiveness.As demonstrated by SMART Vaccines, a decision support software system developed by the Institute of Medicine and the National Academy of Engineering, new approaches to strategic planning allow the formal incorporation of multiple stakeholder views and multicriteria decision making that surpass even those sophisticated cost‐effectiveness analyses widely recommended and used for public health planning.Institutions of higher education can and should respond by building on modern strategic planning tools as they teach their students how to improve population health and public health practice. Context Strategic planning in population health and public health practice often uses single indicators of success or, when using multiple indicators, provides no mechanism for coherently combining the assessments. Cost‐effectiveness analysis, the most complex strategic planning tool commonly applied in public health, uses only a single metric to evaluate programmatic choices, even though other factors often influence actual decisions. Methods Our work employed a multicriteria systems analysis approach—specifically, multiattribute utility theory—to assist in strategic planning and priority setting in a particular area of health care (vaccines), thereby moving beyond the traditional cost‐effectiveness analysis approach. Findings (1) Multicriteria systems analysis provides more flexibility, transparency, and clarity in decision support for public health issues compared with cost‐effectiveness analysis. (2) More sophisticated systems‐level analyses will become increasingly important to public health as disease burdens increase and the resources to deal with them become

  4. Strategic Planning in Population Health and Public Health Practice: A Call to Action for Higher Education.

    Science.gov (United States)

    Phelps, Charles; Madhavan, Guruprasad; Rappuoli, Rino; Levin, Scott; Shortliffe, Edward; Colwell, Rita

    2016-03-01

    Scarce resources, especially in population health and public health practice, underlie the importance of strategic planning. Public health agencies' current planning and priority setting efforts are often narrow, at times opaque, and focused on single metrics such as cost-effectiveness. As demonstrated by SMART Vaccines, a decision support software system developed by the Institute of Medicine and the National Academy of Engineering, new approaches to strategic planning allow the formal incorporation of multiple stakeholder views and multicriteria decision making that surpass even those sophisticated cost-effectiveness analyses widely recommended and used for public health planning. Institutions of higher education can and should respond by building on modern strategic planning tools as they teach their students how to improve population health and public health practice. Strategic planning in population health and public health practice often uses single indicators of success or, when using multiple indicators, provides no mechanism for coherently combining the assessments. Cost-effectiveness analysis, the most complex strategic planning tool commonly applied in public health, uses only a single metric to evaluate programmatic choices, even though other factors often influence actual decisions. Our work employed a multicriteria systems analysis approach--specifically, multiattribute utility theory--to assist in strategic planning and priority setting in a particular area of health care (vaccines), thereby moving beyond the traditional cost-effectiveness analysis approach. (1) Multicriteria systems analysis provides more flexibility, transparency, and clarity in decision support for public health issues compared with cost-effectiveness analysis. (2) More sophisticated systems-level analyses will become increasingly important to public health as disease burdens increase and the resources to deal with them become scarcer. The teaching of strategic planning in public

  5. City planning and population health: a global challenge.

    Science.gov (United States)

    Giles-Corti, Billie; Vernez-Moudon, Anne; Reis, Rodrigo; Turrell, Gavin; Dannenberg, Andrew L; Badland, Hannah; Foster, Sarah; Lowe, Melanie; Sallis, James F; Stevenson, Mark; Owen, Neville

    2016-12-10

    Significant global health challenges are being confronted in the 21st century, prompting calls to rethink approaches to disease prevention. A key part of the solution is city planning that reduces non-communicable diseases and road trauma while also managing rapid urbanisation. This Series of papers considers the health impacts of city planning through transport mode choices. In this, the first paper, we identify eight integrated regional and local interventions that, when combined, encourage walking, cycling, and public transport use, while reducing private motor vehicle use. These interventions are destination accessibility, equitable distribution of employment across cities, managing demand by reducing the availability and increasing the cost of parking, designing pedestrian-friendly and cycling-friendly movement networks, achieving optimum levels of residential density, reducing distance to public transport, and enhancing the desirability of active travel modes (eg, creating safe attractive neighbourhoods and safe, affordable, and convenient public transport). Together, these interventions will create healthier and more sustainable compact cities that reduce the environmental, social, and behavioural risk factors that affect lifestyle choices, levels of traffic, environmental pollution, noise, and crime. The health sector, including health ministers, must lead in advocating for integrated multisector city planning that prioritises health, sustainability, and liveability outcomes, particularly in rapidly changing low-income and middle-income countries. We recommend establishing a set of indicators to benchmark and monitor progress towards achievement of more compact cities that promote health and reduce health inequities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Vulnerable Populations in Hospital and Health Care Emergency Preparedness Planning: A Comprehensive Framework for Inclusion.

    Science.gov (United States)

    Kreisberg, Debra; Thomas, Deborah S K; Valley, Morgan; Newell, Shannon; Janes, Enessa; Little, Charles

    2016-04-01

    As attention to emergency preparedness becomes a critical element of health care facility operations planning, efforts to recognize and integrate the needs of vulnerable populations in a comprehensive manner have lagged. This not only results in decreased levels of equitable service, but also affects the functioning of the health care system in disasters. While this report emphasizes the United States context, the concepts and approaches apply beyond this setting. This report: (1) describes a conceptual framework that provides a model for the inclusion of vulnerable populations into integrated health care and public health preparedness; and (2) applies this model to a pilot study. The framework is derived from literature, hospital regulatory policy, and health care standards, laying out the communication and relational interfaces that must occur at the systems, organizational, and community levels for a successful multi-level health care systems response that is inclusive of diverse populations explicitly. The pilot study illustrates the application of key elements of the framework, using a four-pronged approach that incorporates both quantitative and qualitative methods for deriving information that can inform hospital and health facility preparedness planning. The conceptual framework and model, applied to a pilot project, guide expanded work that ultimately can result in methodologically robust approaches to comprehensively incorporating vulnerable populations into the fabric of hospital disaster preparedness at levels from local to national, thus supporting best practices for a community resilience approach to disaster preparedness.

  7. Population-based health promotion perspective for older driver safety: Conceptual framework to intervention plan

    Directory of Open Access Journals (Sweden)

    Sherrilene Classen

    2008-01-01

    Full Text Available Sherrilene Classen1,2, Ellen DS Lopez3, Sandra Winter2, Kezia D Awadzi4, Nita Ferree5, Cynthia W Garvan61Department of Occupational Therapy, College of Public Health and Health Professions (CPHHP, University of Florida (UF, Gainesville, FL, USA; 2PhD Program in Rehabilitation Science, CPHHP, UF Gainesville, FL, USA; 3Department of Behavioral Science and Community Health, CPHHP, UF, Gainesville, FL, USA; 4Department of Health Services Research, Management, and Policy, CPHHP, UF, Gainesville, FL, USA; 5Health Science Center Libraries, UF, Gainesville, FL, USA; 6Division of Biostatistics, College of Medicine, UF, Gainesville, FL, USAAbstract: The topic of motor vehicle crashes among the elderly is dynamic and multi-faceted requiring a comprehensive and synergistic approach to intervention planning. This approach must be based on the values of a given population as well as health statistics and asserted through community, organizational and policy strategies. An integrated summary of the predictors (quantitative research, and views (qualitative research of the older drivers and their stakeholders, does not currently exist. This study provided an explicit socio-ecological view explaining the interrelation of possible causative factors, an integrated summary of these causative factors, and empirical guidelines for developing public health interventions to promote older driver safety. Using a mixed methods approach, we were able to compare and integrate main findings from a national crash dataset with perspectives of stakeholders. We identified: 11 multi-causal factors for safe elderly driving; the importance of the environmental factors - previously underrated in the literature- interacting with behavioral and health factors; and the interrelatedness among many socio-ecological factors. For the first time, to our knowledge, we conceptualized the fundamental elements of a multi-causal health promotion plan, with measurable intermediate and long

  8. Institutional facilitators and barriers to local public health preparedness planning for vulnerable and at-risk populations.

    Science.gov (United States)

    Bevc, Christine A; Simon, Matthew C; Montoya, Tanya A; Horney, Jennifer A

    2014-01-01

    Numerous institutional facilitators and barriers to preparedness planning exist at the local level for vulnerable and at-risk populations. Findings of this evaluation study contribute to ongoing practice-based efforts to improve response services and address public health preparedness planning and training as they relate to vulnerable and at-risk populations. From January 2012 through June 2013, we conducted a multilevel, mixed-methods evaluation study of the North Carolina Preparedness and Emergency Response Research Center's Vulnerable & At-Risk Populations Resource Guide, an online tool to aid local health departments' (LHDs') preparedness planning efforts. We examined planning practices across multiple local, regional, and state jurisdictions utilizing user data, follow-up surveys, and secondary data. To identify potential incongruities in planning, we compared respondents' reported populations of interest with corresponding census data to determine whether or not there were differences in planning priorities. We used data collected from evaluation surveys to identify key institutional facilitators and barriers associated with planning for at-risk populations, including challenges to conducting assessments and lack of resources. Results identified both barriers within institutional culture and disconnects between planning priorities and evidence-based identification of vulnerable and at-risk populations, including variation in the planning process, partnerships, and perceptions. Our results highlight the important role of LHDs in preparedness planning and the potential implications associated with organizational and bureaucratic impediments to planning implementation. A more in-depth understanding of the relationships among public institutions and the levels of preparedness that contribute to the conditions and processes that generate vulnerability is needed.

  9. Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?

    Directory of Open Access Journals (Sweden)

    Andrew J Barnes

    Full Text Available The Affordable Care Act's marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool--plan recommendations--in improving marketplace decisions.Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia.We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. For participants randomized to a plan recommendation condition, the plan that maximized expected earnings, and minimized total expected annual health care costs, was recommended.Primary data were gathered using an online choice experiment and questionnaire.Plan recommendations resulted in a 21 percentage point increase in the probability of choosing the earnings maximizing plan, after controlling for participant characteristics. Two conditions, government or providers recommending the lowest cost plan, resulted in plan choices that lowered annual costs compared to marketplaces where no recommendations were made.As millions of adults grapple with choosing plans in marketplaces and whether to switch plans during open enrollment, it is time to consider marketplace redesigns and leverage insights from the behavioral sciences to facilitate consumers' decisions.

  10. Understanding health insurance plans

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000879.htm Understanding health insurance plans To use the sharing features on this ... plan for you and your family. Types of Health Insurance Plans Depending on how you get your health ...

  11. Effectiveness of the population health and environment approach in improving family planning outcomes in the Gurage, Zone South Ethiopia.

    Science.gov (United States)

    Sinaga, Makeda; Mohammed, Ahmed; Teklu, Negash; Stelljes, Kristen; Belachew, Tefera

    2015-11-13

    Family planning is a strategy of balancing population growth with economic development for sustainable use of natural resources. A high population growth induces increased demand for resources and the rate at which these resources are exploited. Population, health and environment are connected inextricably. Population growth unbalanced with economic development leads to food insecurity which exposes households to the consumption of food with reduced quality and quantity leading to increased risk of malnutrition and poor health. Food insecurity again obliges people to encroach into the natural environment leading to a spiraling progress to destitution. A study in the Philippines provided concrete evidence that integrated development programming incorporating population, health, and the environment (PHE) can be more effective in lowering population growth rates and preserving critical coastal ecosystems than single-sector development interventions". Although the PHE approach has been implemented for 5 years (2008-2012) Guraghe Zone of South Ethiopia, its outcomes have not been evaluated. The objective of this study was to evaluate the effectiveness of PHE approach for achieving family planning (FP) outcomes in Gurage Zone. A comparative cross-sectional study was conducted in October, 2012. A total of 962 married women in the reproductive age group were included in the study. Data were collected using an interviewer administered Amharic version questionnaire. Descriptive statistics and multivariable logistic regression analyses were performed to compare the PHE and non-PHE Woredas (district) based on family planning parameters adopted from Measure Evaluation Manual. Comparison of non-new family panning acceptor women showed that PHE Woreda had a significantly high CPR compared to non-PHE (78% vs 52%, P over four times more likely to use family planning methods during the study period (P environmental issues into the grassroots level interventions in the PHE Woreda

  12. Variation in vitamin D supplementation among adults in a multi-race/ethnic health plan population, 2008.

    Science.gov (United States)

    Gordon, Nancy P; Caan, Bette J; Asgari, Maryam M

    2012-12-11

    Vitamin D may have a role in many chronic conditions in addition to bone health. Nutritional surveys among Americans have reported high levels of vitamin D insufficiency, especially among Blacks and Latinos. Our study examined variation in vitamin D supplementation practices in an adult health plan population by age, gender, and race-ethnicity. Self-report data from a 2008 general health survey in a large Northern California health plan were used to characterize number and types of sources of vitamin D supplementation (multivitamin, calcium with D, singular D) among women and men aged 25-85, overall, by race-ethnicity, and for obese, diabetic, and hypertensive subgroups. In this population, 40% of women and 54% of men ≤ 50, and 24% of women and 53% of men aged 51-85 get no vitamin D from dietary supplements. Higher vitamin D supplementation among women > 50 is associated with higher reported intake of calcium with D. Black and Latina women aged 25-85 and Filipinas in the ≤ 50 age group were significantly less likely than non-Hispanic Whites to get vitamin D from supplements, whereas vitamin D supplementation practices among Chinese women did not significantly differ from non-Hispanic Whites. Among men, Latinos aged 25-85 and Black and Chinese ≤ 50 were significantly less likely than non-Hispanic Whites to get vitamin D from supplements. Similar race-ethnic differences in vitamin D supplementation patterns were observed for people in the obese, diabetic, and hypertensive groups. Our survey results suggest that in 2008, a large percentage of women and an even larger percentage of men in a large Northern California health plan get no vitamin D from dietary supplements, and that Blacks and Latinos and obese adults, who are at higher risk of vitamin D deficiency, are also the least likely to get any vitamin D from dietary supplements.

  13. Variation in vitamin D supplementation among adults in a multi-race/ethnic health plan population, 2008

    Directory of Open Access Journals (Sweden)

    Gordon Nancy P

    2012-12-01

    Full Text Available Abstract Background Vitamin D may have a role in many chronic conditions in addition to bone health. Nutritional surveys among Americans have reported high levels of vitamin D insufficiency, especially among Blacks and Latinos. Our study examined variation in vitamin D supplementation practices in an adult health plan population by age, gender, and race-ethnicity. Methods Self-report data from a 2008 general health survey in a large Northern California health plan were used to characterize number and types of sources of vitamin D supplementation (multivitamin, calcium with D, singular D among women and men aged 25-85, overall, by race-ethnicity, and for obese, diabetic, and hypertensive subgroups. Results In this population, 40% of women and 54% of men ≤ 50, and 24% of women and 53% of men aged 51-85 get no vitamin D from dietary supplements. Higher vitamin D supplementation among women > 50 is associated with higher reported intake of calcium with D. Black and Latina women aged 25-85 and Filipinas in the ≤ 50 age group were significantly less likely than non-Hispanic Whites to get vitamin D from supplements, whereas vitamin D supplementation practices among Chinese women did not significantly differ from non-Hispanic Whites. Among men, Latinos aged 25-85 and Black and Chinese ≤ 50 were significantly less likely than non-Hispanic Whites to get vitamin D from supplements. Similar race-ethnic differences in vitamin D supplementation patterns were observed for people in the obese, diabetic, and hypertensive groups. Conclusions Our survey results suggest that in 2008, a large percentage of women and an even larger percentage of men in a large Northern California health plan get no vitamin D from dietary supplements, and that Blacks and Latinos and obese adults, who are at higher risk of vitamin D deficiency, are also the least likely to get any vitamin D from dietary supplements.

  14. Family planning and health.

    Science.gov (United States)

    1994-01-01

    Family planning and its association with women's health and the health of families, communities, and societies will be a central theme of the International Conference on Population and Development in Cairo, Egypt, in September 1994. The conference will provide an opportunity to determine new directions for the development of family planning programs. Making family planning programs woman-friendly is to insure that they: are based on the principle of voluntary informed choice; are available to all; offer confidentiality in counseling and services; provide a broad choice of traditional and modern methods; make the user's safety a prime concern; encourage male involvement; are supportive of women with unwanted pregnancies; and provide protection from, as well as management of, sexually transmitted diseases. The need to encourage male involvement and sharing in responsibilities is essential. Although the bulk of contraceptive methods are for use by women, many require the active cooperation of men. With the spread of sexually transmitted diseases and HIV/AIDS, barrier methods and cooperation between sex partners will gain importance. The responsibilities of men as partners, fathers, and family members should be emphasized in all family planning programs. Policy makers must insure that family planning programs offer high quality counseling, the prevention of unsafe abortion, and the management of genital infections, sexually transmitted diseases, infertility and diseases of the reproductive tract.

  15. Population-Level Exposure to Particulate Air Pollution during Active Travel: Planning for Low-Exposure, Health-Promoting Cities

    Science.gov (United States)

    Hankey, Steve; Lindsey, Greg; Marshall, Julian D.

    2016-01-01

    mostly unchanged with land use. Conclusions: Public health officials and urban planners may use our findings to promote healthy transportation choices. When designing health-promoting cities, benefits (physical activity) as well as hazards (air pollution) should be evaluated. Citation: Hankey S, Lindsey G, Marshall JD. 2017. Population-level exposure to particulate air pollution during active travel: planning for low-exposure, health-promoting cities. Environ Health Perspect 125:–534; http://dx.doi.org/10.1289/EHP442 PMID:27713109

  16. Health and family planning.

    Science.gov (United States)

    1984-01-01

    The high rates of infant, child, and maternal mortality and morbidity observed in many developing countries could be decreased through the provision of adequate family planning services. Poor women in developing countries, compared to women in industrialized nations, have poor health statuses and little or no access to health care. In addition, they endure frequent pregnancies throughout their reproductive life spans. Closely spaced births do not give these women's bodies an opportunity to recuperate from the strains of pregnancy, and these drained women are further burdened with the task of caring for large families. Many women in developing countries subject themseleves to the riskse associated with illegal abortion in order to avoid another unwanted pregnancy. Maternal mortality rates in come countries are as high as 1000/100,000 live births, 2/3 of all pregnant women in developing countries (excluding China) suffer from nutritional anemia, and 200,000 women die each year from illegal abortions. Closely spaced births and childbearing during the late and early phases of the reproductive life span enhance, not only the risk of maternal mortality and morbidity, but the risk of infant and child mortality and morbidity. Children born after a birth interval of 1 year or less are 2 times more likely to die than children born after a birth interval of 2 or more years. Compared to infants born to women aged 20-35 years, infants born to women under 20 years of age have a higher risk of premature birth, and those born to women over 35 years of age have a greater risk of death and of birth defects. The provision of family planning services would also help couples overcome infertility problems and provide women with an opportunity to pursue educational and employment goals. The decline in breastfeeding in developing countries increases the need to provide family planning services. Breastfeeding delays the return of fertility following delivery. As breastfeeding declines

  17. City health development planning.

    Science.gov (United States)

    Green, Geoff; Acres, John; Price, Charles; Tsouros, Agis

    2009-11-01

    The objective of this evaluation was to review the evolution and process of city health development planning (CHDP) in municipalities participating in the Healthy Cities Network organized by the European Region of the World Health Organization. The concept of CHDP combines elements from three theoretical domains: (a) health development, (b) city governance and (c) urban planning. The setting was the 56 cities which participated in Phase III (1998-2002) of the Network. Evidence was gathered from documents either held in WHO archives or made available from Network cities and from interviews with city representatives. CHDPs were the centrepiece of Phase III, evolving from city health plans developed in Phase II. They are strategic documents giving direction to municipalities and partner agencies. Analysis revealed three types of CHDP, reflecting the realpolitik of each city. For many cities, the process of CHDP was as important as the plan itself.

  18. A model for similar organizations. The Turkish Family Health Planning Foundation (TFHPF) is the recipient of the 1994 U.N. Population Award. [Acceptance speech].

    Science.gov (United States)

    Koc, V

    1994-09-01

    The Turkish Family Health and Planning Foundation (TFHPF) received the 1994 United Nations Population Award. Turkey has excessive population growth and an unbalanced population distribution. TFHPF was established in 1985 in order to provide innovative solutions to the economic and social problems caused by fast population growth through the involvement of the private sector. TFHPF was founded by the businessman Mr. Vehbi Koc. The 1988 information, education, and communication campaign was carried out in collaboration with the Johns Hopkins University Population Communication Services. It included the designing and production of experimental radio and television dramas, comedy spots, and serials. Following the campaign, surveys identified about 350,000 new users of modern contraceptive methods, particularly the intrauterine device. TFHPF, in collaboration with The Futures Group, has also established a contraceptive social marketing program that has promoted and sold both oral contraceptives and condoms. TFHPF, in cooperation with major pharmaceutical companies, was the first to air advertisements for condoms and oral contraceptives on Turkey's public television. The social marketing program boosted the use of oral contraceptives from 8% to 12%. The market share of low-dose pills increased from 50% in 1991 to 61% in 1992, while the total commercial market for pills increased by 18%. This represents an increase of more than 50,000 women using this method in less than one year. Family planning services were provided in the health clinics of 14 factories located in provinces in 1987. By integrating family planning services into the health units of six factories in Eskisehir and Izmit provinces, more than 12,000 workers were provided with family planning information, education, and services. The primary task is to provide children with improved health and nutrition, basic education for both children and mothers, equal rights for women, and improved maternal health and

  19. Health Manpower Planning in Turkish Development Plans

    Directory of Open Access Journals (Sweden)

    Fatih ŞANTAŞ

    2012-12-01

    Full Text Available Health manpower planning is process that includes macro and micro planning, manpower supply and requirement, manpower distribution, personnel standards, job description, job requirements and establishing control structures related all these. Since being established the State Planning Organization has been applied nine five-year development plan. Plans in the 1960s can be said to outweigh direction of statism, in 1960-1980 mixed economy and in 1980-2000 liberal. In this study since 1963 applied objectives of the planning of health manpower in the nine development planning is evaluated.

  20. A population health surveillance theory.

    Science.gov (United States)

    El Allaki, Farouk; Bigras-Poulin, Michel; Michel, Pascal; Ravel, André

    2012-01-01

    Despite its extensive use, the term "Surveillance" often takes on various meanings in the scientific literature pertinent to public health and animal health. A critical appraisal of this literature also reveals ambiguities relating to the scope and necessary structural components underpinning the surveillance process. The authors hypothesized that these inconsistencies translate to real or perceived deficiencies in the conceptual framework of population health surveillance. This paper presents a population health surveillance theory framed upon an explicit conceptual system relative to health surveillance performed in human and animal populations. The population health surveillance theory reflects the authors' system of thinking and was based on a creative process. POPULATION HEALTH SURVEILLANCE INCLUDES TWO BROAD COMPONENTS: one relating to the human organization (which includes expertise and the administrative program), and one relating to the system per se (which includes elements of design and method) and which can be viewed as a process. The population health surveillance process is made of five sequential interrelated steps: 1) a trigger or need, 2) problem formulation, 3) surveillance planning, 4) surveillance implementation, and 5) information communication and audit. The population health surveillance theory provides a systematic way of understanding, organizing and evaluating the population health surveillance process.

  1. Multistate Health Plans

    Directory of Open Access Journals (Sweden)

    Robert E. Moffit PhD

    2015-09-01

    Full Text Available We discuss and evaluate the Multi-State Plan (MSP Program, a provision of the Affordable Care Act that has not been the subject of much debate as yet. The MSP Program provides the Office of Personnel Management with new authority to negotiate and implement multistate insurance plans on all health insurance exchanges within the United States. We raise the concern that the MSP Program may lead to further consolidation of the health insurance industry despite the program’s stated goal of increasing competition by means of health insurance exchanges. The MSP Program arguably gives a competitive advantage to large insurers, which already dominate health insurance markets. We also contend that the MSP Program’s failure to produce increased competition may motivate a new effort for a public health insurance option.

  2. Socioeconomic disadvantage and its implications for population health planning of obesity and overweight, using cross-sectional data from general practices from a regional catchment in Australia

    OpenAIRE

    Ghosh, Abhijeet; Charlton, Karen E; Batterham, Marijka J

    2016-01-01

    Objectives To identify smaller geographic and region-specific evidence to inform population health planning for overweight and obesity. Design Cross-sectional secondary analysis of data. Setting Primary healthcare?17 general practices located in the Illawarra-Shoalhaven region of New South Wales (NSW). Participants A subset (n=36?674) of the Sentinel Practices Data Sourcing project adult persons data set (n=118?794) that included information on disease status of all adult patients who had hei...

  3. Family Planning and the Samburu: A Qualitative Study Exploring the Thoughts of Men on a Population Health and Environment Programme in Rural Kenya.

    Science.gov (United States)

    Kock, Loren; Prost, Audrey

    2017-05-13

    Population Health and Environment (PHE) strategies are argued to improve ecosystem and human health by addressing family size and its effects on natural resource use, food security, and reproductive health. This study investigates men's views on a PHE family planning (FP) programme delivered among the pastoral Samburu tribe in rural northern Kenya. Three focus group discussions and nine semi-structured interviews were conducted with 27 Samburu men. These discussions revealed support for environmentally-sensitised family planning promotion. Men highlighted their dependency on natural resources and challenges faced in providing for large families and maintaining livestock during drought. These practices were said to lead to natural resource exhaustion, environmental degradation, and wildlife dispersal, undermining key economic benefits of environmental and wildlife conservation. Relating family size to the environment is a compelling strategy to improve support for FP among Samburu men. Kenyan policy-makers should consider integrating community-based PHE strategies among underserved pastoral groups living in fragile ecosystems.

  4. Urban planning and health equity.

    Science.gov (United States)

    Northridge, Mary Evelyn; Freeman, Lance

    2011-06-01

    Although the fields of urban planning and public health share a common origin in the efforts of reformers to tame the ravages of early industrialization in the 19th century, the 2 disciplines parted ways in the early 20th century as planners increasingly focused on the built environment while public health professionals narrowed in on biomedical causes of disease and disability. Among the unfortunate results of this divergence was a tendency to discount the public health implications of planning decisions. Given increasingly complex urban environments and grave health disparities in cities worldwide, urban planners and public health professionals have once again become convinced of the need for inclusive approaches to improve population health and achieve health equity. To make substantive progress, intersectoral collaboration utilizing ecological and systems science perspectives will be crucial as the solutions lie well beyond the control of any single authority. Grounded in the social determinants of health, and with a renewed sense of interconnectedness, dedicated and talented people in government agencies and communities who recognize that our future depends on cultivating local change and evaluating the results can come to grips with the enormous challenge that lies ahead to create more equitable, sustainable, and healthier cities worldwide.

  5. Role of students’ youth in strategic planning of external communications of population physical health “Sports for all” centers

    OpenAIRE

    Kravchenko O.V.

    2016-01-01

    Purpose: to work out strategy of external communications system’s improvement of population physical health and determine students’ role in optimization of this system. Material: we questioned 136 centers’ functionaries and 338 representatives of groups of influence. SWOT-analysis was used. With the help of SWOT-analysis method we simulated 16 the most probable situations and strategic actions in case of their occurrence. For determination of experts’ opinions concordance, we used concordance...

  6. Population-Level Exposure to Particulate Air Pollution during Active Travel: Planning for Low-Exposure, Health-Promoting Cities.

    Science.gov (United States)

    Hankey, Steve; Lindsey, Greg; Marshall, Julian D

    2017-04-01

    Providing infrastructure and land uses to encourage active travel (i.e., bicycling and walking) are promising strategies for designing health-promoting cities. Population-level exposure to air pollution during active travel is understudied. Our goals were a ) to investigate population-level patterns in exposure during active travel, based on spatial estimates of bicycle traffic, pedestrian traffic, and particulate concentrations; and b ) to assess how those exposure patterns are associated with the built environment. We employed facility-demand models (active travel) and land use regression models (particulate concentrations) to estimate block-level ( n = 13,604) exposure during rush-hour (1600-1800 hours) in Minneapolis, Minnesota. We used the model-derived estimates to identify land use patterns and characteristics of the street network that are health promoting. We also assessed how exposure is correlated with indicators of health disparities (e.g., household income, proportion of nonwhite residents). Our work uses population-level rates of active travel (i.e., traffic flows) rather than the probability of walking or biking (i.e., "walkability" or "bikeability") to assess exposure. Active travel often occurs on high-traffic streets or near activity centers where particulate concentrations are highest (i.e., 20-42% of active travel occurs on blocks with high population-level exposure). Only 2-3% of blocks (3-8% of total active travel) are "sweet spots" (i.e., high active travel, low particulate concentrations); sweet spots are located a ) near but slightly removed from the city-center or b ) on off-street trails. We identified 1,721 blocks (~ 20% of local roads) where shifting active travel from high-traffic roads to adjacent low-traffic roads would reduce exposure by ~ 15%. Active travel is correlated with population density, land use mix, open space, and retail area; particulate concentrations were mostly unchanged with land use. Public health officials and

  7. Qualified Health Plan (QHP) Landscape

    Data.gov (United States)

    U.S. Department of Health & Human Services — QHP Landscape Files present basic information about certified Qualified Health Plans and Stand-alone Dental Plans for individuals-families and small businesses...

  8. Scoping of models to support population-based regional health planning and management: comparison with the regional operating model in Victoria, Australia.

    Science.gov (United States)

    Levesque, Jean-Frederic; O'Dowd, John J M; Ní Shé, Éidín M; Weenink, Jan-Willem; Gunn, Jane

    2017-05-01

    Objective The aim of the present study was to try to understand the breadth and comprehensiveness of a regional operating model (ROM) developed within the Victorian Department of Health's North West Metropolitan Region office in Melbourne, Australia. Methods A published literature search was conducted, with additional website scanning, snowballing technique and expert consultation, to identify existing operating models. An analytical grid was developed covering 16 components to evaluate the models and assess the exhaustiveness of the ROM. Results From the 34 documents scoped, 10 models were identified to act as a direct comparator to the ROM. These concerned models from Australia (n=5) and other comparable countries (Canada, UK). The ROM was among the most exhaustive models, covering 13 of 16 components. It was one of the few models that included intersectoral actions and levers of influence. However, some models identified more precisely the planning tools, prioritisation criteria and steps, and the allocation mechanisms. Conclusions The review finds that the ROM appears to provide a wide coverage of aspects of planning and integrates into a single model some of the distinctive elements of the other models scoped. What is known about the topic? Various jurisdictions are moving towards a population-based approach to manage public services with regard to the provision of individual medical and social care. Various models have been proposed to guide the planning of services from a population health perspective. What does this paper add? This paper assesses the coverage of attributes of operating models supporting a population health planning approach to the management of services at the regional or local level. It provides a scoping of current models proposed to organise activities to ensure an integrated approach to the provision of services and compares the scoped models to a model recently implemented in Victoria, Australia. What are the implications for

  9. Features of employment-based health plans.

    Science.gov (United States)

    Fronstin, P

    1998-09-01

    This Issue Brief focuses on changes to the health care financing and delivery system as implemented by employers. It discusses health plan costs, cost sharing, plan funding, health care delivery systems, services covered under various health plan types, coverage limitations, and retiree health coverage. National health expenditures are estimated at $1.035 trillion, representing 13.6 percent of Gross Domestic Product in 1996, up from $699.5 billion and 12.2 percent in 1990. Rising health care spending is also evident at the employer level: In 1996, employer spending on private health insurance totaled $262.7 billion, up from $61.0 billion in 1980. Business health spending as a percentage of total compensation increased from 3.7 percent in 1980 to a high of 6.6 percent in 1993, and declined to 5.9 percent in 1996. Employment-based health plans are the most common source of health insurance coverage among the nonelderly population in the United States, providing coverage to nearly two-thirds of those under age 65. Despite the growth of many cost-sharing provisions, individuals are paying a smaller percentage of total health care costs. In 1960, 69 percent of private health care expenditures were paid out of pocket. Between 1993 and 1996, only 37 percent of private health expenditures were paid out of pocket. One of the most significant developments of the 1980s, which has continued throughout the 1990s, is the growth of managed care plans. As recently as 1994, traditional indemnity plans were the most commonly offered type of employment-based health plan. As fewer employers offered traditional indemnity plans, participation in these plans declined and participation in managed care plans increased. In 1997, 15 percent of employees participating in a health plan were enrolled in an indemnity plan, compared with 52 percent in 1992. Since 1993, employment-based health benefit cost inflation has been virtually nonexistent. Employers have kept cost increases low by using

  10. Refining population health comparisons

    DEFF Research Database (Denmark)

    Hussain, M. Azhar; Jørgensen, Mette Møller; Østerdal, Lars Peter Raahave

    2016-01-01

    How to determine if a population group has better overall (multidimensional) health status than another is a central question in the health and social sciences. We apply a multidimensional first order dominance concept that does not rely on assumptions about the relative importance of each...... dimension. In particular, we show how one can explore the “depth” of dominance relations by gradually refining the health dimensions to see which dominance relations persist. We analyze a Danish health survey with many health indicators. These are initially collapsed into a single composite health dimension...... and then refined to four, seven, and ten health dimensions, each representing an (increasingly refined) area of health. Overall we find that younger age groups dominate older age groups in up to four dimensions, but no dominance relations are present with a more refined view of health. Comparing education groups...

  11. [Health as premise for urban planning].

    Science.gov (United States)

    Ridderström, G

    1999-12-10

    Concerns for health have been a foundation for planning in towns the cities in Norway from the 19th century up to the present. Doctors previously took active part in discussions of urban planning. Planners developed new concepts for urban design and town planning. Sun, air, low density and separation of functions were important tools to achieve a healthy city. Modern planning has led to dispersed cities requiring a great deal of transport. A more dense built-up urban area is necessary to achieve sustainable development. Higher population density and a mix of functions should be encouraged in order to reduce the need for transport. This strategy is contrary to the development of urban planning over the last 150 years. Health professionals must participate in the discussion on urban form and planning in order to avoid new health problems higher density and a mix of functions in our cities may cause.

  12. Role of students’ youth in strategic planning of external communications of population physical health “Sports for all” centers

    Directory of Open Access Journals (Sweden)

    Kravchenko O.V.

    2016-04-01

    Full Text Available Purpose: to work out strategy of external communications system’s improvement of population physical health and determine students’ role in optimization of this system. Material: we questioned 136 centers’ functionaries and 338 representatives of groups of influence. SWOT-analysis was used. With the help of SWOT-analysis method we simulated 16 the most probable situations and strategic actions in case of their occurrence. For determination of experts’ opinions concordance, we used concordance coefficient in SWOT-analysis. Results: we found strong and weak sides of external communication centers’ system, favorable opportunities and threats of this system. Strategies of centers’ behavior in the most probable situations were worked out and students’ youth role in them analyzed. It was determined that in every simulated situation participation of students-volunteers of physical culture-sports profile was very important. We also noted demand in increase of personnel’s competence level, in attraction of specialists from other organization. Conclusions: in conditions of limited resources and breadth of functioning the centers shall actively use students’ assistance in organization and realization of different measures; attract them as consumers of the centers’ services.

  13. Implementation of a Proactive Pilot Health Plan-Driven Opioid Tapering Program to Decrease Chronic Opioid Use for Conditions of the Back and Spine in a Medicaid Population.

    Science.gov (United States)

    Page, Julia; Traver, Robin; Patel, Sital; Saliba, Christopher

    2018-03-01

    In 2016, the Oregon Health Authority and the Health Evidence Review Commission implemented guidance for Oregon Medicaid members who were taking opioids for chronic pain related to conditions of the back and spine. This guidance required that an individualized taper plan be developed and initiated by January 1, 2017, and a discontinuation date for all chronic opioid therapy of January 1, 2018. This program evaluated the effect of a proactive and voluntary health plan-driven opioid tapering program on morphine equivalent daily dose (MEDD) before the implementation of governmental guidance. Two mailings were sent to the providers of the targeted members with a variety of resources to facilitate an opioid taper. Pharmacy claims were analyzed to measure member opioid use, in the form of MEDD, after the provider outreach to be compared with their MEDDs before the outreach. A total of 113 members met the study inclusion criteria for the second provider outreach. Of the 19 members' providers who submitted responses via fax to the health plan in response to this outreach, 6 indicated they would initiate taper plans. Of the 6 members with taper plans, 5 had decreases in MEDD (3.6%, 4.5%, 42.9%, 45.5%, and 46.1%) after the 3-month data collection period, while the sixth member had no change in MEDD. Of the 113 members, 16 members (14.2%) had a decrease in MEDD; 23 members (20.4%) had no change in MEDD; and 72 members (63.7%) had an increase in MEDD. This study demonstrated that when a physician agrees to enroll patients in a health-plan driven clinical program it may result in decreased opioid use as referenced by MEDD. However, the results also showed the progressive nature of opioid use in this population. While these initial taper results were promising, a larger sample size and longer follow-up duration are needed to validate long-term adherence to an opioid tapering program and confirm that these results are attributable to the program and not other factors. This study

  14. Socioeconomic disadvantage and its implications for population health planning of obesity and overweight, using cross-sectional data from general practices from a regional catchment in Australia.

    Science.gov (United States)

    Ghosh, Abhijeet; Charlton, Karen E; Batterham, Marijka J

    2016-05-03

    To identify smaller geographic and region-specific evidence to inform population health planning for overweight and obesity. Cross-sectional secondary analysis of data. Primary healthcare-17 general practices located in the Illawarra-Shoalhaven region of New South Wales (NSW). A subset (n=36 674) of the Sentinel Practices Data Sourcing project adult persons data set (n=118 794) that included information on disease status of all adult patients who had height and weight measurements recorded in their electronic health records and had visited the included general practices within the Illawarra-Shoalhaven region of NSW between September 2011 and September 2013. Age-adjusted odds ratio (aOR) of overweight and obesity was determined for high and low levels of socioeconomic disadvantage based on Socio-Economic Indexes for Areas (SEIFA)-Index of Relative Socio-Economic Disadvantage (IRSD) scores of patients' residential statistical local area. In men, overweight was lowest in areas of highest socioeconomic disadvantage (aOR=0.910; 95% CI 0.830 to 0.998; pdisadvantage (aOR=1.292; 95% CI 1.210 to 1.379; pdata analysis reveals multiple layers of evidence that should be assessed for population health approaches to curb the epidemic of obesity and overweight. It strongly highlights the need for preventive health initiatives to be specific to gender and socioeconomic attributes of the target population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Measuring the expected increase in cycling in the city of Milan and evaluating the positive effects on the population's health status: a Community-Based Urban Planning experience.

    Science.gov (United States)

    Rebecchi, A; Boati, L; Oppio, A; Buffoli, M; Capolongo, S

    2016-01-01

    It's scientifically known that inactivity is one of the major risk factors for Non-Communicable Diseases. One of the elements affecting the choice of transport mode, regarding circulation in the city, is the cities' urban morphology, i.e. the infrastructural facilities for the slow mobility service. Cyclability, in fact, can help to increase daily physical activity level, therefore becoming a protective factor for individual health. After a literature review about the state of the art regarding the correlation between built environment, active transport and quantification of the physical activity level, we have developed a specific questionnaire to collect information about current and forecast use of bicycle, in case of improvement and implementation of the cycling network. The questionnaire also investigated social and health aspects concerning the anamnesis of the interviewees (age, gender, health status, sport activity performed, etc) and users' opinions about existing infrastructure and planned interventions, designed to promote cycling mobility. Aim of the research was to quantify the increase of physical activity people would have realized in front of an improvement of the specific infrastructures, and the expected positive effects in terms of health. The collected data (343 interviewed in a district of Milan, named "Zona 7") demonstrate that through the implementation of the cycle network, there would be more cyclists to practice the 150 minutes weekly of physical activity recommended by WHO: time spent in cycling, indeed, would increases by 34.4% compared to the current level of cyclability, as detected by our survey. The investigation confirmed that urban interventions, especially those in small-scale, could play a key role in the promotion of healthy lifestyles, inducing therefore important positive effects on the population health. It was also carried out an application of the WHO "Health Economic Assessment Tool" to evaluate the benefits in terms of

  16. Show Me My Health Plans

    Directory of Open Access Journals (Sweden)

    Mary C. Politi PhD

    2016-11-01

    Full Text Available Introduction: Since the Affordable Care Act was passed, more than 12 million individuals have enrolled in the health insurance marketplace. Without support, many struggle to make an informed plan choice that meets their health and financial needs. Methods: We designed and evaluated a decision aid, Show Me My Health Plans (SMHP, that provides education, preference assessment, and an annual out-of-pocket cost calculator with plan recommendations produced by a tailored, risk-adjusted algorithm incorporating age, gender, and health status. We evaluated whether SMHP compared to HealthCare.gov improved health insurance decision quality and the match between plan choice, needs, and preferences among 328 Missourians enrolling in the marketplace. Results: Participants who used SMHP had higher health insurance knowledge (LS-Mean = 78 vs. 62; P < 0.001, decision self-efficacy (LS-Mean = 83 vs. 75; P < 0.002, confidence in their choice (LS-Mean = 3.5 vs. 2.9; P < 0.001, and improved health insurance literacy (odds ratio = 2.52, P < 0.001 compared to participants using HealthCare.gov . Those using SMHP were 10.3 times more likely to select a silver- or gold-tier plan (P < 0.0001. Discussion: SMHP can improve health insurance decision quality and the odds that consumers select an insurance plan with coverage likely needed to meet their health needs. This study represents a unique context through which to apply principles of decision support to improve health insurance choices.

  17. Health Plan Finder Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act requires that HHS establish a mechanism, including an internet website, through which a resident of, or small business in, any State may...

  18. Health Plans - Trend Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — This page contains several useful trend and competition indicators. Certain files will be updated monthly while others will be updated quarterly. The files are the...

  19. Planning for an ageing population: strategic considerations

    LENUS (Irish Health Repository)

    O'Shea, Dr Eamon

    2005-01-01

    This report presents both the proceedings of the Council’s conference, Planning for an Ageing Population: Strategic Considerations, and the Council’s discussion paper, ‘The Older Population: Information Issues and Deficits’, which was introduced at that conference.\\r\

  20. Urban planning and public health at CDC.

    Science.gov (United States)

    Kochtitzky, Chris S; Frumkin, H; Rodriguez, R; Dannenberg, A L; Rayman, J; Rose, K; Gillig, R; Kanter, T

    2006-12-22

    Urban planning, also called city and regional planning, is a multidisciplinary field in which professionals work to improve the welfare of persons and communities by creating more convenient, equitable, healthful, efficient, and attractive places now and for the future. The centerpiece of urban planning activities is a "master plan," which can take many forms, including comprehensive plans, neighborhood plans, community action plans, regulatory and incentive strategies, economic development plans, and disaster preparedness plans. Traditionally, these plans include assessing and planning for community needs in some or all of the following areas: transportation, housing, commercial/office buildings, natural resource utilization, environmental protection, and health-care infrastructure. Urban planning and public health share common missions and perspectives. Both aim to improve human well-being, emphasize needs assessment and service delivery, manage complex social systems, focus at the population level, and rely on community-based participatory methods. Both fields focus on the needs of vulnerable populations. Throughout their development, both fields have broadened their perspectives. Initially, public health most often used a biomedical model (examining normal/abnormal functioning of the human organism), and urban planning often relied on a geographic model (analysis of human needs or interactions in a spatial context). However, both fields have expanded their tools and perspectives, in part because of the influence of the other. Urban planning and public health have been intertwined for most of their histories. In 1854, British physician John Snow used geographic mapping of an outbreak of cholera in London to identify a public water pump as the outbreak's source. Geographic analysis is a key planning tool shared by urban planning and public health. In the mid-1800s, planners such as Frederick Law Olmsted bridged the gap between the fields by advancing the concept

  1. Population Health and Occupational Therapy.

    Science.gov (United States)

    Braveman, Brent

    2016-01-01

    Occupational therapy practitioners play an important role in improving the health of populations through the development of occupational therapy interventions at the population level and through advocacy to address occupational participation and the multiple determinants of health. This article defines and explores population health as a concept and describes the appropriateness of occupational therapy practice in population health. Support of population health practice as evidenced in the official documents of the American Occupational Therapy Association and the relevance of population health for occupational therapy as a profession are reviewed. Recommendations and directions for the future are included related to celebration of the achievements of occupational therapy practitioners in the area of population health, changes to the Occupational Therapy Practice Framework and educational accreditation standards, and the importance of supporting, recognizing, rewarding, and valuing occupational therapy practitioners who assume roles in which direct care is not their primary function. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  2. Who plans for health improvement? SEA, HIA and the separation of spatial planning and health planning

    Energy Technology Data Exchange (ETDEWEB)

    Bond, Alan, E-mail: alan.bond@uea.ac.uk [InteREAM (Interdisciplinary Research in Environmental Assessment and Management), School of Environmental Sciences, University of East Anglia, Norwich, NR4 7TJ (United Kingdom); Cave, Ben, E-mail: ben.cave@bcahealth.co.uk [Ben Cave Associates Ltd., Leeds (United Kingdom); Ballantyne, Rob, E-mail: robdballantyne@gmail.com [Planning and Health Consultant, Oxfordshire (United Kingdom)

    2013-09-15

    This study examines whether there is active planning for health improvement in the English spatial planning system and how this varies across two regions using a combination of telephone surveys and focus group interviews in 2005 and 2010. The spatial planning profession was found to be ill-equipped to consider the health and well-being implications of its actions, whilst health professionals are rarely engaged and have limited understanding and aspirations when it comes to influencing spatial planning. Strategic Environmental Assessment was not considered to be successful in integrating health into spatial plans, given it was the responsibility of planners lacking the capacity to do so. For their part, health professionals have insufficient knowledge and understanding of planning and how to engage with it to be able to plan for health gains rather than simply respond to health impacts. HIA practice is patchy and generally undertaken by health professionals outside the statutory planning framework. Thus, whilst appropriate assessment tools exist, they currently lack a coherent context within which they can function effectively and the implementation of the Kiev protocol requiring the engagement of health professionals in SEA is not to likely improve the consideration of health in planning while there continues to be separation of functions between professions and lack of understanding of the other profession. -- Highlights: ► Health professionals have limited aspirations for health improvement through the planning system. ► Spatial planners are ill-equipped to understand the health and well-being implications of their activities. ► SEA and HIA currently do not embed health consideration in planning decisions. ► The separation of health and planning functions is problematic for the effective conduct of SEA and/or HIA.

  3. Population and Reproductive Health in National Adaptation ...

    African Journals Online (AJOL)

    This paper reviews 44 National Adaptation Programmes of Action (NAPAs) to assess the NAPA process and identify the range of interventions included in countries' priority adaptation actions and highlight how population issues and reproductive health/family planning (RH/FP) are addressed as part of the adaptation ...

  4. Telephonic advance care planning facilitated by health plan case managers.

    Science.gov (United States)

    Boettcher, Iris; Turner, Rozanne; Briggs, Linda

    2015-06-01

    The insurance plan case managers (CMs) of Priority Health, part of a regional healthcare system located in Michigan, work telephonically with frail patients who have multiple comorbidities. However, these CMs have lacked facilitation skills for advance care planning (ACP) discussions in this vulnerable population. In 2012, the findings of a six-month pilot study of telephonic ACP (TACP) with some of the plan's Medicare population were implemented with Medicare members under case management. Case mangers were trained and certified by Respecting Choices® to introduce and facilitate ACP discussions telephonically utilizing both First Steps and Last Steps protocols. The CMs identified appropriate patients using hospitalization and emergency room utilization data, severity of illness, and diagnostic criteria. The primary goal was to complete both the ACP discussion and the documentation for each protocol on identified patients. They also attempted to schedule facilitated conversations with the patients' healthcare advocates present. During a 12-month period, 576 health plan members were offered First Steps discussions, with 198 interested in engaging in further ACP. Some 152 members were identified for Last Steps TACP using established criteria; discussions occurred with 56 members. TACP implementation resulted in 55 new or updated First Steps documents and 4 Last Steps documents. A total of 50 discussions included the designated healthcare advocate. Following TACP implementation with the Medicare CM team and evaluation of the results, processes and methods were instituted to increase engagement and completion of discussions and documents. These included enhancements to the electronic assessment and ongoing support of the CM team to increase the engagement of patients and advocates. Dissemination of the project to the entire Medicare CM team demonstrated opportunities and lessons learned for facilitated TACP discussions. The TACP model has the potential to be

  5. Applications of the epidemiological modelling outputs for targeted mental health planning in conflict-affected populations: the Syria case-study.

    Science.gov (United States)

    Charlson, F J; Lee, Y Y; Diminic, S; Whiteford, H

    2016-01-01

    Epidemiological models are frequently utilised to ascertain disease prevalence in a population; however, these estimates can have wider practical applications for informing targeted scale-up and optimisation of mental health services. We explore potential applications for a conflict-affected population, Syria. We use prevalence estimates of major depression and post-traumatic stress disorder (PTSD) in conflict-affected populations as inputs for subsequent estimations. We use Global Burden of Disease (GBD) methodology to estimate years lived with a disability (YLDs) for depression and PTSD in Syrian populations. Human resource (HR) requirements to scale-up recommended packages of care for PTSD and depression in Syria over a 15-year period were modelled using the World Health Organisation mhGAP costing tool. Associated avertable burden was estimated using health benefit analyses. The total number of cases of PTSD in Syria was estimated at approximately 2.2 million, and approximately 1.1 million for depression. An age-standardised major depression rate of 13.4 (95% UI 9.8-17.5) YLDs per 1000 Syrian population is estimated compared with the GBD 2010 global age-standardised YLD rate of 9.2 (95% UI 7.0-11.8). HR requirements to support a linear scale-up of services in Syria using the mhGAP costing tool demonstrates a steady increase from 0.3 FTE in at baseline to 7.6 FTE per 100 000 population after scale-up. Linear scale-up over 15 years could see 7-9% of disease burden being averted. Epidemiological estimates of mental disorders are key inputs into determining disease burden and guiding optimal mental health service delivery and can be used in target populations such as conflict-affected populations.

  6. Asia's population and family planning programmes: leaders in strategic communication.

    Science.gov (United States)

    Piotrow, P T; Rimon, J G

    1999-12-01

    Countries in Asia played a key a role in identifying problems related to population growth and high fertility and in developing strategies to address these problems. Despite the economic problems experienced by some, they continue to lead the world in designing and implementing programs in the areas of reproductive and family health using a strategic communication approach. This modern strategic communication program has the following characteristics: science and research-based, client-centered, benefit-oriented, service-linked, entertainment-education focused, professionally developed, and programmatically sustainable. This paper describes several outstanding Asian family planning communication programs in 5 countries that clearly illustrate these 7 elements. Overall, these Asian countries have shown that strategic communication can be the steering wheel for modern family planning and health promotion programs. The article concludes by giving future directions for strategic communication programs to address new emerging health and population concerns in the region.

  7. Understanding the population dimension in development planning.

    Science.gov (United States)

    Rivera, P C

    1983-01-01

    In the Philippines initial efforts to adopt population policies focused on reducing rapid population growth through fertility control. The history of the national population welfare congress, which started in 1978, reflects this emphasis on family planning as a major deterrent to rapid population growth. It was only in recent years that the 2-way relationship between population and development came to be better appreciated. The 6th National Populaton Welfare Congress was a response to this need to broaden the scope of population concerns and integrate the population dimension into development planning. This viewpoint regards population not as a demand variable but as a factor that can be influenced by economic and social development. Dr. Mercedes B. Concepcion, dean of the University of the Philippines Population Institute (UPPI), discussed population trends, prospects, and problems in a paper presented before the 6th congress. In 1980, she said, the Philippine population was 48.1 million persons, up by 11.4 million persons or 31%, over the3l.7 million enumerated in 1970. While the rate of populated growth remains high, data indicate a decreasing post-World War II trend, from 3.06% in 1948-60 to 2.68% in 1975-80. The proportion of the population below 15 has dropped by 2 percentage points, while the number of persons in the working ages 15-64 has increased. In 1 of the 3 group sessions during the congress, the participants tried to define the Philippines' population distribution goals, the requirement of an urban-rural balance, and priority intervention areas. In that session 2 main papers were presented -- one on human settlements and urbanization and the other on macroeconomic policies and their spatial implications. In another sessionplanners and researchers examined the socioeconomic and demographic impact of development programs, specifically the impact of rural electrification on fertility change in Misamis Oriental, a province in Southern Philippines. In the

  8. How to choose a health plan

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000861.htm How to choose a health plan To use the ... need to do some paperwork for tax purposes. How to Compare Health Plans Employers and government sites, ...

  9. Boundary Spanning Leadership Practices for Population Health.

    Science.gov (United States)

    Shirey, Maria R; White-Williams, Connie

    2015-09-01

    This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. In this article, the authors discuss boundary spanning leadership practices for achieving the Triple Aim of simultaneously improving the health of populations, improving the patient experience, and reducing per-capita cost of health care. Drawing on experience with an existing population-focused heart failure clinic borne of an academic-practice partnership, the authors discuss boundary spanning leadership practices aimed at achieving the Triple Aim concept and its intended design.

  10. Birth control, population control, and family planning: an overview.

    Science.gov (United States)

    Critchlow, D T

    1995-01-01

    This overview of the US birth control movement reflects on the emergence of family planning policy due to the efforts of Margaret Sanger, feminists, and the civil rights movement, the eugenics motive to limit "deviant" populations, and the population control movement, which aims to solve social and economic problems through fertility control. Population control moved through three stages: from the cause of "voluntary motherhood" to advance suffrage and women's political and social status, to the concept of "birth control" promoted by socialist feminists to help empower women and the working class, to, from 1920 on, a liberal movement for civil rights and population control. Physicians such as Dr. Robert Latou Dickinson legitimized the movement in the formation of the Committee on Maternal Health in 1925, but the movement remained divided until 1939, when Sanger's group merged with the American Birth Control League, the predecessor of the present Planned Parenthood Federation of America. A key legal decision in 1939 in the United States v. One Package amended the Comstock Act and allowed for the distribution of birth control devices by mail to physicians. Sanger, after a brief retirement, formed the International Planned Parenthood Federation and supported research into the pill. Eugenicists through the Committee on Maternal Health supported Christopher Tietze and others developing the pill. Final constitutional access to contraception based on the right to privacy was granted in Griswold v. Connecticut. The ruling in Eisenstadt v. Baird in 1972 extended this right to unmarried persons. The right to privacy was further extended in the Roe v. Wade decision in 1973 on legal abortion. The argument for improving the quality of the population remained from the formation of the Population Reference Bureau in 1929 through the 1960s. Under the leadership of Rockefeller, population control was defined as justified on a scientific and humanitarian basis. US government support

  11. Program Planning in Health Professions Education

    Science.gov (United States)

    Schmidt, Steven W.; Lawson, Luan

    2018-01-01

    In this chapter, the major concepts from program planning in adult education will be applied to health professions education (HPE). Curriculum planning and program planning will be differentiated, and program development and planning will be grounded in a systems thinking approach.

  12. Consumer health plan choice: current knowledge and future directions.

    Science.gov (United States)

    Scanlon, D P; Chernew, M; Lave, J R

    1997-01-01

    A keystone of the competitive strategy in health insurance markets is the assumption that "consumers" can make informed choices based on the costs and quality of competing health plans, and that selection effects are not large. However, little is known about how individuals use information other than price in the decision making process. This review summarizes the state of knowledge about how individuals make choices among health plans and outlines an agenda for future research. We find that the existing literature on health plan choice is no longer sufficient given the widespread growth and acceptance of managed care, and the increased proportion of consumers' income now going toward the purchase of health plans. Instead, today's environment of health plan choice requires better understanding of how plan attributes other than price influence plan choice, how other variables such as health status interact with plan attributes in the decision making process, and how specific populations differ from one another in terms of the sensitivity of their health plan choices to these different types of variables.

  13. Application of spatial analysis technology to the planning of access to oral health care for at-risk populations in Australian capital cities.

    Science.gov (United States)

    Almado, Haidar; Kruger, Estie; Tennant, Marc

    2015-01-01

    Australians are one of the healthiest populations in the world but there is strong evidence that health inequalities exist. Australia has 23.1 million people spread very unevenly over -20 million square kilometres. This study aimed to apply spatial analysis tools to measure the spatial distribution of fixed adult public dental clinics in the eight metropolitan capital cities of Australia. All population data for metropolitan areas of the eight capital cities were integrated with socioeconomic data and health-service locations, using Geographic Information Systems, and then analysed. The adult population was divided into three subgroups according to age, consisting of 15-year-olds and over (n = 7.2 million), retirees 65 years and over (n = 1.2 million), and the elderly, who were 85 years and over (n = 0.15 million). It was evident that the States fell into two groups; Tasmania, Northern Territory, Australian Capital Territory and Western Australia in one cluster, and Victoria, New South Wales, Queensland and South Australia in the other. In the first group, the average proportion of the population of low socioeconomic status living in metropolitan areas within 2.5 km of a government dental clinic is 13%, while for the other cluster, it is 42%. The clustering remains true at 5 km from the clinics. The first cluster finds that almost half (46%) of the poorest 30% of the population live within 5km of a government dental clinic. The other cluster of States finds nearly double that proportion (86%). The results from this study indicated that access distances to government dental services differ substantially in metropolitan areas of the major Australian capital cities.

  14. Public policy frameworks for improving population health.

    Science.gov (United States)

    Tarlov, A R

    1999-01-01

    Four conceptual frameworks provide bases for constructing comprehensive public policy strategies for improving population health within wealthy (OECD) nations. (1) Determinants of population health. There are five broad categories: genes and biology, medical care, health behaviors, the ecology of all living things, and social/societal characteristics. (2) Complex systems: Linear effects models and multiple independent effects models fail to yield results that explain satisfactorily the dynamics of population health production. A different method (complex systems modeling) is needed to select the most effective interventions to improve population health. (3) An intervention framework for population health improvement. A two-by-five grid seems useful. Most intervention strategies are either ameliorative or fundamentally corrective. The other dimension of the grid captures five general categories of interventions: child development, community development, adult self-actualization, socioeconomic well-being, and modulated hierarchical structuring. (4) Public policy development process: the process has two phases. The initial phase, in which public consensus builds and an authorizing environment evolves, progresses from values and culture to identification of the problem, knowledge development from research and experience, the unfolding of public awareness, and the setting of a national agenda. The later phase, taking policy action, begins with political engagement and progresses to interest group activation, public policy deliberation and adoption, and ultimately regulation and revision. These frameworks will be applied to help understand the 39 recommendations of the Independent Inquiry into Inequalities in Health, the Sir Donald Acheson Report from the United Kingdom, which is the most ambitious attempt to date to develop a comprehensive plan to improve population health.

  15. Educational planning in health care.

    Science.gov (United States)

    Cordera, A; Bobenrieth, M

    1981-01-01

    This paper describes the basic educational planning process involved in primary health care programs in developing countries. The problem in present educational programs are the lack of concentration by educators on the distribution of resources and the lack of achieving objectives of specific services. Educational planning seeks to ascertain the existing situation in a defined social setting in order to develop educational programs consistent with general development efforts. General learning and motivation principles include meaningfulness, requirements, modeling, open communication, freshness, active practice, adequate distribution of practical work, phasing out assistance, and developing agreeable conditions for learning. The purpose of an educational program should be "product-oriented" or "impact-oriented." Educational objectives can be reached through a process of elements in a cognitive, affective, or psycomotor domain. The curriculum process includes the following 5 stages: 1) selection of purpose and objectives, 2) organization of learning experiences, 3) selection of program content material), 4) selection of teaching methods, and 5) evaluation of the effectiveness of stages 2-4.

  16. Population and Health in Developing Countries: Population, Health ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2002-01-10

    Jan 10, 2002 ... For the one billion people living in the world's poorest countries, where the burden of disease is highest, those who are born or who die are still not counted. The health profile of these populations is akin to an iceberg: the bulk of reliable data remains hidden. This great information void is a major, ...

  17. Urban health: an urban planning perspective.

    Science.gov (United States)

    Dubé, P

    2000-01-01

    Urban planning processes and practices, and their impacts on the health and well being of citizens, are numerous and take many forms. Creating living urban environments that are conducive to health and well being requires an integrated approach between urban planners and health professionals. This article focuses on the almost 100 years of experience of Canada's National Capital Commission (NCC) in developing urban plans (policy plans, master plans) for planning and building Canada's Capital. To address the continuous growing public interest in environmental concerns, the NCC developed in the 1990s an integrated approach using a strategic environmental assessment (SEA). This approach could be easily transferred to various urban-planning contexts worldwide. This paper aims to describe the NCC approach, in order to stimulate discussion on growing environmental health concerns and urban planning.

  18. Community health assessment. The first step in community health planning.

    Science.gov (United States)

    Rice, J A

    1993-01-01

    Hospitals face a paradigm shift: from planning service delivery to population-based community health planning. Comprehensive community health planning is a two-step process: assessment and action, in that order. Assessment identifies community problems and resources; action follows planning, which determines which of those problems should be addressed with which resources. This paper provides an overview of the community assessment process. The first challenge in launching a community health initiative is to identify and recruit partners drawn from the ranks of prominent community organizations, such as school boards, public health agencies, and elected officials. The best enlistment strategies are those that empower persons outside the hospital to take visible control. Defining the community is the first step in analyzing the community. It is important that everyone involved in the assessment process agree on the definition, which should take in those characteristics that make the community unique, including its social systems, environmental factors, and demographics. The next step in the process is developing a community health profile, a set of key community indicators or measures that will help you set priorities, document successes and failures, and monitor trends. There are a number of models available to consult in developing indicators, whether traditional, medically oriented determinants of health or broader parameters, such as housing and public safety. Criteria for selecting indicators include validity, stability and reliability, and responsiveness. Most indicators will be developed using secondary, or already existing, sources of data, such as census data, Medicare and Medicaid files, police records, and hospital admission and exit records. Conducting the community assessment involves putting together a list of problems to be solved and a list of available resources, both of which can be compiled using the same four-step process of gathering and

  19. Population health in New Zealand 2000-2013: From determinants of health to targets.

    Science.gov (United States)

    Sheridan, Nicolette F; Kenealy, Timothy W; Schmidt-Busby, Jacqueline Ig; Rea, Harold H

    2015-01-01

    To determine how 'population health' has been understood in practice and policy and has influenced health system restructuring in New Zealand since 2000. Interviews in 2007-2008 with managers, clinicians, government policy advisors and academics were undertaken to explore the relationships between population health, determinants of health, and health system restructuring. This was augmented by a review of major government health policies from 2009 to 2013 to establish which notions of population health were reflected. Population health shifted from a broad notion of health determinants to focus on a small number of quantifiable health targets driven by financial incentives. Meantime, an emphasis on 'quality and safety' impeded population health activities. District Health Board programmes to identify high risk individuals, by disease or hospital service utilisation, diverted attention from broader population health outcomes. District Health Boards were not held accountable for integrating a population health approach in service planning and did not initiate or lead intersectoral work. Community consultation was limited. Primary Health Organisations, although mandated to address population health, typically aligned with the small-business model of general practice making service integration difficult to achieve. In policy, 'population health' dropped from favour in the mid-2000s, although many documents, outside the health sector, carried forward these values. A progressively narrower focus on a small number of health targets and on organisational processes undermined earlier policy intentions and health system restructuring that sought to improve broader population health outcomes.

  20. EM Health and Safety Plan Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1994-12-01

    This document contains information about the Health and Safety Plan Guidelines. Topics discussed include: Regulatory framework; key personnel; hazard assessment; training requirements; personal protective equipment; extreme temperature disorders or conditions; medical surveillance; exposure monitoring/air sampling; site control; decontamination; emergency response/contingency plan; emergency action plan; confined space entry; and spill containment.

  1. Indigenous populations health protection: A Canadian perspective

    Directory of Open Access Journals (Sweden)

    Richardson Katya L

    2012-12-01

    Full Text Available Abstract The disproportionate effects of the 2009 H1N1 pandemic on many Canadian Aboriginal communities have drawn attention to the vulnerability of these communities in terms of health outcomes in the face of emerging and reemerging infectious diseases. Exploring the particular challenges facing these communities is essential to improving public health planning. In alignment with the objectives of the Pandemic Influenza Outbreak Research Modelling (Pan-InfORM team, a Canadian public health workshop was held at the Centre for Disease Modelling (CDM to: (i evaluate post-pandemic research findings; (ii identify existing gaps in knowledge that have yet to be addressed through ongoing research and collaborative activities; and (iii build upon existing partnerships within the research community to forge new collaborative links with Aboriginal health organizations. The workshop achieved its objectives in identifying main research findings and emerging information post pandemic, and highlighting key challenges that pose significant impediments to the health protection and promotion of Canadian Aboriginal populations. The health challenges faced by Canadian indigenous populations are unique and complex, and can only be addressed through active engagement with affected communities. The academic research community will need to develop a new interdisciplinary framework, building upon concepts from ‘Communities of Practice’, to ensure that the research priorities are identified and targeted, and the outcomes are translated into the context of community health to improve policy and practice.

  2. Population health in New Zealand 2000–2013: From determinants of health to targets

    Directory of Open Access Journals (Sweden)

    Nicolette F Sheridan

    2015-03-01

    Full Text Available Objective: To determine how ‘population health’ has been understood in practice and policy and has influenced health system restructuring in New Zealand since 2000. Methods: Interviews in 2007–2008 with managers, clinicians, government policy advisors and academics were undertaken to explore the relationships between population health, determinants of health, and health system restructuring. This was augmented by a review of major government health policies from 2009 to 2013 to establish which notions of population health were reflected. Results: Population health shifted from a broad notion of health determinants to focus on a small number of quantifiable health targets driven by financial incentives. Meantime, an emphasis on ‘quality and safety’ impeded population health activities. District Health Board programmes to identify high risk individuals, by disease or hospital service utilisation, diverted attention from broader population health outcomes. District Health Boards were not held accountable for integrating a population health approach in service planning and did not initiate or lead intersectoral work. Community consultation was limited. Primary Health Organisations, although mandated to address population health, typically aligned with the small-business model of general practice making service integration difficult to achieve. In policy, ‘population health’ dropped from favour in the mid-2000s, although many documents, outside the health sector, carried forward these values. Conclusion: A progressively narrower focus on a small number of health targets and on organisational processes undermined earlier policy intentions and health system restructuring that sought to improve broader population health outcomes.

  3. Health plan choice in the Netherlands : Restrictive health plans preferred by young and healthy individuals

    NARCIS (Netherlands)

    Bes, Romy E.; Curfs, Emile C.; Groenewegen, Peter P.|info:eu-repo/dai/nl/071985409; De Jong, Judith D.

    2017-01-01

    In a health care system based on managed competition, health insurers negotiate on quality and price with care providers and are allowed to offer restrictive health plans. It is crucial that enrolees who need care choose restrictive health plans, as otherwise health insurers cannot channel patients

  4. Health plan choice in the Netherlands: restrictive health plans preferred by young and healthy individuals.

    NARCIS (Netherlands)

    Bes, R.E.; Curfs, E.C.; Groenewegen, P.P.; Jong, J.D. de

    2017-01-01

    In a health care system based on managed competition, health insurers negotiate on quality and price with care providers and are allowed to offer restrictive health plans. It is crucial that enrolees who need care choose restrictive health plans, as otherwise health insurers cannot channel patients

  5. A public health hazard mitigation planning process.

    Science.gov (United States)

    Griffith, Jennifer M; Kay Carpender, S; Crouch, Jill Artzberger; Quiram, Barbara J

    2014-01-01

    The Texas A&M Health Science Center School of Rural Public Health, a member of the Training and Education Collaborative System Preparedness and Emergency Response Learning Center (TECS-PERLC), has long-standing partnerships with 2 Health Service Regions (Regions) in Texas. TECS-PERLC was contracted by these Regions to address 2 challenges identified in meeting requirements outlined by the Risk-Based Funding Project. First, within Metropolitan Statistical Areas, there is not a formal authoritative structure. Second, preexisting tools and processes did not adequately satisfy requirements to assess public health, medical, and mental health needs and link mitigation strategies to the Public Health Preparedness Capabilities, which provide guidance to prepare for, respond to, and recover from public health incidents. TECS-PERLC, with its partners, developed a framework to interpret and apply results from the Texas Public Health Risk Assessment Tool (TxPHRAT). The 3-phase community engagement-based TxPHRAT Mitigation Planning Process (Mitigation Planning Process) and associated tools facilitated the development of mitigation plans. Tools included (1) profiles interpreting TxPHRAT results and identifying, ranking, and prioritizing hazards and capability gaps; (2) a catalog of intervention strategies and activities linked to hazards and capabilities; and (3) a template to plan, evaluate, and report mitigation planning efforts. The Mitigation Planning Process provided a framework for Regions to successfully address all funding requirements. TECS-PERLC developed more than 60 profiles, cataloged and linked 195 intervention strategies, and developed a template resulting in 20 submitted mitigation plans. A public health-focused, community engagement-based mitigation planning process was developed by TECS-PERLC and successfully implemented by the Regions. The outcomes met all requirements and reinforce the effectiveness of academic practice partnerships and importance of

  6. Health Insurance: Understanding Your Health Plan's Rules

    Science.gov (United States)

    ... Read MoreDepression in Children and TeensRead MoreBMI Calculator Health Insurance: Understanding What It CoversCancer: End-of-Life Issues ... Home Your Health Resources Healthcare Management Insurance & Bills Health Insurance: Understanding Your Health Plan’s Rules Health Insurance: Understanding ...

  7. World population growth, family planning, and American foreign policy.

    Science.gov (United States)

    Sharpless, J

    1995-01-01

    The US decision since the 1960s to link foreign policy with family planning and population control is noteworthy for its intention to change the demographic structure of foreign countries and the magnitude of the initiative. The current population ideologies are part of the legacy of 19th century views on science, morality, and political economy. Strong constraints were placed on US foreign policy since World War II, particularly due to presumptions about the role of developing countries in Cold War ideology. Domestic debates revolved around issues of feminism, birth control, abortion, and family political issues. Since the 1960s, environmental degradation and resource depletion were an added global dimension of US population issues. Between 1935 and 1958 birth control movements evolved from the ideologies of utopian socialists, Malthusians, women's rights activists, civil libertarians, and advocates of sexual freedom. There was a shift from acceptance of birth control to questions about the role of national government in supporting distribution of birth control. Immediately postwar the debates over birth control were outside political circles. The concept of family planning as a middle class family issue shifted the focus from freeing women from the burdens of housework to making women more efficient housewives. Family planning could not be taken as a national policy concern without justification as a major issue, a link to national security, belief in the success of intervention, and a justifiable means of inclusion in public policy. US government involvement began with agricultural education, technological assistance, and economic development that would satisfy the world's growing population. Cold War politics forced population growth as an issue to be considered within the realm of foreign policy and diplomacy. US government sponsored family planning was enthusiastic during 1967-74 but restrained during the 1980s. The 1990s has been an era of redefinition of

  8. FastStats: Health of Mexican American Population

    Science.gov (United States)

    ... or Alaska Native Population Health of Asian or Pacific Islander Population Health of Black or African American non-Hispanic Population Health of Hispanic or Latino Population Health of Mexican American Population Health of White non-Hispanic Population ...

  9. Womens' Roles and Education: Changing Traditions in Population Planning.

    Science.gov (United States)

    Vaughn, Gladys Gary, Comp.

    This collection of readings on women and education in regard to changing traditions in population/family planning is designed for international home economists, students, and other educators. It presents background information in designing curriculum which integrates family planning and population education concepts into home economics programs.…

  10. Course Plan for Women's Health.

    Science.gov (United States)

    Whitaker, Linda A.

    In view of women's misconceptions about their bodies, their sexuality, their mental health, and the health care system, this three-credit evening community college course on women's health needs and concerns was designed. Course objectives include recording and analyzing the effects of nutrition, sleep, exercise, and stress on various body…

  11. Process engineering for primary care: Quality improvement and population health

    Directory of Open Access Journals (Sweden)

    William Riley

    2016-05-01

    Full Text Available A fundamental paradox of the health care delivery systems in many industrialized nations is that desired population health metrics are often not achieved despite large expenditures in the health care delivery system. For example, the United States commits nearly 18% of its GDP to the health care delivery system, the largest amount of any nation, yet is 37th in achieving health or health care delivery metrics. This article addresses how general practice can be an important driver of population health in the Chinese health care delivery system through the application of quality improvement methods. The article shows examples of how the cause-and-effect diagram, the process map, and the plan, do, study, act (PDSA cycle are important techniques to assist primary care practitioners for improving population health.

  12. Status report, The Public Health and Planning 101 project: strengthening collaborations between the public health and planning professions.

    Science.gov (United States)

    Mahendra, A; Vo, T; Einstoss, C; Weppler, J; Gillen, P; Ryan, L; Haley, K

    2017-01-01

    Land use planning is a complex field comprised of legislation, policies, processes and tools. A growing body of evidence supports the relationship between land use planning decisions, community design and health. The built environment has been shown to be associated with physical inactivity, obesity, cardiovascular disease, respiratory disease and mental illness. Consequently, there is a growing interest within public health to work with planners on land use planning initiatives such as official plans and transportation master plans. Two surveys were developed: one for public health professionals and the other for planning professionals (survey questions available upon request to the corresponding author). The surveys were pilot tested in two separate focus group sessions with public health and planning professionals. Focus group volunteers helped to validate the surveys by verifying survey questions, design and overall flow. In early 2012, 304 public health professionals and 301 planning professionals completed the two separate surveys, comprising the total survey respondents for each respective profession used to calculate proportions. The survey results represent a convenience sample and are not generalizable to the entire population of public health and planning professionals in Ontario. Results compare survey responses from both groups where appropriate. Most respondents worked either as public health staff (78%) or planners/senior planners (58%). A smaller percentage of public health and planning professionals worked either as managers (15% and 11%, respectively) or directors (5% and 9%, respectively). Health is associated with how communities are planned and built, and the services and resources provided within them. Inspired by the results of our survey and based on user feedback from the pilot tests, a free online training program entitled "Public Health and Planning 101: An Online Course for Public Health and Planning Professionals to Create Healthier

  13. Confronting the challenges in reconnecting urban planning and public health.

    Science.gov (United States)

    Corburn, Jason

    2004-04-01

    Although public health and urban planning emerged with the common goal of preventing urban outbreaks of infectious disease, there is little overlap between the fields today. The separation of the fields has contributed to uncoordinated efforts to address the health of urban populations and a general failure to recognize the links between, for example, the built environment and health disparities facing low-income populations and people of color. I review the historic connections and lack thereof between urban planning and public health, highlight some challenges facing efforts to recouple the fields, and suggest that insights from ecosocial theory and environmental justice offer a preliminary framework for reconnecting the fields around a social justice agenda.

  14. Energy Systems and Population Health

    Energy Technology Data Exchange (ETDEWEB)

    Ezzati, Majid; Bailis, Rob; Kammen, Daniel M.; Holloway, Tracey; Price, Lynn; Cifuentes, Luis A.; Barnes, Brendon; Chaurey, Akanksha; Dhanapala, Kiran N.

    2004-04-12

    to rural and urban health facilities allows increased delivery and coverage of 3 various health services and interventions such as tests and treatments, better storage of medicine and vaccines, disinfection of medical equipment by boiling or radiation, and more frequent and efficient health system encounters through mobile clinics or longer working hours; and so on. In fact, while the dominant view of development-energy-health linkages has been that improvements in energy and health are outcomes of the socioeconomic development process (e.g., the ''energy ladder'' framework discussed below), it has even been argued that access to higher quality energy sources and technologies can initiate a chain of demographic, health, and development outcomes by changing the household structure and socioeconomic relationships. For example, in addition to increased opportunities for food and income production, reduced infant mortality as a result of transition to cleaner fuels or increased coverage of vaccination with availability of refrigerators in rural clinics may initiate a process of ''demographic transition'' to low-mortality and low-fertility populations (14). Such a transition has historically been followed with further improvements in maternal and child health and increased female participation in the labor markets and other economic activities.

  15. Health plan choice in the Netherlands: restrictive health plans preferred by young and healthy individuals.

    Science.gov (United States)

    Bes, Romy E; Curfs, Emile C; Groenewegen, Peter P; de Jong, Judith D

    2017-07-01

    In a health care system based on managed competition, health insurers negotiate on quality and price with care providers and are allowed to offer restrictive health plans. It is crucial that enrolees who need care choose restrictive health plans, as otherwise health insurers cannot channel patients to contracted providers and they will lose their bargaining power in negotiations with providers. We aim to explain enrolees' choice of a restrictive health plan in exchange for a lower premium. In 2014 an online survey with an experimental design was conducted on members of an access panel (response 78%; n=3,417). Results showed 37.4% of respondents willing to choose a restrictive health plan in exchange for a lower premium. This fell to 22% when the restrictive health plan also included a longer travelling time. Enrolees who choose a restrictive health plan are younger and healthier, or on lower incomes, than those preferring a non-restrictive one. This means that enrolees who use care will be unlikely to choose a restrictive health plan and, therefore, health insurers will not be able to channel them to contracted care providers. This undermines the goals of the health care system based on managed competition.

  16. The world population plan of action and the regional commissions.

    Science.gov (United States)

    1987-01-01

    Since their establishment, the regional commissions of the United Nations have been devoting particular attention to population and development concerns. Each commission with its unique social, demographic, economic and political characteristics, has contributed to the international debate on population issues. The commissions have provided a suitable forum for the discussion of those issues, have established programs and activities to respond to them, and, with growing experience and expertise, have contributed to a better understanding of them. National Governments, international organizations, private groups, and the public in general have benefited from their regional activities. This article deals with the substantive contributions of the regional commissions to the last 2 population conferences, the World Population Conference (Bucharest, 1974), where the World Population Plan of Action was adopted, and the International Conference on Population (Mexico City, 1984), where the experience in applying Plan of Action was assessed and a set recommendations for the further implementation of the Plan adopted.

  17. Intersectoral planning for city health development.

    Science.gov (United States)

    Green, Geoff

    2012-04-01

    The article reviews the evolution and process of city health development planning (CHDP) in municipalities participating in the European Network of Healthy Cities organized by the European Region of the World Health Organization. The concept of CHDP combines elements from three theoretical domains: (a) health development, (b) city governance, and (c) urban planning. The setting was the 77 cities which participated in Phase IV (2003-2008) of the network. Evidence was gathered principally from a general evaluation questionnaire sent to all network cities. CHDPs are strategic documents giving direction to municipalities and partner agencies. Analysis revealed a trend away from "classic" CHDPs with a primary focus on health development towards ensuring a health dimension to other sector plans, and into the overarching strategies of city governments. Linked to the Phase IV priority themes of Healthy aging and healthy urban planning, cities further developed the concept and application of human-centered sustainability. More work is required to utilize cost-benefit analysis and health impact assessment to unmask the synergies between health and economic prosperity.

  18. Population Consultation: A Powerful Means to Ensure that Health Strategies are Oriented Towards Universal Health Coverage.

    Science.gov (United States)

    Rohrer, Katja; Rajan, Dheepa; Schmets, Gerard

    2017-01-01

    We seek to highlight why population consultations need to be promoted more strongly as a powerful means to move health reforms towards Universal Health Coverage (UHC). However, despite this increasing recognition that the "population" is the key factor of successful health planning and high-quality service delivery, there has been very little systematic reflection and only limited (international) attention brought to the idea of specifically consulting the population to improve the quality and soundness of health policies and strategies and to strengthen the national health planning process and implementation. So far, research has done little to assess the significance of population consultations for the health sector and its importance for strategic planning and implementation processes; in addition, there has been insufficient evaluation of population consultations in the health sector or health-related areas. We drew on ongoing programmatic work of World Health Organization (WHO) offices worldwide, as most population consultations are not well-documented. In addition, we analyzed any existing documentation available on population consultations in health. We then elaborate on the potential benefits of bringing the population's voice into national health planning. We briefly mention the key methods used for population consultations, and we put forward recent country examples showing that population consultation is an effective way of assessing the population's needs and expectations, and should be more widely used in strategizing health. Giving the voice to the population is a means to strengthen accountability, to reinforce the commitment of policy makers, decision-makers and influencers (media, political parties, academics, etc.) to the health policy objectives of UHC, and, in the specific case of donor-dependent countries, to sensitize donors' engagement and alignment with national health strategies. The consequence of the current low international interest for

  19. Transforming Health Professionals into Population Health Change Agents.

    Science.gov (United States)

    Naccarella, Lucio; Butterworth, Iain; Moore, Timothy

    2016-04-26

    With the recognition that professional education has not kept pace with the challenges facing the health and human service system, there has been a move to transformative education and learning professional development designed to expand the number of enlightened and empowered change agents with the competence to implement changes at an individual, organisation and systems level. Since 2010, the Department of Health and Human Services in Victoria, Australia, in collaboration with The University of Melbourne's School of Population and Global Health, has delivered seven population health short courses aimed to catalyse participants' transformation into population health change agents. This paper presents key learnings from a combination of evaluation data from six population health short courses using a transformative learning framework from a 2010 independent international commission for health professionals that was designed to support the goals of transformative and interdependent health professionals. Participatory realist evaluation approaches and qualitative methods were used. Evaluation findings reveal that there were mixed outcomes in facilitating participants' implementation of population health approaches, and their transformation into population health agents upon their return to their workplaces. Core enablers, barriers and requirements, at individual, organisational and system levels influence the capability of participants to implement population health approaches. The iterative and systemic evolution of the population health short courses, from a one off event to a program of inter-dependent modules, demonstrates sustained commitment by the short course developers and organisers to the promotion of transformative population health learning outcomes. To leverage this commitment, recognising that professional development is not an event but part of an ongoing transformative process, suggestions to further align recognition of population health

  20. Space radiation health program plan

    Science.gov (United States)

    1991-01-01

    The Space Radiation Health Program intends to establish the scientific basis for the radiation protection of humans engaged in the exploration of space, with particular emphasis on the establishment of a firm knowledge base to support cancer risk assessment for future planetary exploration. This document sets forth the technical and management components involved in the implementation of the Space Radiation Health Program, which is a major part of the Life Sciences Division (LSD) effort in the Office of Space Science and Applications (OSSA) at the National Aeronautics and Space Administration (NASA). For the purpose of implementing this program, the Life Sciences Division supports scientific research into the fundamental mechanisms of radiation effects on living systems and the interaction of radiation with cells, tissues, and organs, and the development of instruments and processes for measuring radiation and its effects. The Life Sciences Division supports researchers at universities, NASA field centers, non-profit research institutes and national laboratories; establishes interagency agreements for cooperative use and development of facilities; and conducts a space-based research program using available and future spaceflight vehicles.

  1. FastStats: Health of Asian or Pacific Islander Population

    Science.gov (United States)

    ... Health of Hispanic or Latino Population Health of Mexican American Population Health of White non-Hispanic Population More data Health, United States, trend tables with data for Asian or Pacific Islander population Tables of Summary Health Statistics from ...

  2. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology planning advance planning document requirements (HIT PAPD). 495.336 Section 495.336 Public Health CENTERS FOR MEDICARE... Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

  3. Empowering health personnel for decentralized health planning in India: The Public Health Resource Network

    Directory of Open Access Journals (Sweden)

    Prasad Vandana

    2009-07-01

    Full Text Available Abstract The Public Health Resource Network is an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level, to improve accountability of health systems, elicit community participation for health, ensure equitable and accessible health facilities and to bring about convergence in programmes and services. The question confronting health systems in India is how best to reform, revitalize and resource primary health systems to deliver different levels of service aligned to local realities, ensuring universal coverage, equitable access, efficiency and effectiveness, through an empowered cadre of health personnel. To achieve these outcomes it is essential that health planning be decentralized. Districts vary widely according to the specific needs of their population, and even more so in terms of existing interventions and available resources. Strategies, therefore, have to be district-specific, not only because health needs vary, but also because people's perceptions and capacities to intervene and implement programmes vary. In centrally designed plans there is little scope for such adaptation and contextualization, and hence decentralized planning becomes crucial. To undertake these initiatives, there is a strong need for trained, motivated, empowered and networked health personnel. It is precisely at this level that a lack of technical knowledge and skills and the absence of a supportive network or adequate educational opportunities impede personnel from making improvements. The absence of in-service training and of training curricula that reflect field realities also adds to this, discouraging health workers from pursuing effective strategies. The Public Health Resource Network is thus an attempt to reach out to motivated

  4. Utilizing Genomics through Family Health History with the Theory of Planned Behavior: Prediction of Type 2 Diabetes Risk Factors and Preventive Behavior in an African American Population in Florida.

    Science.gov (United States)

    Seaborn, Cynthia; Suther, Sandra; Lee, Torhonda; Kiros, Gebre-Egziabher; Becker, Alan; Campbell, Ellen; Collins-Robinson, Jackie

    2016-01-01

    African Americans are disproportionately affected by type 2 diabetes. The purpose of this study was to assess to what extent African Americans' knowledge and awareness of family health history and related risk factors for developing type 2 diabetes influence their likelihood of adopting a preventive behavior. This study employed an anonymous pencil-and-paper, self-administered survey consisting of two sections. Section 1 was a modified version of the US Surgeon General's Family Health History Initiative and the American Diabetes Association Diabetes Risk Factor Survey. Section 2 of the survey was based on the constructs of the theory of planned behavior. Over 394 African American participants completed the survey. 'Perceived behavioral control' was the strongest predictor of 'likelihood of adopting preventive behavior'. Participants were aware of their family history as a risk factor for type 2 diabetes, but it was not a significant predictor of behavior modifications based on that knowledge. The lack of perceived risk in this population shows the importance of not only knowing one's risk factors but translating those risk factors to a more personalized form that fits into the current lifestyle of the individual in a meaningful way. © 2016 S. Karger AG, Basel.

  5. Physical inactivity: direct cost to a health plan.

    Science.gov (United States)

    Garrett, Nancy A; Brasure, Michelle; Schmitz, Kathryn H; Schultz, Monica M; Huber, Michael R

    2004-11-01

    The purpose of this study was to estimate the total medical expenditures attributable to physical inactivity patterns among members of a large health plan, Blue Cross Blue Shield of Minnesota. The study used a cost-of-illness approach to attribute medical and pharmacy costs for specific diseases to physical inactivity in 2000. Relative risks come from the scientific literature, demonstrating that heart disease, stroke, hypertension, type 2 diabetes, colon cancer, breast cancer, osteoporosis, depression, and anxiety are directly related to individual physical activity patterns in adults. Data sources were the 2000 Behavioral Risk Factor Surveillance System and medical claims incurred in 2000 among 1.5 million health plan members aged > or =18 years. Primary analysis was completed in 2002. Nearly 12% of depression and anxiety and 31% of colon cancer, heart disease, osteoporosis, and stroke cases were attributable to physical inactivity. Heart disease was the most expensive outcome of physical inactivity within the health plan population, costing US dollar 35.3 million in 2000. Total health plan expenditures attributable to physical inactivity were US dollar 83.6 million, or US dollar 56 per member. This study confirms the growing body of research quantifying physical inactivity as a serious and expensive public health problem. The costs associated with physical inactivity are borne by taxpayers, employers, and individuals in the form of higher taxes to subsidize public insurance programs and increased health insurance premiums.

  6. UMTRA Project: Environment, Safety, and Health Plan

    Energy Technology Data Exchange (ETDEWEB)

    1995-02-01

    The US Department of Energy has prepared this UMTRA Project Environment, Safety, and Health (ES and H) Plan to establish the policy, implementing requirements, and guidance for the UMTRA Project. The requirements and guidance identified in this plan are designed to provide technical direction to UMTRA Project contractors to assist in the development and implementation of their ES and H plans and programs for UMTRA Project work activities. Specific requirements set forth in this UMTRA Project ES and H Plan are intended to provide uniformity to the UMTRA Project`s ES and H programs for processing sites, disposal sites, and vicinity properties. In all cases, this UMTRA Project ES and H Plan is intended to be consistent with applicable standards and regulations and to provide guidance that is generic in nature and will allow for contractors` evaluation of site or contract-specific ES and H conditions. This plan specifies the basic ES and H requirements applicable to UMTRA Project ES and H programs and delineates responsibilities for carrying out this plan. DOE and contractor ES and H personnel are expected to exercise professional judgment and apply a graded approach when interpreting these guidelines, based on the risk of operations.

  7. Population-based service planning for implementation of MBCT: linking epidemiologic data to practice.

    Science.gov (United States)

    Patten, Scott B; Meadows, Graham M

    2009-11-01

    The study explored population-based service planning for mindfulness-based cognitive therapy (MBCT). Evidence suggests the usefulness of MBCT in relapse prevention for individuals reporting three or more major depressive episodes. Depression data were from the Canadian Community Health Survey. A simulation model estimated recurrence rates and population sizes to sustain MBCT therapists (each conducting two ten-person groups per year). Approximately 4.2% of the population are candidates for MBCT, and about 13 candidates would arise annually per 10,000 population. If MBCT was acceptable to 20%, for example, a population of 200,000 could support two therapists. A large proportion of the population is eligible for MBCT introduction; however, after introduction, the rate of emergence of candidates would yield a smaller patient pool, which may limit implementation in small population centers. Treatment acceptability is a key variable. These analyses highlight the potential value of epidemiologic data and simulation modeling in planning.

  8. An economic assessment of population health risk in region

    Directory of Open Access Journals (Sweden)

    Nina Vladimirovna Zaytseva

    2012-06-01

    Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory

  9. 42 CFR 51c.105 - Accord with health planning.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Accord with health planning. 51c.105 Section 51c... COMMUNITY HEALTH SERVICES General Provisions § 51c.105 Accord with health planning. A grant may be made... approval by the appropriate health planning agencies have been met. ...

  10. 42 CFR 56.105 - Accord with health planning.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Accord with health planning. 56.105 Section 56.105... HEALTH SERVICES General Provisions § 56.105 Accord with health planning. A grant may be made under this... appropriate health planning agencies have been met. ...

  11. Health effects of smoke from planned burns: a study protocol

    Directory of Open Access Journals (Sweden)

    David O’Keeffe

    2016-02-01

    Full Text Available Abstract Background Large populations are exposed to smoke from bushfires and planned burns. Studies investigating the association between bushfire smoke and health have typically used hospital or ambulance data and been done retrospectively on large populations. The present study is designed to prospectively assess the association between individual level health outcomes and exposure to smoke from planned burns. Methods/design A prospective cohort study will be conducted during a planned burn season in three locations in Victoria (Australia involving 50 adult participants who undergo three rounds of cardiorespiratory medical tests, including measurements for lung inflammation, endothelial function, heart rate variability and markers of inflammation. In addition daily symptoms and twice daily lung function are recorded. Outdoor particulate air pollution is continuously measured during the study period in these locations. The data will be analysed using mixed effect models adjusting for confounders. Discussion Planned burns depend on weather conditions and dryness of ‘fuels’ (i.e. forest. It is potentially possible that no favourable conditions occur during the study period. To reduce the risk of this occurring, three separate locations have been identified as having a high likelihood of planned burn smoke exposure during the study period, with the full study being rolled out in two of these three locations. A limitation of this study is exposure misclassification as outdoor measurements will be conducted as a measure for personal exposures. However this misclassification will be reduced as participants are only eligible if they live in close proximity to the monitors.

  12. Workshop on promotion of reproductive health and family planning held.

    Science.gov (United States)

    1997-09-01

    Two reproductive health advocacy networks have been established in two districts in eastern Africa to help promote family planning and reproductive health among the people in this area. The districts are the Suhum-Kraboa-Coaltar and the New Juaben Municipality. To enhance the performance of the network, a 4-day workshop was held at Koforidua for the members to prepare an action plan for their advocacy and map out areas of collaboration between the public and the private sector group. The workshop, organized by the Futures Group International based in the US with support from the USAID, was attended by 30 participants from nongovernmental organizations and public offices. In an address, Ms. Patience Adow, the Regional Minister observed that through the idea of family planning has been promoted in the country over the past two decades, the country continues to experience a population growth rate of about 2.8%. She expressed the hope that the workshop will equip the participants with the relevant skills to develop and implement their advocacy strategy effectively. Dr. J. E. Taylor, Medical Administrator of the Koforidua Central Hospital, who chaired the function in a bid to improve the health of women and the quality of life of the people. The Ministry of Health as part of its medium term strategic plan has developed the national reproductive health and service policy.

  13. Population mental health: evidence, policy, and public health practice

    National Research Council Canada - National Science Library

    Cohen, Neal L; Galea, Sandro

    2011-01-01

    ... on population mental health with public mental health policy and practice. Issues covered in the book include the influence of mental health policies on the care and well-­ being of individuals with mental illness, the interconnectedness of physical and mental disorders, the obstacles to adopting a public health orientation to mental health/mental ill...

  14. Report of Workshop on Traffic, Health, and Infrastructure Planning

    Science.gov (United States)

    White, Ronald H.; Spengler, John D.; Dilwali, Kumkum M.; Barry, Brenda E.; Samet, Jonathan M.

    2009-01-01

    Recent air pollutant measurement data document unique aspects of the air pollution mixture near roadways, and an expanding body of epidemiological data suggests increased risks for exacerbation of asthma and other respiratory diseases, premature mortality, and certain cancers and birth outcomes from air pollution exposures in populations residing in relatively close proximity to roadways. The Workshop on Traffic, Health, and Infrastructure Planning, held in February 2004, was convened to provide a forum for interdisciplinary discussion of motor vehicle emissions, exposures and potential health effects related to proximity to motor vehicle traffic. This report summarizes the workshop discussions and findings regarding the current science on this issue, identifies planning and policy issues related to localized motor vehicle emissions and health concerns, and provides recommendations for future research and policy directions. PMID:16983859

  15. Switching health insurance plans: results from a health survey.

    Science.gov (United States)

    Lako, Christiaan J; Rosenau, Pauline; Daw, Chris

    2011-12-01

    The study is designed to provide an informal summary of what is known about consumer switching of health insurance plans and to contribute to knowledge about what motivates consumers who choose to switch health plans. Do consumers switch plans largely on the basis of critical reflection and assessment of information about the quality, and price? The literature suggests that switching is complicated, not always possible, and often overwhelming to consumers. Price does not always determine choice. Quality is very hard for consumers to understand. Results from a random sample survey (n = 2791) of the Alkmaar region of the Netherlands are reported here. They suggest that rather than embracing the opportunity to be active critical consumers, individuals are more likely to avoid this role by handing this activity off to a group purchasing organization. There is little evidence that consumers switch plans on the basis of critical reflection and assessment of information about quality and price. The new data reported here confirm the importance of a group purchasing organizations. In a free-market-health insurance system confidence in purchasing groups may be more important for health insurance choice than health informatics. This is not what policy makers expected and might result a less efficient health insurance market system.

  16. City and regional planning: a primer for public health officials.

    Science.gov (United States)

    Malizia, Emil E

    2005-01-01

    Recognizing that planners' decisions affect the public's health, some public health officials are becoming more involved in city and regional planning. This article describes city and regional planning fundamentals to help public health practitioners better understand plan making and plan implementation, including the development project review process; provides examples of how three local public health agencies are currently involved in planning; and discusses general strategies for such participation. With this information, public health officials could increase their influence on local planning with consequent public health benefits.

  17. In place of fear: aligning health care planning with system objectives to achieve financial sustainability.

    Science.gov (United States)

    Birch, Stephen; Murphy, Gail Tomblin; MacKenzie, Adrian; Cumming, Jackie

    2015-04-01

    The financial sustainability of publicly funded health care systems is a challenge to policymakers in many countries as health care absorbs an ever increasing share of both national wealth and government spending. New technology, aging populations and increasing public expectations of the health care system are often cited as reasons why health care systems need ever increasing funding as well as reasons why universal and comprehensive public systems are unsustainable. However, increases in health care spending are not usually linked to corresponding increases in need for care within populations. Attempts to promote financial sustainability of systems such as limiting the range of services is covered or the groups of population covered may compromise their political sustainability as some groups are left to seek private cover for some or all services. In this paper, an alternative view of financial sustainability is presented which identifies the failure of planning and management of health care to reflect needs for care in populations and to integrate planning and management functions for health care expenditure, health care services and the health care workforce. We present a Health Care Sustainability Framework based on disaggregating the health care expenditure into separate planning components. Unlike other approaches to planning health care expenditure, this framework explicitly incorporates population health needs as a determinant of health care requirements, and provides a diagnostic tool for understanding the sources of expenditure increase. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  18. Public health and urban planning: a powerful alliance to be enhanced in Italy.

    Science.gov (United States)

    D'Alessandro, D; Appolloni, L; Capasso, L

    2017-01-01

    Urban planning has played and still plays a key role in improving urban health and indoor health. The authors sketch out the historical evolution of the relationships between Public Health and urban planning, in particular to what happened in Italy during the past 150 years. The authors suggest some lines for further research, but also describe some interventions that could obtain practical results in terms of health gains for the population.

  19. State of emergency preparedness for US health insurance plans.

    Science.gov (United States)

    Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

    2015-01-01

    Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

  20. Operating plan for the Office of International Health Programs

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-01-01

    In this report unified ideas are presented about what the Office of International Health Programs does, what the individual contributions are, and how the organization connects to the Department of Energy. The planning efforts have focused on the office`s three areas of responsibility: Europe, Japan, and the Marshall Islands. Common to each technical program area are issues related to the following: health of populations exposed to radiation incidents and the associated medical aspects of exposure; dose reconstruction; training; and public involvement. Each of the program areas, its customers, and primary customer interests are described.

  1. Social learning and health plan choice.

    Science.gov (United States)

    Sorensen, Alan T

    2006-01-01

    I use data from the University of California to empirically examine the role of social learning in employees' choices of health plans. The basic empirical strategy starts with the observation that if social learning is important, health plan selections should appear to be correlated across employees within the same department. Estimates of discrete choice models in which individuals' perceived payoffs are influenced by coworkers' decisions reveal a significant (but not dominant) social effect. The strength of the effect depends on factors such as the department's size or the employee's demographic distance from her coworkers. The estimated effects are present even when the model allows for unobserved, department-specific heterogeneity in employee preferences, so the results cannot be explained away by unobservable characteristics that are common to employees of the same department.

  2. Transforming health professionals into population health change agents

    Directory of Open Access Journals (Sweden)

    Lucio Naccarella

    2016-04-01

    Full Text Available Background. With the recognition that professional education has not kept pace with the challenges facing the health and human service system, there has been a move to transformative education and learning professional development designed to expand the number of enlightened and empowered change agents with the competence to implement changes at an individual, organisation and systems level. Design and Methods. Since 2010, the Department of Health and Human Services in Victoria, Australia, in collaboration with The University of Melbourne’s School of Population and Global Health, has delivered seven population health short courses aimed to catalyse participants’ transformation into population health change agents. This paper presents key learnings from a combination of evaluation data from six population health short courses using a transformative learning framework from a 2010 independent international commission for health professionals that was designed to support the goals of transformative and interdependent health professionals. Participatory realist evaluation approaches and qualitative methods were used. Results. Evaluation findings reveal that there were mixed outcomes in facilitating participants’ implementation of population health approaches, and their transformation into population health agents upon their return to their workplaces. Core enablers, barriers and requirements, at individual, organisational and system levels influence the capability of participants to implement population health approaches. The iterative and systemic evolution of the population health short courses, from a one off event to a program of inter-dependent modules, demonstrates sustained commitment by the short course developers and organisers to the promotion of transformative population health learning outcomes. Conclusions: To leverage this commitment, recognising that professional development is not an event but part of an ongoing transformative

  3. Federal Employees Health Benefits Program (FEHBP) Plan Information

    Data.gov (United States)

    Office of Personnel Management — A list of all Federal Employees Health Benefits Program (FEHBP) plans available in each state, as well as links to the plan brochures, changes for each plan from the...

  4. Security planning for public health emergencies.

    Science.gov (United States)

    Warren, Bryan

    2015-01-01

    In this article the author identifies the security sensitive areas of a hospital during a public health emergency event, and the need to have processes and plans in place to mitigate the security and traffic related problems that accompany such events. He describes a number of specialized security and safety guidelines and tools that have been designed by and provided to healthcare security professionals free of charge.

  5. Private Health Care Coverage in the Brazilian population, according to the 2013 Brazilian National Health Survey.

    Science.gov (United States)

    Malta, Deborah Carvalho; Stopa, Sheila Rizzato; Pereira, Cimar Azeredo; Szwarcwald, Célia Landmann; Oliveira, Martha; Reis, Arthur Chioro Dos

    2017-01-01

    This study aims to present the percentages of the Brazilian population holding health insurance plans, itemized by social-demographic characteristics, based on the data of the National Health Survey carried out in 2013, and to compare this information with the administrative data of the National Supplementary Health Agency for the same year. Data from the National Health Survey, and from the Beneficiaries Information System of the National Health Agency for the year 2013, were used. The percentage of people having a health plan was described according to stratification for: all of Brazil, urban/rural, Brazilian official Regions, Brazilian States and state capitals, gender, age group, level of schooling, position in the workforce, ethnic classification, and self-assessed state of health. Results include the following: The percentage of people saying they had some health plan in Brazil was 27.9% (CI 95%: 27.1-28.8). A significant difference was found relating to level of schooling - the percentage being highest for those who stated they had complete secondary education (68.8% CI 95%: 67.2-70.4) and for those who said they were currently in work (32.5% CI 95%: 31.5-33.5). The increase in health plan coverage in the Brazilian population reflects the improvement of the suply of employment and the growth in the country's economy.

  6. Slum health: Diseases of neglected populations

    Directory of Open Access Journals (Sweden)

    Unger Alon

    2007-03-01

    Full Text Available Abstract Background Urban slums, like refugee communities, comprise a social cluster that engenders a distinct set of health problems. With 1 billion people currently estimated to live in such communities, this neglected population has become a major reservoir for a wide spectrum of health conditions that the formal health sector must deal with. Discussion Unlike what occurs with refugee populations, the formal health sector becomes aware of the health problems of slum populations relatively late in the course of their illnesses. As such, the formal health sector inevitably deals with the severe and end-stage complications of these diseases at a substantially greater cost than what it costs to manage non-slum community populations. Because of the informal nature of slum settlements, and cultural, social, and behavioral factors unique to the slum populations, little is known about the spectrum, burden, and determinants of illnesses in these communities that give rise to these complications, especially of those diseases that are chronic but preventable. In this article, we discuss observations made in one slum community of 58,000 people in Salvador, the third largest city in Brazil, to highlight the existence of a spectrum and burden of chronic illnesses not likely to be detected by the formal sector health services until they result in complications or death. Lack of health-related data from slums could lead to inappropriate and unrealistic allocation of health care resources by the public and private providers. Similar misassumptions and misallocations are likely to exist in other nations with large urban slum populations. Summary Continued neglect of ever-expanding urban slum populations in the world could inevitably lead to greater expenditure and diversion of health care resources to the management of end-stage complications of diseases that are preventable. A new approach to health assessment and characterization of social

  7. Financial Performance of Health Plans in Medicaid Mana...

    Data.gov (United States)

    U.S. Department of Health & Human Services — This study assesses the financial performance of health plans that enroll Medicaid members across the key plan traits, specifically Medicaid dominant, publicly...

  8. The proof's in the partnerships: Are Affordable Care Act and Local Health Department accreditation practices influencing collaborative partnerships in community health assessment and improvement planning?

    Science.gov (United States)

    Laymon, Barbara; Shah, Gulzar; Leep, Carolyn J; Elligers, Julia Joh; Kumar, Vibha

    2015-01-01

    The strengthened requirement for nonprofit hospitals to complete a community health needs assessment and implementation plan in the Affordable Care Act, concurrent with a new voluntary accreditation process for local health departments that requires collaborative community health assessments and community health improvement plans, have led to a resurgence of interest in assessment and improvement planning. This study provides baseline data that will help determine whether the Affordable Care Act and public health accreditation will result in more collaborative community assessment and community health improvement activity by describing trends in collaborative community health assessment and community health improvement plan activities. Data sources include the National Profile of Local Health Departments studies and a database of community health assessment, community health needs assessment, community health improvement plan, and other implementation planning reports from across the country. The study finds that collaborative community assessment activity is positively associated with population size, governance type, and local health department and coalition-led efforts.

  9. Cultural Diversity and the Challenge of Health Planning in Nigeria ...

    African Journals Online (AJOL)

    Cultural Diversity and the Challenge of Health Planning in Nigeria. ... The cultural diversities equally manifest in diversity of health care demands and outcomes. ... Also that a grand health planning and framework will not work in producing desired health development until cultural factors accounting for failure in health ...

  10. How to inject consumerism into your existing health plans.

    Science.gov (United States)

    Havlin, Linda J; McAllister, Michael F; Slavney, David H

    2003-09-01

    Consumerism seeks to create a behavior change on the part of consumers so that they become accountable, knowledgeable and actively engaged in managing their health. It can be used in any existing health plan through targeted plan design changes and consumer education efforts. Employers have many options in addition to consumer-directed health plans (CDHPs).

  11. Hospitalization in older adults: association with multimorbidity, primary health care and private health plan

    Directory of Open Access Journals (Sweden)

    Bruno Pereira Nunes

    Full Text Available ABSTRACT OBJECTIVE Evaluate the association of multimorbidity, primary health care model and possession of a private health plan with hospitalization. METHODS A population-based cross-sectional study with 1,593 elderly individuals (60 years old or older living in the urban area of the city of Bagé, State of Rio Grande do Sul, Brazil. The outcome was hospitalization in the year preceding the interview. The multimorbidity was evaluated through two cut-off points (≥ 2 and ≥ 3. The primary health care model was defined by residence in areas covered by traditional care or by Family Health Strategy. The older adults mentioned the possession of a private health plan. We performed a gross and adjusted analysis by Poisson regression using a hierarchical model. The adjustment included demographic, socioeconomic, functional capacity disability and health services variables. RESULTS The occurrence of overall and non-surgical hospitalization was 17.7% (95%CI 15.8–19.6 and 10.6% (95%CI 9.1–12.1, respectively. Older adults with multimorbidity were admitted to hospitals more often when to older adults without multimorbidity, regardless of the exhibition’ form of operation. Having a private health plan increased the hospitalization by 1.71 (95%CI 1.09–2.69 times among residents in the areas of the Family Health Strategy when compared to elderly residents in traditional areas without a private health plan. CONCLUSIONS The multimorbidity increased the occurrence of hospitalizations, especially non-surgical ones. Hospitalization was more frequent in older adults with private health plan and those living in Family Health Strategy areas, regardless of the presence of multiple diseases.

  12. Is population flow an unintended consequence of alcohol management plans?

    Science.gov (United States)

    Usher, Kim; Woods, Cindy; Lynch, Paul; Pointing, Shane Boris; Budden, Lea; Barker, Ruth; Catchpoole, Jesani; Clough, Alan

    2017-03-01

    The aim of this study was to gauge whether, and to what extent, population flow occurred as a result of the implementation of alcohol management plans in Indigenous communities. Alcohol management plans involving carriage limits and dry places were introduced into 15 Queensland Indigenous communities between 2002-2004. Controls on alcohol availability were further tightened between 2008-2010, seeing the closure of eight mainly remote community taverns/canteens. A retrospective observational study was undertaken using data from the Queensland Injury Surveillance Unit. Population flow was measured by changing patterns of alcohol-related injuries in a mining region near dry Indigenous communities following the introduction of alcohol management plans and a control mining region distant from Indigenous communities with alcohol management plans. Data were analysed using descriptive and inferential statistics. Logistic regression was used for the comparison of the characteristics between the emergency department presentations. The rates of alcohol-related injury presentations per 1000/population were calculated and age-standardised to the Australian population. Between the five-year periods 2003-2007 and 2008-2012, alcohol-related injury presentations to the Mount Isa emergency department trebled from an age-adjusted average annual rate of 9·5/1000 in the region's population to 27·1/1000 population. In the control region, alcohol-related emergency department injury presentations did not increase to the same degree with age-adjusted average annual rates of 1·42/1000 and 2·21/1000, respectively. The 10-year pattern of emergency department presentations for alcohol-related injuries increased significantly in the Mount Isa region compared with the control region. Further research should investigate the impacts of population flow related to Indigenous community alcohol management plans. Although initiatives such as alcohol management plans have been implemented to reduce

  13. Forest health monitoring 1992 activities plan

    Energy Technology Data Exchange (ETDEWEB)

    Alexander, S.A.; Barnard, J.E.

    1993-11-01

    Forests, which cover approximately one-third of the United States, are an important part of the U.S. economy, culture, and ecology. In response to legislative mandate and concerns for our environment, several government agencies have been working together to develop a program to monitor the condition of the Nation's forests. The multiagency program is called the Forest Health Monitoring (FHM) program. The report is designed to serve two purposes for FHM. The first is to provide a description of major FHM activities planned for the fiscal year 1992. These activities range from the initial planning stages of field work to the assessment and reporting activities. The second is to provide background information about the FHM program organization, the indicator development process, and other activities within FHM.

  14. Mental health in war-affected populations

    NARCIS (Netherlands)

    Scholte, W.F.

    2013-01-01

    This book addresses mental health problems in populations in nonwestern war-affected regions, and methods to mitigate these problems through interventions focusing on social reintegration. It describes a number of studies among war-affected populations in widely different areas: refugees from the

  15. Coverage of the Brazilian population 18 years and older by private health plans: an analysis of data from the World Health Survey Cobertura da população brasileira com 18 anos ou mais por plano de saúde privado: uma análise dos dados da Pesquisa Mundial de Saúde

    Directory of Open Access Journals (Sweden)

    Francisco Viacava

    2005-01-01

    Full Text Available This study analyzes data from the World Health Survey (WHS conducted in 2003, with a sample of 5,000 individuals 18 years and older. Some 24.0% of the interviewees had private health insurance, and the main variables associated with private coverage were number of household assets, age, level of education, formal employment, living in municipalities with more than 50,000 inhabitants, and good self-rated health. The socioeconomic profiles of needs for and use of health services in the population covered by private health plans are different, confirming the findings of other studies reporting that this population segment as a whole presents better health conditions and greater use of services as compared to the population without private coverage, even after adjusting for socio-demographic variables and self-rated health. The WHS data also suggest that individuals with private health plans do not always use their insurance to pay for services, except in the case of mammograms.Esse estudo analisa os dados da Pesquisa Mundial de Saúde (PMS, realizada em 2003, em uma amostra de 5 mil indivíduos com 18 anos ou mais. Cerca de 24,0% dos indivíduos entrevistados têm seguro privado de saúde, sendo que os fatores associados à posse do plano são o número de bens, idade, escolaridade, ter emprego formal, residir em municípios com menos de 50 mil habitantes e referir boa auto-avaliação do estado de saúde. Os perfis sócio-demográficos de necessidades e uso de serviços de saúde da população coberta por plano de saúde são distintos, confirmando os achados de outros trabalhos que referem que esse segmento populacional como um todo apresenta melhores condições de saúde e um maior uso de serviços em relação à população não coberta por seguro de saúde, mesmo após o controle por variáveis sócio-demográficas e a auto-avaliação do estado de saúde. Os dados da PMS também sugerem que pessoas cobertas por plano de saúde nem sempre

  16. 77 FR 38296 - Draft Public Health Action Plan-A National Public Health Action Plan for the Detection...

    Science.gov (United States)

    2012-06-27

    ... HUMAN SERVICES Centers for Disease Control and Prevention Draft Public Health Action Plan--A National Public Health Action Plan for the Detection, Prevention, and Management of Infertility AGENCY: Centers... Federal Register requesting public comment on the draft National Public Health Action Plan for the...

  17. 77 FR 28883 - Draft Public Health Action Plan-A National Public Health Action Plan for the Detection...

    Science.gov (United States)

    2012-05-16

    ... HUMAN SERVICES Centers for Disease Control and Prevention Draft Public Health Action Plan--A National Public Health Action Plan for the Detection, Prevention, and Management of Infertility AGENCY: Centers... requesting public comment on the draft National Public Health Action Plan for the Detection, Prevention, and...

  18. Service-based health human resources planning for older adults.

    Science.gov (United States)

    Tomblin Murphy, Gail; MacKenzie, Adrian; Rigby, Janet; Rockwood, Kenneth; Gough, Amy; Greeley, Gogi; Montpetit, Frederick; Dill, Donna; Alder, Robert; Lackie, Kelly

    2013-08-01

    To test a service-based health human resources (HHR) planning approach for older adults in the context of home and long term care (LTC); to create a practical template/tools for use in various jurisdictions and/or health care settings. The most serious health needs of seniors in 2 Canadian jurisdictions were identified and linked to the specific services and associated competencies required of health care providers (HCPs) to address those needs. The amounts of each service required were quantified and compared against the capacity of HCPs to perform the services, measured using a self-assessment survey, by using a previously developed analytical framework. Home and LTC sectors in Nova Scotia and Nunavut, Canada. Regulated and nonregulated HCPs were invited to complete either an online or paper-based competency self-assessment survey. Survey response rates in Nova Scotia and Nunavut were 11% (160 responses) and 20% (22 responses), respectively. Comparisons of the estimated number of seniors likely to need each service with the number who can be served by the workforces in each jurisdiction indicated that the workforces in both jurisdictions are sufficiently numerous, active, productive, and competent to provide most of the services likely to be required. However, significant gaps were identified in pharmacy services, ongoing client assessment, client/family education and involvement, and client/family functional and social supports. Service-based HHR planning is feasible for identifying gaps in services required by older adults, and can guide policy makers in planning hiring/recruitment, professional development, and provider education curricula. Implementation will require commitment of policy makers and other stakeholders, as well as ongoing evaluation of its effectiveness. More broadly, the ongoing effectiveness of the approach will depend on workforce planning being conducted in an iterative way, driven by regular reevaluation of population health needs and HHR

  19. 75 FR 51831 - Request for Measures of Health Plan Efforts To Address Health Plan Members' Health Literacy Needs

    Science.gov (United States)

    2010-08-23

    ... gain patients' perspective on how well health and health plan information is communicated to them by... the service, explanation of screening results); (b) health problems/concerns (e.g., information on how... medications, possible side effects); and, (e) care management/disease management. A survey using the new...

  20. Health Literacy in the German Population.

    Science.gov (United States)

    Schaeffer, Doris; Berens, Eva-Maria; Vogt, Dominique

    2017-01-27

    Persons with low health literacy have difficulty dealing with the health care system and understanding health-related information. Studies from multiple countries have shown that low health literacy negatively affects health, health-related and illness-related behavior, and the utilization of health care resources. The data available till now on health literacy in Germany have been sparse. The goal of this study is to acquire representative data on the health literacy of the German population. In a cross-sectional study, we collected data from a representative group of 2000 persons over age 15 in Germany by means of computer-assisted personal interviews (CAPI) that were based on the long version of the questionnaire used in the European Health Literacy Survey (HLS-EU-Q47). Sociodemographic data were also collected. The respondents were a representative sample of the German population. 54.3% of them were found to have limited health literacy. Multiple logistic regression revealed associations of limited health literacy with advanced age (odds ratio [OR] 1.83, 95% confidence interval [CI] [1.36; 2.48]), an immigrant background (OR 1.87 [1.27; 2.75]), low self-assessed social status (OR 5.25 [3.57; 7.72]), and low functional literacy (OR 1.94 [1.49; 2.52]). The low health literacy of many Germans can impair communication between doctors and patients and exacerbate existing problems in health policy. In the future, greater effort will have to be made to foster health literacy, make health-related information for patients easier to understand, and intensify research in the field of health literacy.

  1. Risk adjusting community rated health plan premiums: a survey of risk assessment literature and policy applications.

    Science.gov (United States)

    Giacomini, M; Luft, H S; Robinson, J C

    1995-01-01

    This paper surveys recent health care reform debates and empirical evidence regarding the potential role for risk adjusters in addressing the problem of competitive risk segmentation under capitated financing. We discuss features of health plan markets affecting risk selection, methodological considerations in measuring it, and alternative approaches to financial correction for risk differentials. The appropriate approach to assessing risk differences between health plans depends upon the nature of market risk selection allowed under a given reform scenario. Because per capita costs depend on a health plan's population risk, efficiency, and quality of service, risk adjustment will most strongly promote efficiency in environments with commensurately strong incentives for quality care.

  2. Agriculture and Health Sectors Collaborate in Addressing Population Health.

    Science.gov (United States)

    Kaufman, Arthur; Boren, Jon; Koukel, Sonja; Ronquillo, Francisco; Davies, Cindy; Nkouaga, Carolina

    2017-09-01

    Population health is of growing importance in the changing health care environment. The Cooperative Extension Service, housed in each state's land grant university, has a major impact on population health through its many community-based efforts, including the Supplemental Nutrition Assistance Program - Education (SNAP-Ed) nutrition programs, 4-H youth engagement, health and wellness education, and community development. Can the agricultural and health sectors, which usually operate in parallel, mostly unknown to each other, collaborate to address population health? We set out to provide an overview of the collaboration between the Cooperative Extension Service and the health sector in various states and describe a case study of 1 model as it developed in New Mexico. We conducted a literature review and personally contacted states in which the Cooperative Extension Service is collaborating on a "Health Extension" model with academic health centers or their health systems. We surveyed 6 states in which Health Extension models are being piloted as to their different approaches. For a case study of collaboration in New Mexico, we drew on interviews with the leadership of New Mexico State University's Cooperative Extension Service in the College of Agricultural, Consumer and Environmental Sciences; the University of New Mexico (UNM) Health Science Center's Office for Community Health; and the personal experiences of frontline Cooperative Extension agents and UNM Health Extension officers who collaborated on community projects. A growing number of states are linking the agricultural Cooperative Extension Service with academic health centers and with the health care system. In New Mexico, the UNM academic health center has created "Health Extension Rural Offices" based on principles of the Cooperative Extension model. Today, these 2 systems are working collaboratively to address unmet population health needs in their communities. Nationally, the Cooperative Extension

  3. Population issues in economic planning: uses of demography in business.

    Science.gov (United States)

    Graham, R J

    1984-01-01

    Economists use demography in planning and forecasting business needs. As a bank, Westpac uses the information for its own internal business purposes and to assess general economic trends. Externally, the bank is expected by government and the public to have some authoritative views on the state of the economy. To form these views, it is necessary to understand a very wide array of statistical indicators, including demographic statistics. The main population issues of concern are: size, location, and changes in the population of Australia as a whole and by State; labor force (including projections); age profile of Australia and by State. The major source for this information is the Australian Bureau of Statistics. More detailed patterns often emerge, particularly for individual States, from papers prepared by others. This information is used by Westpac in 3 main planning areas and 2 broad assessment areas: planning -- location of bank branches, products/services offered, and marketing of products/services; and assessment -- economic outlook (labor force, housing needs, demand for funds) and specific industries. Recently, Westpac restructured its organization to cater to the changing needs of customers and the changing geographic patterns of population spread. The bank now has 4 major groups: retail financial services for personal and commercial markets; corporate and international; management services; and group planning (includes economic department). To offer products that fit the market, the bank needs to know the characteristics of the population by age, spending patterns, lifestyle preferences, and investment needs. Within Australia, a relatively new service offered by most financial institutions, which is directly related to population issues, is a counseling service for retirees. Westpac has a product called Club 55, which is a package of services designed for persons who have retired or are planning to retire. Another clearly perceived community need is for

  4. The Malaysian health care system: Ecology, plans, and reforms

    Directory of Open Access Journals (Sweden)

    Andrea Sebastian

    2016-08-01

    Full Text Available Malaysia is on its way to achieving developed nation status in the next 4 years. Currently, Malaysia is on track for three Millennium Development Goals (MDG1, MDG4, and MDG7. The maternal mortality rate, infant mortality rate, and mortality rate of children younger than 5 years improved from 25.6% (2012 to 6.6% (2013, and 7.7% (2012 per 100,000 live births, respectively whereas immunization coverage for infants increased to an average of 90%. As of 2013 the ratio of physicians to patients improved to 1:633 while the ratio of health facilities to the population was 1:10,272. The current government administration has proposed a reform in the form of the 10th Malaysian Plan coining the term “One Care for One Malaysia” as the newly improved and reorganized health care plan, where efficiency, effectiveness, and equity are the main focus. This review illustrates Malaysia’s transition from pre-independence to the current state, and its health and socioeconomic achievement as a country. It aims to contribute knowledge through identifying the plans and reforms by the Malaysian government while highlighting the challenges faced as a nation.

  5. Communicating health information to disadvantaged populations.

    Science.gov (United States)

    Beacom, Amanda M; Newman, Sandra J

    2010-01-01

    Interest in the communication of health information among disadvantaged populations has increased in recent years with the shift from a model of patient-provider communication to one of a more empowered healthcare consumer; with the use of new communication technologies that increase the number of channels through which health information may be accessed; and with the steadily increasing number of people without health insurance. Three separate research literatures contribute to our current understanding of this issue. In the medicine and public health literature, disparities in health access and outcomes among socioeconomic, ethnic, and racial groups are now well documented. In the information sciences literature, scholars note that on a continuum of health information behaviors, ranging from information avoidance and nonseeking to active seeking, nonseeking behaviors are associated with disadvantaged populations. In the communication literature, enthusiasm over the technology-driven growth of online health information seeking is tempered by evidence supporting the knowledge gap hypothesis, which indicates that as potential access to health information increases, systematic gaps in health knowledge also increase as groups with higher socioeconomic status acquire this information at a faster rate than those with lower socioeconomic status. A number of diverse strategies show promise in reducing information and health disparities, including those that focus on technology, such as programs to increase computer and Internet access, skills, and comprehension; those that focus on interpersonal communication, such as the community health worker model; and those that focus on mass media channels, such as entertainment education.

  6. The Hemophilia Games: An Experiment in Health Education Planning.

    Science.gov (United States)

    National Heart and Lung Inst. (DHEW/PHS), Bethesda, MD.

    The Hemophilia Health Education Planning Project was designed to (1) create a set of tools useful in hemophilia planning and education, and (2) create a planning model for other diseases with similar factors. The project used the game-simulations technique which was felt to be particularly applicable to hemophilia health problems, since as a…

  7. Knowledge and Attitude about Reproductive Health and Family Planning among Young Adults in Yemen

    Directory of Open Access Journals (Sweden)

    Muhammed S. A. Masood

    2017-01-01

    Full Text Available Background. The Yemeni government is focusing more attention on the needs of youth to ensure a healthy transition to adulthood. This is critical because adolescent population (ages 15–24 of 3.35 million will double in just 20 years. Young adults often lack basic knowledge about reproductive health and family planning. Objectives. To determine reproductive health and family planning knowledge and attitude among young adults aged 15 to 25+ years. Method. Sample study was taken from Marie Stopes International in Yemen which was conducted from March to July 2013 on the reproductive health age 15–49 years. Descriptive, bivariate, and multivariate analyses were employed. Results. Majority had heard about reproductive health and family planning and encouraged its methods. Television, relatives, and radio were major sources of information. Adults with higher education tend to have more awareness about health services. Knowledge about health services and family planning methods among older adults was significant, and adults in Belqees Club were more likely to have high empowerment scores for family planning methods. Conclusion. The level of knowledge about health services for reproductive health and family planning and its methods was low to moderate. The introduction of contraceptives remains a challenge in Yemen because the educational reproductive health is weak in Yemeni schools or health institutes or universities. Information about reproductive health and family planning should be provided to adolescents through medical schools curricula.

  8. Regional health workforce planning through action research: lessons for commissioning health services from a case study in Far North Queensland.

    Science.gov (United States)

    Panzera, Annette June; Murray, Richard; Stewart, Ruth; Mills, Jane; Beaton, Neil; Larkins, Sarah

    2016-01-01

    Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services

  9. Medication therapy disease management: Geisinger's approach to population health management.

    Science.gov (United States)

    Jones, Laney K; Greskovic, Gerard; Grassi, Dante M; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R; Murray, Michael F; Manickam, Kandamurugu; Nathanson, Douglas C; Wright, Eric A; Evans, Michael A

    2017-09-15

    Pharmacists' involvement in a population health initiative focused on chronic disease management is described. Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS). Over a 15-year period, Geisinger Health Plan (GHP)-insured patients with AF whose warfarin therapy was managed by the MTDM program had, on average, 18% fewer emergency department (ED) visits and 18% fewer hospitalizations per year than GHP enrollees with AF who did not receive MTDM services, with 23% lower annual total care costs. Over a 2-year period, GHP-insured patients with MS whose pharmacotherapy was managed by pharmacists averaged 28% fewer annual ED visits than non-pharmacist-managed patients; however, the mean annual total care cost was 21% higher among MTDM clinic patients. The Geisinger MTDM program has evolved over 20 years from a single pharmacist-run anticoagulation clinic into a large program focused on managing the health of an ever-growing population. Initial challenges in integrating pharmacists into the Geisinger patient care framework as clinical experts were overcome by demonstrating the MTDM program's positive impact on patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  10. Extinction risk assessment for the species survival plan (SSP) population of the Bali mynah (Leucopsar rothschildi).

    Science.gov (United States)

    Earnhardt, Joanne M; Thompson, Steven D; Faust, Lisa J

    2009-05-01

    The Bali mynah Species Survival Plan (SSP), an Association of Zoos and Aquariums program, strives to maintain the genetic and demographic health of its population, avoid unplanned changes in size, and minimize the risk of population extinction. The SSP population meets current demographic and genetic objectives with a population size of 209 birds at 61 institutions and 96% genetic diversity (GD) retained from the source population. However, participating institutions have expressed concerns regarding space allocation, target population size (TPS), breeding restrictions, inbreeding depression, and harvest in relation to future population availability and viability. Based on these factors, we assess five questions with a quantitative risk assessment, specifically a population viability analysis (PVA) using ZooRisk software. Using an individual-based stochastic model, we project potential population changes under different conditions (e.g. changes in TPS and genetic management) to identify the most effective management actions. Our projections indicate that under current management conditions, population decline and extinction are unlikely and that although GD will decline over 100 years the projected loss does not exceed levels acceptable to population managers (less than 90% GD retained). Model simulations indicate that the combination of two genetic management strategies (i.e. priority breeding based on mean kinship and inbreeding avoidance) benefits the retention of GD and reduces the accumulation of inbreeding. The current TPS (250) is greater than necessary to minimize the risk of extinction for the SSP population but any reduction in TPS must be accompanied by continued application of genetic management. If carefully planned, birds can be harvested for transfer to Bali for a reintroduction program without jeopardizing the SSP population.

  11. Administrative data for public health surveillance and planning.

    Science.gov (United States)

    Virnig, B A; McBean, M

    2001-01-01

    Electronically available administrative data are increasingly used by public health researchers and planners. The validity of the data source has been established, and its strengths and weaknesses relative to data abstracted from medical records and obtained via survey are documented. Administrative data are available from a variety of state, federal, and private sources and can, in many cases, be combined. As a tool for planning and surveillance, administrative data show great promise: They contain consistent elements, are available in a timely manner, and provide information about large numbers of individuals. Because they are available in an electronic format, they are relatively inexpensive to obtain and use. In the United States, however, there is no administrative data set covering the entire population. Although Medicare provides health care for an estimated 96% of the elderly, age 65 years and older, there is no comparable source for those under 65.

  12. Health Law 2015: Individuals and Populations.

    Science.gov (United States)

    Jacobson, Peter D; Dahlen, Rachel

    2016-12-01

    In this article, we assess two particular trends in judicial doctrine that are likely to emerge in the post-ACA era. The first trend is the inevitable emergence of enterprise medical liability (EML) that will supplant tort law's unstable attempt to apportion liability between physicians and institutions. Arguments favoring EML in health law date back to the early 1980s. But health care's ongoing consolidation suggests that the time has arrived for courts or state legislatures to develop legal doctrine that more closely resembles the ways in which health care is now delivered. This would result in a more appropriate allocation of liability to the institutional level. The second judicial trend will be the convergence of health law and public health law concepts. Because the ACA arguably stimulates closer engagement between health systems and public health departments, health systems will have greater responsibility for keeping their communities healthy along with obligations for individual patient care (i.e., individuals and populations). If so, courts will need to incorporate elements from health law and public health law in resolving disputes. Copyright © 2016 by Duke University Press.

  13. Land use planning: why public health must be involved.

    Science.gov (United States)

    Jackson, Richard; Harp, Toni; Wright, Tom

    2002-01-01

    The way that land is used has a direct impact on public health. Legislators and other with responsibility for land use planning need to be aware of the public health connection and need to promote effective land use planning as a means of improving the public's health. This article discusses the public health/land use connection and the role that local, state, and national legislators can play in promoting land use planning that supports the public's health. It also provides an example of a collaborative local land use initiative aimed at addressing a public health problem in a city and at providing a model that other locations can use in making land use conform to sound public health policy. Finally, it provides an overview of initiatives to promote healthy land use in the New York metropolitan area by Regional Plan Association, a private non-profit planning organization.

  14. School-Sponsored Health Insurance: Planning for a New Reality

    Science.gov (United States)

    Liang, Bryan A.

    2010-01-01

    Health care reform efforts in both the Clinton and Obama administrations have attempted to address college and university health. Yet, although the world of health care delivery has almost universally evolved to managed care, school health programs have not. In general, school-sponsored health plans do little to improve access and have adopted…

  15. Macroeconomic conditions and population health in Iceland

    Directory of Open Access Journals (Sweden)

    Kristín Helga Birgisdóttir

    2017-09-01

    Full Text Available Background: Results from recent research on the impact of economic cycles and population health have been mixed, with results appearing to be context-sensitive. Objective: We examine the long-term relationship between economic conditions and population health in Iceland, which has experienced some economically turbulent times in the last years and decades. Methods: We use aggregate annual data for 1981‒2014. We use three aggregate indicators of economic activity to proxy the economic cycle: unemployment rate, real GDP per capita, and real GDP. Life expectancy at birth, infant mortality, and total mortality as well as four cause-specific mortality rates were used as outcome measures. Results: Our results do not suggest a statistically significant relationship between economic conditions and total mortality, infant mortality, or life expectancy. Different responses between causes of death are found, and in some instances between genders, although statistical significance is low. We do, however, find a consistent and statistically significant relationship for females aged 45‒64, where economic downturns are associated with lower all-cause mortality. Conclusions: For the time period studied we do not find a significant relationship between economic cycles and population health, where health is proxied by mortality rates, life expectancy at birth, and infant mortality. Further studies using less extreme health outcomes, such as morbidity rates, are warranted. Contribution: This type of study has not been performed using Icelandic data before and provides a comparison to research from other countries where the relationship has been explored more. Additionally, one of the contributions of this paper is to use a variety of economic indicators as proxies for economic cycles in a study examining their relationship with population health.

  16. [Family planning as a determinant of individual and community health].

    Science.gov (United States)

    Trias, M

    1991-06-01

    The most recent contraceptive prevalence survey in Colombia indicated that over 2/3 of couples at risk of conception used some contraceptive method in 1990. This figure is close to the 80% or over common in developed countries and far exceeds the rates of 10% or even less in sub-Saharan African countries. Colombia's prevalence rate of around 15% in 1965, the 1st year of institutionalized family planning programs, included many users of ineffective traditional methods. Family planning, the possibility of determining the number and spacing of children, can be analyzed from various perspectives including its legal foundation as a human right and the demographic benefits of reproductive moderation. A stable population size would substantially simplify the problems of health, education, housing, and employment faced by developing countries. From a humanitarian perspective, family planning satisfies the ancient desire of human beings to separate reproduction and sex and also opens the door to different techniques of medically assisted conception. Some of the most significant benefits of family planning are those in the area of health. The positive effects on maternal and infant health and survival of avoiding pregnancy at the extremes of the reproductive period as well as pregnancies that are too numerous or closely spaced are now recognized. Colombia's infant mortality rate has fallen from 100/1000 live births in 1965 to 24 in 1990. Many factors besides family planning were involved, and the exact contribution of higher educational levels of mothers, use of oral rehydration therapy, promotion of breastfeedings, greater availability of potable water, and vaccination programs as well as of family planning are difficult to assess. But it is clear that child survival programs that neglect to include modern contraception as a principal component are shortsighted. Infants of adolescent mothers face mortality rates that are 15-40% higher than those of mothers over 20. Beyond

  17. Right to sexual and reproductive health in new population policies of Iran.

    Science.gov (United States)

    Kokabisaghi, Fatemeh

    2017-02-24

    Sexual and reproductive health services in Iran are influenced by population policies. Willingness of Iranian policy makers to control the population's growth rate resulted in the provision of countrywide family planning services and contraceptives from 1990 to 2013. Now policy makers favour population growth because of a statistically significant decline in the fertility rate and ageing of the population. New population policies contain incentives for higher fertility and limitations on family planning services. Some elements of these policies contradict standards of international human rights treaties including prohibition against retrogressive measures and limitations on sexual and reproductive health services. These policies may jeopardize individual and public health. Iran should immediately revoke these laws and policies and progressively improve people's enjoyment of their right to sexual and reproductive health. The country's population policies should focus on encouraging people to have higher fertility by providing financial and social support to parents and future children.

  18. Psychedelics and Mental Health: A Population Study

    Science.gov (United States)

    Krebs, Teri S.; Johansen, Pål-Ørjan

    2013-01-01

    Background The classical serotonergic psychedelics LSD, psilocybin, mescaline are not known to cause brain damage and are regarded as non-addictive. Clinical studies do not suggest that psychedelics cause long-term mental health problems. Psychedelics have been used in the Americas for thousands of years. Over 30 million people currently living in the US have used LSD, psilocybin, or mescaline. Objective To evaluate the association between the lifetime use of psychedelics and current mental health in the adult population. Method Data drawn from years 2001 to 2004 of the National Survey on Drug Use and Health consisted of 130,152 respondents, randomly selected to be representative of the adult population in the United States. Standardized screening measures for past year mental health included serious psychological distress (K6 scale), mental health treatment (inpatient, outpatient, medication, needed but did not receive), symptoms of eight psychiatric disorders (panic disorder, major depressive episode, mania, social phobia, general anxiety disorder, agoraphobia, posttraumatic stress disorder, and non-affective psychosis), and seven specific symptoms of non-affective psychosis. We calculated weighted odds ratios by multivariate logistic regression controlling for a range of sociodemographic variables, use of illicit drugs, risk taking behavior, and exposure to traumatic events. Results 21,967 respondents (13.4% weighted) reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote), or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems. Conclusion We did not find use of psychedelics to be an independent risk factor for mental health problems. PMID:23976938

  19. Psychedelics and mental health: a population study.

    Science.gov (United States)

    Krebs, Teri S; Johansen, Pål-Ørjan

    2013-01-01

    The classical serotonergic psychedelics LSD, psilocybin, mescaline are not known to cause brain damage and are regarded as non-addictive. Clinical studies do not suggest that psychedelics cause long-term mental health problems. Psychedelics have been used in the Americas for thousands of years. Over 30 million people currently living in the US have used LSD, psilocybin, or mescaline. To evaluate the association between the lifetime use of psychedelics and current mental health in the adult population. Data drawn from years 2001 to 2004 of the National Survey on Drug Use and Health consisted of 130,152 respondents, randomly selected to be representative of the adult population in the United States. Standardized screening measures for past year mental health included serious psychological distress (K6 scale), mental health treatment (inpatient, outpatient, medication, needed but did not receive), symptoms of eight psychiatric disorders (panic disorder, major depressive episode, mania, social phobia, general anxiety disorder, agoraphobia, posttraumatic stress disorder, and non-affective psychosis), and seven specific symptoms of non-affective psychosis. We calculated weighted odds ratios by multivariate logistic regression controlling for a range of sociodemographic variables, use of illicit drugs, risk taking behavior, and exposure to traumatic events. 21,967 respondents (13.4% weighted) reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote), or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems. We did not find use of psychedelics to be an independent risk factor for mental health problems.

  20. Psychedelics and mental health: a population study.

    Directory of Open Access Journals (Sweden)

    Teri S Krebs

    Full Text Available The classical serotonergic psychedelics LSD, psilocybin, mescaline are not known to cause brain damage and are regarded as non-addictive. Clinical studies do not suggest that psychedelics cause long-term mental health problems. Psychedelics have been used in the Americas for thousands of years. Over 30 million people currently living in the US have used LSD, psilocybin, or mescaline.To evaluate the association between the lifetime use of psychedelics and current mental health in the adult population.Data drawn from years 2001 to 2004 of the National Survey on Drug Use and Health consisted of 130,152 respondents, randomly selected to be representative of the adult population in the United States. Standardized screening measures for past year mental health included serious psychological distress (K6 scale, mental health treatment (inpatient, outpatient, medication, needed but did not receive, symptoms of eight psychiatric disorders (panic disorder, major depressive episode, mania, social phobia, general anxiety disorder, agoraphobia, posttraumatic stress disorder, and non-affective psychosis, and seven specific symptoms of non-affective psychosis. We calculated weighted odds ratios by multivariate logistic regression controlling for a range of sociodemographic variables, use of illicit drugs, risk taking behavior, and exposure to traumatic events.21,967 respondents (13.4% weighted reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote, or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems.We did not find use of psychedelics to be an independent risk factor for mental health problems.

  1. 76 FR 46677 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Coverage of...

    Science.gov (United States)

    2011-08-03

    ... Center for Consumer Information & Insurance Oversight of the U.S. Department of Health and Human Services... with respect to group health plans and health insurance coverage offered in connection with a group.... The temporary regulations provide guidance to employers, group health plans, and health insurance...

  2. Strategic Planning in a Health Leadership Sector: A Report from UNESCO Chair in Health Education, Iran

    OpenAIRE

    K Bidad; F Farzadi; Pourpak, Z.; Moin, M.

    2009-01-01

    "nStrategic planning defines the formal decision of a company for its future. Like all organizations, health care sectors need to prepare their strategic planning and act according to it. UNESCO chair in health edu­cation as a leader health sector, describes the course and steps for preparing its strategic planning based on SWOT analysis technique. 

  3. Risk sharing between competing health plans and sponsors

    NARCIS (Netherlands)

    E.M. van Barneveld (Erik); W.P.M.M. van de Ven (Wynand); R.C.J.A. van Vliet (René)

    2001-01-01

    textabstractIn many countries, competing health plans receive capitation payments from a sponsor, whether government or a private employer. All capitation payment methods are far from perfect and have raised concerns about risk selection. Paying health plans partly on the basis of

  4. Rhetoric and Reality of Community Participation in Health Planning ...

    African Journals Online (AJOL)

    being. Participation in health planning. Planning begins at the stage of needs assessment or situation analysis. [32] but it is not always easy to have health care policies created with a full or realistic reflection of community values. This arises from the fact that no single society is made up of single. 'community', and therefore ...

  5. A joint urban planning and public health framework: contributions to health impact assessment.

    Science.gov (United States)

    Northridge, Mary E; Sclar, Elliott

    2003-01-01

    A joint urban planning and public health perspective is articulated here for use, in health impact assessment. Absent a blueprint for a coherent and supportive structure on which to test our thinking, we are bound to fall flat. Such a perspective is made necessary by the sheer number of people living in cities throughout the world, the need for explicit attention to land use and transportation systems as determinants of population health, and the dearth of useful indicators of the built environment for monitoring progress. If explicit attention is not paid to the overarching goals of equality and democracy, they have little if any chance of being realized in projects, programs, and policies that shape the built environment and therefore the public's health.

  6. A Joint Urban Planning and Public Health Framework: Contributions to Health Impact Assessment

    Science.gov (United States)

    Northridge, Mary E.; Sclar, Elliott

    2003-01-01

    A joint urban planning and public health perspective is articulated here for use, in health impact assessment. Absent a blueprint for a coherent and supportive structure on which to test our thinking, we are bound to fall flat. Such a perspective is made necessary by the sheer number of people living in cities throughout the world, the need for explicit attention to land use and transportation systems as determinants of population health, and the dearth of useful indicators of the built environment for monitoring progress. If explicit attention is not paid to the overarching goals of equality and democracy, they have little if any chance of being realized in projects, programs, and policies that shape the built environment and therefore the public’s health. PMID:12511400

  7. Health and disease in unacculturated Amerindian populations

    Energy Technology Data Exchange (ETDEWEB)

    Neel, J.V.

    1977-08-01

    The stereotype of uncontacted tribal populations is that they must reproduce at near capacity to maintain or slightly increase their numbers. This paper argues that the health of minimally contacted Amerindians, as judged by the results of physical examinations and life tables for the Yanomama of Southern Venezuela and Northern Brazil, is relatively good, with population control a feature of the Indian culture. It is further argued that the usual deterioration in health with contacts with western culture probably does not result so much from special innate susceptibilities to certain epidemic diseases and to the diets and ''stresses'' of civilization as from the epidemiological characteristics of newly contacted peoples.

  8. Health Care Provider Initiative Strategic Plan

    Science.gov (United States)

    National Environmental Education & Training Foundation, 2012

    2012-01-01

    This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…

  9. Health returns of the older adult population

    OpenAIRE

    Cortez V., Rafael; Zavala L., José

    2014-01-01

    The oldest people is described as one of the most vulnerable population groups in the country. They require special public attention since there is a weak protection to risks and external changes. The demographic transition in Peru is increasing the proportion of people older than 60 years in a constant pattern. Besides, labor participation is high around 54%, and poverty levels even higher (70%). The objective of the study is to estimate the impact of health status on labour productivity in ...

  10. 75 FR 34571 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-06-17

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ50 Group Health Plans and Health Insurance Coverage Rules... respect to group health plans and health insurance coverage offered in connection with a group health plan... temporary regulations provide guidance to employers, group health plans, and health insurance issuers...

  11. Status report - The Public Health and Planning 101 project: strengthening collaborations between the public health and planning professions

    Science.gov (United States)

    Mahendra, Ahalya; Vo, Tin; Einstoss, Candice; Weppler, Jason; Gillen, Pauline; Ryan, Loretta; Haley, Kevin

    2017-01-01

    Abstract The Public Health and Planning 101 project aimed to increase cross-disciplinary knowledge among public health and planning professionals involved in the land use planning process. The multi-disciplinary project team administered an online survey in 2012 to Ontario public health and planning professionals in order to identify learning needs related to the built environment that would inform the development of the education module. The survey asked about built environment work, experience with collaborations, barriers faced working with the other profession, and learning needs. Most survey respondents agreed that both professions should be working together on the built environment, although only half indicated they actually were. The survey findings revealed the need for an education module to help public health and planning professionals collaborate in the land use planning process in Ontario, and to help inform policy related to healthy built environments. PMID:28102993

  12. Adult height, nutrition, and population health

    Science.gov (United States)

    Perkins, Jessica M.; Subramanian, S.V.; Davey Smith, George

    2016-01-01

    In this review, the potential causes and consequences of adult height, a measure of cumulative net nutrition, in modern populations are summarized. The mechanisms linking adult height and health are examined, with a focus on the role of potential confounders. Evidence across studies indicates that short adult height (reflecting growth retardation) in low- and middle-income countries is driven by environmental conditions, especially net nutrition during early years. Some of the associations of height with health and social outcomes potentially reflect the association between these environmental factors and such outcomes. These conditions are manifested in the substantial differences in adult height that exist between and within countries and over time. This review suggests that adult height is a useful marker of variation in cumulative net nutrition, biological deprivation, and standard of living between and within populations and should be routinely measured. Linkages between adult height and health, within and across generations, suggest that adult height may be a potential tool for monitoring health conditions and that programs focused on offspring outcomes may consider maternal height as a potentially important influence. PMID:26928678

  13. Population health diagnosis with an ecohealth approach

    Science.gov (United States)

    Arenas-Monreal, Luz; Cortez-Lugo, Marlene; Parada-Toro, Irene; Pacheco-Magaña, Lilian E; Magaña-Valladares, Laura

    2015-01-01

    OBJECTIVE To analyze the characteristics of health diagnosis according to the ecohealth approach in rural and urban communities in Mexico. METHODS Health diagnosis were conducted in La Nopalera, from December 2007 to October 2008, and in Atlihuayan, from December 2010 to October 2011. The research was based on three principles of the ecohealth approach: transdisciplinarity, community participation, gender and equity. To collect information, a joint methodology and several techniques were used to stimulate the participation of inhabitants. The diagnostic exercise was carried out in five phases that went from collecting information to prioritization of problems. RESULTS The constitution of the transdisciplinary team, as well as the participation of the population and the principle of gender/equity were differentials between the communities. In the rural community, the active participation of inhabitants and authorities was achieved and the principles of transdisciplinarity and gender/equity were incorporated. CONCLUSIONS With all the difficulties that entails the boost in participation, the incorporation of gender/equity and transdisciplinarity in health diagnosis allowed a holistic public health approach closer to the needs of the population. PMID:26538099

  14. Population health diagnosis with an ecohealth approach.

    Science.gov (United States)

    Arenas-Monreal, Luz; Cortez-Lugo, Marlene; Parada-Toro, Irene; Pacheco-Magaña, Lilian E; Magaña-Valladares, Laura

    2015-01-01

    To analyze the characteristics of health diagnosis according to the ecohealth approach in rural and urban communities in Mexico. Health diagnosis were conducted in La Nopalera, from December 2007 to October 2008, and in Atlihuayan, from December 2010 to October 2011. The research was based on three principles of the ecohealth approach: transdisciplinarity, community participation, gender and equity. To collect information, a joint methodology and several techniques were used to stimulate the participation of inhabitants. The diagnostic exercise was carried out in five phases that went from collecting information to prioritization of problems. The constitution of the transdisciplinary team, as well as the participation of the population and the principle of gender/equity were differentials between the communities. In the rural community, the active participation of inhabitants and authorities was achieved and the principles of transdisciplinarity and gender/equity were incorporated. With all the difficulties that entails the boost in participation, the incorporation of gender/equity and transdisciplinarity in health diagnosis allowed a holistic public health approach closer to the needs of the population.

  15. [Quality planning of Family Health Units using Quality Function Deployment (QFD)].

    Science.gov (United States)

    Volpato, Luciana Fernandes; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi

    2010-08-01

    Quality is an indispensible requirement in the health field, and its pursuit is necessary in order to meet demands by a population that is aware of its rights, as part of the essence of good work relations, and to decrease technological costs. Quality thus involves all parties to the process (users and professionals), and is no longer merely an attribute of the health service. This study aimed to verify the possibility of quality planning in the Family Health Units, using Quality Function Deployment (QFD). QFD plans quality according to user satisfaction, involving staff professionals and identifying new approaches to improve work processes. Development of the array, called the House of Quality, is this method's most important characteristics. The results show a similarity between the quality demanded by users and the quality planned by professionals. The current study showed that QFD is an efficient tool for quality planning in public health services.

  16. Public health spending and population health: a systematic review.

    Science.gov (United States)

    Singh, Simone R

    2014-11-01

    This systematic review synthesizes what is known about the relationship between public health spending and population health outcomes, as well as the pathways that may explain how outcomes vary with spending. It also discusses the limitations of the existing literature and identifies areas in need of future research. Studies included in this review were retrieved through an iterative process, primarily through key word searches in two literature databases (PubMed and JSTOR) conducted in 2013. All retrieved studies underwent initial and secondary screening. Articles were included if they (1) examined the link between spending and outcomes or (2) explored pathways that mediate the relationship between spending and outcomes. Seventeen empirical studies and five literature reviews published between 1985 and 2012 were included in this review. Existing evidence suggests that increases in public health spending are associated with improved population health, at least for some outcomes. However, there is little evidence to suggest that increased spending contributes to meaningful reductions in health disparities. Moreover, the pathways through which greater spending translates into better outcomes are not well understood. Although the complexity of the public health delivery system makes it difficult to demonstrate definitive associations between spending and outcomes, financial investments in public health have the potential to improve community health. Additional research is needed to explore the pathways that mediate this relationship. This research would benefit public health practitioners who need evidence on how to best spend financial resources to achieve better health outcomes. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  17. 77 FR 18309 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Science.gov (United States)

    2012-03-27

    ... Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans; Exchange Standards... Qualified Health Plans; Exchange Standards for Employers AGENCY: Department of Health and Human Services..., 2011 rule titled Establishment of Exchanges and Qualified Health Plans (``Exchange establishment...

  18. Identifying Health Maintenance Organization membership through self-report of health plan name: ascertainment and reliability.

    Science.gov (United States)

    Clements, Karen M; Cohen, Bruce B; Brawarsky, Phyllis; Brooks, Daniel R; Mucci, Lorelei A; Wood, Phillip A

    2006-01-01

    To evaluate the feasibility and reliability of (1) identifying Health Maintenance Organization (HMO) membership by ascertaining self-reported health plan name in a telephone survey and (2) using external information to determine whether the plan was an HMO. Respondents to the 1999-2001 Massachusetts Behavioral Risk Factor Surveillance System (BRFSS) and the 1999 Massachusetts Colorectal Cancer (CRC) survey were asked to name their health plan. The authors used information from external sources to classify the plan as an HMO or a non-HMO. Test-retest reliability of reported plan name was examined overall, by demographic characteristics, and by health plan name. Reliability of HMO classification was tested with the kappa statistic. More than 88 percent of respondents with commercial health insurance provided their health plan name; 84 percent reported a plan that could be assigned as either an HMO or a non-HMO. The percentage whose HMO status could be assigned differed by demographic characteristics. Among those assigned, the distribution of specific HMOs among survey respondents was similar to the distribution reported by the Massachusetts Division of Insurance. In a subsample, 78 percent reported the same health plan during a follow-up interview. Agreement was higher for men, and differed according to the plan reported at the first time point. Kappa for HMO classification from health plan name was 0.87. Self-report of health plan name is a feasible and reliable method to ascertain health insurance information in a telephone interview.

  19. Using Smartphones and Health Apps to Change and Manage Health Behaviors: A Population-Based Survey.

    Science.gov (United States)

    Ernsting, Clemens; Dombrowski, Stephan U; Oedekoven, Monika; O Sullivan, Julie L; Kanzler, Melanie; Kuhlmey, Adelheid; Gellert, Paul

    2017-04-05

    Chronic conditions are an increasing challenge for individuals and the health care system. Smartphones and health apps are potentially promising tools to change health-related behaviors and manage chronic conditions. The aim of this study was to explore (1) the extent of smartphone and health app use, (2) sociodemographic, medical, and behavioral correlates of smartphone and health app use, and (3) associations of the use of apps and app characteristics with actual health behaviors. A population-based survey (N=4144) among Germans, aged 35 years and older, was conducted. Sociodemographics, presence of chronic conditions, health behaviors, quality of life, and health literacy, as well as the use of the Internet, smartphone, and health apps were assessed by questionnaire at home visit. Binary logistic regression models were applied. It was found that 61.25% (2538/4144) of participants used a smartphone. Compared with nonusers, smartphone users were younger, did more research on the Internet, were more likely to work full-time and more likely to have a university degree, engaged more in physical activity, and less in low fat diet, and had a higher health-related quality of life and health literacy. Among smartphone users, 20.53% (521/2538) used health apps. App users were younger, less likely to be native German speakers, did more research on the Internet, were more likely to report chronic conditions, engaged more in physical activity, and low fat diet, and were more health literate compared with nonusers who had a smartphone. Health apps focused on smoking cessation (232/521, 44.5%), healthy diet (201/521, 38.6%), and weight loss (121/521, 23.2%). The most common app characteristics were planning (264/521, 50.7%), reminding (188/521, 36.1%), prompting motivation (179/521 34.4%), and the provision of information (175/521, 33.6%). Significant associations were found between planning and the health behavior physical activity, between feedback or monitoring and physical

  20. Is enough attention given to climate change in health service planning? An Australian perspective.

    Science.gov (United States)

    Burton, Anthony J; Bambrick, Hilary J; Friel, Sharon

    2014-01-01

    Within an Australian context, the medium to long-term health impacts of climate change are likely to be wide, varied and amplify many existing disorders and health inequities. How the health system responds to these challenges will be best considered in the context of existing health facilities and services. This paper provides a snapshot of the understanding that Australian health planners have of the potential health impacts of climate change. The first author interviewed (n=16) health service planners from five Australian states and territories using an interpretivist paradigm. All interviews were digitally recorded, key components transcribed and thematically analysed. Results indicate that the majority of participants were aware of climate change but not of its potential health impacts. Despite this, most planners were of the opinion that they would need to plan for the health impacts of climate change on the community. With the best available evidence pointing towards there being significant health impacts as a result of climate change, now is the time to undertake proactive service planning that address market failures within the health system. If considered planning is not undertaken then Australian health system can only deal with climate change in an expensive ad hoc, crisis management manner. Without meeting the challenges of climate change to the health system head on, Australia will remain unprepared for the health impacts of climate change with negative consequences for the health of the Australian population.

  1. [Health in all policies and intersectoriality in health promotion: the Public Health Interdepartmental Plan of Catalonia].

    Science.gov (United States)

    Mateu i Serra, Antoni

    2015-11-01

    In February 2014, the autonomous government in Catalonia, the Generalitat de Catalunya, approved the Catalan Public Health System Interdepartmental Plan (PINSAP, as per the Catalan acronym), responsible for the strategy in Catalonia for Health in All Policies, as recommended by the WHO and other international institutions. The PINSAP, as outlined under the Catalan Public Health Law, is binding for the government. The Plan was drawn up by the Interdepartmental Health Commission (CIS, as per the Catalan acronym) and is a collaboration between all Departments of the Generalitat. The Plan also receives contributions from 42 local, social and scientific bodies. Apart from the specific initiatives performed by each department which have a greater impact on health, the Plan proposes 30 initiatives, which are defined by their collaboration between public sectors, targeting determining health factors and paying special attention to combating inequalities and measuring the impact on health. The PINSAP encourages interdepartmental initiatives and collaboration between public sectors regarding determinants of health. Although it is only in its first year of implementation, many of their initiatives are already up and running and involving many healthcare professionals in Catalonia. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  2. [Occupational health protection in business economics--business plan for health intervention].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela

    2011-01-01

    One of the company's actions for strengthening human capital is the protection of health and safety of its employees. Its implementation needs financial resources, therefore, employers expect tangible effectiveness in terms of health and economics. Business plan as an element of company planning can be a helpful tool for new health interventions management. The aim of this work was to elaborate a business plan framework for occupational health interventions at the company level, combining occupational health practices with company management and economics. The business plan of occupational health interventions was based on the literature review, the author's own research projects and meta-analysis of research reports on economic relations between occupational health status and company productivity. The study resulted in the development of the business plan for occupational health interventions at the company level. It consists of summary and several sections that address such issues as the key elements of the intervention discussed against a background of the company economics and management, occupational health and safety status of the staff, employees' health care organization, organizational plan of providing the employees with health protection, marketing plan, including specificity of health interventions in the company marketing plan and financial plan, reflecting the economic effects of health care interventions on the overall financial management of the company. Business plan defines occupational health and safety interventions as a part of the company activities as a whole. Planning health care interventions without relating them to the statutory goals of the company may have the adverse impact on the financial balance and profitability of the company. Therefore, business plan by providing the opportunity of comparing different options of occupational health interventions to be implemented by employers is a key element of the management of employees

  3. Health system responsiveness after health sector evolution plan (HSEP): An inpatient survey in Kermanshah in 2015.

    Science.gov (United States)

    Najafi, Farid; Karami-Matin, Behzad; Rezaei, Satar; Rajabi-Gilan, Nader; Soofi, Moslem

    2016-01-01

    Responsiveness is one of the three main goals of the health system introduced by World Health Organization. This study aimed at examining health system responsiveness after Health Sector Evolution Plan in Kermanshah, Western Iran. A sample of 335 hospitalized patients was selected using proportionate allocation to population size method in the city of Kermanshah (Iran) in 2015. World Health Survey (WHS) questionnaire was used to collect data. Data were analyzed using descriptive statistics and principal component analysis by STATA 12. The overall health system responsiveness score was 72.6. The best and worst performance for domains of dignity and autonomy were 82.2 and 62.5, respectively. Socio-demographic variables of the patients had no significant effect on the total health system responsiveness score. The principal component analysis findings indicated that 68% of the variance of the overall responsiveness score was explained by four components. The overall responsiveness score of each of the domains was higher than that of other similar previous studies in Iran. Although it is difficult to reach a conclusion, our findings may show better responsiveness of the health system compared to the previous reports.

  4. Pathways to health in a deprived population: relationships between smoking, mental health & physical health

    OpenAIRE

    Kemp, Kim

    2011-01-01

    Introduction: Recently there has been increasing interest in understanding and addressing health inequalities and enhancing the well-being of the population as a whole through anticipatory care and better health care delivery. The current study aimed to investigate the predictive relationships between smoking behaviour, physical health, and mental health in a deprived population using models of mediation. Method: Participants had attended a Keep Well health check, a natio...

  5. Variation in US outpatient antibiotic prescribing quality measures according to health plan and geography.

    Science.gov (United States)

    Roberts, Rebecca M; Hicks, Lauri A; Bartoces, Monina

    2016-08-01

    Antibiotic prescribing has become increasingly viewed as an issue related to patient safety and quality of care. The objective of this study was to better understand the differences between health plan reporting and the geographic variation seen in quality measures related to antibiotic use. We focused on 3 measures from the Healthcare Effectiveness Data and Information Set (HEDIS) related to antibiotic prescribing and testing to guide antibiotic prescribing. We analyzed data for 3 relevant measures for the years 2008 to 2012, including only commercial health plans. We analyzed the following 3 HEDIS measures: 1) "Appropriate Testing for Children With Pharyngitis," 2) "Appropriate Treatment for Children With Upper Respiratory Infections," and 3) "Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis." Out of these 3 measures, health plans consistently performed poorly on the adult bronchitis measure. Performance was better on the 2 measures focused on the pediatric population. We also saw geographic variation between measures when looking at Census divisions across all years. There is wide variation between individual health plan performance on the measures related to antibiotic use. Geographic differences were also observed on these measures, with health plans in the South Central Census division performing worse than other parts of the country. Stakeholders, such as public health, advocacy groups, foundations, and professional societies, interested in improving the quality of care that patients receive related to antibiotic use in the outpatient setting should consider how existing measures and working with health plans could be used to improve prescribing.

  6. Common and Critical Components Among Community Health Assessment and Community Health Improvement Planning Models.

    Science.gov (United States)

    Pennel, Cara L; Burdine, James N; Prochaska, John D; McLeroy, Kenneth R

    Community health assessment and community health improvement planning are continuous, systematic processes for assessing and addressing health needs in a community. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. We identified 11 common assessment and planning components across 18 models and requirements, with a particular focus on health department, health system, and hospital models and requirements. These common components included preplanning; developing partnerships; developing vision and scope; collecting, analyzing, and interpreting data; identifying community assets; identifying priorities; developing and implementing an intervention plan; developing and implementing an evaluation plan; communicating and receiving feedback on the assessment findings and/or the plan; planning for sustainability; and celebrating success. Within several of these components, we discuss characteristics that are critical to improving community health. Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. In addition, federal and state policy and accreditation requirements may be revised or implemented to better facilitate assessment and planning collaboration between health departments, hospitals, and others for the purpose of improving community health.

  7. Comprehensive health workforce planning: re-consideration of the ...

    African Journals Online (AJOL)

    Comprehensive health workforce planning: re-consideration of the primary health care approach as a tool for addressing the human resource for health crisis in low and middle ... A descriptive literature review of selected case studies in middle and low income countries reinforced with the evidence from Tanzania was used.

  8. 3 CFR - Mexico City Policy and Assistance for Voluntary Population Planning

    Science.gov (United States)

    2010-01-01

    ... Population Planning Presidential Documents Other Presidential Documents Memorandum of January 23, 2009 Mexico City Policy and Assistance for Voluntary Population Planning Memorandum for the Secretary of State the... subsequently extended the policy to “voluntary population planning” assistance provided by the Department of...

  9. Using Systems Science for Population Health Management in Primary Care

    National Research Council Canada - National Science Library

    Li, Yan; Kong, Nan; Lawley, Mark A; Pagán, José A

    2014-01-01

    .... The objective of this study is to show how systems science methodologies could be incorporated into population health management to compare different interventions and improve health outcomes. Methods...

  10. Choosing the 'best' plan in a health insurance exchange: actuarial value tells only part of the story.

    Science.gov (United States)

    Lore, Ryan; Gabel, Jon R; McDevitt, Roland; Slover, Michael

    2012-08-01

    In the health insurance exchanges that will come online in 2014, consumers will be able to compare health plans with respect to actuarial value, or the percentage of health care costs that a plan would pay for a standard population. This analysis illustrates the out-of-pocket costs that might result from plans with various plan designs and actuarial values. We find that average out-of-pocket expense declines as actuarial values rise, but two plans with similar actuarial values can produce very different outcomes for a given person. The overall affordability of a plan also will be influenced by age rating, income-related premium subsidies, and out-of-pocket subsidies. Actuarial value is a useful starting point for selecting a plan, but it does not pinpoint which plan will produce the best overall value for a particular person.

  11. Is health systems integration being advanced through Local Health District planning?

    Science.gov (United States)

    Saunders, Carla; Carter, David J

    2017-05-01

    Objective Delivering genuine integrated health care is one of three strategic directions in the New South Wales (NSW) Government State Health Plan: Towards 2021. This study investigated the current key health service plan of each NSW Local Health District (LHD) to evaluate the extent and nature of health systems integration strategies that are currently planned. Methods A scoping review was conducted to identify common key principles and practices for successful health systems integration to enable the development of an appraisal tool to content assess LHD strategic health service plans. Results The strategies that are planned for health systems integration across LHDs focus most often on improvements in coordination, health care access and care delivery for complex at-risk patients across the care continuum by both state- and commonwealth-funded systems, providers and agencies. The most common reasons given for integrated activities were to reduce avoidable hospitalisation, avoid inappropriate emergency department attendance and improve patient care. Conclusions Despite the importance of health systems integration and finding that all NSW LHDs have made some commitment towards integration in their current strategic health plans, this analysis suggests that health systems integration is in relatively early development across NSW. What is known about the topic? Effective approaches to managing complex chronic diseases have been found to involve health systems integration, which necessitates sound communication and connection between healthcare providers across community and hospital settings. Planning based on current health systems integration knowledge to ensure the efficient use of scarce resources is a responsibility of all health systems. What does this paper add? Appropriate planning and implementation of health systems integration is becoming an increasingly important expectation and requirement of effective health systems. The present study is the first of

  12. Succession planning for local health department top executives: reducing risk to communities.

    Science.gov (United States)

    Schmalzried, Hans; Fallon, L Fleming

    2007-06-01

    This study assessed the degree to which local health departments (LHDs) are preparing to replace retiring top executives. Questionnaires were sent to all 134 local health departments in Ohio. It is typical of many states in terms of the organization of LHDs. Ninety-two LHD top executives responded. The questionnaire addressed aspects of departmental succession planning and demographic parameters of their departments. Approximately half (51.7%) of responding LHD top executives rated having succession plans as being important. Overall, local boards of health are not very concerned about actually having a succession plan. One in four (27.6%) local health departments reported that they have succession plans. Half of those were grooming a successor. Succession planning is not a high priority among the majority of LHDs, despite the fact that 43.7% of top executives reported planning to leave their current position within six years. Experienced and continuous LHD leadership is important for strong responses to public health crises like major disease outbreaks and natural disasters. Having a succession plan in place that identifies how leadership voids are filled can help minimize risks to populations in an emergency.

  13. Impact of public health emergencies on modern disaster taxonomy, planning, and response.

    Science.gov (United States)

    Burkle, Frederick M; Greenough, P Gregg

    2008-10-01

    Current disaster taxonomy describes diversity, distinguishing characteristics, and common relations in disaster event classifications. The impact of compromised public health infrastructure and systems on health consequences defines and greatly influences the manner in which disasters are observed, planned for, and managed, especially those that are geographically widespread, population dense, and prolonged. What may first result in direct injuries and death may rapidly change to excess indirect illness and subsequent death as essential public health resources are destroyed, deteriorate, or are systematically denied to vulnerable populations. Public health and public health infrastructure and systems in developed and developing countries must be seen as strategic and security issues that deserve international public health resource monitoring attention from disaster managers, urban planners, the global humanitarian community, World Health Organization authorities, and participating parties to war and conflict. We posit here that disaster frameworks be reformed to emphasize and clarify the relation of public health emergencies and modern disasters.

  14. Enhancing the Career Planning Self-Determination of Young Adults with Mental Health Challenges.

    Science.gov (United States)

    Sowers, Jo-Ann; Swank, Paul

    2017-01-01

    The impact of an intervention on the self-determination and career planning engagement of young adults with mental health challenges was studied. Sixty-seven young adults, 20 to 30 years of age, with mental health diagnoses (e.g., depression, bipolar disorder) were randomly assigned to intervention and control groups. Statistically significant greater increases were made by the intervention group versus the control group for self-determination and career planning engagement, and self-determination at least partially mediated increases in career planning engagement. With career planning self-determination interventions, young adults with mental health challenges might be able to achieve better career and life outcomes than is typical for this population.

  15. Health Information Search and Retirement Planning

    Science.gov (United States)

    Carr, Nicholas A.; Sages, Ronald A.; Fernatt, Frederick R.; Nabeshima, George G.; Grable, John E.

    2015-01-01

    Prior research has found a relationship between the health habits of individuals and their financial well-being. Little research has been conducted, however, to explore the nature of the health-wealth connection. The purpose of this study was to explore and test the association of physical health behaviors, namely exercise and diet, and health…

  16. 1997 Operating plan for the Office of International Health Programs

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    One year ago, the Office of International Health Programs provided you with our 1996 Operating Plan, which defined our ideas and ideals for conducting business in 1996. We have again this year undertaken an intensive planning effort, first reviewing our accomplishments and shortcomings during 1996, and then developing plans and priorities for the upcoming year, taking into account input from customers and outside review panels, and ensuring that the demands on the office have been balanced with anticipated human, financial, and material resources.

  17. K basins interim remedial action health and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    DAY, P.T.

    1999-09-14

    The K Basins Interim Remedial Action Health and Safety Plan addresses the requirements of the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), as they apply to the CERCLA work that will take place at the K East and K West Basins. The provisions of this plan become effective on the date the US Environmental Protection Agency issues the Record of Decision for the K Basins Interim Remedial Action, currently planned in late August 1999.

  18. [Stroke health care plan (ICTUS II. 2010)].

    Science.gov (United States)

    Masjuan, J; Alvarez-Sabín, J; Arenillas, J; Calleja, S; Castillo, J; Dávalos, A; Díez Tejedor, E; Freijo, M; Gil-Núñez, A; Fernández, J C López; Maestre, J F; Martínez-Vila, E; Morales, A; Purroy, F; Ramírez, J M; Segura, T; Serena, J; Tejada, J; Tejero, C

    2011-09-01

    The Spanish Stroke Group published the "Plan for stroke healthcare delivery" in 2006 with the aim that all stroke patients could receive the same degree of specialised healthcare according to the stage of their disease, independently of where they live, their age, gender or ethnicity. This Plan needs to be updated in order to introduce new developments in acute stroke. A committee of 19 neurologists specialised in neurovascular diseases representing different regions of Spain evaluated previous experience with this Plan and the available scientific evidence according to published literature. The new organised healthcare system must place emphasis on the characteristics of the different care levels with promotion of Reference Stroke Hospitals, set up less restrictive Stroke Code activation criteria that include new therapeutic options, establish new standard measures for endovascular treatment and develop tele-medicine stroke networks. 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  19. A quantitative model of population pressure and its potential use in development planning.

    Science.gov (United States)

    Soemarwoto, O

    1985-12-01

    An attempt is made to develop a quantitative model of the concept of population pressure, using the example of population pressure on land resources in agricultural societies. "The model shows that environmental quality is tied to population growth and that population pressure does not bear relationship with population density." The implications of the findings for development planning are considered. (summary in IND) excerpt

  20. Medicare health maintenance organization benefits packages and plan performance measures.

    Science.gov (United States)

    Cox, Don; Lanyi, Bettina; Strabic, Allison

    2002-01-01

    This article reports the results of an analysis of the relationship between supplemental benefits offered by Medicare+Choice (M+C) plans and their plan performance ratings. We examined two measures of plan performance: (1) plan ratings as reported in the Medicare Managed Care (MMC) Consumer Assessment of Health Care Study (CAHPS), and (2) disenrollment rates. The results of our analysis indicated that variations in plan supplemental offerings have little impact on enrollees' plan performance ratings--both overall ratings and access to care measures. Furthermore, disenrollment rates were found to be more sensitive to the availability of alternative M+C plans, either in general, or for specific benefits than to variations in benefit offerings.

  1. Rocky Mountain Arsenal National Wildlife Refuge : Health and Safety Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Health and Safety Plan (HASP) applies to all U.S. Fish and Wildlife Service (Service) personnel including employees, graduate students, and volunteers on the...

  2. Health impact assessment of the 2012 London Olympic transport plans

    National Research Council Canada - National Science Library

    McCarthy, Mark; Ravelli, Robert J; Sinclair-Williams, Mike

    2010-01-01

    Transport is a structural determinant of health. We have assessed the potential of transport plans for the 2012 London Olympic Games to achieve the sustainability commitment of 'encouraging healthy living...

  3. Population and reproductive health in National Adaptation Programmes of Action (NAPAs) for climate change in Africa.

    Science.gov (United States)

    Mutunga, Clive; Hardee, Karen

    2010-12-01

    This paper reviews 44 National Adaptation Programmes of Action (NAPAs) to assess the NAPA process and identify the range of interventions included in countries' priority adaptation actions and highlight how population issues and reproductive health/family planning (RH/FP) are addressed as part of the adaptation agenda. A majority of the 44 NAPAs identify rapid population growth as a key component of vulnerability to climate change impacts. However, few chose to prioritise NAPA funds for family planning/reproductive health programmes. The paper emphasizes the need to translate the recognition of population pressure as a factor related to countries' ability to adapt to climate change into relevant project activities. Such projects should include access to RH/FP, in addition to other strategies such as girls' education and women's empowerment that lead to lower fertility. Attention to population and integrated strategies should be central and aligned to longer-term national adaptation plans and strategies.

  4. Climate Change-Related Water Disasters' Impact on Population Health.

    Science.gov (United States)

    Veenema, Tener Goodwin; Thornton, Clifton P; Lavin, Roberta Proffitt; Bender, Annah K; Seal, Stella; Corley, Andrew

    2017-11-01

    Rising global temperatures have resulted in an increased frequency and severity of cyclones, hurricanes, and flooding in many parts of the world. These climate change-related water disasters (CCRWDs) have a devastating impact on communities and the health of residents. Clinicians and policymakers require a substantive body of evidence on which to base planning, prevention, and disaster response to these events. The purpose of this study was to conduct a systematic review of the literature concerning the impact of CCRWDs on public health in order to identify factors in these events that are amenable to preparedness and mitigation. Ultimately, this evidence could be used by nurses to advocate for greater preparedness initiatives and inform national and international disaster policy. A systematic literature review of publications identified through a comprehensive search of five relevant databases (PubMed, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Embase, Scopus, and Web of Science) was conducted using a modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach in January 2017 to describe major themes and associated factors of the impact of CCRWDs on population health. Three major themes emerged: environmental disruption resulting in exposure to toxins, population susceptibility, and health systems infrastructure (failure to plan-prepare-mitigate, inadequate response, and lack of infrastructure). Direct health impact was characterized by four major categories: weather-related morbidity and mortality, waterborne diseases/water-related illness, vector-borne and zoonotic diseases, and psychiatric/mental health effects. Scope and duration of the event are factors that exacerbate the impact of CCRWDs. Discussion of specific factors amenable to mitigation was limited. Flooding as an event was overrepresented in this analysis (60%), and the majority of the research reviewed was conducted in high-income or upper

  5. A new axiomatic approach to the evaluation of population health

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    2013-01-01

    In this paper we explore the implications of normative principles for the evaluation of population health. We formalize those principles as axioms for social preferences over distributions of health for a given population. We single out several focal population health evaluation functions, which ...... to capture concerns for distributive justice, without resorting to controversial assumptions on individual preferences....

  6. Public Health Climate Change Adaptation Planning Using Stakeholder Feedback.

    Science.gov (United States)

    Eidson, Millicent; Clancy, Kathleen A; Birkhead, Guthrie S

    2016-01-01

    Public health climate change adaptation planning is an urgent priority requiring stakeholder feedback. The 10 Essential Public Health Services can be applied to adaptation activities. To develop a state health department climate and health adaptation plan as informed by stakeholder feedback. With Centers for Disease Control and Prevention (CDC) funding, the New York State Department of Health (NYSDOH) implemented a 2010-2013 climate and health planning process, including 7 surveys on perceptions and adaptation priorities. New York State Department of Health program managers participated in initial (n = 41, denominator unknown) and follow-up (72.2%) needs assessments. Surveillance system information was collected from 98.1% of surveillance system managers. For adaptation prioritization surveys, participants included 75.4% of NYSDOH leaders; 60.3% of local health departments (LHDs); and 53.7% of other stakeholders representing environmental, governmental, health, community, policy, academic, and business organizations. Interviews were also completed with 38.9% of other stakeholders. In 2011 surveys, 34.1% of state health program directors believed that climate change would impact their program priorities. However, 84.6% of state health surveillance system managers provided ideas for using databases for climate and health monitoring/surveillance. In 2012 surveys, 46.5% of state health leaders agreed they had sufficient information about climate and health compared to 17.1% of LHDs (P = .0046) and 40.9% of other stakeholders (nonsignificant difference). Significantly fewer (P leaders (55.8%) and other stakeholders (68.2%). Stakeholder groups agreed on the 4 highest priority adaptation categories including core public health activities such as surveillance, coordination/collaboration, education, and policy development. Feedback from diverse stakeholders was utilized by NYSDOH to develop its Climate and Health Strategic Map in 2013. The CDC Building Resilience Against

  7. [Primary and secondary data on dementia care as an example of regional health planning].

    Science.gov (United States)

    Ulrich, Lisa-R; Schatz, Tanja R; Lappe, Veronika; Ihle, Peter; Barthen, Linda; Gerlach, Ferdinand M; Erler, Antje

    2017-12-01

    Health service planning that takes into account as far as possible the regional needs and regional discrepancies is a controversial health issue in Germany. In a pilot scheme, we tested a planning process for regional healthcare services, based on the example of dementia care. The aim of this article is to present the strengths and limitations of this planning process. We developed an indicator set for dementia care based on routine regional data obtained from two German statutory health insurance companies. Additionally, primary data based on a questionnaire sent to all GPs in the area were evaluated. These data were expanded through the addition of official socio-demographic population data. Procedures and evaluation strategies, discussion of the results and the derivation of planning measures followed, in close agreement with a group of local experts. Few epidemiological data on regional variations in health care planning are publicly available. Secondary data from statutory health insurance companies can be assessed to support the estimation of regional health care needs, but interpretation is difficult. The use of surveys to collect primary data, and the assessment of results by the local health board may facilitate interpretation and may contribute towards more valid statements regarding regional health planning. Despite the limited availability of data and the considerable efforts involved in data analysis, the project demonstrates how needs-based health service planning can be carried out in a small region, taking into account the increasing demands of the local health care providers and the special local features.

  8. Benefits of Water Safety Plans: microbiology, compliance, and public health.

    Science.gov (United States)

    Gunnarsdottir, Maria J; Gardarsson, Sigurdur M; Elliott, Mark; Sigmundsdottir, Gudrun; Bartram, Jamie

    2012-07-17

    The Water Safety Plan (WSP) methodology, which aims to enhance safety of drinking water supplies, has been recommended by the World Health Organization since 2004. WSPs are now used worldwide and are legally required in several countries. However, there is limited systematic evidence available demonstrating the effectiveness of WSPs on water quality and health. Iceland was one of the first countries to legislate the use of WSPs, enabling the analysis of more than a decade of data on impact of WSP. The objective was to determine the impact of WSP implementation on regulatory compliance, microbiological water quality, and incidence of clinical cases of diarrhea. Surveillance data on water quality and diarrhea were collected and analyzed. The results show that HPC (heterotrophic plate counts), representing microbiological growth in the water supply system, decreased statistically significant with fewer incidents of HPC exceeding 10 cfu per mL in samples following WSP implementation and noncompliance was also significantly reduced (p < 0.001 in both cases). A significant decrease in incidence of diarrhea was detected where a WSP was implemented, and, furthermore, the results indicate that population where WSP has been implemented is 14% less likely to develop clinical cases of diarrhea.

  9. [Use of an index of social welfare for health planning at a municipal level].

    Science.gov (United States)

    Ochoa-Díaz López, H; Sánchez-Pérez, H J; Martínez-Guzmán, L A

    1996-01-01

    This paper analyzes the relationship between a living standards index for small areas based on census data and information on morbidity and health care utilization. The information was gathered through a health interview survey of a random sample of 1 238 households from rural areas of Tlaxcala, Mexico. The population from localities with lower living standards showed significantly higher prevalences of morbidity and worse self-reported health status measures, as compared to localities with higher living standards. On the contrary, higher living standards were related with a greater utilization of health services. The approach proved to be useful in discriminating localities and areas of high and low prevalence of morbidity and utilization of health care services, which in turn could be used to identify those areas where needs are greatest. The implications of the results for health planning and resource allocation (based on population health needs and underlying social conditions) at the local level are discussed.

  10. Animal Health and Welfare Planning in Organic Dairy Cattle Farms

    DEFF Research Database (Denmark)

    Vaarst, Mette; Winckler, Christoph; Roderick, Stephen

    2011-01-01

    Continuous development is needed within the farm to reach the goal of good animal health and welfare in organic livestock farming. The very different conditions between countries call for models that are relevant for different farming types and can be integrated into local practice and be relevant...... for each type of farming context. This article reviews frameworks, principles and practices for animal health and welfare planning which are relevant for organic livestock farming. This review is based on preliminary analyses carried out within a European project (acronym ANIPLAN) with participants from...... as well as animal health and welfare professionals (veterinarians and advisors) is paramount. This paper provides an overview of some current animal health and welfare planning initiatives and explains the principles of animal health and welfare planning which are being implemented in ANIPLAN partner...

  11. How integrating primary care and public health could improve population health outcomes: a view from Liverpool, UK.

    Science.gov (United States)

    Gosling, Rachael; Davies, Sandra M; Hussey, John A

    2016-01-28

    Although primary care is at the forefront of delivering healthcare to the population, its role in preventing poor health has varied throughout history. Faced with growing demand on healthcare services and a rise in noncommunicable diseases, some health systems are attempting to integrate healthcare delivery with broader population health and wellbeing interventions. Liverpool has a rich history of taking action to improve population health; this paper discusses a range of interventions that have taken place across the city. There is a renewed opportunity to systematise approaches to primary and secondary prevention, strengthened by the lead that general practitioners now have in commissioning health services and their accountability for improved population health outcomes through clinical commissioning groups. This is strongly articulated in the Healthy Liverpool program, a city-wide plan for health and care services. This paper suggests that four key enablers strengthen delivery of public health priorities through primary care: maximising opportunities to identify risk factors for preventable disease, fully exploiting the data collected in primary care to plan and design services, responding to community needs and assets through community engagement, and addressing wider determinants of health through strong partnerships.

  12. Integrating public health policy, practice, evaluation, surveillance, and research: the school health action planning and evaluation system.

    Science.gov (United States)

    Cameron, Roy; Manske, Stephen; Brown, K Stephen; Jolin, Mari Alice; Murnaghan, Donna; Lovato, Chris

    2007-04-01

    The Canadian Cancer Society and the National Cancer Institute of Canada have charged their Centre for Behavioral Research and Program Evaluation with contributing to the development of the country's systemic capacity to link research, policy, and practice related to population-level interventions. Local data collection and feedback systems are integral to this capacity. Canada's School Health Action Planning and Evaluation System (SHAPES) allows data to be collected from all of a school's students, and these data are used to produce computer-generated school "health profiles." SHAPES is being used for intervention planning, evaluation, surveillance, and research across Canada. Strong demand and multipartner investment suggest that SHAPES is adding value in all of these domains. Such systems can contribute substantially to evidence-informed public health practice, public engagement, participatory action research, and relevant, timely population intervention research.

  13. Responsive consumerism: empowerment in markets for health plans.

    Science.gov (United States)

    Elbel, Brian; Schlesinger, Mark

    2009-09-01

    American health policy is increasingly relying on consumerism to improve its performance. This article examines a neglected aspect of medical consumerism: the extent to which consumers respond to problems with their health plans. Using a telephone survey of five thousand consumers conducted in 2002, this article assesses how frequently consumers voice formal grievances or exit from their health plan in response to problems of differing severity. This article also examines the potential impact of this responsiveness on both individuals and the market. In addition, using cross-group comparisons of means and regressions, it looks at how the responses of "empowered" consumers compared with those who are "less empowered." The vast majority of consumers do not formally voice their complaints or exit health plans, even in response to problems with significant consequences. "Empowered" consumers are only minimally more likely to formally voice and no more likely to leave their plan. Moreover, given the greater prevalence of trivial problems, consumers are much more likely to complain or leave their plans because of problems that are not severe. Greater empowerment does not alleviate this. While much of the attention on consumerism has focused on prospective choice, understanding how consumers respond to problems is equally, if not more, important. Relying on consumers' responses as a means to protect individual consumers or influence the market for health plans is unlikely to be successful in its current form.

  14. Population, resources, environment and development: highlights of the issues in the context of the World Population Plan of Action.

    Science.gov (United States)

    1984-01-01

    In examining interrelationships among population, resources, environment and development, it must always be kept in mind that population trends not only affect those other factors but are profoundly affected by them. This requires an approach that goes beyond inquiries into the determinants and consequences of demographic change, involving a systems approach in which all factors are treated simultaneously. 4 topics are treated: 1) food and nutrition; 2) social aspects of development; 3) resources and environment; and 4) integrated planning; each viewed as a selected example of key problem areas, the understanding of which is better revealed when considered as an aspect of the holistic and synergistic character of the interrelationships. The division of topics is not arbitrary: the 1st 2 sections are devoted to issues considered crucial in the alleviation of poverty. Lack of food, adequate nutrition, health care, education, gainful employment, old age security and adequate per capita incomes perpetuate poverty of large numbers of people in developing countries and therefore also their production and consumption patterns which undermine, through environmental and resource degradation, the very resources on which they depend for their livelihood. The latter process and the environmental problems which result from affluence are described in the next section, where the environment is viewed both as a supplier of resources and as a repository of wastes. Supplies of minerals, energy and water are considered 1st. Attention then turns to the stock of agricultural land that can be expanded through fertilization and irrigation and that may be reduced as a result of desertification, deforestation, urbanization, salinization and waterlogging. The 4th section focuses on the need for integrating population variables into development planning.

  15. Advancing Public Health in Cancer - Annual Plan

    Science.gov (United States)

    Cancer is the leading cause of death from disease among Americans under 85. Learn how NCI advances public health by conducting research to improve the delivery of quality cancer prevention, screening, and treatment to all Americans.

  16. Case-mix adjustment of consumer reports about managed behavioral health care and health plans.

    Science.gov (United States)

    Eselius, Laura L; Cleary, Paul D; Zaslavsky, Alan M; Huskamp, Haiden A; Busch, Susan H

    2008-12-01

    To develop a model for adjusting patients' reports of behavioral health care experiences on the Experience of Care and Health Outcomes (ECHO) survey to allow for fair comparisons across health plans. Survey responses from 4,068 individuals enrolled in 21 managed behavioral health plans who received behavioral health care within the previous year (response rate = 48 percent). Potential case-mix adjustors were evaluated by combining information about their predictive power and the amount of within- and between-plan variability. Changes in plan scores and rankings due to case-mix adjustment were quantified. The final case-mix adjustment model included self-reported mental health status, self-reported general health status, alcohol/drug treatment, age, education, and race/ethnicity. The impact of adjustment on plan report scores was modest, but large enough to change some plan rankings. Adjusting plan report scores on the ECHO survey for differences in patient characteristics had modest effects, but still may be important to maintain the credibility of patient reports as a quality metric. Differences between those with self-reported fair/poor health compared with those in excellent/very good health varied by plan, suggesting quality differences associated with health status and underscoring the importance of collecting quality information.

  17. How will changes in health insurance tax policy and employer health plan contributions affect access to health care and health care costs?

    Science.gov (United States)

    Marquis, M S; Buchanan, J L

    To understand how changes in federal taxation of and employer contributions to health insurance benefits affect the decisions of firms to offer insurance, the willingness of households to purchase different health plans, and the resultant health expenditures. Economic policy simulation. Secondary data analysis. A total of 18,343 sampled families (representing 77 million total families throughout the United States) with a working household head from the 1988 Current Population Survey who were not covered by either Medicare, Medicaid, or CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) insurance. One intervention limits the amounts of tax-free employer contributions to health insurance premiums to 80% of our estimate of the base plan in the market and assumes that employer contributions will also be limited to this maximum. A second intervention eliminates the favorable tax treatment of employer-paid premiums altogether and assumes that employees will pay the full price of insurance. Change in the number of working families offered employment-based insurance, change in insurance plan choice, and change in medical spending. Capping the favorable tax treatment and employer contributions decreases the number of families offered employment-based insurance by approximately 91,000, increases the number of families selecting the least generous insurance plan from 20% under the current situation to 33%, and reduces overall health spending by less than 2%. By eliminating the tax exemption altogether, the number of families offered employment-based insurance decreases by approximately half a million families, the number of families selecting the least generous plan goes from 20% to 40%, and overall spending falls by about $16 billion. Eliminating the tax subsidy and limiting employer-paid contributions to the low-cost plan substantially increases the number of low-income uninsured under a voluntary insurance system, decreases overall spending only

  18. Health Care Transition Planning among Adolescents with Autism Spectrum Disorder

    Science.gov (United States)

    Walsh, Casey; Jones, Barbara; Schonwald, Alison

    2017-01-01

    Improving the health care transition process for youth with autism spectrum disorder (ASD) is critically important. This study was designed to examine the overall national transition core outcome among youth with ASD and each of the component measures of health care transition planning. Fewer than 10% of youth with ASD meet the national transition…

  19. Family Planning - A Priority Social and Health Action Programme for ...

    African Journals Online (AJOL)

    Family Planning - A Priority Social and Health Action Programme for. Africa and the Role of the Physician. Dr. A.A. Arkutu ... cern about che risk - benefit factor while ochers cite che spread of HIV infection as justification for not ... promote health and reduce che high levels of illness and mortality, especially among vulnerable.

  20. Health Seeking Behavior and Family Planning Services Accessibility in Indonesia

    Directory of Open Access Journals (Sweden)

    Niniek Lely Pratiwi

    2014-11-01

    Full Text Available Background: The MDG target to increase maternal health will be achieved when 50% of maternal deaths can be prevented through improvment the coverage of K1, K4, to make sure that midwife stay in the village improve the delivery by health workers in health facilities, increase coverage long-term contraceptive methods participant as well as family and community empowerment in health. Methods: This study is a further analysis of Riskesdas in 2010 to assess how big the accessibility of services in family planning in Indonesia. Results: Women of 3–4 children in rural greater and prevalence (27.1% compared to women who live in urban areas (25.0%. The main reason of not using contraception mostly because they want to have children 27.0% in urban, 28.2% rural whereas, the second reason is the fear of side effects 23.1% in urban, 16.5% rural. There is 10% of respondent did not use contraceptives, because they did not need it. Health seeking behavior of pregnant women with family planning work status has a significant relationship (prevalence ratio 1.073. The jobless mothers has better access to family planning services compared to working mother. Conclusions: Accessibility of family planning services is inadequate, because not all rural ‘Poskesdes’ equipped with infrastructure and family planning devices, a lack of knowledge of family planning in rural areas. Health seeking behavior of family planning services is mostly to the midwives, the scond is to community health centers and than polindes, ‘poskesdes’ as the ranks third.

  1. 76 FR 37207 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

    Science.gov (United States)

    2011-06-24

    ... 45 CFR Part 147 Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims... Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals and External... internal claims and appeals and external review processes for group health plans and health insurance...

  2. 75 FR 70114 - Amendment to the Interim Final Rules for Group Health Plans and Health Insurance Coverage...

    Science.gov (United States)

    2010-11-17

    ... Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under... and Insurance Oversight, Department of Health and Human Services. ACTION: Amendment to interim final... regulations implementing the rules for group health plans and health insurance coverage in the group and...

  3. 75 FR 27141 - Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age...

    Science.gov (United States)

    2010-05-13

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ45 Group Health Plans and Health Insurance Issuers Providing... Labor and the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health... health plans and health insurance coverage offered in connection with a group health plan under the...

  4. 76 FR 44491 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

    Science.gov (United States)

    2011-07-26

    ...-AQ66 Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals and... amendment to the interim final rules (76 FR 37208) entitled, ``Group Health Plans and Health Insurance... rule with request for comments entitled, ``Group Health Plans and Health Insurance Issuers: Rules...

  5. Joining up health and planning: how Joint Strategic Needs Assessment (JSNA) can inform health and wellbeing strategies and spatial planning.

    Science.gov (United States)

    Tomlinson, Paul; Hewitt, Stephen; Blackshaw, Neil

    2013-09-01

    There has been a welcome joining up of the rhetoric around health, the environment and land use or spatial planning in both the English public health white paper and the National Planning Policy Framework. However, this paper highlights a real concern that this is not being followed through into practical guidance needed by local authorities (LAs), health bodies and developers about how to deliver this at the local level. The role of Joint Strategic Needs Assessments (JSNAs) and Health and Wellbeing Strategies (HWSs) have the potential to provide a strong basis for integrated local policies for health improvement, to address the wider determinants of health and to reduce inequities. However, the draft JSNA guidance from the Department of Health falls short of providing a robust, comprehensive and practical guide to meeting these very significant challenges. The paper identifies some examples of good practice. It recommends that action should be taken to raise the standards of all JSNAs to meet the new challenges and that HWSs should be aligned spatially and temporally with local plans and other LA strategies. HWSs should also identify spatially targeted interventions that can be delivered through spatial planning or transport planning. Steps need to be taken to ensure that district councils are brought into the process.

  6. Hospital service areas – a new tool for health care planning in Switzerland

    Directory of Open Access Journals (Sweden)

    Widmer Marcel

    2005-05-01

    Full Text Available Abstract Background The description of patient travel patterns and variations in health care utilization may guide a sound health care planning process. In order to accurately describe these differences across regions with homogeneous populations, small area analysis (SAA has proved as a valuable tool to create appropriate area models. This paper presents the methodology to create and characterize population-based hospital service areas (HSAs for Switzerland. Methods We employed federal hospital discharge data to perform a patient origin study using small area analysis. Each of 605 residential regions was assigned to one of 215 hospital provider regions where the most frequent number of discharges took place. HSAs were characterized geographically, demographically, and through health utilization indices and rates that describe hospital use. We introduced novel planning variables extracted from the patient origin study and investigated relationships among health utilization indices and rates to understand patient travel patterns for hospital use. Results were visualized as maps in a geographic information system (GIS. Results We obtained 100 HSAs using a patient origin matrix containing over four million discharges. HSAs had diverse demographic and geographic characteristics. Urban HSAs had above average population sizes, while mountainous HSAs were scarcely populated but larger in size. We found higher localization of care in urban HSAs and in mountainous HSAs. Half of the Swiss population lives in service areas where 65% of hospital care is provided by local hospitals. Conclusion Health utilization indices and rates demonstrated patient travel patterns that merit more detailed analyses in light of political, infrastructural and developmental determinants. HSAs and health utilization indices provide valuable information for health care planning. They will be used to study variation phenomena in Swiss health care.

  7. Expanding Medicare and employer plans to achieve universal health insurance.

    Science.gov (United States)

    Davis, K

    1991-05-15

    This article presents a proposal for expanding Medicare and employer-based health insurance plans to achieve universal health insurance. Under this proposed health care financing system, employees would provide basic health insurance coverage to workers and dependents, or pay a payroll tax contribution toward the cost of their coverage under Medicare. States would have the option of buying all Medicaid beneficiaries and other poor individuals into Medicare by paying the Medicare premiums and cost sharing. Other uninsured individuals would be automatically covered by Medicare. Employer plans would incorporate Medicare's provider payment methods. This proposal would result in incremental federal governmental outlays on the order of $25 billion annually. These new federal budgetary costs would be met through a combination of premiums, employer payroll tax, income tax, and general tax revenues. The principal advantage of this plan is that it draws on the strengths of the current system while simplifying the benefit and provider payment structure and instituting innovations to promote efficiency.

  8. Use rates under President Clinton's health reform plan.

    Science.gov (United States)

    Weil, T P

    1993-01-01

    During the 1992 presidential debates there was considerable rhetoric on health reform. Based on the broad principles now available concerning President Clinton's plan, this article compares differences in hospital and physician use rates of the now uninsured, who would be covered by his proposal, to those who have been traditionally enrolled in health insurance plans. Numerous studies illustrate that these new insurees have historically needed more and received less health care than the insured. Hospitals and physicians will be under pressure to provide a greater volume of benefits. It is predicted that these future estimated use rates will be more akin to the Canadian single-payor rather than the German multipayor national health insurance plan.

  9. Governments urged to integrate environmental and population concerns in development planning.

    Science.gov (United States)

    1992-01-01

    Governments were asked to coordinate their policies and programs regarding development, population, and environment and to take into account demographic trends and patterns of production and consumption by the UN Expert Group Meeting on Population, Environment, and Development (New York, January 20-24, 1992). The meeting urged developed countries to make technologies, which were designed to achieve sustained economic growth and sustainable development, available to developing countries at a reasonable cost. International organizations were advised to increase their assistance in the fields of population, sustainable development, and environment. Governments were encouraged to undertake projects that were ecologically beneficial and labor intensive (reforestation, contour leveling, terracing small scale irrigation); to enhance the access of the rural poor to employment opportunities, credit, and social services (health, education, and family planning); to place emphasis on popular education, especially for women; to provide additional resources to local authorities for city management, particularly those experiencing rapid population growth; to provide adequate training in municipal management, including provisional environmental services; and to emphasize the participation of women as environmental managers in community-based population and environmental programs.

  10. Price-Shopping in Consumer-Directed Health Plans.

    Science.gov (United States)

    Sood, Neeraj; Wagner, Zachary; Huckfeldt, Peter; Haviland, Amelia

    2013-01-01

    We use health insurance claims data from 63 large employers to estimate the extent of price shopping for nine common outpatient services in consumer-directed health plans (CDHPs) compared to traditional health plans. The main measures of price-shopping include: (1) the total price paid on the claim, (2) the share of claims from low and high cost providers and (3) the savings from price shopping relative to choosing prices randomly. All analyses control for individual and zip code level demographics and plan characteristics. We also estimate differences in price shopping within CDHPs depending on expected health care costs and whether the service was bought before or after reaching the deductible. For 8 out of 9 services analyzed, prices paid by CDHP and traditional plan enrollees did not differ significantly; CDHP enrollees paid 2.3% less for office visits. Similarly, office visits was the only service where CDHP enrollment resulted in a significantly larger share of claims from low cost providers and greater savings from price shopping relative to traditional plans. There was also no evidence that, within CDHP plans, consumers with lower expected medical expenses exhibited more price-shopping or that consumers exhibited more price-shopping before reaching the deductible.

  11. Incorporating intersectionality theory into population health research methodology: challenges and the potential to advance health equity.

    Science.gov (United States)

    Bauer, Greta R

    2014-06-01

    Intersectionality theory, developed to address the non-additivity of effects of sex/gender and race/ethnicity but extendable to other domains, allows for the potential to study health and disease at different intersections of identity, social position, processes of oppression or privilege, and policies or institutional practices. Intersectionality has the potential to enrich population health research through improved validity and greater attention to both heterogeneity of effects and causal processes producing health inequalities. Moreover, intersectional population health research may serve to both test and generate new theories. Nevertheless, its implementation within health research to date has been primarily through qualitative research. In this paper, challenges to incorporation of intersectionality into population health research are identified or expanded upon. These include: 1) confusion of quantitative terms used metaphorically in theoretical work with similar-sounding statistical methods; 2) the question of whether all intersectional positions are of equal value, or even of sufficient value for study; 3) distinguishing between intersecting identities, social positions, processes, and policies or other structural factors; 4) reflecting embodiment in how processes of oppression and privilege are measured and analysed; 5) understanding and utilizing appropriate scale for interactions in regression models; 6) structuring interaction or risk modification to best convey effects, and; 7) avoiding assumptions of equidistance or single level in the design of analyses. Addressing these challenges throughout the processes of conceptualizing and planning research and in conducting analyses has the potential to improve researchers' ability to more specifically document inequalities at varying intersectional positions, and to study the potential individual- and group-level causes that may drive these observed inequalities. A greater and more thoughtful incorporation

  12. FastStats: Health of Black or African American non-Hispanic Population

    Science.gov (United States)

    ... or Alaska Native Population Health of Asian or Pacific Islander Population Health of Hispanic or Latino Population Health of Mexican American Population Health of White non-Hispanic Population ...

  13. Defining "Rural" for Veterans' Health Care Planning

    Science.gov (United States)

    West, Alan N.; Lee, Richard E.; Shambaugh-Miller, Michael D.; Bair, Byron D.; Mueller, Keith J.; Lilly, Ryan S.; Kaboli, Peter J.; Hawthorne, Kara

    2010-01-01

    Purpose: The Veterans Health Administration (VHA) devised an algorithm to classify veterans as Urban, Rural, or Highly Rural residents. To understand the policy implications of the VHA scheme, we compared its categories to 3 Office of Management and Budget (OMB) and 4 Rural-Urban Commuting Area (RUCA) geographical categories. Method: Using…

  14. Health-related characteristics and preferred methods of receiving health education according to dominant language among Latinos Aged 25 to 64 in a large Northern California health plan

    Directory of Open Access Journals (Sweden)

    Iribarren Carlos

    2008-09-01

    Full Text Available Abstract Background Latinos are a fast growing segment of the U.S. health care population. Acculturation factors, including English fluency, result in an ethnic group heterogeneous with regard to SES, health practices, and health education needs. This study examined how demographic and health-related characteristics of Spanish-dominant (SD, Bilingual (BIL, and English-dominant (ED Latino men and women aged 25–64 differed among members of a large Northern California health plan. Methods This observational study was based on data from cohorts of 171 SD (requiring an interpreter, 181 BIL, and 734 ED Latinos aged 25–64 who responded to random sample health plan member surveys conducted 2005–2006. Language groups were compared separately by gender on education, income, behavioral health risks (smoking, obesity, exercise frequency, dietary practices, health beliefs, health status (overall health and emotional health, diabetes, hypertension, high cholesterol, heartburn/acid reflux, back pain, depression, computer and Internet access, and health education modality preferences. Results Compared with ED Latinos, higher percentages of the SD and BIL groups had very low educational attainment and low income. While groups were similar in prevalence of diabetes, hypertension, and high cholesterol, SD were less likely than ED Latinos to rate overall health and emotional well-being as good, very good, or excellent and more likely to report heartburn and back pain (women only. The groups were similar with regard to smoking and obesity, but among women, SD were more likely to be physically inactive than ED, and BIL were less likely than SD and ED groups to eat Conclusion There are important differences among Latinos of different English language proficiency with regard to education, income, health status, health behaviors, IT access, and health education modality preferences that ought to be considered when planning and implementing health programs for this

  15. The population health approach: A qualitative study of conceptual and operational definitions for leaders in Canadian healthcare.

    Science.gov (United States)

    Cohen, Deborah; Huynh, Tai; Sebold, Anne; Harvey, Jean; Neudorf, Cory; Brown, Adalsteinn

    2014-01-01

    The population health approach is increasingly recognized for its role in health system reform; however, its broad scope and definition have been criticized for being a barrier to clear communication. This qualitative study examined the way senior healthcare leaders in Canada conceptualize and operationalize the population health approach in planning and decision-making. Core elements of the population health approach included focusing on health and wellness rather than illness, taking a population rather than individual orientation, understanding needs and solutions through community outreach, addressing health disparities/health in vulnerable groups, addressing the social determinants of health and inter-sectoral action and partnerships. The population health approach is increasingly recognized for its role in reducing healthcare demand and contributing to health system sustainability. This study demonstrated the growing need to clarify terminology among multiform partners to establish a foundation for future healthcare integration and inter-sectoral action.

  16. Evaluating sexual health planning for the London 2012 Olympics.

    Science.gov (United States)

    Lorenc, Ava; Robinson, Nicola

    2015-09-01

    The public health impact of mass gatherings should not be underestimated, requiring careful planning. This evaluation identified the successes and failures of a programme targeted to mitigate against potential increases in sexual ill health during the London 2012 Olympics. Programme planning was evaluated using documentary analysis. Stakeholders' experiences were explored using an online survey. Finally, selected stakeholders were interviewed in depth. Over 100 documents were analysed, 36 survey responses received and 12 interviews conducted. Most respondents felt aims were appropriate, potentially overambitious. 'Business as usual', with no disruption or increased demand, was reported in sexual health services. Some interviewees felt evidence for increased demand was limited, although contingency planning was needed. Signposting service users and providing 'residual risk responses' appeared successful. Planned service transformation was not fully achieved and perhaps inappropriate, although new service collaborations emerged. Over 2000 individuals participated; wider public engagement was seen as inappropriate. A 'Sex Factor 2012' competition was particularly successful. Legacy opportunities included planning work, groundwork for transformation, relationship building and continuing the resilience changes. The Games allowed sexual health services to explore new ways of working, engage with stakeholders and develop new relationships, although in reality demand for services did not increase. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Planning and change: a Cambodian public health case study.

    Science.gov (United States)

    Hill, P S

    2000-12-01

    This paper questions the appropriateness of highly structured strategic planning approaches in situations of complexity and change, using the Cambodian German Health Project as a case study. Based on participant observation and organisational analysis in the Cambodian public health sector, the paper examines the rhetoric of values, objectives and strategies outlined in the original project documents and their assumptions and implications, and the responses to the changing political situation. It demonstrates the limitations of these planning processes in complex situations of high uncertainty, with little reliable information and a rapidly changing environment. Having highlighted the limitations of the strategic planning process in these circumstances, the paper recommends changes that shift the focus away from planning towards informed strategic management, that monitors the changing environment and is given freedom to respond to emerging risks and opportunities. The Cambodian German Health Project was initiated in October 1995 as a bilateral health aid project between the German government and the government of the Kingdom of Cambodia, but was disrupted by the "events of 5-6 July, 1997", as the military action is officially described. Project planning had included an intensive goal oriented planning process (ZOPP) undertaken in collaboration with counterparts from the Ministry of Health, Provincial Health Departments and other bilateral, international and non-government stakeholders. Following the military action, the project was initially suspended, then substantially re-drafted within a new framework of assistance, and eventually re-established after an interval of eight months. The paper will examine these planning processes and responses in the light of Mintzberg's (1994 The rise and fall of strategic planning. New York: Prentice-Hall) argument that strategic planning fails because of three conceptual fallacies implicit in the process: (1) The fallacy of

  18. A Primer on Population Health Management and Its Perioperative Application.

    Science.gov (United States)

    Boudreaux, Arthur M; Vetter, Thomas R

    2016-07-01

    The movement toward value-based payment models, driven by governmental policies, federal statutes, and market forces, is propelling the importance of effectively managing the health of populations to the forefront in the United States and other developed countries. However, for many anesthesiologists, population health management is a new or even foreign concept. A primer on population health management and its potential perioperative application is thus presented here. Although it certainly continues to evolve, population health management can be broadly defined as the specific policies, programs, and interventions directed at optimizing population health. The Population Health Alliance has created a particularly cogent conceptual framework and interconnected and very useful population health process model, which together identify the key components of population health and its management. Population health management provides a useful rationale for patients, providers, payers, and policymakers to move collectively away from the traditional system of individual, siloed providers to a more integrated, coordinated, team-based approach, thus creating a holistic view of the patient population. The goal of population health management is to keep the targeted patient population as healthy as possible, thus minimizing the need for costly interventions such as emergency department visits, acute hospitalizations, laboratory testing and imaging, and diagnostic and therapeutic procedures. Population health management strategies are increasingly more important to leaders of health care systems as the health of populations for which they care, especially in a strong cost risk-sharing environment, must be optimized. Most population health management efforts rely on a patient-centric team approach, coordination of care, effective communication, robust outcomes data analysis, and continuous quality improvement. Anesthesiologists have an opportunity to help lead these efforts in

  19. Changing health needs of the ageing population.

    Science.gov (United States)

    Brody, J A

    1988-01-01

    The drama unfolding in this century can be viewed in terms of the age at which people are now dying. Most medical needs, attention and costs occur in the last years of life. At the turn of the century about 25% of people survived age 65. In the developed countries at least 70% of the population now survive beyond this age and 30-40% of deaths are at age 80 or over. Entirely different diseases, conditions and social structures are involved when most people survive to these late ages. Increasing longevity raises the issue of net gain in active functional years versus total years of disability and dysfunction. The available evidence gives rise to pessimism: at present for each active functional year gained we add about 3.5 compromised years. The need for long-term care will continue to grow. Improvements in long-term care involve economic considerations, political will and better mechanisms for the delivery and acceptance of this labour-intensive practice. The education and preparation of the ageing population in terms of normal realities and expectations are even more important. Health-care givers, politicians, and other decision makers are increasingly likely to have first-hand exposure to the good and bad realities of an ageing society, and thereby to perceive the realities of ageing more clearly than ever before. A new political will for more creative and equitable responses to the needs of the elderly and their families is rapidly emerging. The greater our familiarity with the problems of old age, the greater the likelihood for us to find means for improvement.

  20. Changing men's involvement in reproductive health and family planning.

    Science.gov (United States)

    Bustamante-Forest, Rosa; Giarratano, Gloria

    2004-06-01

    The shift in focus on men's reproductive health was influenced by the 1994 Cairo (ICPD) Action Plan to promote gender equality and equity, empower women, and improve family health in society. Changing and improving the way in which men are involved in reproductive health can only have a positive impact on women's, men's, and children's health. Educating and counseling men about contraceptive choices is essential if they are to be supportive of women's reproductive health. Research on new male contraceptive methods must continue if the bias of women shouldering the major responsibility for contraception is to be eliminated.

  1. International Population Assistance and Family Planning Programs: Issues for Congress

    National Research Council Canada - National Science Library

    Blanchfield, Luisa

    2008-01-01

    ...." The Mexico City policy denies U.S. funds to foreign nongovernmental organizations (NGOs) that perform or promote abortion as a method of family planning -- even if the activities are undertaken with non-U.S. funds...

  2. Population Mobility, Urban Planning and Management in China

    National Research Council Canada - National Science Library

    Wong, Tai-Chee; Han, Sun Sheng; Zhang, Hongmei

    2015-01-01

    .... The essays also detail efforts in adopting the latest options in city building such as specific urban planning approaches in developing large city regions, building cities without slums, constructing...

  3. Stillwater Wildlife Management Area Populations management : Trapping plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The proposed action is a revision of the 30 year old fur harvesting plan. This includes: 1) The establishment of a trapping permit system for the entire Stillwater...

  4. Mental Snapshots: Creating an Organized Plan for Health Assessment.

    Science.gov (United States)

    Fosbrook, Susan Curro

    2015-01-01

    Beginning nursing students enter a rapidly moving and changing health care climate. Multiple stimulations can frighten and overwhelm the student's ability to find order of essential patient information. Students need to know how to collect, process, and manage important health data accurately and efficiently in the clinical setting. An integrative method for teaching nursing students to walk into the patient's room and construct a patterned sequence of focused assessments assists students in creating an organized plan for health assessment. The Mental Snapshots Method includes three components for health assessment: (a) sequential assessment steps of the patient; (b) color-coded visual images of the patient representing a bodily condition; and (c) focused assessment questions of primary health complaint(s) with a plan for nursing care. This mental snapshots strategy employs an information processing model of sensory, memory, and motor functioning, which enable students to maintain patient quality and safety. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Barriers and opportunities for evidence-based health service planning: the example of developing a Decision Analytic Model to plan services for sexually transmitted infections in the UK

    Directory of Open Access Journals (Sweden)

    Aicken Catherine R H

    2012-07-01

    Full Text Available Abstract Background Decision Analytic Models (DAMs are established means of evidence-synthesis to differentiate between health interventions. They have mainly been used to inform clinical decisions and health technology assessment at the national level, yet could also inform local health service planning. For this, a DAM must take into account the needs of the local population, but also the needs of those planning its services. Drawing on our experiences from stakeholder consultations, where we presented the potential utility of a DAM for planning local health services for sexually transmitted infections (STIs in the UK, and the evidence it could use to inform decisions regarding different combinations of service provision, in terms of their costs, cost-effectiveness, and public health outcomes, we discuss the barriers perceived by stakeholders to the use of DAMs to inform service planning for local populations, including (1 a tension between individual and population perspectives; (2 reductionism; and (3 a lack of transparency regarding models, their assumptions, and the motivations of those generating models. Discussion Technological advances, including improvements in computing capability, are facilitating the development and use of models such as DAMs for health service planning. However, given the current scepticism among many stakeholders, encouraging informed critique and promoting trust in models to aid health service planning is vital, for example by making available and explicit the methods and assumptions underlying each model, associated limitations, and the process of validation. This can be achieved by consultation and training with the intended users, and by allowing access to the workings of the models, and their underlying assumptions (e.g. via the internet, to show how they actually work. Summary Constructive discussion and education will help build a consensus on the purposes of STI services, the need for service planning to

  6. Do health care workforce, population, and service provision significantly contribute to the total health expenditure? An econometric analysis of Serbia.

    Science.gov (United States)

    Santric-Milicevic, M; Vasic, V; Terzic-Supic, Z

    2016-08-15

    In times of austerity, the availability of econometric health knowledge assists policy-makers in understanding and balancing health expenditure with health care plans within fiscal constraints. The objective of this study is to explore whether the health workforce supply of the public health care sector, population number, and utilization of inpatient care significantly contribute to total health expenditure. The dependent variable is the total health expenditure (THE) in Serbia from the years 2003 to 2011. The independent variables are the number of health workers employed in the public health care sector, population number, and inpatient care discharges per 100 population. The statistical analyses include the quadratic interpolation method, natural logarithm and differentiation, and multiple linear regression analyses. The level of significance is set at P < 0.05. The regression model captures 90 % of all variations of observed dependent variables (adjusted R square), and the model is significant (P < 0.001). Total health expenditure increased by 1.21 standard deviations, with an increase in health workforce growth rate by 1 standard deviation. Furthermore, this rate decreased by 1.12 standard deviations, with an increase in (negative) population growth rate by 1 standard deviation. Finally, the growth rate increased by 0.38 standard deviation, with an increase of the growth rate of inpatient care discharges per 100 population by 1 standard deviation (P < 0.001). Study results demonstrate that the government has been making an effort to control strongly health budget growth. Exploring causality relationships between health expenditure and health workforce is important for countries that are trying to consolidate their public health finances and achieve universal health coverage at the same time.

  7. Self-esteem, stress and self-rated health in family planning clinic patients

    Directory of Open Access Journals (Sweden)

    Young Rodney

    2004-06-01

    Full Text Available Abstract Background The independent effects of stress on the health of primary care patients might be different for different types of clinic populations. This study examines these relationships in a low-income female population of patients attending a family planning clinic. Methods This study investigated the relevance of different sources of personal stress and social support to self-rated health, adjusting for mental health, health behavior and demographic characteristics of subjects. Five hundred women who attended family planning clinics were surveyed and 345 completed the form for a response rate of 72 percent. Results Multiple logistic regression analysis revealed that liking oneself was related to good self-rated health (Odds ratio = 7.11, but stress or support from children, parents, friends, churches or spouses were not significant. White non-Hispanic and non-white non-Hispanic respondents had lower odds of reporting good self-rated health than Hispanic respondents (odds ratios were 2.87 and 2.81, respectively. Exercising five or more days per week also was related to good self-rated health. Smoking 20 or more cigarettes per day, and obese III were negatively related to good self-rated health (odds ratios were .19 and .22, respectively with corresponding p-values equal to .0043 and .0332. Conclusions Among younger low-income women, addressing low self-esteem might improve health status.

  8. Family planning practice in a tertiary health institution in north ...

    African Journals Online (AJOL)

    Background: Family planning in our environment had remained a delicate issue that is still reluctantly being accepted based on religious belief and the perception that it is synonymouswith population control. Objective: This study was carried out with the objectives of identifying the characteristics of contraceptive acceptors ...

  9. A population perspective to evidence based medicine: "evidence for population health"

    OpenAIRE

    Heller, R; Page, J

    2002-01-01

    We explore the notion that the public health community could learn lessons from the success of evidence based medicine (EBM) and develop a public health counterpart called "Evidence for Population Health". While EBM focuses on individual patients, its public health counterpart would aim to improve the health of communities effectively and efficiently.

  10. [A tentative discussion on the objective necessity of the socialist population plan].

    Science.gov (United States)

    Li, R

    1983-01-29

    In a socialist system a new problem being encountered is whether or not to implement planned management in human reproduction, and whether or not it is possible. Marx and Engels foresaw that human reproduction would undergo basic changes. In following Marx, Socialist China has brought about for the first time in history planned management in human reproduction. According to the author, the objective necessity of the population plan stems from public ownership of the means of production, is compatible with planned development of material production and conforms to Socialist economic laws. 3 main general points are made: 1) the public ownership of the means of production supplies the objective conditions for population planning; population reproduction in a system of private ownership is the basis for class opposites, but the public ownership of the means of production erases this type of opposites; 2) population planning is an important integral part of national economic planning; man, the unification of production and consumption, is the primary element in economic activity; 3) population planning embodies the demands of basic socialist economic laws. Basic socialist economic laws determine the character of social production and hence determines the character of population production.

  11. [A national plan for action on the environment and health].

    Science.gov (United States)

    Chuchkova, M

    1996-01-01

    Preserving the environment and human health is an irreversible part of the activity towards stable development. Acknowledging the necessity of such development, the European countries commence working out of plans that subordinate their policy to this object. Concerning the health policy the new strategy requires improving of the integrated system for environmental and health control-an administrative framework that reflects the partnership between health and environmental institutions and the other sectors at all levels of control. The main means and instruments for control of health and the environment are: 1) information system for health and environment; 2) identification and evaluation of the health and environmental risks; 3) a framework of the current legislation; 4) additional measures for control, including economical and fiscal instruments; 5) professional training and qualification; 6) public information and health education; 7) public participation; 8) researches and technological works. The correct functioning of the complex "taking decisions-control system" and the expected results depend on the adequate working out and application of the above mentioned means. The national action plan for environment and health is a fundamental project on a large scale for preserving the health and environmental interests of the country targeting at its stable progress.

  12. Health policies planning: methodological standards, boundaries and possibilities

    Directory of Open Access Journals (Sweden)

    Cassius Guimarães Chai

    2016-12-01

    Full Text Available Before the health right recognition and expansion brought about by the Federal Constitution of 1988,the impact on public accounts and the need to rationalize the system, now bound to the universalisation matrix, place “planning” as fundamental for the operationalization of actions and services of health accessing. The objective of this article is to carry out an integrative literature review in order to know the factors related to the methodological frameworks, challenges and possibilities for structuring a Municipal Health Plan (Administration. The following databases were searched: Lilacs, Library Digital Thesis and Dissertation (BDTD, in Google Scholar, the Coordination of Improvement of Higher Education Personnel (CAPES Thesis Bank. For the composition of the sample, the following descriptors were associated: Health Policy, Decentralization and Municipalization with Health Planning. In addition, papers were selected among dissertations, theses and scientific articles, as well as institutional handbooks of the Ministry of Health-MS Publics of PlanejaSUS, adopting scientific works published between 2005 and 2015 as a time cut. The results found synthesize the scenario of the intersectoral and tripartite arrangement of health management, contributing to a critical and evaluative exercise of experience, challenges and possibility Of advances in the understanding of the importance of SUS municipal planning.

  13. Health Care Consumerism: Lessons My 401(k) Plan Taught Me.

    Science.gov (United States)

    Steinberg, Allen T

    2015-01-01

    Changes to the U.S. health care system are here. As we think about how individuals will pay for health care--while actively employed and while retired--our experiences with 401(k) plans provide some valuable lessons. In order to support employees in this new health care world--a challenge arguably more daunting than the 401(k) challenge we faced 20 years ago--some very different types of support are needed. Employers should consider providing their employees with the resources to manage health care changes.

  14. Integrating a Proposed Population Health Model with Nursing Informatics Research.

    Science.gov (United States)

    Dowding, Dawn; Arcia, Adriana; Bjarnadottir, Ragnhildur Ingibjargardottir; Iribarren, Sarah; Yoon, Sunmoo

    2016-01-01

    In this panel we discuss how nursing informatics can provide a framework for carrying out population health nursing research, using a conceptual model for nursing and population health; the Conceptual Model of Nursing and Population Health (CMNPH). The panel will provide an overview of the CMNPH and then each presenter will present findings from ongoing informatics research that provides insights to different levels of the CNMPH model. The panel is targeted towards informatics researchers who wish to use novel informatics approaches to carry out population health research.

  15. Assessing Emergency Department Utilization in the Era of Population Health.

    Science.gov (United States)

    Schold, Jesse D; Locke, Jayme E

    2017-12-30

    Population health has been broadly defined as "health outcomes of a group of individuals, including the distribution of such outcomes within the group." (1) Increasingly, population health has gained prominence and impact with emergence of Accountable Care Organizations that serve populations across transitions of care and different providers (often extended to communities). Population health has also been a focus of healthcare reform and development of policies and interventions aimed at simultaneously improving quality and reducing costs. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  16. Awakening consumer stewardship of health benefits: prevalence and differentiation of new health plan models.

    Science.gov (United States)

    Rosenthal, Meredith; Milstein, Arnold

    2004-08-01

    Despite widespread publicity of consumer-directed health plans, little is known about their prevalence and the extent to which their designs adequately reflect and support consumerism. We examined three types of consumer-directed health plans: health reimbursement accounts (HRAs), premium-tiered, and point-of-care tiered benefit plans. We sought to measure the extent to which these plans had diffused, as well as to provide a critical look at the ways in which these plans support consumerism. Consumerism in this context refers to efforts to enable informed consumer choice and consumers' involvement in managing their health. We also wished to determine whether mainstream health plans-health maintenance organization (HMO), point of service (POS), and preferred provider organization (PPO) models-were being influenced by consumerism. Our study uses national survey data collected by Mercer Human Resource Consulting from 680 national and regional commercial health benefit plans on HMO, PPO, POS, and consumer-directed products. We defined consumer-directed products as health benefit plans that provided (1) consumer incentives to select more economical health care options, including self-care and no care, and (2) information and support to inform such selections. We asked health plans that offered consumer-directed products about 2003 enrollment, basic design features, and the availability of decision support. We also asked mainstream health plans about their activities that supported consumerism (e.g., proactive outreach to inform or influence enrollee behavior, such as self-management or preventive care, reminders sent to patients with identified medical conditions.) We analyzed survey responses for all four product lines in order to identify those plans that offer health reimbursement accounts (HRAs), premium-tiered, or point-of-care tiered models as well as efforts of mainstream health plans to engage informed consumer decision making. The majority of enrollees in

  17. Health human resources planning and the production of health: development of an extended analytical framework for needs-based health human resources planning.

    Science.gov (United States)

    Birch, Stephen; Kephart, George; Murphy, Gail Tomblin; O'Brien-Pallas, Linda; Alder, Rob; MacKenzie, Adrian

    2009-11-01

    Health human resources planning is generally based on estimating the effects of demographic change on the supply of and requirements for healthcare services. In this article, we develop and apply an extended analytical framework that incorporates explicitly population health needs, levels of service to respond to health needs, and provider productivity as additional variables in determining the future requirements for the levels and mix of healthcare providers. Because the model derives requirements for providers directly from the requirements for services, it can be applied to a wide range of different provider types and practice structures including the public health workforce. By identifying the separate determinants of provider requirements, the analytical framework avoids the "illusions of necessity" that have generated continuous increases in provider requirements. Moreover, the framework enables policy makers to evaluate the basis of, and justification for, increases in the numbers of provider and increases in education and training programs as a method of increasing supply. A broad range of policy instruments is identified for responding to gaps between estimated future requirements for care and the estimated future capacity of the healthcare workforce.

  18. Measuring efficiency of health plan payment systems in managed competition health insurance markets.

    Science.gov (United States)

    Layton, Timothy J; Ellis, Randall P; McGuire, Thomas G; van Kleef, Richard

    2017-12-01

    Adverse selection in health insurance markets leads to two types of inefficiency. On the demand side, adverse selection leads to plan price distortions resulting in inefficient sorting of consumers across health plans. On the supply side, adverse selection creates incentives for plans to inefficiently distort benefits to attract profitable enrollees. Reinsurance, risk adjustment, and premium categories address these problems. Building on prior research on health plan payment system evaluation, we develop measures of the efficiency consequences of price and benefit distortions under a given payment system. Our measures are based on explicit economic models of insurer behavior under adverse selection, incorporate multiple features of plan payment systems, and can be calculated prior to observing actual insurer and consumer behavior. We illustrate the use of these measures with data from a simulated market for individual health insurance. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Evaluating the impact of equity focused health impact assessment on health service planning: three case studies.

    Science.gov (United States)

    Harris-Roxas, Ben; Haigh, Fiona; Travaglia, Joanne; Kemp, Lynn

    2014-09-05

    Health impact assessment has been identified internationally as a mechanism to ensure potential health impacts and health equity impacts of proposals are considered before implementation. This paper looks at the impact of three equity focused health impact assessments (EFHIAs) of health service plans on subsequent decision-making and implementation, and then utilises these findings to test and refine an existing conceptual framework for evaluating the impact and effectiveness of health impact assessments for use in relation to EFHIAs. Case study analysis of three EFHIAs conducted on health sector plans in New South Wales, Australia. Data was drawn from 14 semi-structured interviews and the analysis of seven related documents (draft plans and EFHIA reports). The case studies showed that the EFHIAs all had some impact on the decision-making about the plans and their implementation, most clearly in relation to participants' understandings of equity and in the development of options for modifying service plans to ensure this was addressed. The timing of the EFHIA and individual responses to the EFHIA process and its recommendations were identified as critical factors influencing the impact of the EFHIAs. Several modifications to the conceptual framework are identified, principally adding factors to recognise the role individuals play in influencing the impact and effectiveness of EFHIAs. EFHIA has the potential to improve the consideration of health equity in health service planning processes, though a number of contextual and individual factors affect this. Current approaches can be strengthened by taking into account personal and organisational responses to the EFHIA process.

  20. Strategies for expanding health insurance coverage in vulnerable populations

    OpenAIRE

    Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue

    2014-01-01

    Background Health insurance has the potential to improve access to health care and protect people from the financial risks of diseases. However, health insurance coverage is often low, particularly for people most in need of protection, including children and other vulnerable populations. Objectives To assess the effectiveness of strategies for expanding health insurance coverage in vulnerable populations. Search methods We searched Cochrane Central Register of Controlled Trials (CENTRAL), pa...

  1. Population Health Research: Early Description of the Organizational Shift Toward Population Health Management and Defining a Vision for Leadership.

    Science.gov (United States)

    Caldararo, Kristi L; Nash, David B

    2017-10-01

    As health care delivery systems adapt to the changing marketplace, many struggle to define a clear strategy that will prove successful in managing the health of entire populations. The federal government continues to put increasing pressure on organizations to shift away from the traditional way of delivering episodic care and move toward managing populations as a whole-before, during, and after a patient presents in a health care facility. Private payers have begun to follow suit as risk-based payer contracts and bundled payment models become increasingly popular. For organizations to adequately influence the health outcomes of a population, they must be responsible for more than just a patient's medical care. They must partner with the community to create a strategy that encompasses the psychosocial and environmental factors that contribute to one's health. Although health care leaders know this industry transformation is imminent, there is minimal research that shares best practices in regard to designing and implementing a successful population health management strategy. Interviews were conducted with leadership from 10 organizations in order to understand the strategic approach taken by delivery systems and health care institutions that view population health as a key aspect of their overall mission. Responses were recorded and outlined in a detailed response grid. The objective is to provide a qualitative overview of how industry leaders are currently responding to population health. Additionally, common themes and recommendations are presented to serve as guidance for other health care organizations that are at the start of their journey toward population health management.

  2. Advance care planning with individuals experiencing homelessness: Literature review and recommendations for public health practice.

    Science.gov (United States)

    Hubbell, Sarah A

    2017-09-01

    Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet health care needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to communicate end-of-life preferences. This paper includes a narrative literature review of advance care planning interventions and qualitative investigations into end-of-life concerns among people experiencing homelessness. Trials of clinician-guided interventions with homeless individuals demonstrated effectiveness in achieving advance directive completion and surrogate decision-maker designation. End-of-life concerns among homeless persons included fears of dying alone, dying unnoticed, or remaining unidentified after death. Research participants also reported concerns regarding burial and notification of family members. Public health practitioners should facilitate advance care planning for people who are homeless by providing opportunities for education and discussion on care options and advance directives. © 2017 Wiley Periodicals, Inc.

  3. Strategic planning--a plan for excellence for South Haven Health System.

    Science.gov (United States)

    Urbanski, Joanne; Baskel, Maureen; Martelli, Mary

    2011-01-01

    South Haven Health System has developed an innovative approach to strategic planning. The key to success of this process has been the multidisciplinary involvement of all stakeholders from the first planning session through the final formation of a strategic plan with measurable objectives for each goal. The process utilizes a Conversation Café method for identifying opportunities and establishing goals, Strategic Oversight Teams to address each goal and a Champion for implementation of each objective. Progress is measured quarterly by Strategic Oversight Team report cards. Transparency of communication within the organization and the sharing of information move the plan forward. The feedback from participant evaluations has been overwhelmingly positive. They are involved and excited.

  4. Sanitation health risk and safety planning in urban residential ...

    African Journals Online (AJOL)

    It is concluded that sustainable sanitation safety planning is imperative in every developing nation's urban neighborhood. It is therefore recommended that sanitation standards should be set through consultative process; and monitoring should be participatory and multi-dimensional in approach. Keywords: Health Risk ...

  5. Urban planning, downstream petroleum industry and human health ...

    African Journals Online (AJOL)

    Urban growth in Nigeria has been phenomenal over the past five decades. Zoning controls and urban planning regulations are however not being enforced or sustained. Consequences include lawless development of urban space, congestion, squalor, pollution and attendant environmental and health challenges.

  6. Strategic Medicines Planning in Primary Health Care | Adindu ...

    African Journals Online (AJOL)

    Strategic medicines planning requires broad understanding of health and medicines realities within a context. Pharmacists viewing the community from a holistic perspective promote effectiveness in pharmacy, and facilitate synergy among the various groups to solve intractable medicines problems. Strategic medicines ...

  7. 78 FR 33233 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Science.gov (United States)

    2013-06-04

    ...; Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program AGENCY: Centers for... Care Act; Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers... proposed in the Establishment of Exchanges and Qualified Health Plans; Small Business Health Options...

  8. Canadian support for population stabilization. The Rome draft Plan of Action. Dr. Jean Augustine, MP (Canada).

    Science.gov (United States)

    1996-01-01

    Canada strongly believes in the central role to be played by the civil sector in the process leading to the World Food Summit. Dr. Augustine, Member of Parliament of Canada, described how the Canadian Government involved 350 national organizations over an eight-month period in the creation of the country's official position on food security. Canada has also negotiated with several other countries and international organizations on issues such as trade, human rights, the right to food, and follow-up to the Plan of Action. Dr. Augustine summarized Canada's 18 priorities for the World Food Summit. The priorities include human rights and good governance; poverty reduction; peace, security and conflict resolution; national responsibility for food security; national and global partnerships; nutrition and health; human resource development; gender equity; population stabilization; trade liberalization; agricultural adjustment to international markets; post-harvest marketing and food marketing; the role of the private sector; capacity building; environment and sustainable production; and research and technology transfer.

  9. Health transformation plan: Goals achievement in Nemazee hospital

    Directory of Open Access Journals (Sweden)

    Ali Akbar Ahmadi

    2016-01-01

    Full Text Available Introduction: The main purpose of this study was to assess fulfillment of goals about “Health Transformation Plan (HTP of Ministry of Health, Treatment and Medical Education” from the perspective of managers, which is as one of the most important management challenges in the Health System Reform Plan. These goals included six packages determined by the Ministry of Health, Treatment and Medical Education, the fulfillment of each of which one was evaluated separately as sub-goals in the current study. Finally, the rank of each package in comparison to other packages was determined and presented, using means rank test (Friedman test. Method: This study was conducted using a questionnaire in which comments of the senior and middle managers of Nemazee hospital were collected as the research data. Due to the fact that about one year has passed since the beginning of implementation of HTP and since there were no documented methods or questionnaires, the researcher designed a self-made questionnaire. The basis of designing the questionnaire was the set of guidelines developed for Health System Reform Plan. These guidelines include goals that a hospital should achieve during implementation of Health System Reform Plan. After sharing these goals with senior and middle managers of Nemazee hospital (as the place of research, they were converted to a questionnaire including 20 questions. The questionnaire included the goals that must be achieved in Nemazee hospital of Shiraz during the implementation of the plan. After designing the questionnaire, a preliminary test was taken to assess the reliability. Results: Cronbach’s alpha coefficient (0.88 showed a high rate of reliability in the above questionnaire. After the final data collection, the questionnaire was tested in a sample of 100 senior and middle managers; the results showed that about six packages were specified by the Ministry of Health, Treatment and Medical Education. The majority of

  10. A critical review of population health literacy assessment.

    Science.gov (United States)

    Guzys, Diana; Kenny, Amanda; Dickson-Swift, Virginia; Threlkeld, Guinever

    2015-03-04

    Defining health literacy from a public health perspective places greater emphasis on the knowledge and skills required to prevent disease and for promoting health in everyday life. Addressing health literacy at the community level provides great potential for improving health knowledge, skills and behaviours resulting in better health outcomes. Yet there is a notable absence of discussion in the literature of what a health literate population looks like, or how this is best assessed. The emphasis in assessing health literacy has predominantly focused on the functional health literacy of individuals in clinical settings. This review examines currently available health literacy assessment tools to identify how well suited they are in addressing health literacy beyond clinical care settings and beyond the individual. Although public health literature appears to place greater emphasis on conceptualizing critical health literacy, the focus continues to remain on assessing individuals, rather than on health literacy within the context of families, communities and population groups. When a population approach is adopted, an aggregate of individual health literacy assessment is generally used. Aggregation of individual health literacy fails to capture the dynamic and often synergistic relationships within communities, and fails to reflect societal influences on health knowledge, beliefs and behaviours. We hypothesise that a different assessment framework is required to adequately address the complexities of community health literacy. We assert that a public health approach, founded on health promotion theories provides a useful scaffold to assess the critical health literacy of population groups. It is proposed that inclusion of community members in the research process is a necessary requirement to coproduce such an appropriate assessment framework. We contend that health literacy assessment and potential interventions need to shift to promoting the knowledge and skills

  11. POPULATION GROWTH AND HEALTH CARE DELIVERY IN ...

    African Journals Online (AJOL)

    Adamawa state population is projected to be approximately 2,819million by the year 2001. This gives an increase of 716,784 as compared to the 1991 census figure, which is 2,102,053 for the state. The last census (1991) formed the basis of this projection. Further,1996 projected population was projected to the year 2001.

  12. Population and Reproductive Health in National Adaptation ...

    African Journals Online (AJOL)

    Erah

    increase vulnerability to many of the most serious impacts of climate change. Scarcity of food and water, vulnerability to natural disasters and infectious diseases, and population displacement are all exacerbated by rapid population growth.9, 10. Recognizing that LDCs, including developing. Small Island States, are among ...

  13. Qualifications and Competencies for Population Health Management Positions: A Content Analysis of Job Postings.

    Science.gov (United States)

    Meyer, Melanie

    2017-12-01

    The need for population health management expertise has increased as the health care industry shifts toward value-based care. However, many organizations report hiring gaps as they seek to fill positions. The purpose of this study was to analyze the types of population health management positions for which health care organizations are hiring, including qualifications and competencies required for these positions. A content analysis was conducted on 271 job postings collected during a 2-month period. A typology of qualifications and competencies was developed based on the content analysis. Profiles were generated for the top 5 job title classifications: directors, coordinators, care managers, analysts, and specialists. This study highlights the investment health care organizations are making in population health management and the prominent role these positions are playing in the health care environment today. Many organizations are building out population health management teams resulting in multiple positions at different levels being added. As the market demands competent candidates who are equipped with specialized population health expertise as well as practical experience in program development, technology applications, care management, and analytics, professional education programs will need to adapt curricula to address the required areas. Competencies for specific job title classifications may need further evaluation and refinement over time. Study results can be used by organizations for strategic planning, by educators to target needed qualifications and competencies, and by researchers and policy advisors to assess progress toward value-based care.

  14. The Obama health care plan: what it means for mental health care of older adults.

    Science.gov (United States)

    Sorrell, Jeanne M

    2009-01-01

    Health care was an important issue for both the Obama and McCain election campaigns. Now that Barack Obama is poised to serve as the 44th President of the United States, many health care providers are focused on what Obama's administration will mean for new health care initiatives. This article focuses specifically on aspects of the Obama and Biden health care plan that affects mental health care for older adults.

  15. [Toward a national plan to control health effects of mercury in Colombia].

    Science.gov (United States)

    Casas, Isabel Cristina; Gómez, Elidier; Rodríguez, Lina María; Girón, Sandra Lorena; Mateus, Julio César

    2015-08-01

    The problem of mercury effects on humans and the environment is global, and it has different impacts on health. It is necessary, therefore, to address this issue from a broad overview to identify populations at risk of exposure, health effects, the production processes involved and the actions aimed at reducing exposure and mitigating the impact. To design a conceptual and operational framework to develop strategies for prevention, control and mitigation of mercury effects on health and on the environment in Colombia. We conducted a two-phase study: a literature review following the Cochrane methodology and forums with national and international experts using a comprehensive planning methodology to identify priority actions and establish a national research agenda. The results of the review were structured into four components: mercury effects on health, legal framework in Colombia, emission inventory for the country and health plans and programs. We made recommendations for the design of an intervention plan considering five lines of action: technologies for exposure management, institutional strengthening for exposure prevention and control, strategies for strengthening diagnosis and care, health education on mercury risks, and knowledge generation. We detected information gaps, technical weaknesses, and the need of administrative and other resources in this field in Colombia. We proposed priority actions to reduce the economic, social and health impact from exposure to mercury.

  16. A Social Work Approach to Policy: Implications for Population Health.

    Science.gov (United States)

    Miller, Daniel P; Bazzi, Angela R; Allen, Heidi L; Martinson, Melissa L; Salas-Wright, Christopher P; Jantz, Kathryn; Crevi, Katherine; Rosenbloom, David L

    2017-12-01

    The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health.

  17. A Social Work Approach to Policy: Implications for Population Health

    Science.gov (United States)

    Bazzi, Angela R.; Allen, Heidi L.; Martinson, Melissa L.; Salas-Wright, Christopher P.; Jantz, Kathryn; Crevi, Katherine; Rosenbloom, David L.

    2017-01-01

    The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health. PMID:29236535

  18. Trends Affecting the U.S. Health Care System. Health Planning Information Series.

    Science.gov (United States)

    Cerf, Carol

    This integrated review of national trends affecting the health care system is primarily intended to facilitate the planning efforts of health care providers and consumers, Government agencies, medical school administrators, health insurers, and companies in the medical market. It may also be useful to educators as a textbook to give their students…

  19. News Framing of Population and Family Planning Issues via Syntactic Network Analysis

    Science.gov (United States)

    Legara, Erika; Monterola, Christopher; David, Clarissa; Mae Atun, Jenna

    Contentious political debates regarding the issues on population and family planning have been perennial over the past four decades especially in developing countries. While its prominence in the public agenda varies depending on other national issues vying for public attention, its presence in policy and political agendas is constant. Here, a computational approach to framing analysis is developed that examines the pattern of media coverage on the population issue in the Philippines. The content of 146 articles sampled from 1988 to 2007 in Manila Bulletin (one of the leading newspapers in the Philippines) is analyzed by creating a syntactic network of concept co-occurrences. The topological properties of the network indicates that the discussion of an article revolves around few central ideas. Moreover, cluster analysis of the network suggests three well-defined frame themes, namely: (1) Development Frame; (2) Maternal Health Frame; and (3) Framing by the Catholic Church. Our results support the thesis that the inability to fruitfully discuss points of contention to reach agreement about suitable population policies in the Philippines is due to the mismatched frames within which it is discussed.

  20. Health Literacy Skills in Rural and Urban Populations

    Science.gov (United States)

    Zahnd, Whitney E.; Scaife, Steven L.; Francis, Mark L.

    2009-01-01

    Objective: To determine whether health literacy is lower in rural populations. Method: We analyzed health, prose, document, and quantitative literacy from the National Assessment of Adult Literacy study. Metropolitan Statistical Area designated participants as rural or urban. Results: Rural populations had lower literacy levels for all literacy…

  1. Health Care Procedure Considerations and Individualized Health Care Plans

    Science.gov (United States)

    Heller, Kathryn Wolff; Avant, Mary Jane Thompson

    2011-01-01

    Teachers need to maintain a safe, healthy environment for all their students in order to promote learning. However, there are additional considerations when students require health care procedures, such as tube feeding or clean intermittent catheterization. Teachers must effectively monitor their students and understand their roles and…

  2. State Health Mapper: An Interactive, Web-Based Tool for Physician Workforce Planning, Recruitment, and Health Services Research.

    Science.gov (United States)

    Krause, Denise D

    2015-11-01

    Health rankings in Mississippi are abysmal. Mississippi also has fewer physicians to serve its population compared with all other states. Many residents of this predominately rural state do not have access to healthcare providers. To better understand the demographics and distribution of the current health workforce in Mississippi, the main objective of the study was to design a Web-based, spatial, interactive application to visualize and explore the physician workforce. A Web application was designed to assist in health workforce planning. Secondary datasets of licensure and population information were obtained, and live feeds from licensure systems are being established. Several technologies were used to develop an intuitive, user-friendly application. Custom programming was completed in JavaScript so the application could run on most platforms, including mobile devices. The application allows users to identify and query geographic locations of individual or aggregated physicians based on attributes included in the licensure data, to perform drive time or buffer analyses, and to explore sociodemographic population data by geographic area of choice. This Web-based application with analytical tools visually represents the physician workforce licensed in Mississippi and its attributes, and provides access to much-needed information for statewide health workforce planning and research. The success of the application is not only based on the practicality of the tool but also on its ease of use. Feedback has been positive and has come from a wide variety of organizations across the state.

  3. 29 CFR 825.211 - Maintenance of benefits under multi-employer health plans.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Maintenance of benefits under multi-employer health plans... Family and Medical Leave Act § 825.211 Maintenance of benefits under multi-employer health plans. (a) A multi-employer health plan is a plan to which more than one employer is required to contribute, and...

  4. Pacific Flyway management plan for the Western Population of tundra swans

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of this plan is to establish guidelines for the cooperative management of the Western Population (WP) of tundra swans (Cygnus c. columbianus). This...

  5. Plan for Establishment of a Breeding Canada Goose Population on the Montezuma National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report outlines a plan on how to implement a program for the establishment of a breeding Canada Goose population on the Montezuma National Wildlife Refuge. It...

  6. 75 FR 70159 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-11-17

    ... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ50 Group Health Plans and Health Insurance Coverage... provide guidance to employers, group health plans, and health insurance issuers providing group health... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar...

  7. Social Determinants of Population Health: A Systems Sciences Approach.

    Science.gov (United States)

    Fink, David S; Keyes, Katherine M; Cerdá, Magdalena

    2016-03-01

    Population distributions of health emerge from the complex interplay of health-related factors at multiple levels, from the biological to the societal level. Individuals are aggregated within social networks, affected by their locations, and influenced differently across time. From aggregations of individuals, group properties can emerge, including some exposures that are ubiquitous within populations but variant across populations. By combining a focus on social determinants of health with a conceptual framework for understanding how genetics, biology, behavior, psychology, society, and environment interact, a systems science approach can inform our understanding of the underlying causes of the unequal distribution of health across generations and populations, and can help us identify promising approaches to reduce such inequalities. In this paper, we discuss how systems science approaches have already made several substantive and methodological contributions to the study of population health from a social epidemiology perspective.

  8. The role of health impact assessment in promoting population health and health equity.

    Science.gov (United States)

    Wise, Marilyn; Harris, Patrick; Harris-Roxas, Ben; Harris, Elizabeth

    2009-12-01

    Within the discipline of health promotion there has been long-standing understanding of the social determinants of health and life expectancy.1-3 There is also long-standing evidence of the unfair, unjust distribution of these resources within and among societies. It has proven difficult to translate this evidence of the need for the fairer distribution of socially-distributed resources into powerful action by the range of sectors through whose policies and programs/services much of this inequitable distribution is created.4 Health promotion has proven effective in contributing to significant improvements in the health of populations. It is, now, based on well-developed theory and a comprehensive body of evidence. However, health promotion in particular and the health sector in general have found it difficult to work with other sectors to influence public policy to create the social, economic, environmental and cultural conditions necessary for health equity. Health Impact Assessment (HIA) is outlined as an approach that offers the health sector a structured, transparent method and process to work with other sectors to predict the impact of policy proposals on the health of populations (and on the determinants of health), and to predict the distribution of these impacts in advance of adoption and implementation of the policy. Based on Australian experience of conducting HIAs, the paper outlines contributions that HIA can make to formulating and implementing of healthy public policy. It describes the steps in HIA and illustrates the use of these in practice.

  9. Health literacy among Saudi population: a cross-sectional study.

    Science.gov (United States)

    Abdel-Latif, Mohamed M M; Saad, Sherif Y

    2017-09-12

    Health literacy is a major problem worldwide and adversely affects an individual's health. The aim of the present study was to assess health literacy level among Saudi population. A cross-sectional study was conducted among a randomly selected population (n = 500) in Saudi Arabia. The questionnaire comprised of questions pertaining to demographic characteristics, health literacy and health information. Health literacy was measured by REALM-R test. Internal reliability was determined using Cronbach's alpha coefficient. The majority of the respondents had intermediate (43.8%) and basic (34.4%) health literacy levels. A higher percentage among men had intermediate (59.8%) and basic (70.93%) health literacy levels compared with women. About 30% of respondents had difficulty in understanding health screening tests and disease treatment. More than half of participants (52.4%) had difficulty in finding health information. The REALM-R test revealed that about 42.6% of individuals with score of >6 had adequate health literacy compared with 57.4% with score of ≤6 had inadequate health literacy. The present study demonstrated that a majority of Saudi individuals had inadequate health literacy that associated with poor knowledge of health information. Our findings highlighted the importance of understanding the status of health literacy among Saudis and the need for educational programs to raise the health literacy awareness among Saudi population. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Tank farm health and safety plan. Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Mickle, G.D.

    1995-03-29

    This Tank Farm Health and Safety Plan (HASP) for the conduct of all operations and work activities at the Hanford Site 200 Area Tank Farms is provided in order to minimize health and safety risks to workers and other onsite personnel. The HASP accomplishes this objective by establishing requirements, providing general guidelines, and conveying farm and facility-specific hazard communication information. The HASP, in conjunction with the job-specific information required by the HASP, is provided also as a reference for use during the planning of work activities at the tank farms. This HASP applies to Westinghouse Hanford Company (WHC), other prime contractors to the U.S. Department of Energy (DOE), and subcontractors to WHC who may be involved in tank farm work activities. This plan is intended to be both a requirements document and a useful reference to aid tank farm workers in understanding the safety and health issues that are encountered in routine and nonroutine work activities. The HASP defines the health and safety responsibilities of personnel working at the tank farms. It has been prepared in recognition of and is consistent with National Institute of Safety and Health (NIOSH), and Occupational Safety and Health Administration (OSHA)/Unlimited State Coast Guard (USCG)/U.S. Environmental Protection Agency (EPA), Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities (NIOSH 1985); WHC-CM-4-3, Industrial Safety Manual, Volume 4, {open_quotes}Health and Safety Programs for Hazardous Waste Operations;{close_quotes} 29 CFR 1910.120, Hazardous Waste Operations and Emergency Response; WHC-CM-1-1, Management Policies; and WHC-CM-1-3, Management Requirements and Procedures. When differences in governing regulations or policies exist, the more stringent requirements shall apply until the discrepancy can be resolved.

  11. POPULATION HEALTH AND THE RISE OF CONSUMERISM.

    Science.gov (United States)

    2015-09-01

    Earlier this summer, we convened a panel of health care executives and industry experts to consider how hospitals can balance the demands of high-value, more efficient care with the emergence of the savvy health care consumer. Their insights and words of advice are eye-opening.

  12. Assessment of the National Library of Medicine's health disparities plan: a focus on Native American outreach.

    Science.gov (United States)

    Siegel, Elliot R; Wood, Frederick B; Dutcher, Gale A; Ruffin, Angela; Logan, Robert A; Scott, John C

    2005-10-01

    Overcoming health disparities between majority and minority populations is a significant national challenge. This paper assesses outreach to Native Americans (American Indians, Alaska Natives, and Native Hawaiians) by the National Library of Medicine (NLM). A companion paper details NLM's portfolio of Native American outreach projects. NLM's Native American outreach is assessed in light of the presentations at a community-based health information outreach symposium and the goals set by NLM's plan to reduce health disparities. NLM's current portfolio of Native American outreach projects appears most advanced in meeting the goal set in area 1 of the health disparities plan, "Promote use of health information by health professionals and the public." NLM's portfolio also shows significant strength and good progress regarding area 2 of the plan, "Expand partnerships among various types of libraries and community-based organizations." The portfolio is weaker in area 3, "Conduct and support informatics research." More knowledge-building efforts would benefit NLM, the National Network of Libraries of Medicine, and Native American and community-based organizations. The current Native American outreach portfolio should be continued, but new approaches are needed for evaluating Native American outreach and for forging collaborations with Native American groups, approaches grounded in consultation and mutual understanding of needs and perspectives.

  13. A mismatch between population health literacy and the complexity of health information

    DEFF Research Database (Denmark)

    Rowlands, Gillian; Protheroe, Joanne; Winkley, John

    2015-01-01

    skills in relation to these. DESIGN AND SETTING: An English observational study comparing health materials with national working-age population skills. METHOD: Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified...... of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information.......BACKGROUND: Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. AIM: To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population...

  14. [The Health Plan for Catalonia: an instrument to transform the health system].

    Science.gov (United States)

    Constante i Beitia, Carles

    2015-11-01

    The Department of Health of the Generalitat in Catalonia periodically draws up the Health Plan, which is the strategic document that brings together the reference framework for initiatives concerning public health in terms of the Catalan health administration. The 2011-2015 version of the Health Plan incorporates key care and system governance-related elements, which, in conjunction with health goals, make up the complete picture of what the health system in Catalonia should look like until 2015. The Plan was drawn up at a time when the environmental conditions were extremely particular, given the major economic crisis that began in 2007. This has meant that the system has been forced to address public health problems using a significant reduction in the economic resources available, while aiming to maintain the level of care provided, both quantitatively and qualitatively, and preserve the sustainability of the system whose defining traits are its universality, equity and the wide range of services on offer. The Health Plan focuses on three areas of action, 9 major courses of action and 32 strategic projects designed to respond to new social needs: addressing the most common health issues, comprehensive care for chronic patients and organizational modernization. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  15. Top Health Issues for LGBT Populations

    Science.gov (United States)

    ... in a female- to-male transsexual patient. Gynecologic & Obstetric Investigation, 62 (4), 226-228. 5 Xavier, J., ... and drug-related risk behaviors or improving health outcomes. Some target LGBTs; others target groups likely to ...

  16. 42 CFR 440.350 - Employer-sponsored insurance health plans.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Employer-sponsored insurance health plans. 440.350... Benchmark-Equivalent Coverage § 440.350 Employer-sponsored insurance health plans. (a) A State may provide... health insurance. (b) The State must assure that employer sponsored plans meet the requirements of...

  17. Public health, privatization, and market populism: a time for reflection.

    Science.gov (United States)

    Beauchamp, D

    1997-01-01

    The political, social, and economic ideology fueling the movement toward privatization in health care may be characterized as "market populism." Whether or not public health agencies retain their traditional roles in personal health services delivery, these organizations must serve as the predominant external source for quality monitoring, oversight, enforcement, and advocacy for communities in an environment that regards the private market as a panacea.

  18. Documenting the Effects of Armed Conflict on Population Health.

    Science.gov (United States)

    Levy, Barry S; Sidel, Victor W

    2016-01-01

    War and other forms of armed conflict have profound adverse effects on population health. It is important to document these effects to inform the general public and policy makers about the consequences of armed conflict, provide services to meet the needs of affected populations, protect human rights and document violations of international humanitarian law, and help to prevent future armed conflict. Documentation can be accomplished with surveillance, epidemiological surveys, and rapid assessment. Challenges include inadequate or absent data systems, social breakdown, forced migration, reporting biases, and the fog of war. The adverse effects of the Iraq War on population health demonstrate how the effects of armed conflict on population health can be documented. We recommend the establishment of an independent mechanism, operated by the United Nations or a multilateral organization, to investigate and document the effects of armed conflict on population health.

  19. International Population Assistance and Family Planning Programs: Issues for Congress

    Science.gov (United States)

    2008-07-24

    following rape or incest ; health care facilities may treat injuries or illnesses caused by legal or illegal abortions (post-abortion care). ! “Passive...an act of promoting abortion; referrals for abortion as a result of rape, incest , or where the mother’s life would be endangered, or for post

  20. Planning Critical Infrastructure based on Population Growth and Environmental Constraints

    Directory of Open Access Journals (Sweden)

    Nabawiya Khamis Al Masuudi

    2018-02-01

    Full Text Available This study explores the impact of public school location/distribution and surrounding build environment based on its distance from the main street, service road, petrol stations in Sohar, Oman using GIS. Data have been collected from various official sources to fulfil the requirements of this study, which helped in constructing the geodatabase for this project. The results of this study demonstrated that there is an apparent inconsistency in public schools distribution, as most public schools are concentrated in one location. The study concludes with suggestions and recommendations to use GIS and spatial planning by the decision makers to make future sound decisions of building public schools. It is desirable to build schools in areas with lower percentages of highways and commercial sectors.

  1. Extension of landscape-based population viability models to ecoregional scales for conservation planning

    Science.gov (United States)

    Thomas W. Bonnot; Frank R. III Thompson; Joshua Millspaugh

    2011-01-01

    Landscape-based population models are potentially valuable tools in facilitating conservation planning and actions at large scales. However, such models have rarely been applied at ecoregional scales. We extended landscape-based population models to ecoregional scales for three species of concern in the Central Hardwoods Bird Conservation Region and compared model...

  2. Trends in Health Insurance Coverage of Title X Family Planning Program Clients, 2005-2015.

    Science.gov (United States)

    Decker, Emily J; Ahrens, Katherine A; Fowler, Christina I; Carter, Marion; Gavin, Loretta; Moskosky, Susan

    2017-12-13

    The federal Title X Family Planning Program supports the delivery of family planning services and related preventive care to 4 million individuals annually in the United States. The implementation of the 2010 Affordable Care Act's (ACA's) Medicaid expansion and provisions expanding access to health insurance, which took effect in January 2014, resulted in higher rates of health insurance coverage in the U.S. population; the ACA's impact on individuals served by the Title X program has not yet been evaluated. Using administrative data we examined changes in health insurance coverage among Title X clinic patients during 2005-2015. We found that the percentage of clients without health insurance decreased from 60% in 2005 to 48% in 2015, with the greatest annual decrease occurring between 2013 and 2014 (63% to 54%). Meanwhile, between 2005 and 2015, the percentage of clients with Medicaid or other public health insurance increased from 20% to 35% and the percentage of clients with private health insurance increased from 8% to 15%. Although clients attending Title X clinics remained uninsured at substantially higher rates compared with the national average, the increase in clients with health insurance coverage aligns with the implementation of ACA-related provisions to expand access to affordable health insurance.

  3. Mental Health Services Utilization and Expenditures Among Children Enrolled in Employer-Sponsored Health Plans.

    Science.gov (United States)

    Walter, Angela Wangari; Yuan, Yiyang; Cabral, Howard J

    2017-05-01

    Mental illness in children increases the risk of developing mental health disorders in adulthood, and reduces physical and emotional well-being across the life course. The Mental Health Parity and Addiction Equity Act (MHPAEA, 2008) aimed to improve access to mental health treatment by requiring employer-sponsored health plans to include insurance coverage for behavioral health services. Investigators used IBM Watson/Truven Analytics MarketScan claims data (2007-2013) to examine: (1) the distribution of mental illness; (2) trends in utilization and out-of-pocket expenditures; and (3) the overall effect of the MHPAEA on mental health services utilization and out-of-pocket expenditures among privately-insured children aged 3 to 17 with mental health disorders. Multivariate Poisson regression and linear regression modeling techniques were used. Mental health services use for outpatient behavioral health therapy (BHT) was higher in the years after the implementation of the MHPAEA (2010-2013). Specifically, before the MHPAEA implementation, the annual total visits for BHT provided by mental health physicians were 17.1% lower and 2.5% lower for BHT by mental health professionals, compared to years when MHPAEA was in effect. Children covered by consumer-driven and high-deductible plans had significantly higher out-of-pocket expenditures for BHT compared to those enrolled PPOs. Our findings demonstrate increased mental health services use and higher out-of-pocket costs per outpatient visit after implementation of the MHPAEA. As consumer-driven and high-deductible health plans continue to grow, enrollees need to be cognizant of the impact of health insurance benefit designs on health services offered in these plans. Copyright © 2017 by the American Academy of Pediatrics.

  4. NIF conventional facilities construction health and safety plan

    Energy Technology Data Exchange (ETDEWEB)

    Benjamin, D W

    1998-05-14

    The purpose of this Plan is to outline the minimum health and safety requirements to which all participating Lawrence Livermore National Laboratory (LLNL) and non-LLNL employees (excluding National Ignition Facility [NIF] specific contractors and subcontractors covered under the construction subcontract packages (e.g., CSP-9)-see Construction Safety Program for the National Ignition Facility [CSP] Section I.B. ''NIF Construction Contractors and Subcontractors'' for specifics) shall adhere to for preventing job-related injuries and illnesses during Conventional Facilities construction activities at the NIF Project. For the purpose of this Plan, the term ''LLNL and non-LLNL employees'' includes LLNL employees, LLNL Plant Operations staff and their contractors, supplemental labor, contract labor, labor-only contractors, vendors, DOE representatives, personnel matrixed/assigned from other National Laboratories, participating guests, and others such as visitors, students, consultants etc., performing on-site work or services in support of the NIF Project. Based upon an activity level determination explained in Section 1.2.18, in this document, these organizations or individuals may be required by site management to prepare their own NIF site-specific safety plan. LLNL employees will normally not be expected to prepare a site-specific safety plan. This Plan also outlines job-specific exposures and construction site safety activities with which LLNL and non-LLNL employees shall comply.

  5. 76 FR 37037 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

    Science.gov (United States)

    2011-06-24

    ... the Center for Consumer Information & Insurance Oversight of the U.S. Department of Health and Human... with respect to group health plans and health insurance coverage offered in connection with a group.... The temporary regulations provide guidance to employers, group health plans, and health insurance...

  6. 75 FR 27121 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Dependent...

    Science.gov (United States)

    2010-05-13

    ... Health Plans and Health Insurance Issuers Relating to Dependent Coverage of Children to Age 26 Under the... and Health Insurance Issuers Relating to Dependent Coverage of Children to Age 26 Under the Patient... implementing the requirements for group health plans and health insurance issuers in the group and individual...

  7. 75 FR 37242 - Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and...

    Science.gov (United States)

    2010-06-28

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ57 Requirements for Group Health Plans and Health Insurance... temporary regulations provide guidance to employers, group health plans, and health insurance issuers providing group health insurance coverage. The text of those temporary regulations also serves as the text...

  8. 75 FR 34537 - Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a...

    Science.gov (United States)

    2010-06-17

    ... Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient Protection...-AB68 Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a... Consumer Information and Insurance Oversight, Department of Health and Human Services. ACTION: Interim...

  9. 75 FR 43329 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Internal...

    Science.gov (United States)

    2010-07-23

    ... Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and External... CFR Part 147 RIN 0991-AB70 Interim Final Rules for Group Health Plans and Health Insurance Issuers... Administration, Department of Labor; Office of Consumer Information and Insurance Oversight, Department of Health...

  10. Competition and health plan performance: evidence from health maintenance organization insurance markets.

    Science.gov (United States)

    Scanlon, Dennis P; Swaminathan, Shailender; Chernew, Michael; Bost, James E; Shevock, John

    2005-04-01

    We sought to assess whether health maintenance organizations (HMOs) operating in competitive markets, or markets with substantial HMO penetration, perform better on the standardized Health Plan Employer Data and Information Set (HEDIS) and Consumer Assessment of Health Plans Survey (CAHPS) measures. We performed a secondary analysis of nonexperimental, cross-sectional data. Data were obtained from a variety of sources, including the National Committee for Quality Assurance (NCQA), Interstudy, the Area Resource File, the U.S. Office of Personnel Management, and the U.S. Department of Labor. Multiple Indicator Multiple Cause models were used to simultaneously estimate 6 latent quality variables from 35 HEDIS and CAHPS measures and to relate these latent variables to HMO competition and HMO penetration while controlling for other health plan and market characteristics. Greater competition, as measured by the Herfindahl index, was associated with inferior health plan performance on 3 of 6 quality dimensions. Plans in markets with greater HMO penetration perform better on HEDIS- but not CAHPS-based dimensions of performance. Plans that make their data available publicly perform significantly better on both the HEDIS and CAHPS domains, performing one third to three quarters of a standard deviation better than plans that don't make their results available publicly. Plans in more competitive markets in 1999 did not achieve better quality after controlling for other important covariates, although plans in markets with a high degree of HMO penetration are performing better on the HEDIS quality dimensions. Although our study design cannot determine causality, the results suggest reason to revisit the belief that competition among HMOs will inherently improve quality.

  11. Sustainability science: an integrated approach for health-programme planning.

    Science.gov (United States)

    Gruen, Russell L; Elliott, Julian H; Nolan, Monica L; Lawton, Paul D; Parkhill, Anne; McLaren, Cameron J; Lavis, John N

    2008-11-01

    Planning for programme sustainability is a key contributor to health and development, especially in low-income and middle-income countries. A consensus evidence-based operational framework would facilitate policy and research advances in understanding, measuring, and improving programme sustainability. We did a systematic review of both conceptual frameworks and empirical studies about health-programme sustainability. On the basis of the review, we propose that sustainable health programmes are regarded as complex systems that encompass programmes, health problems targeted by programmes, and programmes' drivers or key stakeholders, all of which interact dynamically within any given context. We show the usefulness of this approach with case studies drawn from the authors' experience.

  12. Is mental health in the Canadian population changing over time?

    Science.gov (United States)

    Simpson, Keith R S; Meadows, Graham N; Frances, Allen J; Patten, Scott B

    2012-05-01

    Mental health in populations may be deteriorating, or it may be improving, but there is little direct evidence to support either possibility. Our objective was to examine secular trends in mental health indicators from national data sources. We used data (1994-2008) from the National Population Health Survey and from a series of cross-sectional studies (Canadian Community Health Survey) conducted in 2001, 2003, 2005, and 2007. We calculated population-weighted proportions and also generated sex-specific, age-standardized estimates of major depressive episode prevalence, distress, professionally diagnosed mood disorders, antidepressant use, self-rated perceived mental health, and self-rated stress. Major depression prevalence did not change over time. No changes in the frequency of severe distress were seen. However, there were increases in reported diagnoses of mood disorders and an increasing proportion of the population reported that they were taking antidepressants. The proportion of the population reporting that their life was extremely stressful decreased, but the proportion reporting poor mental health did not change. Measures based on assessment of symptoms showed no evidence of change over time. However, the frequency of diagnosis and treatment appears to be increasing and perceptions of extreme stress are decreasing. These changes probably reflect changes in diagnostic practice, mental health literacy, or willingness to report mental health concerns. However, no direct evidence of changing mental health status was found.

  13. Conceptual evaluation of population health surveillance programs: method and example.

    Science.gov (United States)

    El Allaki, Farouk; Bigras-Poulin, Michel; Ravel, André

    2013-03-01

    Veterinary and public health surveillance programs can be evaluated to assess and improve the planning, implementation and effectiveness of these programs. Guidelines, protocols and methods have been developed for such evaluation. In general, they focus on a limited set of attributes (e.g., sensitivity and simplicity), that are assessed quantitatively whenever possible, otherwise qualitatively. Despite efforts at standardization, replication by different evaluators is difficult, making evaluation outcomes open to interpretation. This ultimately limits the usefulness of surveillance evaluations. At the same time, the growing demand to prove freedom from disease or pathogen, and the Sanitary and Phytosanitary Agreement and the International Health Regulations require stronger surveillance programs. We developed a method for evaluating veterinary and public health surveillance programs that is detailed, structured, transparent and based on surveillance concepts that are part of all types of surveillance programs. The proposed conceptual evaluation method comprises four steps: (1) text analysis, (2) extraction of the surveillance conceptual model, (3) comparison of the extracted surveillance conceptual model to a theoretical standard, and (4) validation interview with a surveillance program designer. This conceptual evaluation method was applied in 2005 to C-EnterNet, a new Canadian zoonotic disease surveillance program that encompasses laboratory based surveillance of enteric diseases in humans and active surveillance of the pathogens in food, water, and livestock. The theoretical standard used for evaluating C-EnterNet was a relevant existing structure called the "Population Health Surveillance Theory". Five out of 152 surveillance concepts were absent in the design of C-EnterNet. However, all of the surveillance concept relationships found in C-EnterNet were valid. The proposed method can be used to improve the design and documentation of surveillance programs. It

  14. Understanding experiences of and preferences for service user and carer involvement in physical health care discussions within mental health care planning.

    Science.gov (United States)

    Small, Nicola; Brooks, Helen; Grundy, Andrew; Pedley, Rebecca; Gibbons, Chris; Lovell, Karina; Bee, Penny

    2017-04-13

    People with severe mental illness suffer more physical comorbidity than the general population, which can require a tailored approach to physical health care discussions within mental health care planning. Although evidence pertaining to service user and carer involvement in mental health care planning is accumulating, current understanding of how physical health is prioritised within this framework is limited. Understanding stakeholder experiences of physical health discussions within mental health care planning, and the key domains that underpin this phenomena is essential to improve quality of care. Our study aimed to explore service user, carer and professional experiences of and preferences for service user and carer involvement in physical health discussions within mental health care planning, and develop a conceptual framework of effective user-led involvement in this aspect of service provision. Six focus groups and four telephone interviews were carried out with twelve service users, nine carers, three service users with a dual service user and carer role, and ten mental health professionals recruited from one mental health Trust in the United Kingdom. Data was analysed utilising a thematic approach, analysed separately for each stakeholder group, and combined to aid comparisons. No service users or carers recalled being explicitly involved in physical health discussions within mental health care planning. Six prerequisites for effective service user and carer involvement in physical care planning were identified. Three themes confirmed general mental health care planning requirements: tailoring a collaborative working relationship, maintaining a trusting relationship with a professional, and having access to and being able to edit a living document. Three themes were novel to feeling involved in physical health care planning discussions: valuing physical health equally with mental health; experiencing coordination of care between physical-mental health

  15. Assessing the potential of national strategies for electronic health records for population health monitoring and research.

    Science.gov (United States)

    Friedman, Daniel J

    2006-01-01

    This report assesses the potential of national strategies for electronic health records for population health monitoring and research. This study: (1) Reviewed national strategies for electronic health records in Australia, Canada, England, and New Zealand, through written materials available before January 2006. (2) Identified the potential of national strategies for electronic health records for population health monitoring and research through interviews with 96 experts in the U.S., Australia, Canada, England, and New Zealand. (3) Delineated fundamental issues that must be confronted to maximize the contribution of national strategies for electronic health records to population health monitoring and research. National strategies for electronic health records reflect the political, healthcare, and market systems of individual countries. National strategies also reflect technical decisions and political judgments. National strategies are evolving, and passing through stages of conceptualization, design, pilot testing, and implementation. Only England has moved to implementation. Population health monitoring and research are secondary to the primary uses of clinical care and management in all national strategies for electronic health records. Only England has conceptualized, designed, and is implementing the use of electronic health records for population health monitoring and research. Canada's strategy includes communicable disease surveillance, but not broader population health monitoring for developing health statistics. This study identifies definitional, numerator, denominator, and overarching issues that must be evaluated in assessing the potential of national strategies for electronic health records for population health monitoring and research. It delineates success factors that increase the potential for those national strategies to contribute to population health monitoring and research. Finally, this study assesses barriers that must be overcome if

  16. Population health metrics: crucial inputs to the development of evidence for health policy

    Directory of Open Access Journals (Sweden)

    Salomon Joshua A

    2003-04-01

    Full Text Available Abstract Valid, reliable and comparable measures of the health states of individuals and of the health status of populations are critical components of the evidence base for health policy. We need to develop population health measurement strategies that coherently address the relationships between epidemiological measures (such as risk exposures, incidence, and mortality rates and multi-domain measures of population health status, while ensuring validity and cross-population comparability. Studies reporting on descriptive epidemiology of major diseases, injuries and risk factors, and on the measurement of health at the population level – either for monitoring trends in health levels or inequalities or for measuring broad outcomes of health systems and social interventions – are not well-represented in traditional epidemiology journals, which tend to concentrate on causal studies and on quasi-experimental design. In particular, key methodological issues relating to the clear conceptualisation of, and the validity and comparability of measures of population health are currently not addressed coherently by any discipline, and cross-disciplinary debate is fragmented and often conducted in mutually incomprehensible language or paradigms. Population health measurement potentially bridges a range of currently disjoint fields of inquiry relating to health: biology, demography, epidemiology, health economics, and broader social science disciplines relevant to assessment of health determinants, health state valuations and health inequalities. This new journal will focus on the importance of a population based approach to measurement as a way to characterize the complexity of people's health, the diseases and risks that affect it, its distribution, and its valuation, and will attempt to provide a forum for innovative work and debate that bridge the many fields of inquiry relevant to population health in order to contribute to the development of valid

  17. Electronic health records: a valuable tool for dental school strategic planning.

    Science.gov (United States)

    Filker, Phyllis J; Cook, Nicole; Kodish-Stav, Jodi

    2013-05-01

    The objective of this study was to investigate if electronic patient records have utility in dental school strategic planning. Electronic health records (EHRs) have been used by all predoctoral students and faculty members at Nova Southeastern University's College of Dental Medicine (NSU-CDM) since 2006. The study analyzed patient demographic and caries risk assessment data from October 2006 to May 2011 extracted from the axiUm EHR database. The purpose was to determine if there was a relationship between high oral health care needs and patient demographics, including gender, age, and median income of the zip code where they reside in order to support dental school strategic planning including the locations of future satellite clinics. The results showed that about 51 percent of patients serviced by the Broward County-based NSU-CDM oral health care facilities have high oral health care needs and that about 60 percent of this population resides in zip codes where the average income is below the median income for the county ($41,691). The results suggest that EHR data can be used adjunctively by dental schools when proposing potential sites for satellite clinics and planning for future oral health care programming.

  18. Hospitalization in older adults: association with multimorbidity, primary health care and private health plan.

    Science.gov (United States)

    Nunes, Bruno Pereira; Soares, Mariangela Uhlmann; Wachs, Louriele Soares; Volz, Pâmela Moraes; Saes, Mirelle de Oliveira; Duro, Suele Manjourany Silva; Thumé, Elaine; Facchini, Luiz Augusto

    2017-05-04

    Evaluate the association of multimorbidity, primary health care model and possession of a private health plan with hospitalization. A population-based cross-sectional study with 1,593 elderly individuals (60 years old or older) living in the urban area of the city of Bagé, State of Rio Grande do Sul, Brazil. The outcome was hospitalization in the year preceding the interview. The multimorbidity was evaluated through two cut-off points (≥ 2 and ≥ 3). The primary health care model was defined by residence in areas covered by traditional care or by Family Health Strategy. The older adults mentioned the possession of a private health plan. We performed a gross and adjusted analysis by Poisson regression using a hierarchical model. The adjustment included demographic, socioeconomic, functional capacity disability and health services variables. The occurrence of overall and non-surgical hospitalization was 17.7% (95%CI 15.8-19.6) and 10.6% (95%CI 9.1-12.1), respectively. Older adults with multimorbidity were admitted to hospitals more often when to older adults without multimorbidity, regardless of the exhibition' form of operation. Having a private health plan increased the hospitalization by 1.71 (95%CI 1.09-2.69) times among residents in the areas of the Family Health Strategy when compared to elderly residents in traditional areas without a private health plan. The multimorbidity increased the occurrence of hospitalizations, especially non-surgical ones. Hospitalization was more frequent in older adults with private health plan and those living in Family Health Strategy areas, regardless of the presence of multiple diseases. Avaliar a associação da multimorbidade, modelo de atenção básica e posse de plano de saúde com hospitalização. Estudo transversal de base populacional com 1.593 idosos (60 anos ou mais) residentes na zona urbana do município de Bagé, Rio Grande do Sul. O desfecho foi a hospitalização no ano anterior à entrevista. A

  19. [Health inequalities in immigrant populations in Spain: a scoping review].

    Science.gov (United States)

    Malmusi, Davide; Ortiz-Barreda, Gaby

    2014-01-01

    Health differences between immigrants and natives should be analyzed from an equity perspective due to socioeconomic inequality between them. The aim of this study is to Know the influence of social determinants of health in the immigrant population in Spain and/or inequalities compared with the Spanish population. SA scoping review of the literature published in the period 1998-2012 was performed. The literature search was conducted on Medline and MEDES-MEDicina databases. All studies that include the participation of immigrant population from areas such as Latin America, Africa, Asia and Eastern Europe and performed in Spain were selected. A 27 articles were included. Most of the studies were published in the year 2009 (n=11). Twelve used population health surveys at national (n=6) and autonomous (n = 6) level. A total of 23 studies focused on adult population over 15 years. The most frequently studied indicators were self-rated health (n=9) and mental health (n=7). The immigrant population is exposed to lower socioeconomic status than natives and, despite a lower prevalence of chronic diseases, it appears to experience more mental health problems and worse self-rated health, especially in women and with longer stay.

  20. Planning and Incorporating Public Health Preparedness Into the Medical Curriculum

    National Research Council Canada - National Science Library

    Carney, Jan K; Schilling, Lisa M; Frank, Scott H; Biddinger, Paul D; Bertsch, Tania F; Grace, Christopher J; Finkelstein, Jonathan A

    2011-01-01

    ... population health topic in the curriculum of many medical schools. Although some literature about developing such curricula in medical education exists 9–12 and some medical institutions are experimenting with new approaches, 12,13 much of the current literature focuses on response to the anthrax attacks following September 11, 2001, an...

  1. National Committee on Quality Assurance health-plan accreditation: predictors, correlates of performance, and market impact.

    Science.gov (United States)

    Dean Beaulieu, Nancy; Epstein, Arnold M

    2002-04-01

    Accreditation of health care organizations has traditionally been considered a building block of quality assurance. However, the differences between accredited and nonaccredited health plans and the impact of accreditation on plan enrollment are not well understood. To determine the characteristics of plans that have submitted to accreditation review, the performance of accredited plans on quality indicators and the impact of accreditation on enrollment. The databases containing 1996 data on health plans' National Committee on Quality Assurance (NCQA) accreditation status, organizational characteristics, Health Plan Employer Data and Information Set (HEDIS) scores, and patient-reported quality and satisfaction scores were linked to compare accredited health plans to nonaccredited plans. We also combined longitudinal data sets (1993-1998) on accreditation and health plan enrollment. Mean performance of accredited and nonaccredited plans on HEDIS measures and patient-reported measures of quality; health plan enrollment changes. Accredited plans have higher HEDIS scores but similar or lower performance on patient-reported measures of health plan quality and satisfaction. Furthermore, a substantial number of the plans in the bottom decile of quality performance were accredited suggesting that accreditation does not ensure high quality care. Receipt of accreditation has been associated with increased enrollment in the early years of the accreditation program; however, plans denied NCQA accreditation do not appear to suffer enrollment losses. NCQA accreditation is positively associated with some measures of quality but does not assure a minimal level of performance. Efforts now underway to incorporate plan performance on HEDIS into criteria for accreditation seem warranted.

  2. 76 FR 13197 - National Institute of Environmental Health Sciences Strategic Planning

    Science.gov (United States)

    2011-03-10

    ... Strategic Planning AGENCY: National Institutes of Health (NIH), National Institute of Environmental Health... planning process is to define an overarching Vision Statement, Strategic Goals, and Implementation... background and follow the progress of this planning process, visit the NIEHS Strategic Planning Web site at...

  3. Do consumer-directed health plans drive change in enrollees' health care behavior?

    Science.gov (United States)

    Dixon, Anna; Greene, Jessica; Hibbard, Judith

    2008-01-01

    Using panel data from two surveys of employees at one large employer from 2004 and 2005, this paper examines consumer-directed health plans' (CDHPs') influence on the use of health-related information and health services. We compare enrollees in a high-deductible CDHP, a lower-deductible CDHP, and a preferred provider organization (PPO). Enrollees in the lower-deductible CDHP were more likely than enrollees in the other plans to start using information. Enrollees in the high-deductible CDHP were more likely than those in the PPO to start forgoing medical care to save money.

  4. 77 FR 70163 - Recognition of Entities for the Accreditation of Qualified Health Plans

    Science.gov (United States)

    2012-11-23

    ... the National Committee for Quality Assurance (NCQA) and URAC as recognized accrediting entities for the purposes of fulfilling the accreditation requirement as part of qualified health plan... HUMAN SERVICES Recognition of Entities for the Accreditation of Qualified Health Plans AGENCY...

  5. Health and Marital Experience in an Urban Population

    Science.gov (United States)

    Renne, Karen S.

    1971-01-01

    the findings indicated that (1) physical and psychlogical health are associated with marital happiness regardless of marital history, and (2) at the same time, divorce and remarriage tend to "select" the healthier members of the unhappy married population. (Author)

  6. Meeting health and family planning needs in Latin America and the Caribbean.

    Science.gov (United States)

    1995-06-01

    The operations research and technical assistance (OR/TA) project in The Population Council has concentrated on fertility and infant mortality issues in Latin American and the Caribbean for more than a decade through INOPAL. INOPAL is an acronym for Investigacion Operacional en Planificacion Familiar y Atencion Materno-Infantil para America Latina y el Caribe (Operations Research in Family Planning and Maternal-Child Health in Latin America and the Caribbean). In March 1995, the project entered its third phase, INOPAL III, with the renewal of its contract from the United States Agency for International Development (USAID). To facilitate communication between INOPAL, collaborating agencies, and USAID, INOPAL Director James Foreit moved from Peru to a Council office in Washington, D.C. INOPAL has six objectives: 1) to test the integration of family planning and reproductive health services; 2) to increase access to family planning; 3) to develop strategies to reach special populations; 4) to improve the sustainability of family planning programs; 5) to improve service quality; and 6) to institutionalize operations research capability in the region. INOPAL II conducted 61 subprojects in 12 countries in collaboration with 24 USAID cooperating agencies and other international organizations. The project established new services for postpartum women, adolescents, and rural women; improved program quality and financial sustainability; increased vasectomy promotion and the range of available contraceptives; and developed new modes of service delivery. A key finding of INOPAL II operations research was the importance of increasing cost-effectiveness to ensure program sustainability. INOPAL III will work toward all six objectives, with an emphasis on integrating reproductive health and family planning services. Operations research and technical assistance (OR/TA) subprojects will focus on the prevention and treatment of sexually transmitted diseases, perinatal and postpartum

  7. National aquatic animal health plans: the Australian experience.

    Science.gov (United States)

    Bernoth, E M; Ernst, I; Wright, B

    2008-04-01

    Following a major pilchard (Sardinops sagax) mortality event in 1995, Australia recognised the need for a national approach to aquatic animal health, particularly with respectto disease response. Cooperation between industry and government led to the development of AQUAPLAN, Australia's National Strategic Plan for Aquatic Animal Health. Under AQUAPLAN, institutional arrangements for the national technical response to aquatic animal health emergencies were developed based on existing arrangements for terrestrial animal health. The number and range of Australian Aquatic Veterinary Emergency Plan (AQUAVETPLAN) manuals are rising steadily; these are manuals that outline Australia's approach to national disease preparedness and propose the technical response and control strategies to be activated. Additional resources include standard diagnostic techniques and a disease field identification guide. Simulation exercises provide training to respond to aquatic emergency animal disease events. While resource issues and addressing governance remain priorities for the further implementation of AQUAPLAN, the highest priority is the development of a formal arrangement between governments and private sectors on the response to an aquatic emergency animal disease event.

  8. Accounting for vulnerable populations in rural hazard mitigation plans: results of a survey of emergency managers.

    Science.gov (United States)

    Horney, Jennifer A; Nguyen, Mai; Cooper, John; Simon, Matthew; Ricchetti-Masterson, Kristen; Grabich, Shannon; Salvesen, David; Berke, Philip

    2013-01-01

    Rural areas of the United States are uniquely vulnerable to the impacts of natural disasters. One possible way to mitigate vulnerability to disasters in rural communities is to have a high-quality hazard mitigation plan in place. To understand the resources available for hazard mitigation planning and determine how well hazard mitigation plans in rural counties meet the needs of vulnerable populations, we surveyed the lead planning or emergency management official responsible for hazard mitigation plans in 96 rural counties in eight states in the Southeastern United States. In most counties, emergency management was responsible for implementing the county's hazard mitigation plan and the majority of counties had experienced a presidentially declared disaster in the last 5 years. Our research findings demonstrated that there were differences in subjective measures of vulnerability (as reported by survey respondents) and objective measures of vulnerability (as determined by US Census data). In addition, although few counties surveyed included outreach to vulnerable groups as a part of their hazard mitigation planning process, a majority felt that their hazard mitigation plan addressed the needs of vulnerable populations "well" or "very well." These differences could result in increased vulnerabilities in rural areas, particularly for certain vulnerable groups.

  9. Health workforce metrics pre- and post-2015: a stimulus to public policy and planning.

    Science.gov (United States)

    Pozo-Martin, Francisco; Nove, Andrea; Lopes, Sofia Castro; Campbell, James; Buchan, James; Dussault, Gilles; Kunjumen, Teena; Cometto, Giorgio; Siyam, Amani

    2017-02-15

    Evidence-based health workforce policies are essential to ensure the provision of high-quality health services and to support the attainment of universal health coverage (UHC). This paper describes the main characteristics of available health workforce data for 74 of the 75 countries identified under the 'Countdown to 2015' initiative as accounting for more than 95% of the world's maternal, newborn and child deaths. It also discusses best practices in the development of health workforce metrics post-2015. Using available health workforce data from the Global Health Workforce Statistics database from the Global Health Observatory, we generated descriptive statistics to explore the current status, recent trends in the number of skilled health professionals (SHPs: physicians, nurses, midwives) per 10 000 population, and future requirements to achieve adequate levels of health care in the 74 countries. A rapid literature review was conducted to obtain an overview of the types of methods and the types of data sources used in human resources for health (HRH) studies. There are large intercountry and interregional differences in the density of SHPs to progress towards UHC in Countdown countries: a median of 10.2 per 10 000 population with range 1.6 to 142 per 10 000. Substantial efforts have been made in some countries to increase the availability of SHPs as shown by a positive average exponential growth rate (AEGR) in SHPs in 51% of Countdown countries for which there are data. Many of these countries will require large investments to achieve levels of workforce availability commensurate with UHC and the health-related sustainable development goals (SDGs). The availability, quality and comparability of global health workforce metrics remain limited. Most published workforce studies are descriptive, but more sophisticated needs-based workforce planning methods are being developed. There is a need for high-quality, comprehensive, interoperable sources of HRH data to

  10. Politics, welfare regimes, and population health: controversies and evidence.

    Science.gov (United States)

    Muntaner, Carles; Borrell, Carme; Ng, Edwin; Chung, Haejoo; Espelt, Albert; Rodriguez-Sanz, Maica; Benach, Joan; O'Campo, Patricia

    2011-09-01

    In recent years, a research area has emerged within social determinants of health that examines the role of politics, expressed as political traditions/parties and welfare state characteristics, on population health. To better understand and synthesise this growing body of evidence, the present literature review, informed by a political economy of health and welfare regimes framework, located 73 empirical and comparative studies on politics and health, meeting our inclusion criteria in three databases: PubMed (1948-), Sociological Abstracts (1953-), and ISI Web of Science (1900-). We identified two major research programmes, welfare regimes and democracy, and two emerging programmes, political tradition and globalisation. Primary findings include: (1) left and egalitarian political traditions on population health are the most salutary, consistent, and substantial; (2) the health impacts of advanced and liberal democracies are also positive and large; (3) welfare regime studies, primarily conducted among wealthy countries, find that social democratic regimes tend to fare best with absolute health outcomes yet consistently in terms of relative health inequalities; and (4) globalisation defined as dependency indicators such as trade, foreign investment, and national debt is negatively associated with population health. We end by discussing epistemological, theoretical, and methodological issues for consideration for future research. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  11. Promoting global population health while constraining the environmental footprint.

    Science.gov (United States)

    McMichael, A J; Butler, C D

    2011-01-01

    Populations today face increasing health risks from human-induced regional and global environmental changes and resultant ecological nonsustainability. Localized environmental degradation that has long accompanied population growth, industrialization, and rising consumerism has now acquired a global and often systemic dimension (e.g., climate change, disrupted nitrogen cycling, biodiversity loss). Thus, the economic intensification and technological advances that previously contributed to health gains have now expanded such that humanity's environmental (and ecological) footprint jeopardizes global population health. International data show, in general, a positive correlation of a population's health with level of affluence and size of per-person footprint. Yet, beyond a modest threshold, larger footprints afford negligible health gain and may impair health (e.g., via the rise of obesity). Furthermore, some lower-income countries have attained high levels of health. Many changes now needed to promote ecological (and social) sustainability will benefit local health. Continued improvement of global health could thus coexist with an equitably shared global environmental footprint.

  12. Barriers to health care in rural Mozambique: a rapid ethnographic assessment of planned mobile health clinics for ART.

    Science.gov (United States)

    Schwitters, Amee; Lederer, Philip; Zilversmit, Leah; Gudo, Paula Samo; Ramiro, Isaias; Cumba, Luisa; Mahagaja, Epifanio; Jobarteh, Kebba

    2015-03-01

    In Mozambique, 1.6 million people are living with HIV, and over 60% of the population lives in rural areas lacking access to health services. Mobile health clinics, implemented in 2013 in 2 provinces, are beginning to offer antiretroviral therapy (ART) and basic primary care services. Prior to introduction of the mobile health clinics in the communities, we performed a rapid ethnographic assessment to understand barriers to accessing HIV care and treatment services and acceptability and potential use of the mobile health clinics as an alternative means of service delivery. We conducted assessments in Gaza province in January 2013 and in Zambezia Province in April-May 2013 in districts where mobile health clinic implementation was planned. Community leaders served as key informants, and chain-referral sampling was used to recruit participants. Interviews were conducted with community leaders, health care providers, traditional healers, national health system patients, and traditional healer patients. Interviewees were asked about barriers to health services and about mobile health clinic acceptance. In-depth interviews were conducted with 117 participants (Gaza province, n = 57; Zambezia Province, n = 60). Barriers to accessing health services included transportation and distance-related issues (reliability, cost, and travel time). Participants reported concurrent use of traditional and national health systems. The decision to use a particular health system depended on illness type, service distance, and lack of confidence in the national health system. Overall, participants were receptive to using mobile health clinics for their health care and ability to increase access to ART. Hesitations concerning mobile health clinics included potentially long wait times due to high patient loads. Participants emphasized the importance of regular and published visit schedules and inclusion of community members in planning mobile health clinic services. Mobile health clinics

  13. Stigma as a Fundamental Cause of Population Health Inequalities

    Science.gov (United States)

    Phelan, Jo C.

    2013-01-01

    Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health. PMID:23488505

  14. Suicide Prevention Strategies for Improving Population Health.

    Science.gov (United States)

    Wilcox, Holly C; Wyman, Peter A

    2016-04-01

    Suicide is a public health problem that accounts for more than 1 million deaths annually worldwide. This article addresses evidence-based and promising youth suicide prevention approaches at the primary, secondary, and tertiary levels. Coordinated, developmentally timed, evidence-based suicide prevention approaches at all intervention levels are likely to reduce youth suicide. For most youth who die by suicide, there are opportunities for intervention before imminent risk develops. Current research in suicide prevention points to the value of investing in "upstream" universal interventions that build skills and resilience as well as policies that enable access to care and protection from lethal means. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Health and safety plan for operations performed for the Environmental Restoration Program

    Energy Technology Data Exchange (ETDEWEB)

    Trippet, W.A. II (IT Corp., (United States)); Reneau, M.; Morton, S.L. (EG and G Idaho, Inc., Idaho Falls, ID (United States))

    1992-04-01

    This document constitutes the generic health and safety plan for the Environmental Restoration Program (ERP). It addresses the health and safety requirements of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA); Occupational Safety and Health Administration (OSHA) 29 CFR 1910.120 standard; and EG G Idaho, Inc. This plan is a guide to individuals who must complete a health and safety plan for a task performed for the EPR. It contains a task specific addendum that, when completed, specifically addresses task specific health and safety issues. This health and safety plan reduces the time it takes to write a task specific health and safety plan by providing discussions of requirements, guidance on where specific information is located, and specific topics in the Addendum that must be discussed at a task level. This format encourages a complete task specific health and safety plan and a standard for all health and safety plans written for ERP.

  16. Community Health Needs Assessments: Expanding the Boundaries of Nursing Education in Population Health.

    Science.gov (United States)

    Evans-Agnew, Robin; Reyes, David; Primomo, Janet; Meyer, Karen; Matlock-Hightower, Corrie

    2017-01-01

    Conducting federally mandated community health needs assessments through academic-practice partnerships provides new opportunities for developing population health nursing competencies. The purpose of this article was to describe how a baccalaureate practicum experience within such an assessment process, involving health care system partners, re-affirms the importance of community and population health assessment in the development of future nursing leaders. Student evaluations indicated an emerging appreciation for the social determinants of health, the power of partnerships, and the importance of diversity. Integrating health care and public health system perspectives on assessment meets both public health and nursing accreditation standards and extends student leadership experiences. Such integration also improves regional capacity for improving population health. Federal mandates for community health needs assessments provide opportunities to advance leadership roles for nursing graduates throughout the health care system, and for confirming the importance of community assessment as an essential nursing competency. © 2016 Wiley Periodicals, Inc.

  17. National Institutes of Health Research Plan on Rehabilitation.

    Science.gov (United States)

    2017-04-01

    One in five Americans experiences disability that affects their daily function because of impairments in mobility, cognitive function, sensory impairment, or communication impairment. The need for rehabilitation strategies to optimize function and reduce disability is a clear priority for research to address this public health challenge. The National Institutes of Health (NIH) recently published a Research Plan on Rehabilitation that provides a set of priorities to guide the field over the next 5 years. The plan was developed with input from multiple Institutes and Centers within the NIH, the National Advisory Board for Medical Rehabilitation Research, and the public. This article provides an overview of the need for this research plan, an outline of its development, and a listing of six priority areas for research. The NIH is committed to working with all stakeholder communities engaged in rehabilitation research to track progress made on these priorities and to work to advance the science of medical rehabilitation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Social Change and its Potential Impacts on Chinese Population Health

    Directory of Open Access Journals (Sweden)

    Wang, Hong

    2004-12-01

    Full Text Available Within the past 25 years, China has experienced transformation of its economic system from a highly centralized planned economy toward a market oriented economic system. This process has led to massive and rapid changes in all aspects of society with profound effects on the population’s health in the large parts of the country. Along with the material prosperity, the living conditions of Chinese people, such as food, shelter, and sanitation status, have been improving steadily. People have more capability to purchase health related merchandise as well as health services. Overall the health status of most Chinese has improved but there are significant exceptions to this overall conclusion. These exceptions arise from increasing inequity of income, increases in unemployment rates, the decline of health insurance coverage, changes in demography, changes in social value, culture, health related behaviors, and the changes of health care systems.

  19. 76 FR 60788 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Science.gov (United States)

    2011-09-30

    ... of Exchanges and Qualified Health Plans, and Standards Related to Reinsurance, Risk Corridors and...) 492-4372 for general information and matters related to Exchanges and qualified health plans. Alissa...; Establishment of Exchanges and Qualified Health Plans,'' is significant in that it proposes--(1) Federal...

  20. Using systems science for population health management in primary care.

    Science.gov (United States)

    Li, Yan; Kong, Nan; Lawley, Mark A; Pagán, José A

    2014-10-01

    Population health management is becoming increasingly important to organizations managing and providing primary care services given ongoing changes in health care delivery and payment systems. The objective of this study is to show how systems science methodologies could be incorporated into population health management to compare different interventions and improve health outcomes. The New York Academy of Medicine Cardiovascular Health Simulation model (an agent-based model) and data from the Behavioral Risk Factor Surveillance System were used to evaluate a lifestyle program that could be implemented in primary care practice settings. The program targeted Medicare-age adults and focused on improving diet and exercise and reducing weight. The simulation results suggest that there would be significant reductions projected in the proportion of the Medicare-age population with diabetes after the implementation of the proposed lifestyle program for a relatively long term (3 and 5 years). Similar results were found for the subpopulations with high cholesterol, but the proposed intervention would not have a significant effect in the proportion of the population with hypertension over a time period of science methodologies can be useful to compare the health outcomes of different interventions. These tools can become an important component of population health management because they can help managers and other decision makers evaluate alternative programs in primary care settings. © The Author(s) 2014.

  1. Health Literacy Assessment in an Otolaryngology Clinic Population.

    Science.gov (United States)

    Megwalu, Uchechukwu C; Lee, Jennifer Y

    2016-12-01

    To assess health literacy in an adult tertiary care otolaryngology clinic population and to explore potential determinants of inadequate health literacy. Cross-sectional study. Tertiary care otolaryngology clinic. The study population included all adult patients treated at 3 of Stanford University's adult otolaryngology clinic sites between March 1 and 11, 2016. Data were collected via an anonymous questionnaire. Health literacy was assessed with the Brief Health Literacy Screen. Ten percent of patients had inadequate health literacy. White race (odds ratio [OR], 0.23) and having English as the primary language (OR, 0.12) were associated with adequate health literacy, while high school or lower level of education (OR, 3.2) was associated with inadequate health literacy. Age, sex, and Hispanic ethnicity were not associated with health literacy. Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  2. Determining size and dispersion of minimum viable populations for land management planning and species conservation

    Science.gov (United States)

    Lehmkuhl, John F.

    1984-03-01

    The concept of minimum populations of wildlife and plants has only recently been discussed in the literature. Population genetics has emerged as a basic underlying criterion for determining minimum population size. This paper presents a genetic framework and procedure for determining minimum viable population size and dispersion strategies in the context of multiple-use land management planning. A procedure is presented for determining minimum population size based on maintenance of genetic heterozygosity and reduction of inbreeding. A minimum effective population size ( N e ) of 50 breeding animals is taken from the literature as the minimum shortterm size to keep inbreeding below 1% per generation. Steps in the procedure adjust N e to account for variance in progeny number, unequal sex ratios, overlapping generations, population fluctuations, and period of habitat/population constraint. The result is an approximate census number that falls within a range of effective population size of 50 500 individuals. This population range defines the time range of short- to long-term population fitness and evolutionary potential. The length of the term is a relative function of the species generation time. Two population dispersion strategies are proposed: core population and dispersed population.

  3. Pesticide exposures and respiratory health in general populations.

    Science.gov (United States)

    Ye, Ming; Beach, Jeremy; Martin, Jonathan W; Senthilselvan, Ambikaipakan

    2017-01-01

    Human exposures to pesticides can occur in the workplace, in the household and through the ambient environment. While several articles have reviewed the impact of pesticide exposures on human respiratory health in occupational settings, to the best of our knowledge, this article is the first one to review published studies on the association between pesticide exposures and human respiratory health in the general populations. In this article, we critically reviewed evidences up to date studying the associations between non-occupational pesticide exposures and respiratory health in general populations. This article also highlighted questions arising from these studies, including our recent analyses using the data from the Canadian Health Measures Survey (CHMS), for future research. We found few studies have addressed the impact of environmental pesticide exposures on respiratory health, especially on lung function, in general populations. In the studies using the data from CHMS Cycle 1, exposures to OP insecticides, pyrethroid insecticides, and the organochlorine pesticide DDT were associated with impaired lung function in the Canadian general population, but no significant associations were observed for the herbicide 2,4-D. Future research should focus on the potential age-specific and pesticide-specific effect on respiratory health in the general population, and repeated longitudinal study design is critical for assessing the temporal variations in pesticide exposures. Research findings from current studies of non-occupational pesticide exposures and their health impact in general population will help to improve the role of regulatory policies in mitigating pesticide-related public health problems, and thereafter providing greater benefit to the general population. Copyright © 2016. Published by Elsevier B.V.

  4. Health status of an elderly population in Sharpeville, South Africa ...

    African Journals Online (AJOL)

    The objective of this cross-sectional study was a comprehensive nutrition and health assessment to provide a basis for future intervention strategies for an elderly population attending a day-care centre. Socio-demographic, health and 24-hour recall dietary intake questionnaires were administered and anthropometric and ...

  5. The time dimension in measurements of population health

    NARCIS (Netherlands)

    J.A. Lauer (Jeremy)

    2009-01-01

    textabstractAs recently attested by the Millennium Declaration (United Nations, 2000), the health of populations is a concern for both governments and civil society: three of the eight Millennium Development Goals are defined in terms of health objectives. It is therefore reasonable to enquire what

  6. Adult Mosquito Populations and Their Health Impact around and far ...

    African Journals Online (AJOL)

    Bheema

    Tropical Medicine and International. Health, 10:12: 1274-1285. Ministry of Health. 2002. Guide for Malaria Vector Control in Ethiopia. Addis Ababa. Quinones, M.L., Lines, J., Thomson, M., Jawara, M & Greenwood, B.M. 1998. Permethrin- treated bednets do not have a "mass-killing effect" on village populations of Anopheles.

  7. Health examination utilization in the visually disabled population in Taiwan: a nationwide population-based study.

    Science.gov (United States)

    Hsu, Yueh-Han; Tsai, Wen-Chen; Kung, Pei-Tseng

    2013-12-05

    People with visual disabilities have increased health needs but face worse inequity to preventive health examinations. To date, only a few nationwide studies have analyzed the utilization of preventive adult health examinations by the visually disabled population. The aim of this study was to investigate the utilization of health examinations by the visually disabled population, and analyze the factors associated with the utilization. Visual disability was certified by ophthalmologists and authenticated by the Ministry of the Interior (MOI), Taiwan. We linked data from three different nationwide datasets (from the MOI, Bureau of Health Promotion, and National Health Research Institutes) between 2006 and 2008 as the data sources. Independent variables included demographic characteristics, income status, health status, and severity of disability; health examination utilization status was the dependent variable. The chi-square test was used to check statistical differences between variables, and a multivariate logistic regression model was used to examine the associated factors with health examination utilization. In total, 47,812 visually disabled subjects aged 40 years and over were included in this study, only 16.6% of whom received a health examination. Lower utilization was more likely in male subjects, in those aged 65 years and above, insured dependents and those with a top-ranked premium-based salary, catastrophic illness/injury, chronic diseases of the genitourinary system, and severe or very severe disabilities. The overall health examination utilization in the visually disabled population was very low. Lower utilization occurred mainly in males, the elderly, and those with severe disabilities.

  8. 1 POPULATION PRESSURE AND HEALTH RISKS IN URBAN ...

    African Journals Online (AJOL)

    environmental and health risks result from attempts by market users to adjust or cope with these inadequacies (as indiscriminate human waste disposal). .... the situation might have been better with proper planning and efficient local government management. Thus, the concern that the physical conditions of these markets ...

  9. Local health care expenditure plans and their opportunity costs.

    Science.gov (United States)

    Karlsberg Schaffer, Sarah; Sussex, Jon; Devlin, Nancy; Walker, Andrew

    2015-09-01

    In the UK, approval decisions by Health Technology Assessment bodies are made using a cost per quality-adjusted life year (QALY) threshold, the value of which is based on little empirical evidence. We test the feasibility of estimating the "true" value of the threshold in NHS Scotland using information on marginal services (those planned to receive significant (dis)investment). We also explore how the NHS makes spending decisions and the role of cost per QALY evidence in this process. We identify marginal services using NHS Board-level responses to the 2012/13 Budget Scrutiny issued by the Scottish Government, supplemented with information on prioritisation processes derived from interviews with Finance Directors. We search the literature for cost-effectiveness evidence relating to marginal services. The cost-effectiveness estimates of marginal services vary hugely and thus it was not possible to obtain a reliable estimate of the threshold. This is unsurprising given the finding that cost-effectiveness evidence is rarely used to justify expenditure plans, which are driven by a range of other factors. Our results highlight the differences in objectives between HTA bodies and local health service decision makers. We also demonstrate that, even if it were desirable, the use of cost-effectiveness evidence at local level would be highly challenging without extensive investment in health economics resources. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Linking population, health, and the environment: an overview of integrated programs and a case study in Nepal.

    Science.gov (United States)

    Hahn, Sigrid; Anandaraja, Natasha; D'Agnes, Leona

    2011-01-01

    Population, health, and environment programs are cross-sectoral development initiatives that link conservation, health, and family planning interventions. These programs are generally located in biodiversity hotspots, where population pressure is among the factors contributing to environmental degradation. This review describes the general structure of population, health, and environment programs and provides selected examples to highlight various aspects of this approach. We focus in depth on a case study from the Integrating Population and Health into Forestry Management Agendas program in Nepal that simultaneously addressed deforestation from fuel-wood harvesting, indoor air pollution from wood fires, acute respiratory infections related to smoke inhalation, as well as family planning in communities in Nepal's densely populated forest corridors. Keys to the success of the Nepal project included empowerment of community forest user groups with population, health, and environment program know-how and appropriate technology. Lessons learned in Nepal point to the critical role that nongovernmental organizations can play as catalysts of cross-sectoral responses to complex development issues such as this one. The population, health, and environment approach can be an effective method for achieving sustainable development and meeting both conservation and health objectives. © 2011 Mount Sinai School of Medicine.

  11. Health Attitudes, Health Cognitions, and Health Behaviors among Internet Health Information Seekers: Population-Based Survey

    OpenAIRE

    Dutta-Bergman, Mohan J

    2004-01-01

    Background Using a functional theory of media use, this paper examines the process of health-information seeking in different domains of Internet use. Objective Based on an analysis of the 1999 HealthStyles data, this study was designed to demonstrate that people who gather information on the Internet are more health-oriented than non-users of Internet health information. Methods The Porter Novelli HealthStyles database, collected annually since 1995, is based on the results of nationally rep...

  12. Public Health Planning for Vulnerable Populations and Pandemic Influenza

    Science.gov (United States)

    2008-12-01

    Lloyd H. Kasper, “ Confronting Potential influenza A (H5N1) Pandemic with Better Vaccines,” Emerging Infectious Diseases 13, no. 10 (2007) Center for...the individuals in their respective jurisdictions that are for example, dialysis dependant (or individuals that need special medical assistance) to...assistance from family member/ caretaker in activities of daily living and have that person with them; those with portable O2 in use; kidney dialysis

  13. Comparing population health in the United States and Canada

    Directory of Open Access Journals (Sweden)

    Huguet Nathalie

    2010-04-01

    Full Text Available Abstract Background The objective of the paper is to compare population health in the United States (US and Canada. Although the two countries are very similar in many ways, there are potentially important differences in the levels of social and economic inequality and the organization and financing of and access to health care in the two countries. Methods Data are from the Joint Canada/United States Survey of Health 2002/03. The Health Utilities Index Mark 3 (HUI3 was used to measure overall health-related quality of life (HRQL. Mean HUI3 scores were compared, adjusting for major determinants of health, including body mass index, smoking, education, gender, race, and income. In addition, estimates of life expectancy were compared. Finally, mean HUI3 scores by age and gender and Canadian and US life tables were used to estimate health-adjusted life expectancy (HALE. Results Life expectancy in Canada is higher than in the US. For those Conclusions The population of Canada appears to be substantially healthier than the US population with respect to life expectancy, HRQL, and HALE. Factors that account for the difference may include access to health care over the full life span (universal health insurance and lower levels of social and economic inequality, especially among the elderly.

  14. Population Aging and Health Trajectories at Older Ages.

    Science.gov (United States)

    Vogelsang, Eric M; Raymo, James M; Liang, Jersey; Kobayashi, Erika; Fukaya, Taro

    2017-06-01

    This study examines relationships between municipal age structure and two types of self-rated health: general (SRH) and comparison with similar-aged peers (C-SRH). Using a national sample of almost 5,000 Japanese older adults over two decades, we employ hierarchical growth curve models to estimate health trajectories. For municipal age structure, we consider both the relative prevalence of elderly adults in the local population and the pace of aging over time. Living in the oldest municipalities was generally associated with worse health, particularly between the ages of 70 and 80 years. For SRH, the speed of municipal population aging was also independently associated with worse health. For C-SRH, worse health in older areas was partially explained by less favorable economic conditions in those municipalities. Results also suggest that higher levels of employment and social integration among older adults living in the oldest municipalities operate in the opposite direction. That is, these attributes partially "protect" individuals from other factors that contribute to worse health. Relative differences in municipal age structure and the pace of population aging are largely unexplored and potentially important correlates of older adult health. This line of research is increasingly salient in a world with substantial and growing regional variation in population aging.

  15. Enhancing resiliency for elderly populations : Shelter-in-place planning and training at facilities serving elderly populations through the Rhode Island Senior Resiliency Project.

    Science.gov (United States)

    Smith, Richard; Mozzer, Michael; Albanese, Joseph; Paturas, James; Gold, Julia

    2017-06-01

    Elderly populations are disproportionately affected by disasters. In part, this is true because for many older adults, special assistance is needed to mitigate the consequences of disasters on their health and wellbeing. In addition, many older adults may reside in diverse living complexes such as long-term care facilities, assisted living facilities and independent-living senior housing complexes. Planning for each type of facility is different and the unique features of these facilities must be considered to develop readiness to deal with disasters. Based on this, the Rhode Island Department of Health established the Senior Resiliency Project to bolster the level of resiliency for the types of living facilities housing older adults. The project involves performing onsite assessments of energy resources, developing site-specific sheltering-inplace and energy resiliency plans, and educating and training facility employees and residents on these plans and steps they can take to be better prepared. Based on the feasibility of conducting these activities within a variety of facilities housing older adults, the project is segmented into three phases. This paper describes survey findings, outcomes of interventions, challenges and recommendations for bridging gaps observed in phases 1 and 2 of the project.

  16. The basic principles of migration health: Population mobility and gaps in disease prevalence

    Directory of Open Access Journals (Sweden)

    MacPherson Douglas W

    2006-05-01

    Full Text Available Abstract Currently, migrants and other mobile individuals, such as migrant workers and asylum seekers, are an expanding global population of growing social, demographic and political importance. Disparities often exist between a migrant population's place of origin and its destination, particularly with relation to health determinants. The effects of those disparities can be observed at both individual and population levels. Migration across health and disease disparities influences the epidemiology of certain diseases globally and in nations receiving migrants. While specific disease-based outcomes may vary between migrant group and location, general epidemiological principles may be applied to any situation where numbers of individuals move between differences in disease prevalence. Traditionally, migration health activities have been designed for national application and lack an integrated international perspective. Present and future health challenges related to migration may be more effectively addressed through collaborative global undertakings. This paper reviews the epidemiological relationships resulting from health disparities bridged by migration and describes the growing role of migration and population mobility in global disease epidemiology. The implications for national and international health policy and program planning are presented.

  17. Building community resilience to climate change through public health planning.

    Science.gov (United States)

    Bajayo, Rachael

    2012-04-01

    Nillumbik Shire Council, in partnership with La Trobe University, used the Municipal Public Health Planning process to develop an approach for building the resilience of local communities to climate-related stressors. The objective was to define an approach for building community resilience to climate change and to integrate this approach with the 'Environments for Health' framework. Key published papers and reports by leading experts the field were reviewed. Literature was selected based on its relevance to the subjects of community resilience and climate change and was derived from local and international publications, the vast majority published within the past two decades. Review of literature on community resilience revealed that four principal resource sets contribute to the capacity of communities to adapt in times of stress, these being: economic development; social capital; information and communication; and community competence. On the strength of findings, a framework for building each resilience resource set within each of the Environments for Health was constructed. This paper introduces the newly constructed 'Community Resilience Framework', which describes how each one of the four resilience resource sets can be developed within social, built, natural and economic environments. The Community Resilience Framework defines an approach for simultaneously creating supportive environments for health and increasing community capacity for adaptation to climate-related stressors. As such, it can be used by Municipal Public Health Planners as a guide in building community resilience to climate change.

  18. [Land planning in Zaire through the spatial distribution of the population].

    Science.gov (United States)

    Ipanga, T

    1992-01-01

    "Land planning in Zaire is examined through the analysis of population distribution by density and potential. The difference between these two techniques is that the calculation of population potential takes into account a genuinely geographical element, which is the distance between one given place and the other places within the area under consideration.... Taking potential as a criterion leads to developing an axis of communication from one end of the country to the other through densely populated, high-potential areas. Population density leads to a limited axis in each of the two regions with a high density of human occupation. In conclusion, the contribution of distance in land planning is to facilitate access for larger numbers of people and increase potential exchanges and contacts with other territories." (SUMMARY IN ENG) excerpt

  19. Roads to health : multi-state modelling of population health and resource use

    NARCIS (Netherlands)

    Niessen, Louis Wilhelmus

    2002-01-01

    The book has described the dynamics of disease occurrence in populations and gives an overview of the major known health determinants of mortality decline, health risk factors and health services, and studies the health interventions options in two example diseases i.e. diabetes and stroke. We

  20. The Copenhagen Oral Health Senior Cohort: design, population and dental health

    DEFF Research Database (Denmark)

    Heegaard, Karen M; Holm-Pedersen, Poul; Jensen, Allan Bardow

    2011-01-01

    Gerodontology 2010; doi: 10.1111/j.1741-2358.2010.00383.x The Copenhagen Oral Health Senior Cohort: design, population and dental health Background: In order to study the way old age influence oral health, the Copenhagen Oral Health Senior Cohort (COHS) has been established. Objectives: To describe...

  1. District health planning at a time of transition: a critical review and lessons learnt from the implementation of regional planning in Uganda.

    Science.gov (United States)

    Curtale, Filippo; Musila, Timothy; Opigo, Jimmy; Nantamu, Dyogo; Ezati, Isaac Alidria

    2016-05-01

    A quarter of a century after the Harare Declaration on Strengthening District Health Systems Based on Primary Health Care (1987) was conceived, district health teams (DHTs) are facing a markedly changed situation. Rapid population growth, urbanization, a rapidly developing private sector, and the increasing role of vertical programs and global initiatives have marginalized the planning process and weakened the entire district health system (DHS). The Ugandan Ministry of Health (MoH) responded to these challenges by beginning a review of district planning: a key action point of the Harare Declaration. The first step was a critical review of relevant literature, then central and district health staff were engaged with to provide their input in developing the new strategy. Through a field experiment started in 2012-13, and still underway, the MoH is developing an innovative regional approach to health planning, which aims to encompass the complexity of the new context of health care provision and coordinate all new actors (private health providers, projects and local government staff from other sectors) operating in the health sector. A strategic revision of the planning process represents an opportunity to develop an appropriate 'Theory of Change', intended as a broader approach of thinking about the entire DHS and the relative role and functions of the DHT. Leadership and stewardship capacities of MoH staff, at central and peripheral level, must be strengthened and supported to achieve the expected changes and results. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. The Olympic and Paralympic Games 2012: literature review of the logistical planning and operational challenges for public health.

    Science.gov (United States)

    Enock, K E; Jacobs, J

    2008-11-01

    To undertake a review of the literature relating to public health planning and interventions at previous summer Olympic and Paralympic Games and other relevant major summer sporting events or mass gatherings, with a focus on official publications and peer-reviewed articles. Literature review. A literature review was undertaken using all biomedical databases and a freetext search using Google to widen the search beyond peer-reviewed publications. Search terms used were: Olympics; Paralympics; mass gatherings; mass gathering medicine; sporting events; weather; planning; and organisation. Citations within articles were searched to identify additional references that would inform this review. This literature review concentrates on the public health aspects of population care at mass gatherings, particularly the Olympic and Paralympic Games which are set over several weeks, focusing on surveillance, prevention and health service quality. The literature identified 10 areas of public health planning: public health command centre and communication; surveillance, assessment and control; environmental health and safety; infectious disease outbreaks; implications of weather conditions; health promotion; travel information; economic assessments; public transport and reduction of asthma events; and preparing athletes for potential allergies. The following themes emerged as crucial factors for the success of any public health interventions at Olympic and Paralympic Games: detailed planning of deliverables; pre-identification of critical success factors; management of risk; detailed contingency planning; and full testing of all plans prior to the event. The 2012 Olympic Games will provide an exciting challenge for public health providers and systems. Preparation requires early detailed planning of policies, procedures and on-site health promotion events, in addition to helping to set up the surveillance and monitoring systems that will capture public health activity alongside

  3. Assessing and Planning Health Actions During a Crisis

    Directory of Open Access Journals (Sweden)

    Selim SUNER

    2015-10-01

    Full Text Available SUMMARY: Initial stage of a disaster is managed with existing resources. The following stages of disaster response often involve assistance from outside of the disaster zone. This may consist of mutual aid from neighboring communities for small-scale incidents but in major disasters, the response is from federal or international agencies or often both. Rapid needs assessment after an incident is a collaborative effort between responding agencies and local emergency preparedness and health authorities. Ideally, a team from responding agencies with intimate knowledge and experience regarding the capabilities and assets of the responding entity along with local authorities, with decision making capacity, who have knowledge of the community, the limitations of the responding agencies and can obtain near real-time information about the incident and subject matter experts (engineering, medical, law enforcement, etc. comprise the needs assessment team. Keywords: Crisis, health action, disaster planning

  4. Overcoming information asymmetry in consumer-directed health plans.

    Science.gov (United States)

    Retchin, Sheldon M

    2007-04-01

    Consumer-centric healthcare has been extolled as the centerpiece of a new model for managing both quality and price. However, information asymmetry in consumer-directed health plans (CDHPs) is a challenge that must be addressed. For CDHPs to work as intended and to gain acceptance, consumers need information regarding the quality and price of healthcare purchases. The federal government, particularly the Agency for Healthcare Research and Quality, could function as an official resource for information on performance and comparisons among facilities and providers. Because of workforce constraints among primary care physicians, a new group of healthcare professionals called "medical decision advisors" could be trained. Academic health centers would have to play a critical role in devising an appropriate curriculum, as well as designing a certification and credentialing process. However, with appropriate curricula and training, medical decision advisors could furnish information for consumers and aid in the complicated decisions they will face under CDHPs.

  5. Publication planning: an effective corporate strategy to influence health professionals.

    Science.gov (United States)

    2013-12-01

    Pharmaceutical companies integrate scientific publications into the communication strategies they employ to influence the practices of health professionals. In their"publication plan", pharmaceutical companies, or the communication agencies they hire, develop key messages to promote their drugs and then plan in advance how, when and where to disseminate them in medical journals or at conferences. Although their true intent is promotional, these messages must appear to be purely scientific, and are therefore disseminated as research articles, review articles, editorials, commentaries. Publication planning involves the use of "ghost" authors who work directly for pharmaceutical companies, but whose contribution is rarely acknowledged in the final published article. Key opinion leaders are recruited as the honorary authors of these articles, to which they have made little, if any, contribution. The criteria for authorship set by journals that publish primary research articles do not provide adequate protection against the practice of ghost and honorary authorship. Certain journals publishing primary research derive a large proportion of their revenue from selling reprints used by pharmaceutical companies to promote their drugs, especially by their sales representatives.

  6. Implementation science and its application to population health.

    Science.gov (United States)

    Lobb, Rebecca; Colditz, Graham A

    2013-01-01

    Implementation science studies the use of strategies to adapt and use evidence-based interventions in targeted settings (e.g., schools, workplaces, health care facilities, public health departments) to sustain improvements to population health. This nascent field of research is in the early stages of developing theories of implementation and evaluating the properties of measures. Stakeholder engagement, effectiveness studies, research synthesis, and mathematical modeling are some of the methods used by implementation scientists to identify strategies to embed evidence-based interventions in clinical and public health programs. However, for implementation science to reach its full potential to improve population health the existing paradigm for how scientists create evidence, prioritize publications, and synthesize research needs to shift toward greater stakeholder input and improved reporting on external validity. This shift will improve the relevance of the research that is produced and provide information that will help guide decision makers in their selection of research-tested interventions.

  7. Physical activity and mental health in a student population.

    Science.gov (United States)

    Tyson, Philip; Wilson, Kelly; Crone, Diane; Brailsford, Richard; Laws, Keith

    2010-12-01

    A growing body of literature indicates that physical activity can have beneficial effects on mental health. However, previous research has mainly focussed on clinical populations, and little is known about the psychological effects of physical activity in those without clinically defined disorders. The present study investigates the association between physical activity and mental health in an undergraduate university population based in the United Kingdom. One hundred students completed questionnaires measuring their levels of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) and their physical activity regime using the Physical Activity Questionnaire (PAQ). Significant differences were observed between the low, medium and high exercise groups on the mental health scales, indicating better mental health for those who engage in more exercise. Engagement in physical activity can be an important contributory factor in the mental health of undergraduate students.

  8. Estimating small area health-related characteristics of populations: a methodological review

    Directory of Open Access Journals (Sweden)

    Azizur Rahman

    2017-05-01

    Full Text Available Estimation of health-related characteristics at a fine local geographic level is vital for effective health promotion programmes, provision of better health services and population-specific health planning and management. Lack of a micro-dataset readily available for attributes of individuals at small areas negatively impacts the ability of local and national agencies to manage serious health issues and related risks in the community. A solution to this challenge would be to develop a method that simulates reliable small-area statistics. This paper provides a significant appraisal of the methodologies for estimating health-related characteristics of populations at geographical limited areas. Findings reveal that a range of methodologies are in use, which can be classified as three distinct set of approaches: i indirect standardisation and individual level modelling; ii multilevel statistical modelling; and iii micro-simulation modelling. Although each approach has its own strengths and weaknesses, it appears that microsimulation- based spatial models have significant robustness over the other methods and also represent a more precise means of estimating health-related population characteristics over small areas.

  9. Pilot-testing an applied competency-based approach to health human resources planning.

    Science.gov (United States)

    Tomblin Murphy, Gail; MacKenzie, Adrian; Alder, Rob; Langley, Joanne; Hickey, Marjorie; Cook, Amanda

    2013-10-01

    A competency-based approach to health human resources (HHR) planning is one that explicitly considers the spectrum of knowledge, skills and judgement (competencies) required for the health workforce based on the health needs of the relevant population in some specific circumstances. Such an approach is of particular benefit to planners challenged to make optimal use of limited HHR as it allows them to move beyond simply estimating numbers of certain professionals required and plan instead according to the unique mix of competencies available from the existing health workforce. This kind of flexibility is particularly valuable in contexts where healthcare providers are in short supply generally (e.g. in many developing countries) or temporarily due to a surge in need (e.g. a pandemic or other disease outbreak). A pilot application of this approach using the context of an influenza pandemic in one health district of Nova Scotia, Canada, is described, and key competency gaps identified. The approach is also being applied using other conditions in other Canadian jurisdictions and in Zambia.

  10. Do individuals respond to cost-sharing subsidies in their selections of marketplace health insurance plans?

    Science.gov (United States)

    DeLeire, Thomas; Chappel, Andre; Finegold, Kenneth; Gee, Emily

    2017-09-20

    The Affordable Care Act (ACA) provides assistance to low-income consumers through both premium subsidies and cost-sharing reductions (CSRs). Low-income consumers' lack of health insurance literacy or information regarding CSRs may lead them to not take-up CSR benefits for which they are eligible. We use administrative data from 2014 to 2016 on roughly 22 million health insurance plan choices of low-income individuals enrolled in ACA Marketplace coverage to assess whether they behave in a manner consistent with being aware of the availability of CSRs. We take advantage of discontinuous changes in the schedule of CSR benefits to show that consumers are highly sensitive to the value of CSRs when selecting insurance plans and that a very low percentage select dominated plans. These findings suggest that CSR subsidies are salient to consumers and that the program is well designed to account for any lack of health insurance literacy among the low-income population it serves. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Knowledge and opinions about dental human health resources planning in Mexico.

    Science.gov (United States)

    Maupome, G; Borges, A; Diez-de-Bonilla, J

    1998-02-01

    Dental human health resource planning (DHHRP), or manpower planning in Mexico has been plagued by fundamental contradictions. In spite of having trained a great many dentists in the past two decades, the dental health status of the population has not significantly improved. Concurrently, the relative scarcity of patients in relation to the number of practising dentists seems to be more marked, a critical issue since most dental care is delivered under private schemes. In the present investigation, 196 practising dentists in Mexico City were interviewed to establish their knowledge and opinions about DHHRP, and their views about the introduction of innovative alternatives in transforming, evaluating and planning human health resources. Concerns were: a need to examine and re-define the aims, skill content and marketability of professional training in professional practice; a lack of consensus as to how this is to be achieved; and a degree of awareness that professional practice has a limited scope in meeting the challenge of providing adequate care because of maldistribution of dentists and of limited financial resources of patients.

  12. Using community-based evidence for decentralized health planning: insights from Maharashtra, India.

    Science.gov (United States)

    Shukla, Abhay; Khanna, Renu; Jadhav, Nitin

    2018-01-01

    Health planning is generally considered a technical subject, primarily the domain of health officials with minimal involvement of community representatives. The National Rural Health Mission launched in India in 2005 recognized this gap and mandated mechanisms for decentralized health planning. However, since planning develops in the context of highly unequal power relations, formal spaces for participation are necessary but not sufficient. Hence a project on capacity building for decentralized health planning was implemented in selected districts of Maharashtra, India during 2010-13. This process developed on the platform of officially supported community-based monitoring and planning, a process for community feedback and participation towards health system change. A specific project on capacity building for decentralized planning included a structured learning course and workshops for major stakeholders. An evaluation of the project, including in-depth interviews of various participants and analysis of change in local health planning processes, revealed positive changes in intervention areas, including increased capacity of key stakeholders leading to preparation of evidence-based, innovative planning proposals, significant community oriented changes in utilization of health facility funds, and inclusion of community-based proposals in village, health facility-based block and district plans. Transparency related to planning increased along with responsiveness of health providers to community suggestions. A key lesson is that active facilitation of decentralized health planning and influencing the health system to expand participation, are essential to ensure changes in planning. Effective strategies included: identifying people's health service related priorities through community-based monitoring, capacity building of diverse stakeholders regarding local health planning, and advocacy to enable participation of community-based actors in the planning process. This

  13. Using the Concept of "Population Dose" in Planning and Evaluating Community-Level Obesity Prevention Initiatives

    Science.gov (United States)

    Cheadle, Allen; Schwartz, Pamela M.; Rauzon, Suzanne; Bourcier, Emily; Senter, Sandra; Spring, Rebecca; Beery, William L.

    2013-01-01

    When planning and evaluating community-level initiatives focused on policy and environment change, it is useful to have estimates of the impact on behavioral outcomes of particular strategies (e.g., building a new walking trail to promote physical activity). We have created a measure of estimated strategy-level impact--"population dose"--based on…

  14. Some Thoughts on Mexican Poverty Viewed from the Perspective of the World Population Plan of Action.

    Science.gov (United States)

    Serron, Luis A.

    The paper summarizes findings of a study of Mexican poverty (SO 010 522), and relates these findings to guidelines of the World Population Plan of Action. The study indicated that poverty in Mexico is based upon national and international economic, political, and social factors. Included among these factors are exploitation of labor, rapid…

  15. Health literacy interventions for immigrant populations: a systematic review.

    Science.gov (United States)

    Fernández-Gutiérrez, M; Bas-Sarmiento, P; Albar-Marín, M J; Paloma-Castro, O; Romero-Sánchez, J M

    2017-04-27

    Health literacy is considered a social health determinant that influences improvement in health, patient empowerment and reduction in inequalities. There is a lack of health literacy interventions for vulnerable social groups (i.e. immigrants), and nurses have shown little familiarity with the concept. This study aimed to identify and analyse whether interventions directed at immigrant populations improve the functional (basic reading, writing and arithmetic skills), interactive (social and cognitive skills) and critical (advanced cognitive and social skills in critically analyzing information and making informed decisions) dimensions of health literacy, taking into account the role played by nursing in these interventions. A systematic review of four databases including PubMed, PsycINFO, the Cochrane Library and ERIC was conducted to identify relevant articles published between 2000 and 2015. Thirty-four articles met the inclusion criteria, and nine articles used a validated instrument. Few specific health literacy interventions for immigrant populations were found. The main findings of the studies showed positive changes in functional health literacy. However, the interventions were less effective in improving interactive and critical health literacy. Several of the findings of this review were based on studies that had their own limitations. The assessment of the articles was not blinded, and the review was restricted to articles written in Spanish and English. The interventions studied were reported as being effective in improving health literacy in immigrants, particularly the functional aspects. Regarding the role played by nursing, this review observed little involvement. It is important for educational strategies to include health literacy dimensions. The concept of health literacy should be included as a Nursing Outcomes Classification and in its subsequent validation taxonomy. To promote community health, health literacy must be a prioritized objective of

  16. Association for population/family planning libraries and information centers-international (APLIC).

    Science.gov (United States)

    Shipman, P E

    1983-04-01

    Population centers and their information units or libraries were established as early as the 1920s, but population evolved as a field of study in its own right mainly during the 1950s and 60s. This paper attempts not so much to describe all that has taken place in the population information field to date, as to describe the activities of the Association for Population/Family Planning Libraries and Information Centers-International (APLIC). It is 1 of 2 international associations of population/family planning information specialists; the other is POPIN, in whose establishment APLIC played a key role. Membership can be either individual or institutional. At present there are 129 members from all parts of the globe. APLIC's goal is to make population, demographic, and family planning information available in the most effective way to researchers, policy-makers, clinicians, administrators, and program practitioners throughout the world. Its efforts are focused on 5 major areas: 1) the development of effective documentation and information systems and services; 2) professional contact among population librarians, documentalists, and information and communication specialists; 3) the global exchange of population information through programs and activities; 4) a cooperative network of population documentation centers and libraries; 5) continuing education to encourage professional development. Every year since 1968, APLIC has held a conference at which a diverse number of international and national information topics have been dealt with, and at which there have been working committees and information panels. Other activities include the publication of a newsletter, inter-library loans, reference services, and other matters relating to respective parent organizations.

  17. Advancing organizational health literacy in health care organizations serving high-needs populations: a case study.

    Science.gov (United States)

    Weaver, Nancy L; Wray, Ricardo J; Zellin, Stacie; Gautam, Kanak; Jupka, Keri

    2012-01-01

    Health care organizations, well positioned to address health literacy, are beginning to shift their systems and policies to support health literacy efforts. Organizations can identify barriers, emphasize and leverage their strengths, and initiate activities that promote health literacy-related practices. The current project employed an open-ended approach to conduct a needs assessment of rural federally qualified health center clinics. Using customized assessment tools, the collaborators were then able to determine priorities for changing organizational structures and policies in order to support continued health literacy efforts. Six domains of organizational health literacy were measured with three methods: environmental assessments, patient interviews, and key informant interviews with staff and providers. Subsequent strategic planning was conducted by collaborators from the academic and clinic teams and resulted in a focused, context-appropriate action plan. The needs assessment revealed several gaps in organizational health literacy practices, such as low awareness of health literacy within the organization and variation in perceived values of protocols, interstaff communication, and patient communication. Facilitators included high employee morale and patient satisfaction. The resulting targeted action plan considered the organization's culture as revealed in the interviews, informing a collaborative process well suited to improving organizational structures and systems to support health literacy best practices. The customized needs assessment contributed to an ongoing collaborative process to implement organizational changes that aided in addressing health literacy needs.

  18. Joint Venture Health Plans May Give ACOs a Run for Their Money.

    Science.gov (United States)

    Reinke, Thomas

    2016-12-01

    Joint venture plans are starting to demonstrate their ability to implement clinical management and financial management reforms. A JV health plan replaces the offloading of financial risk by health plans to ill-equipped providers with an executive-level cost management committee stated jointly by the hospital and payer.

  19. The medicalization of obesity, bariatric surgery, and population health.

    Science.gov (United States)

    Ortiz, Selena E; Kawachi, Ichiro; Boyce, Angie M

    2017-09-01

    This article examines how the medicalization of obesity validates the use of bariatric surgery to treat obesity in the United States and how expansions in access to bariatric surgery normalize surgical procedures as disease treatment and prevention tools. Building on this discussion, the article poses two questions for population health regarding health technology: (1) to what extent does bariatric surgery treat obesity in the United States while diverting attention away from the ultimate drivers of the epidemic and (2) to what extent does bariatric surgery improve outcomes for some groups in the US population while simultaneously generating disparities? We conduct a brief, historical analysis of the American Medical Association's decision to reclassify obesity as a disease through internal documents, peer-reviewed expert reports, and major media coverage. We use medicalization theory to show how this decision by the American Medical Association channels increased focus on obesity into the realm of medical intervention, particularly bariatric surgery, and use this evidence to review research trends on bariatric surgery. We propose research questions that investigate the population health dimensions of bariatric surgery in the United States and note key areas of future research. Our objective is to generate a discourse that considers bariatric surgery beyond the medical realm to better understand how technological interventions might work collectively with population-level obesity prevention efforts and how, in turn, population health approaches may improve bariatric surgery outcomes.

  20. Nursing and the science of prevention for population health.

    Science.gov (United States)

    Clark, Joan Shinkus; Bujnowski, Aaron

    2014-01-01

    The topic of patient-centered care is at the very epicenter of the contemporary emphasis on a value-based approach to health care. Multiple studies confirm that positive outcomes are consistently achieved when clinicians and administrators put appropriate emphasis on patient-centered care. Although we would agree that the patient-centered approach is necessary for achieving positive clinical outcomes for individual patients, we suggest that this approach alone is insufficient to sustain these outcomes across large populations over an extended-period of time. We believe that a science-based approach to population health coupled with patient-centered care pathways will achieve the most effective, long-term impact for large groups of individuals. Furthermore, we believe that nurses play a central role in a science-based approach to patient-centered medical care. In this article, we discuss the intersection of preventative science, patient-centered care, and the role of nurses. We present our experience at Texas Health Resources with the use of clinical nurse leaders in a science-based population health approach to achieve more consistent, positive outcomes during transition of care. Finally, we suggest that care providers integrate the science of prevention with the principles of patient-centered care to more consistently deliver on the promise of population health.

  1. Measuring the health of populations: the veil of ignorance approach.

    Science.gov (United States)

    Pinto-Prades, José-Luis; Abellán-Perpiñán, José-María

    2005-01-01

    We report the results from two surveys designed to explore whether an application of Harsanyi's principle of choice form behind a veil of ignorance (VEI) can be used in order to measure the health of populations. This approach was tentatively recommended by Murray et al. (Bull. World Health Organ 2000; 78: 981-994; Summary Measures of population health: Concepts, Ethics, Measurement and Applications, WHO, 2002.) as an appropriate way of constructing summary measures of population health (SMPH) for comparative purposes. The operationalization of the VEI approach used in this paper was suggested by Nord (Summary Measures of Population Health: Concepts, Ethics, Measurement and Applications, WHO, 2002.). We test if VEI and person trade-off (PTO) methods generate similar quality-of-life weights. In addition, we compare VEI and PTO weights with individual utilities estimated by means of the conventional standard gamble (SG) and a variation of it we call double gamble. Finally, psychometric properties like feasibility, reliability, and consistency are examined. Our main findings are next: (1) VEI and PTO approaches generate very different weights; (2) it seems that differences between PTO and VEI are not due to the 'rule of rescue'; (3) the VEI resembled more a DG than a classical SG; (4) PTO, VEI, and DG exhibited good feasibility, reliability and consistency. Copyright 2004 John Wiley & Sons, Ltd.

  2. Implications of Big Data Analytics on Population Health Management.

    Science.gov (United States)

    Bradley, Paul S

    2013-09-01

    As healthcare providers transition to outcome-based reimbursements, it is imperative that they make the transition to population health management to stay viable. Providers already have big data assets in the form of electronic health records and financial billing system. Integrating these disparate sources together in patient-centered datasets provides the foundation for probabilistic modeling of their patient populations. These models are the core technology to compute and track the health and financial risk status of the patient population being served. We show how the probabilistic formulation allows for straightforward, early identification of a change in health and risk status. Knowing when a patient is likely to shift to a less healthy, higher risk category allows the provider to intervene to avert or delay the shift. These automated, proactive alerts are critical in maintaining and improving the health of a population of patients. We discuss results of leveraging these models with an urban healthcare provider to track and monitor type 2 diabetes patients. When intervention outcome data are available, data mining and predictive modeling technology are primed to recommend the best type of intervention (prescriptions, physical therapy, discharge protocols, etc.) with the best likely outcome.

  3. [Health services utilization by the immigrant population in Spain].

    Science.gov (United States)

    Regidor, Enrique; Sanz, Belén; Pascual, Cruz; Lostao, Lourdes; Sánchez, Elisabeth; Díaz Olalla, José Manuel

    2009-12-01

    To compare health services utilization between the immigrant and indigenous populations in Spain. We used information provided by the following four health surveys carried out around 2005: Catalonia 2005; city of Madrid 2005, Canary Islands 2004 and the Autonomous Community of Valencia 2005. The health services studied were general practice, specialist services, emergency services, hospitalization, and two preventive services: pap smear test and mammography. In general, most health services were less frequently used by the immigrant population than by the Spanish population. The health services showing the least differences between the two populations were general practice and hospitalization, while the greatest differences were found in the use of specialist and preventive services. The most heterogeneous results were found in general practice and hospitalization, since some immigrant groups showed a relatively high frequency of use in some geographical areas and a relatively low frequency in other areas. The results of the present study reproduce those found in other studies carried out in countries with similar social and economic characteristics to Spain. Like previous results, the present results are difficult to explain. Future research should aim to use other study designs and to test hypotheses not put forward by the scientific community to date.

  4. Achieving population dispersal through tailor-made community planning: an Israeli experiment in the Galilee region.

    Science.gov (United States)

    Carmon, N

    1994-04-01

    The author describes a program designed to encourage population dispersal that was carried out in the central Galilee region of Israel during the 1980s. The program involved setting up 52 small communities with the appropriate infrastructures to attract young, well-educated settlers. "The plan succeeded in attracting the desired type of population...to the region, and the newcomers viewed the new communities as their permanent homes. Based on this experience and on the analysis of relevant literature, a development strategy of tailor-made community planning is hereby recommended for future projects. It is especially appropriate in the context of developed countries with a slow to zero population growth and with spreading social norms of the postindustrial society." excerpt

  5. Strategies for health education in North American immigrant populations.

    Science.gov (United States)

    Zou, P; Parry, M

    2012-12-01

    This article is intended to stimulate critical thinking about barriers and strategies related to health education for immigrant populations. Its rationale is to promote an understanding and appreciation for the individuality and diversity of immigrant beliefs, values and culture, and how these contribute to health education through nursing practice, research and theory. Since 2005, over 1,250,000 immigrants annually have obtained legal permanent residence in North America [over 1 million annually in the United States of America (USA) and over 250,000 annually in Canada]. While a broad immigration policy leads to population growth, cultural change and ethnic diversity, migration impacts immigrants' health status. In North America, the 'healthy immigrant effect', whereby immigrants generally tend to be healthier than individuals born in host countries, steadily declines after immigration. Immigration statistics and reports on literacy and learning were sourced from official websites in Canada and the USA. These were reviewed and discussed in the context of scholarly published literature on health literacy, health education and health promotion. Promoting health in immigrant populations is difficult due to cultural, linguistic, health literacy and socio-economic barriers. Cultural sensitivity, careful inquiry and comprehensive knowledge of immigrants' social circumstances are essential to every health education programme. Strategies for immigrant health education must be technologically diverse, involve partnerships with multidisciplinary professionals, elicit active community participation, and facilitate language transfer and interpretation. Future research must continue to explore these barriers and strategies, using both qualitative and quantitative methodologies. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

  6. Perceived health in the Portuguese population aged ? 35

    Directory of Open Access Journals (Sweden)

    João Paulo de Figueiredo

    2014-06-01

    Full Text Available OBJECTIVE : To evaluate the exploratory relationship between determinants of health, life satisfaction, locus of control, attitudes and behaviors and health related quality of life in an adult population. METHODS : Observational study (analytical and cross-sectional with a quantitative methodological basis. The sample was composed oy 1,214 inhabitants aged ≥ 35 in 31 civil parishes in the County of Coimbra, Portugal, 2011-2012. An anonymous and voluntary health survey was conducted, which collected the following information: demographic, clinical record, health and lifestyle behaviors; health related quality of life (Medical Outcomes Study, Short Form-36; health locus of control; survey of health attitudes and behavior, and quality of life index. Pearson’s Linear Correlation, t-Student, Wilcoxon-Mann-Whitney; One-way ANOVA; Brown-Forsythe’s F; Kruskal-Wallis; Multiple Comparisons: Tukey (HSD, Games-Howell and Conover were used in the statistical analysis. RESULTS : Health related quality of life was shown to be lower in females, in older age groups, in obese/overweight individuals, widows, unassisted, those living alone, living in rural/suburban areas, those who did not work and with a medium-low socioeconomic level. Respondents with poor/very poor self-perceived health (p < 0.0001, with chronic disease (p < 0.0001, who consumed < 3 meals per day (p ≤ 0.01, who were sedentary, who slept ≤ 6 h/day and had smoked for several years revealed the worst health results. Health related quality of life was positively related with a bigger internal locus, with better health attitudes and behaviors (physical exercise, health and nutritional care, length of dependence and with different areas of life satisfaction. CONCLUSIONS : Better health related quality of life was associated with certain social, psychological, family and health characteristics, a satisfactory lifestyle, better socioeconomic conditions and a good internal locus of control over

  7. Rational use of electronic health records for diabetes population management.

    Science.gov (United States)

    Eggleston, Emma M; Klompas, Michael

    2014-04-01

    Population management is increasingly invoked as an approach to improve the quality and value of diabetes care. Recent emphasis is driven by increased focus on both costs and measures of care as the US moves from fee for service to payment models in which providers are responsible for costs incurred, and outcomes achieved, for their entire patient population. The capacity of electronic health records (EHRs) to create patient registries, apply analytic tools, and facilitate provider- and patient-level interventions has allowed rapid evolution in the scope of population management initiatives. However, findings on the efficacy of these efforts for diabetes are mixed, and work remains to achieve the full potential of an-EHR based population approach. Here we seek to clarify definitions and key domains, provide an overview of evidence for EHR-based diabetes population management, and recommend future directions for applying the considerable power of EHRs to diabetes care and prevention.

  8. Planning, Implementing, and Evaluating a Program to Address the Oral Health Needs of Aboriginal Children in Port Augusta, Australia

    Directory of Open Access Journals (Sweden)

    E. J. Parker

    2012-01-01

    Full Text Available Aboriginal Australian children experience profound oral health disparities relative to their non-Aboriginal counterparts. In response to community concerns regarding Aboriginal child oral health in the regional town of Port Augusta, South Australia, a child dental health service was established within a Community Controlled Aboriginal Health Service. A partnership approach was employed with the key aims of (1 quantifying rates of dental service utilisation, (2 identifying factors influencing participation, and (3 planning and establishing a program for delivery of Aboriginal children’s dental services that would increase participation and adapt to community needs. In planning the program, levels of participation were quantified and key issues identified through semistructured interviews. After 3.5 years, the participation rate for dental care among the target population increased from 53 to 70 percent. Key areas were identified to encourage further improvements and ensure sustainability in Aboriginal child oral health in this regional location.

  9. [Evaluation of public health plans: a driver of change for regional health policy in France?].

    Science.gov (United States)

    Jabot, Francoise; Marchand, Annie-Claude

    2014-03-01

    Between 2007–2010, each French region carried out an evaluation of their public health plan, at the very moment when regional health system governance reform was taking place. The objective of this article is to analyze the influence of this dynamic of evaluation on health policy at the regional and national levels. An in-depth analysis in nine regions showed short-term consequences that were inconsistent among regions, depending on the implementation schedule and the evaluation process that was put into place. On the other hand, the lessons that emerged reinforced local expertise that was useful for the new planning exercise. This regional work has not yet been taken up nationally, but we cannot exclude the possibility that it fueled discussions in the working groups preparing the reform.

  10. Financial impact of population health management programs: reevaluating the literature.

    Science.gov (United States)

    Grossmeier, Jessica; Terry, Paul E; Anderson, David R; Wright, Steven

    2012-06-01

    Although many employers offer some components of worksite-based population health management (PHM), most do not yet invest in comprehensive programs. This hesitation to invest in comprehensive programs may be attributed to numerous factors, such as other more pressing business priorities, reluctance to intervene in the personal health choices of employees, or insufficient funds for employee health. Many decision makers also remain skeptical about whether investment in comprehensive programs will produce a financial return on investment (ROI). Most peer-reviewed studies assessing the financial impact of PHM were published before 2000 and include a broad array of program and study designs. Many of these studies have also included indirect productivity savings in their assessment of financial outcomes. In contrast, this review includes only peer-reviewed studies of the direct health care cost impact of comprehensive PHM programs that meet rigorous methodological criteria. A systematic search of health sciences databases identified only 5 studies with program designs and study methods meeting these selection criteria published after 2007. This focused review found that comprehensive PHM programs can yield a positive ROI based on their impact on direct health care costs, but the level of ROI achieved was lower than that reported by literature reviews with less focused and restrictive qualifying criteria. To yield substantial short-term health care cost savings, the longer term financial return that can credibly be associated with a comprehensive, prevention-oriented population health program must be augmented by other financial impact strategies.

  11. Maryland's Special Populations Cancer Network: cancer health disparities reduction model.

    Science.gov (United States)

    Baquet, Claudia R; Mack, Kelly M; Bramble, Joy; DeShields, Mary; Datcher, Delores; Savoy, Mervin; Hummel, Kery; Mishra, Shiraz I; Brooks, Sandra E; Boykin-Brown, Stephanie

    2005-05-01

    Cancer in Maryland is a serious health concern for minority and underserved populations in rural and urban areas. This report describes the National Cancer Institute (NCI) supported Maryland Special Populations Cancer Network (MSPN), a community-academic partnership. The MSPN's priority populations include African Americans, Native Americans, and other medically underserved residents of rural and urban areas. The MSPN has established a community infrastructure through formal collaborations with several community partners located in Baltimore City, the rural Eastern Shore, and Southern and Western Maryland, and among the Piscataway Conoy Tribe and the other 27 Native American Tribes in Maryland. Key partners also include the University of Maryland Eastern Shore and the University of Maryland Statewide Health Network. The MSPN has implemented innovative and successful programs in cancer health disparities research, outreach, and training; clinical trials education, health disparities policy, and resource leveraging. The MSPN addresses the goal of the NCI and the Department of Health and Human Services (DHHS) to reduce and eventually eliminate cancer health disparities. Community-academic partnerships are the foundation of this successful network.

  12. Achieving healthy school siting and planning policies: understanding shared concerns of environmental planners, public health professionals, and educators.

    Science.gov (United States)

    Cohen, Alison

    2010-01-01

    Policy decisions regarding the quality of the physical school environment-both, school siting and school facility planning policies-are often considered through the lens of environmental planning, public health, or education policy, but rarely through all three. Environmental planners consider environmental justice issues on a local level and/or consider the regional impact of a school. Public health professionals focus on toxic exposures and populations particularly vulnerable to negative health outcomes. Educators and education policymakers emphasize investing in human capital of both students and staff. By understanding these respective angles and combining these efforts around the common goals of achieving adequacy and excellence, we can work toward a regulatory system for school facilities that recognizes children as a uniquely vulnerable population and seeks to create healthier school environments in which children can learn and adults can work.

  13. [Health impact assessment methodology for urban planning projects in Andalusia (Spain)].

    Science.gov (United States)

    Moya-Ruano, Luis A; Candau-Bejarano, Ana; Rodríguez-Rasero, Francisco J; Ruiz-Fernández, Josefa; Vela-Ríos, José

    To describe the tool developed in Andalusia (Spain) to conduct an analysis and prospective assessment of health impacts from urban planning projects as well as the process followed to design it. On the one hand, direct and indirect relationships between urban setting and health were identified in light of the best scientific evidence available; and, on the other hand, methods and tools in impact assessment were reviewed. After the design of the tool, it was tested via both internal and external validation processes (meetings, workshops and interviews with key informants). The tool consists of seven phases, structured in two stages. A first descriptive stage shows how to obtain information about goals, objectives and general points pertaining the project and also to characterise the potentially affected population. The second one indicates, in several phases, how to identify and sort out potential impacts from the project using different supporting tools. Both in the testing phase and through its implementation since the entry into force of Andalusian Decree 169/2014 (16 June 2015) and forced all urban planning projects to be subjected to an Health Impact Assessment, this methodology has proved responsive, identifying major potential health impacts from the measures included in those projects. However, the tool has been shaped as a living tool and will be adapted in line with the experience acquired in its use. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  14. A mismatch between population health literacy and the complexity of health information: an observational study.

    Science.gov (United States)

    Rowlands, Gillian; Protheroe, Joanne; Winkley, John; Richardson, Marty; Seed, Paul T; Rudd, Rima

    2015-06-01

    Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population skills in relation to these. An English observational study comparing health materials with national working-age population skills. Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified. The proportion of the population above and below these thresholds, and the sociodemographic variables associated with a greater risk of being below the thresholds, were described. Sixty-four health materials were sampled. Two competency thresholds were identified: text (literacy) only, and text + numeracy; 2515/5795 participants (43%) were below the text-only threshold, while 2905/4767 (61%) were below the text + numeracy threshold. Univariable analyses of social determinants of health showed that those groups more at risk of socioeconomic deprivation had higher odds of being below the health literacy competency threshold than those at lower risk of deprivation. Multivariable analysis resulted in some variables becoming non-significant or reduced in effect. Levels of low health literacy mirror those found in other industrialised countries, with a mismatch between the complexity of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information. © British Journal of General Practice 2015.

  15. Reproductive health and family planning needs among HIV-infected women in Sub-Saharan Africa.

    Science.gov (United States)

    Sarnquist, Clea C; Rahangdale, Lisa; Maldonado, Yvonne

    2013-03-01

    Review key topics and recent literature regarding reproductive health and family planning needs for HIV-infected women in Sub-Saharan Africa. Electronic searches performed in PubMed, JSTOR, and Web of Science; identified articles reviewed for inclusion. Most HIV-infected women in Sub-Saharan Africa bear children, and access to antiretroviral therapy may increase childbearing desires and/or fertility, resulting in greater need for contraception. Most contraceptive options can be safely and effectively used by HIV-infected women. Unmet need for contraception is high in this population, with 66- 92% of women reporting not wanting another child (now or ever), but only 20-43% using contraception. During pregnancy and delivery, HIV-infected women need access to prevention of mother-to-child transmission (PMTCT) services, a skilled birth attendant, and quality post-partum care to prevent HIV infection in the infant and maximize maternal health. Providers may lack resources as well as appropriate training and support to provide such services to women with HIV. Innovations in biomedical and behavioral interventions may improve reproductive healthcare for HIV-infected women, but in Sub-Saharan Africa, models of integrating HIV and PMTCT services with family planning and reproductive health services will be important to improve reproductive outcomes. HIV-infected women in Sub-Saharan Africa have myriad needs related to reproductive health, including access to high-quality family planning information and options, high-quality pregnancy care, and trained providers. Integrated services that help prevent unintended pregnancy and optimize maternal and infant health before, during and after pregnancy will both maximize limited resources as well as provide improved reproductive outcomes.

  16. Disadvantaged populations in maternal health in China who and why?

    Directory of Open Access Journals (Sweden)

    Beibei Yuan

    2013-04-01

    Full Text Available Background: China has made impressive progress towards the Millennium Development Goal (MDG for maternal and reproductive health, but ensuring that progress reaches all segments of the population remains a challenge for policy makers. The aim of this review is to map disadvantaged populations in terms of maternal health in China, and to explain the causes of these inequities to promote policy action. Methods: We searched PUBMED, Popline, Proquest and WanFang and included primary studies conducted in mainland China. Experts were also contacted to identify additional studies. Disadvantaged populations in terms of MDG 5 and the reasons for this disadvantage explored by authors were identified and coded based on the conceptual framework developed by the WHO Commission on the Social Determinants of Health. Results: In China, differences in maternal health service utilization and the maternal mortality ratio among different income groups, and among regions with different socio-economic development still exist, although these differences are narrowing. Groups with low levels of education and ethnic minorities utilize maternal health care less frequently and experience higher maternal mortality, although we could not determine whether these differences have changed in the last decade. Rural-to-urban migrants use maternal health care and contraception to a lower extent than permanent residents of cities, and differential maternal mortality shows a widening trend among these groups. Gender inequity also contributes to the disadvantaged position of women. Intermediary factors that explain these inequities include material circumstances such as long distances to health facilities for women living in remote areas, behavioral factors such as traditional beliefs that result in reduced care seeking among ethnic minorities, and health system determinants such as out-of-pocket payments posing financial barriers for the poor. Conclusions: Inequity in maternal

  17. The Case for Diabetes Population Health Improvement: Evidence-Based Programming for Population Outcomes in Diabetes

    Science.gov (United States)

    Maruthur, Nisa; Mathioudakis, Nestoras; Spanakis, Elias; Rubin, Daniel; Zilbermint, Mihail; Hill-Briggs, Felicia

    2017-01-01

    Purpose of Review The goal of this review is to describe diabetes within a population health improvement framework and to review the evidence for a diabetes population health continuum of intervention approaches, including diabetes prevention and chronic and acute diabetes management, to improve clinical and economic outcomes. Recent Findings Recent studies have shown that compared to usual care, lifestyle interventions in prediabetes lower diabetes risk at the population-level and that group-based programs have low incremental medial cost effectiveness ratio for health systems. Effective outpatient interventions that improve diabetes control and process outcomes are multi-level, targeting the patient, provider, and healthcare system simultaneously and integrate community health workers as a liaison between the patient and community-based healthcare resources. A multi-faceted approach to diabetes management is also effective in the inpatient setting. Interventions shown to promote safe and effective glycemic control and use of evidence-based glucose management practices include provider reminder and clinical decision support systems, automated computer order entry, provider education, and organizational change. Summary Future studies should examine the cost-effectiveness of multi-faceted outpatient and inpatient diabetes management programs to determine the best financial models for incorporating them into diabetes population health strategies. PMID:28567711

  18. National ignition facility environment, safety, and health management plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-11-01

    The ES&H Management Plan describes all of the environmental, safety, and health evaluations and reviews that must be carried out in support of the implementation of the National Ignition Facility (NIF) Project. It describes the policy, organizational responsibilities and interfaces, activities, and ES&H documents that will be prepared by the Laboratory Project Office for the DOE. The only activity not described is the preparation of the NIF Project Specific Assessment (PSA), which is to be incorporated into the Programmatic Environmental Impact Statement for Stockpile Stewardship and Management (PEIS). This PSA is being prepared by Argonne National Laboratory (ANL) with input from the Laboratory participants. As the independent NEPA document preparers ANL is directly contracted by the DOE, and its deliverables and schedule are agreed to separately with DOE/OAK.

  19. 75 FR 43109 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

    Science.gov (United States)

    2010-07-23

    ... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations with respect to group health plans and health insurance coverage offered in... health insurance issuers providing group health insurance coverage. The text of those temporary...

  20. Reliability of a patient survey assessing cost-related changes in health care use among high deductible health plan enrollees

    Directory of Open Access Journals (Sweden)

    Galbraith Alison A

    2011-05-01

    Full Text Available Abstract Background Recent increases in patient cost-sharing for health care have lent increasing importance to monitoring cost-related changes in health care use. Despite the widespread use of survey questions to measure changes in health care use and related behaviors, scant data exists on the reliability of such questions. Methods We administered a cross-sectional survey to a stratified random sample of families in a New England health plan's high deductible health plan (HDHP with ≥ $500 in annualized out-of-pocket expenditures. Enrollees were asked about their knowledge of their plan, information seeking, behavior change associated with having a deductible, experience of delay in care due in part to cost, and hypothetical delay in care due in part to cost. Initial respondents were mailed a follow-up survey within two weeks of each family returning the original survey. We computed several agreement statistics to measure the test-retest reliability for select questions. We also conducted continuity adjusted chi-square, and McNemar tests in both the original and follow-up samples to measure the degree to which our results could be reproduced. Analyses were stratified by self-reported income. Results The test-retest reliability was moderate for the majority of questions (0.41 - 0.60 and the level of test-retest reliability did not differ substantially across each of the broader domains of questions. The observed proportions of respondents with delayed or foregone pediatric, adult, or any family care were similar when comparing the original and follow-up surveys. In the original survey, respondents in the lower-income group were more likely to delay or forego pediatric care, adult care, or any family care. All of the tests comparing income groups in the follow-up survey produced the same result as in the original survey. Conclusions In this population of HDHP beneficiaries, we found that survey questions concerning plan knowledge, information

  1. Determinants of self-rated health of a working population

    Directory of Open Access Journals (Sweden)

    Marek Bryła

    2015-02-01

    Full Text Available Background: Self-rated health relates to the use of medical help and, as a consequence, determines sick leave in the population of employees. The aim of the study was to analyze the relationship between socioeconomic variables, selected forms of positive health behaviour and subjective evaluation of health in employees. Material and Methods: Five hundred and 99 subjects were included in the study – 331 females and 268 males, aged 18–67, working in the area of the Świętokrzyskie province. The authors’ survey questionnaire on the selected elements of the state of health and positive health behavior in life style has been used in the study. Anthropometric measures were carried out. A Chi2 test for independence was used in the statistical analysis. In order to evaluate the effect of the selected factors on the self-rated health of the studied subjects the researchers have applied single- and multiple-factor logistic regression. Results: In the multiple-factor logistic regression the features contributing to good or excellent self-rated health were the following: age up to 39 (odds ratio – OR = 4.17; 95% confidence interval – CI: 1.72–10.10; p < 0.002, higher education (OR = 3.01; 95% CI: 1.04–8.70; p < 0.05 and care for health (OR = 4.77; 95% CI: 2.81–8.09; p < 0.001. Conclusions: Working people with higher education are characterized by a better control over their own health and, consequently, by a better perception of it. Monitoring self-rated health in a working population is an invaluable indicator in the evaluation of health in employees and the need for medical care. Med Pr 2015;66(1:17–28

  2. Health-adjusted life expectancy of the British population

    NARCIS (Netherlands)

    Groot, W.; van den Brink, H.M.

    2008-01-01

    In this article, changes in the quality of health-adjusted life expectancy of the British population between 1991 and 1998 are analysed. It is found that at all given age levels, life expectancy increased during this period. Life expectancy at birth increased by 1 year for women and by 1.5 years for

  3. World population, world health and security: 20th century trends.

    Science.gov (United States)

    Bashford, A

    2008-03-01

    The connection between infectious disease control and national security is now firmly entrenched. This article takes a historical look at another security issue once prominent in debate on foreign policy and international relations, but now more or less absent: overpopulation. It explores the nature of the debate on population as a security question, and its complicated historical relation to the development of world health.

  4. An Integrated Work Force Planning Strategy For The Health Services 2009 - 2012

    OpenAIRE

    Department of Health and Children

    2009-01-01

    Workforce planning identifies the composition of the workforce required to deliver health service goals. It encompasses a range of human resource activities aimed at the short, medium and long-term. Workforce planning that is integrated with service and financial planning offers the best opportunity for linking human resource decisions to the strategic goals for the health services. Systems and structures are required to support and develop workforce planning activities

  5. Focus on coal power station installations and population health

    Directory of Open Access Journals (Sweden)

    Marco Valenti

    2011-01-01

    Full Text Available Damage to health associated with emissions from coal power stations can vary greatly from one location to another depending on the size of the plant, location and the characteristics of the population. Population-based studies conducted by independent groups in different locations around the world show effects on health in populations at higher risk, but failed to definitely demonstrate direct effects on morbidity and mortality, to be exclusively attributed to the presence of active power stations. However, evidence on the role of micropollutants from power station activities suggests that a complete and thorough analysis should be made on the environmental cycle. Therefore danger should in any case be assessed as carefully as possible while assuming, at most, that all micropollutants may come into direct contact with man through the various potential pathways throughout their entire lifetime, regardless of the factors that reduce their presence.

  6. Men's health: a population-based study on social inequalities.

    Science.gov (United States)

    Bastos, Tássia Fraga; Alves, Maria Cecília Goi Porto; Barros, Marilisa Berti de Azevedo; Cesar, Chester Luiz Galvão

    2012-11-01

    This study evaluates social inequalities in health according to level of schooling in the male population. This was a cross-sectional, population-based study with a sample of 449 men ranging from 20 to 59 years of age and living in Campinas, São Paulo State, Brazil. The chi-square test was used to verify associations, and a Poisson regression model was used to estimate crude and adjusted prevalence ratios. Men with less schooling showed higher rates of alcohol consumption and dependence, smoking, sedentary lifestyle during leisure time, and less healthy eating habits, in addition to higher prevalence of bad or very bad self-rated health, at least one chronic disease, hypertension, and other health problems. No differences were detected between the two schooling strata in terms of use of health services, except for dental services. The findings point to social inequality in health-related behaviors and in some health status indicators. However, possible equity was observed in the use of nearly all types of health services.

  7. The Relationship between Domestic Violence and Reproductive Health and Family Planning Services in Bolivia, 2003

    Directory of Open Access Journals (Sweden)

    Pinto Aguirre, Guido

    2010-01-01

    Full Text Available The main purpose of this paper is to understand the relationship existing between Gender-Based Violence (GVB and the Use of Reproductive Health and Family Planning services. To carry out this task, we use multivariate logit regression models to explore the direction and strength of the relationship, using a population-based sample for Bolivian women during 2003-2004. Results show a strong, negative and significant relationship between GVB and use of RH/FP services at the population-level, after adjusting for respondent’s and partner’s individual and household characteristics. That is, GBV is strongly and significantly associated with the use of RH/FP services, in a way that women experiencing domestic violence are less likely to use those services.

  8. Improving health literacy in community populations: a review of progress.

    Science.gov (United States)

    Nutbeam, Don; McGill, Bronwyn; Premkumar, Pav

    2017-03-28

    Governments around the world have adopted national policies and programs to improve health literacy. This paper examines progress in the development of evidence to support these policies from interventions to improve health literacy among community populations. Our review found only a limited number of studies (n=7) that met the criteria for inclusion, with many more influenced by the concept of health literacy but not using it in the design and evaluation. Those included were diverse in setting, population and intended outcomes. All included educational strategies to develop functional health literacy, and a majority designed to improve interactive or critical health literacy skills. Several papers were excluded because they described a protocol for an intervention, but not results, indicating that our review may be early in a cycle of activity in community intervention research. The review methodology may not have captured all relevant studies, but it provides a clear message that the academic interest and attractive rhetoric surrounding health literacy needs to be tested more systematically through intervention experimentation in a wide range of populations using valid and reliable measurement tools. The distinctive influence of the concept of health literacy on the purpose and methodologies of health education and communication is not reflected in many reported interventions at present. Evidence to support the implementation of national policies and programs, and the intervention tools required by community practitioners are not emerging as quickly as needed. This should be addressed as a matter of priority by research funding agencies. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Increasing the impact of health plan report cards by addressing consumers' concerns.

    Science.gov (United States)

    Hibbard, J H; Harris-Kojetin, L; Mullin, P; Lubalin, J; Garfinkel, S

    2000-01-01

    Most plan report cards that compare the performance of health plans have framed the decision about plan choice as an opportunity to get better-quality care. This study uses a controlled experimental design to examine the effect of reframing the health plan choice decision to one that emphasizes protecting oneself from possible risk. The findings show that framing the health plan decision using a risk message has a consistent and significant positive impact on how consumers comprehend, value, and weight comparative performance information.

  10. Population Research.

    Science.gov (United States)

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    The scope of population research as carried on by the National Institute of Child Health and Human Development (NICHD) is set forth in this booklet. Population problems of the world, United States, and the individual are considered along with international population policies based on voluntary family planning programs. NICHD goals for biological…

  11. Enabling the participation of marginalized populations: case studies from a health service organization in Ontario, Canada.

    Science.gov (United States)

    Montesanti, Stephanie R; Abelson, Julia; Lavis, John N; Dunn, James R

    2017-08-01

    We examined efforts to engage marginalized populations in Ontario Community Health Centers (CHCs), which are primary health care organizations serving 74 high-risk communities. Qualitative case studies of community participation in four Ontario CHCs were carried out through key informant interviews with CHC staff to identify: (i) the approaches, strategies and methods used in participation initiatives aimed specifically at engaging marginalized populations in the planning of and decision making for health services; and (ii) the challenges and enablers for engaging these populations. The marginalized populations involved in the community participation initiatives studied included Low-German Speaking Mennonites in a rural town, newcomer immigrants and refugees in an urban downtown city, immigrant and francophone seniors in an inner city and refugee women in an inner city. Our analysis revealed that enabling the participation of marginalized populations requires CHCs to attend to the barriers experienced by marginalized populations that constrain their participation. Key informants outlined the features of a 'community development approach' that they rely on to address the barriers to marginalized peoples' involvement by strengthening their skills, abilities and leadership in capacity-building activities. The community development approach also shaped the participation methods that were used in the engagement process of CHCs. However, key informants also described the challenges of applying this approach, influenced by the cultural values of some groups, which shaped their willingness and motivation to participate. This study provides further insight into the approach, strategies and methods used in the engagement process to enable the participation of marginalized populations, which may be transferable to other health services settings. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Query Health: standards-based, cross-platform population health surveillance.

    Science.gov (United States)

    Klann, Jeffrey G; Buck, Michael D; Brown, Jeffrey; Hadley, Marc; Elmore, Richard; Weber, Griffin M; Murphy, Shawn N

    2014-01-01

    Understanding population-level health trends is essential to effectively monitor and improve public health. The Office of the National Coordinator for Health Information Technology (ONC) Query Health initiative is a collaboration to develop a national architecture for distributed, population-level health queries across diverse clinical systems with disparate data models. Here we review Query Health activities, including a standards-based methodology, an open-source reference implementation, and three pilot projects. Query Health defined a standards-based approach for distributed population health queries, using an ontology based on the Quality Data Model and Consolidated Clinical Document Architecture, Health Quality Measures Format (HQMF) as the query language, the Query Envelope as the secure transport layer, and the Quality Reporting Document Architecture as the result language. We implemented this approach using Informatics for Integrating Biology and the Bedside (i2b2) and hQuery for data analytics and PopMedNet for access control, secure query distribution, and response. We deployed the reference implementation at three pilot sites: two public health departments (New York City and Massachusetts) and one pilot designed to support Food and Drug Administration post-market safety surveillance activities. The pilots were successful, although improved cross-platform data normalization is needed. This initiative resulted in a standards-based methodology for population health queries, a reference implementation, and revision of the HQMF standard. It also informed future directions regarding interoperability and data access for ONC's Data Access Framework initiative. Query Health was a test of the learning health system that supplied a functional methodology and reference implementation for distributed population health queries that has been validated at three sites. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under

  13. Physician satisfaction under the Ontario Health Insurance Plan.

    Science.gov (United States)

    Kravitz, R L; Linn, L S; Shapiro, M F

    1990-06-01

    To determine the level of professional satisfaction experienced by physicians practicing in Ontario, Canada, a probability sample of 1,028 physicians was surveyed; 69% responded. The majority of Ontario doctors were at least moderately satisfied with each of 16 aspects of their work, and the percentage who were dissatisfied exceeded 15% for only four aspects. Factor analysis suggested the presence of four underlying satisfaction facets: satisfaction with quality of care, with the rewards of practice, with patients, and with the practice environment. Multivariate regression analysis supported the validity of the four-facet model and demonstrated a consistent association between lower satisfaction and younger age, lower income, and the perception that it is difficult to obtain fair reimbursement for medical services (P less than 0.05). Least satisfied physicians were most likely to have participated in the June, 1986 Ontario doctors' strike (P less than 0.001). Despite some misgivings, the majority of physicians practicing under the Ontario Health Insurance Plan in 1987 were satisfied with their professional lives. They were least satisfied with their ability to make administrative decisions and to manipulate the system for the benefit of their patients. Policymakers should be cognizant of the effects various strategies may have upon physician satisfaction as they consider new approaches to health care organization.

  14. Community-based health insurance knowledge, concern, preferences, and financial planning for health care among informal sector workers in a health district of Douala, Cameroon.

    Science.gov (United States)

    Noubiap, Jean Jacques N; Joko, Walburga Yvonne A; Obama, Joel Marie N; Bigna, Jean Joel R

    2013-01-01

    For the last two decades, promoted by many governments and international number in sub-Saharan Africa. In 2005 in Cameroon, there were only 60 Community-based health insurance (CBHI) schemes nationwide, covering less than 1% of the population. In 2006, the Cameroon government adopted a national strategy aimed at creating at least one CBHI scheme in each health district and covering at least 40% of the population with CBHI schemes by 2015. Unfortunately, there is almost no published data on the awareness and the implementation of CBHI schemes in Cameroon. Structured interviews were conducted in January 2010 with 160 informal sectors workers in the Bonassama health district (BHD) of Douala, aiming at evaluating their knowledge, concern and preferences on CBHI schemes and their financial plan to cover health costs. The awareness on the existence of CHBI schemes was poor awareness schemes among these informal workers. Awareness of CBHI schemes was significantly associated with a high level of education (p = 0.0001). Only 4.4% of respondents had health insurance, and specifically 1.2% were involved in a CBHI scheme. However, 128 (86.2%) respondents thought that belonging to a CBHI scheme could facilitate their access to adequate health care, and were thus willing to be involved in CBHI schemes. Our respondents would have preferred CBHI schemes run by missionaries to CBHI schemes run by the government or people of the same ethnic group (p). There is a very low participation in CBHI schemes among the informal sector workers of the BHD. This is mainly due to the lack of awareness and limited knowledge on the basic concepts of a CBHI by this target population. Solidarity based community associations to which the vast majority of this target population belong are prime areas for sensitization on CBHI schemes. Hence these associations could possibly federalize to create CBHI schemes.

  15. Pittsburgh as a High Risk Population: The Potential Savings of a Personalized Dental Care Plan.

    Science.gov (United States)

    Ng, Andrew J; Vieira, Alexandre R

    2016-01-01

    Objectives. Little evidence exists for the current standard of two annual preventative care visits. The purpose of this study was investigate this claim by modeling the potential savings of implementing a personalized care plan for high risk individuals in the Pittsburgh region. Methods. Using radiographs from 39 patients in the University of Pittsburgh Dental Registry and DNA Repository database, two models were created to analyse the direct savings of implementing a more aggressive preventative treatment plan and to view the longitudinal cost of increased annual yearly visits. Results. There is a significant decrease (p < 0.001) between original and modeled treatment cost when treatment severity is reduced. In addition, there is a significant decrease in adult lifetime treatment cost (p < 0.001) for up to four annual visits. Conclusions. Patients in high risk populations may see significant cost benefits in treatment cost when a personalized care plan, or higher annual preventative care visits, is implemented.

  16. A City for All Citizens: Integrating Children and Youth from Marginalized Populations into City Planning

    Directory of Open Access Journals (Sweden)

    Willem Van Vliet

    2013-07-01

    Full Text Available Socially just, intergenerational urban spaces should not only accommodate children and adolescents, but engage them as participants in the planning and design of welcoming spaces. With this goal, city agencies in Boulder, Colorado, the Boulder Valley School District, the Children, Youth and Environments Center at the University of Colorado, and a number of community organizations have been working in partnership to integrate young people’s ideas and concerns into the redesign of parks and civic areas and the identification of issues for city planning. Underlying their work is a commitment to the Convention on the Rights of the Child and children’s rights to active citizenship from a young age. This paper describes approaches used to engage with young people and methods of participation, and reflects on lessons learned about how to most effectively involve youth from underrepresented populations and embed diverse youth voices into the culture of city planning.

  17. Population Health Science: A Core Element of Health Science Education in Sub-Saharan Africa.

    Science.gov (United States)

    Hiatt, Robert A; Engmann, Natalie J; Ahmed, Mushtaq; Amarsi, Yasmin; Macharia, William M; Macfarlane, Sarah B; Ngugi, Anthony K; Rabbani, Fauziah; Walraven, Gijs; Armstrong, Robert W

    2017-04-01

    Sub-Saharan Africa suffers an inordinate burden of disease and does not have the numbers of suitably trained health care workers to address this challenge. New concepts in health sciences education are needed to offer alternatives to current training approaches.A perspective of integrated training in population health for undergraduate medical and nursing education is advanced, rather than continuing to take separate approaches for clinical and public health education. Population health science educates students in the social and environmental origins of disease, thus complementing disease-specific training and providing opportunities for learners to take the perspective of the community as a critical part of their education.Many of the recent initiatives in health science education in sub-Saharan Africa are reviewed, and two case studies of innovative change in undergraduate medical education are presented that begin to incorporate such population health thinking. The focus is on East Africa, one of the most rapidly growing economies in sub-Saharan Africa where opportunities for change in health science education are opening. The authors conclude that a focus on population health is a timely and effective way for enhancing training of health care professionals to reduce the burden of disease in sub-Saharan Africa.

  18. The cost of unintended pregnancies for employer-sponsored health insurance plans.

    Science.gov (United States)

    Dieguez, Gabriela; Pyenson, Bruce S; Law, Amy W; Lynen, Richard; Trussell, James

    2015-04-01

    Pregnancy is associated with a significant cost for employers providing health insurance benefits to their employees. The latest study on the topic was published in 2002, estimating the unintended pregnancy rate for women covered by employer-sponsored insurance benefits to be approximately 29%. The primary objective of this study was to update the cost of unintended pregnancy to employer-sponsored health insurance plans with current data. The secondary objective was to develop a regression model to identify the factors and associated magnitude that contribute to unintended pregnancies in the employee benefits population. We developed stepwise multinomial logistic regression models using data from a national survey on maternal attitudes about pregnancy before and shortly after giving birth. The survey was conducted by the Centers for Disease Control and Prevention through mail and via telephone interviews between 2009 and 2011 of women who had had a live birth. The regression models were then applied to a large commercial health claims database from the Truven Health MarketScan to retrospectively assign the probability of pregnancy intention to each delivery. Based on the MarketScan database, we estimate that among employer-sponsored health insurance plans, 28.8% of pregnancies are unintended, which is consistent with national findings of 29% in a survey by the Centers for Disease Control and Prevention. These unintended pregnancies account for 27.4% of the annual delivery costs to employers in the United States, or approximately 1% of the typical employer's health benefits spending for 1 year. Using these findings, we present a regression model that employers could apply to their claims data to identify the risk for unintended pregnancies in their health insurance population. The availability of coverage for contraception without employee cost-sharing, as was required by the Affordable Care Act in 2012, combined with the ability to identify women who are at high

  19. Population Health Outcomes of a Student-Led Free Health Clinic for an Underserved Population: A Naturalistic Study.

    Science.gov (United States)

    Stuhlmiller, Cynthia M; Tolchard, Barry

    2017-07-05

    There are a number of hard to reach and underserved communities who experience inadequate health care. In Australia, the Aboriginal and Torres Strait Islanders peoples experience low life expectancy, higher levels for chronic disease and elevated smoking and drinking. These problems are further exacerbated when living in regional and rural Australia and poverty. There are growing concerns over helping such groups in order to close the health disparity gap. A student-led clinic (SLC) was developed to address clinical placement shortages while providing free health and social services in an underserved community in regional Australia. Health data was collected from 2086 attendees enrolled in the SLC to determine health changes and outcomes of student-delivered services. A series of health data was routinely collected at all contact points. This included physical health care, behavioural health risk, and chronic disease measures. All data was recorded in an electronic monitoring system. Population data identified some significant and positive changes to health patterns-smoking, waist size, and body mass index. Unfortunately, gaps in data entry precluded more robust findings. It was clear that this community suffered from experiences commonly associated with health disparity and poverty. There were higher risks of drinking alcohol and smoking with raised levels of lifestyle disease including diabetes. Some of these issues were mitigated by the community being able to attend a locally situated community driven clinic.

  20. Interdisciplinarity and Systems Science to Improve Population Health

    Science.gov (United States)

    Mabry, Patricia L.; Olster, Deborah H.; Morgan, Glen D.; Abrams, David B.

    2008-01-01

    Fueled by the rapid pace of discovery, humankind's ability to understand the ultimate causes of preventable common disease burdens and to identify solutions is now reaching a revolutionary tipping point. Achieving optimal health and well-being for all members of society lies as much in the understanding of the factors identified by the behavioral, social, and public health sciences as by the biological ones. Accumulating advances in mathematical modeling, informatics, imaging, sensor technology, and communication tools have stimulated several converging trends in science: an emerging understanding of epigenomic regulation; dramatic successes in achieving population health-behavior changes; and improved scientific rigor in behavioral, social, and economic sciences. Fostering stronger interdisciplinary partnerships to bring together the behavioral–social–ecologic models of multilevel “causes of the causes” and the molecular, cellular, and, ultimately, physiological bases of health and disease will facilitate breakthroughs to improve the public's health. The strategic vision of the Office of Behavioral and Social Sciences Research (OBSSR) at the National Institutes of Health (NIH) is rooted in a collaborative approach to addressing the complex and multidimensional issues that challenge the public's health. This paper describes OBSSR's four key programmatic directions (next-generation basic science, interdisciplinary research, systems science, and a problem-based focus for population impact) to illustrate how interdisciplinary and transdisciplinary perspectives can foster the vertical integration of research among biological, behavioral, social, and population levels of analysis over the lifespan and across generations. Interdisciplinary and multilevel approaches are critical both to the OBSSR's mission of integrating behavioral and social sciences more fully into the NIH scientific enterprise and to the overall NIH mission of utilizing science in the pursuit

  1. Development of a Nationally Coordinated Evaluation Plan for the Ghana National Strategy for Key Populations.

    Science.gov (United States)

    Reynolds, Heidi W; Atuahene, Kyeremeh; Sutherland, Elizabeth; Amenyah, Richard; Kwao, Isaiah Doe; Larbi, Emmanuel Tettey

    Just as HIV prevention programs need to be tailored to the local epidemic, so should evaluations be country-owned and country-led to ensure use of those results in decision making and policy. The objective of this paper is to describe the process undertaken in Ghana to develop a national evaluation plan for the Ghana national strategy for key populations. This was a participatory process that involved meetings between the Ghana AIDS Commission (GAC), other partners in Ghana working to prevent HIV among key populations, and MEASURE Evaluation. The process included three two-day, highly structured yet participatory meetings over the course of 12 months during which participants shared information about on-going and planned data and identified research questions and methods. An evaluation plan was prepared to inform stakeholders about which data collection activities need to be prioritized for funding, who would implement the study, the timing of data collection, the research question the data will help answer, and the analysis methods. The plan discusses various methods that can be used including the recommendation for the study design using multiple data sources. It has an evaluation conceptual model, proposed analyses, proposed definition of independent variables, estimated costs for filling data gaps, roles and responsibilities of stakeholders to carry out the plan, and considerations for ethics, data sharing and authorship. The experience demonstrates that it is possible to design an evaluation responsive to national strategies and priorities with country leadership, regardless of stakeholders' experiences with evaluations. This process may be replicable elsewhere, where stakeholders want to plan and implement an evaluation of a large-scale program at the national or subnational level that is responsive to national priorities and part of a comprehensive monitoring and evaluation system.

  2. "Planning eye health services in Varamin district, Iran: a cross-sectional study".

    Science.gov (United States)

    Katibeh, Marzieh; Blanchet, Karl; Akbarian, Shadi; Hosseini, Sara; Ahmadieh, Hamid; Burton, Matthew J

    2015-04-03

    A recent survey of avoidable blindness in Varamin District, Iran, identified moderately high levels of visual impairment (10%) and blindness (1.5%) in people >50 years. This study aimed to define current provision, identify gaps and suggest practical solutions for improving eye health services in this area. The World Health Organization (WHO) framework for analyzing health systems has several key components: service delivery, health workforce, information system, medical products and technologies, financing, and governance. We used this structure to investigate the strengths and weaknesses of the eye health system in Varamin. All public and private eye care facilities and a random selection of primary health care (PHC) units were assessed using semi-structured researcher-administered questionnaires. Varamin has 16 ophthalmic clinics, including two secondary hospitals that provide cataract surgery. There were ten ophthalmologists (1:68,000 population), two ophthalmic nurses and five optometrists working in Varamin district. There were no eye care social or community workers, ophthalmic counsellors, low vision rehabilitation staff. Although the Vision 2020 target for ophthalmologists has been met, numbers of other eye care staff were insufficient. The majority of patients travel to Tehran for surgery. The recent survey identified cataract as the leading cause of blindness, despite the availability of surgical services in the district and high health insurance coverage. Poor awareness is a major barrier. No units had a written blindness prevention plan, formal referral pathways or sufficient eye health promotion activities. Only one of the PHC units referred people with diabetes for retinal examination. There is partial integration between eye care services and the general health system particularly for prevention of childhood blindness: chemo-prophylaxis for ophthalmia neonatorum, school vision tests, measles immunization and Vitamin A supplementation. This analysis

  3. Show Me My Health Plans: Using a Decision Aid to Improve Decisions in the Federal Health Insurance Marketplace.

    Science.gov (United States)

    Politi, Mary C; Kuzemchak, Marie D; Liu, Jingxia; Barker, Abigail R; Peters, Ellen; Ubel, Peter A; Kaphingst, Kimberly A; McBride, Timothy; Kreuter, Matthew W; Shacham, Enbal; Philpott, Sydney E

    2016-07-01

    Since the Affordable Care Act was passed, more than 12 million individuals have enrolled in the health insurance marketplace. Without support, many struggle to make an informed plan choice that meets their health and financial needs. We designed and evaluated a decision aid, Show Me My Health Plans (SMHP), that provides education, preference assessment, and an annual out-of-pocket cost calculator with plan recommendations produced by a tailored, risk-adjusted algorithm incorporating age, gender, and health status. We evaluated whether SMHP compared to HealthCare.gov improved health insurance decision quality and the match between plan choice, needs, and preferences among 328 Missourians enrolling in the marketplace. Participants who used SMHP had higher health insurance knowledge (LS-Mean = 78 vs. 62; P < 0.001), decision self-efficacy (LS-Mean = 83 vs. 75; P < 0.002), confidence in their choice (LS-Mean = 3.5 vs. 2.9; P < 0.001), and improved health insurance literacy (odds ratio = 2.52, P <0.001) compared to participants using HealthCare.gov. Those using SMHP were 10.3 times more likely to select a silver- or gold-tier plan (P < 0.0001). SMHP can improve health insurance decision quality and the odds that consumers select an insurance plan with coverage likely needed to meet their health needs. This study represents a unique context through which to apply principles of decision support to improve health insurance choices.

  4. Employment status and health: understanding the health of the economically inactive population in Scotland

    Directory of Open Access Journals (Sweden)

    Brown Judith

    2012-07-01

    Full Text Available Abstract Background Although the association between health and unemployment has been well examined, less attention has been paid to the health of the economically inactive (EI population. Scotland has one of the worst health records compared to any Western European country and the EI population account for 23% of the working age population. The aim of this study is to investigate and compare the health outcomes and behaviours of the employed, unemployed and the EI populations (further subdivided into the permanently sick, looking after home and family [LAHF] and others in Scotland. Methods Using data from the 2003 Scottish Health Survey, the differences in health and health behaviours among the employed, unemployed and the subgroups of the EI population were examined. Results Both low educational attainment and residence in a deprived community were more likely in the permanently sick group. The LAHF and the unemployed showed worse self-reported health and limiting longstanding illness compared to the employed but no significant differences were observed between these groups. The permanently sick group had significantly poorer health outcomes than all the other economic groups. Similar to the unemployed and LAHF they are more likely to smoke than the employed but less likely (along with LAHF and ‘others’ to exhibit heavy alcohol consumption. Interestingly, the LAHF showed better mental health than the rest of the EI group, but a similar mental health status to the unemployed. On the physical health element of lung function, the LAHF were no worse than the employed. Conclusion While on-going health promotion and vocational rehabilitation efforts need to be directed towards all, our data suggests that the EI group is at higher risk and policies and strategies directed at this group may need particular attention.

  5. Strategies for expanding health insurance coverage in vulnerable populations.

    Science.gov (United States)

    Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue

    2014-11-26

    Health insurance has the potential to improve access to health care and protect people from the financial risks of diseases. However, health insurance coverage is often low, particularly for people most in need of protection, including children and other vulnerable populations. To assess the effectiveness of strategies for expanding health insurance coverage in vulnerable populations. We searched Cochrane Central Register of Controlled Trials (CENTRAL), part of The Cochrane Library. www.thecochranelibrary.com (searched 2 November 2012), PubMed (searched 1 November 2012), EMBASE (searched 6 July 2012), Global Health (searched 6 July 2012), IBSS (searched 6 July 2012), WHO Library Database (WHOLIS) (searched 1 November 2012), IDEAS (searched 1 November 2012), ISI-Proceedings (searched 1 November 2012),OpenGrey (changed from OpenSIGLE) (searched 1 November 2012), African Index Medicus (searched 1 November 2012), BLDS (searched 1 November 2012), Econlit (searched 1 November 2012), ELDIS (searched 1 November 2012), ERIC (searched 1 November 2012), HERDIN NeON Database (searched 1 November 2012), IndMED (searched 1 November 2012), JSTOR (searched 1 November 2012), LILACS(searched 1 November 2012), NTIS (searched 1 November 2012), PAIS (searched 6 July 2012), Popline (searched 1 November 2012), ProQuest Dissertation &Theses Database (searched 1 November 2012), PsycINFO (searched 6 July 2012), SSRN (searched 1 November 2012), Thai Index Medicus (searched 1 November 2012), World Bank (searched 2 November 2012), WanFang (searched 3 November 2012), China National Knowledge Infrastructure (CHKD-CNKI) (searched 2 November 2012).In addition, we searched the reference lists of included studies and carried out a citation search for the included studies via Web of Science to find other potentially relevant studies. Randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA) studies and Interrupted time series (ITS) studies that

  6. Health human resource planning in Canada: a typology and its application.

    Science.gov (United States)

    Wranik, Dominika

    2008-04-01

    A series of group interviews were conducted with key stakeholders in Canadian health human resource (HHR) planning. Interviews revealed that innovative HHR models arose primarily in response to perceived needs at the front line. At the same time global HHR initiatives were implemented by policy makers based on population level estimates of need. A large disconnect is identified between the top down and the bottom up approaches to HHR planning. This paper makes two important contributions. First, it provides a comprehensive typology of HHR models currently being utilized in Canada. The classification of existing HHR models is a necessary first step to standardized evaluation of effectiveness of various HHR approaches in terms of improving access to care and health outcomes. Second, the creation of a new type of health care professional is proposed--the collaboration agent. The collaboration agent is to provide much needed leadership to bottom up endavours at the front line. Furthermore, the collaboration agent is to mediate between the top and the bottom, thereby improving deficient communication and funding channels.

  7. Self-rated health and ethnicity: focus on indigenous populations

    Directory of Open Access Journals (Sweden)

    Andrea E. Bombak

    2012-05-01

    Full Text Available Objectives. Self-rated health (SRH is a commonly used measure in surveys to assess general health status or health-related quality of life. Differences have been detected in how different ethnic groups and nationalities interpret the SRH measure and assess their health. This review summarizes the research conducted on SRH within and between ethnic groups, with a focus on indigenous groups. Study design and methods. A search of published academic literature on SRH and ethnicity, including a comprehensive review of all relevant indigenous research, was conducted using PubMed and summarized. Results. A wide variety of research on SRH within ethnic groups has been undertaken. SRH typically serves as an outcome measure. Minority respondents generally rated their health worse than the dominant population. Numerous culturally-specific determinants of SRH have been identified. Cross-national and cross-ethnicity comparisons of the associations of SRH have been conducted to assess the validity of SRH. While SRH is a valid measure within a variety of ethnicities, differences in how SRH is assessed by ethnicities have been detected. Research in indigenous groups remains generally under-represented in the SRH literature. Conclusions. These results suggest that different ethnic groups and nationalities vary in SRH evaluations, interpretation of the SRH measure, and referents employed in rating health. To effectively assess and redress health disparities and establish culturally-relevant and effective health interventions, a greater understanding of SRH is required, particularly among indigenous groups, in which little research has been conducted.

  8. Development and Implementation of South Asia’s First Heat-Health Action Plan in Ahmedabad (Gujarat, India)

    Science.gov (United States)

    Knowlton, Kim; Kulkarni, Suhas P.; Azhar, Gulrez Shah; Mavalankar, Dileep; Jaiswal, Anjali; Connolly, Meredith; Nori-Sarma, Amruta; Rajiva, Ajit; Dutta, Priya; Deol, Bhaskar; Sanchez, Lauren; Khosla, Radhika; Webster, Peter J.; Toma, Violeta E.; Sheffield, Perry; Hess, Jeremy J.

    2014-01-01

    Recurrent heat waves, already a concern in rapidly growing and urbanizing South Asia, will very likely worsen in a warming world. Coordinated adaptation efforts can reduce heat’s adverse health impacts, however. To address this concern in Ahmedabad (Gujarat, India), a coalition has been formed to develop an evidence-based heat preparedness plan and early warning system. This paper describes the group and initial steps in the plan’s development and implementation. Evidence accumulation included extensive literature review, analysis of local temperature and mortality data, surveys with heat-vulnerable populations, focus groups with health care professionals, and expert consultation. The findings and recommendations were encapsulated in policy briefs for key government agencies, health care professionals, outdoor workers, and slum communities, and synthesized in the heat preparedness plan. A 7-day probabilistic weather forecast was also developed and is used to trigger the plan in advance of dangerous heat waves. The pilot plan was implemented in 2013, and public outreach was done through training workshops, hoardings/billboards, pamphlets, and print advertisements. Evaluation activities and continuous improvement efforts are ongoing, along with plans to explore the program’s scalability to other Indian cities, as Ahmedabad is the first South Asian city to address heat-health threats comprehensively. PMID:24670386

  9. Development and Implementation of South Asia’s First Heat-Health Action Plan in Ahmedabad (Gujarat, India

    Directory of Open Access Journals (Sweden)

    Kim Knowlton

    2014-03-01

    Full Text Available Recurrent heat waves, already a concern in rapidly growing and urbanizing South Asia, will very likely worsen in a warming world. Coordinated adaptation efforts can reduce heat’s adverse health impacts, however. To address this concern in Ahmedabad (Gujarat, India, a coalition has been formed to develop an evidence-based heat preparedness plan and early warning system. This paper describes the group and initial steps in the plan’s development and implementation. Evidence accumulation included extensive literature review, analysis of local temperature and mortality data, surveys with heat-vulnerable populations, focus groups with health care professionals, and expert consultation. The findings and recommendations were encapsulated in policy briefs for key government agencies, health care professionals, outdoor workers, and slum communities, and synthesized in the heat preparedness plan. A 7-day probabilistic weather forecast was also developed and is used to trigger the plan in advance of dangerous heat waves. The pilot plan was implemented in 2013, and public outreach was done through training workshops, hoardings/billboards, pamphlets, and print advertisements. Evaluation activities and continuous improvement efforts are ongoing, along with plans to explore the program’s scalability to other Indian cities, as Ahmedabad is the first South Asian city to address heat-health threats comprehensively.

  10. Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health.

    Science.gov (United States)

    Aguilar-Gaxiola, Sergio; Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton Mickey; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B; Strelnick, A Hal; Wallerstein, Nina

    2014-04-01

    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.

  11. Gender in population research: Confusing implications for health policy.

    Science.gov (United States)

    Basu, Alaka Malwade

    2000-01-01

    In this paper I discuss some of the health policy implications of an increasing trend in population research and in its interpretation and presentation - a trend to 'political correctness' - defined not in the popular, often derogatory, sense, but as an ideological commitment to certain principles. For one of these commitments, that to the notion of gender equality, greater strength and legitimacy is today commonly sought by tying it to other less controversial goals such as that of better health. But straining for connections between gender equality and positive health outcomes often unduly constrains the research question, the research methods, and the interpretation of the research. When health policy seeks guidance from this research, it can receive signals which are too often incomplete, silent on the many trade-offs of specific policy measures, and, ultimately, perhaps even detrimental to the very goals of gender equity and social justice from which they are derived. Examples of all these possibilities are discussed.

  12. Patient loyalty in a mature IDS market: is population health management worth it?

    Science.gov (United States)

    Carlin, Caroline S

    2014-06-01

    To understand patient loyalty to providers over time, informing effective population health management. Patient care-seeking patterns over a 6-year timeframe in Minnesota, where care systems have a significant portion of their revenue generated by shared-saving contracts with public and private payers. Weibull duration and probit models were used to examine patterns of patient attribution to a care system and the continuity of patient affiliation with a care system. Clustering of errors within family unit was used to account for within-family correlation in unobserved characteristics that affect patient loyalty. The payer provided data from health plan administrative files, matched to U.S. Census-based characteristics of the patient's neighborhood. Patients were retrospectively attributed to health care systems based on patterns of primary care. I find significant patient loyalty, with past loyalty a very strong predictor of future relationship. Relationships were shorter when the patient's health status was complex and when the patient's care system was smaller. Population health management can be beneficial to the care system making this investment, particularly for patients exhibiting prior continuity in care system choice. The results suggest that co-located primary and specialty services are important in maintaining primary care loyalty. © Health Research and Educational Trust.

  13. Population health and clinical data linkage: the importance of a population registry.

    Science.gov (United States)

    Cameron, Cate M; Purdie, David M; Kliewer, Erich V; McClure, Roderick J; Wajda, Andre

    2007-10-01

    The Australian National Collaborative Research Infrastructure Strategy supports development of a national research capability in population health and clinical data linkage. This paper illustrates the importance of incorporating a population registry within such a system using an example provided by the Manitoba Injury Outcome Study (MIOS) that quantified the long-term burden of mortality attributable to injury in working-age adults. MIOS is a population-based matched cohort study that used administrative health data from Manitoba, Canada. An inception cohort of injured cases (ICD-9-CM 800-995) aged 18-64 years was identified from all Manitoba hospital admissions between 1988 and 1991. A matched non-injured comparison group was randomly selected from the total provincial population using the Manitoba Population Registry. Mortality outcomes were obtained by linking the two cohorts with the deaths data over 10 years. Mortality rate ratios (MRRs) were calculated to compare the injured and non-injured cohorts. A total of 21,032 matched pairs were identified. Using the population registry, the 10-year adjusted all-cause MRR comparing injured and non-injured cohort was 1.80 (95% CI 1.65-1.98). Without the registry, the unadjusted standardised morality ratio was 2.76 (95% CI 2.52-3.02). The effect of injury on mortality outcomes was over-estimated using only the injured cases, without use of the population registry. Use of the population registry enabled the selection of a matched non-injured group for comparison purposes, ensured comprehensive follow-up of almost all participants, and provided more accurate estimates of exposure time, incidence of mortality and relative risk.

  14. Ambient air pollution, climate change, and population health in China.

    Science.gov (United States)

    Kan, Haidong; Chen, Renjie; Tong, Shilu

    2012-07-01

    As the largest developing country, China has been changing rapidly over the last three decades and its economic expansion is largely driven by the use of fossil fuels, which leads to a dramatic increase in emissions of both ambient air pollutants and greenhouse gases (GHGs). China is now facing the worst air pollution problem in the world, and is also the largest emitter of carbon dioxide. A number of epidemiological studies on air pollution and population health have been conducted in China, using time-series, case-crossover, cross-sectional, cohort, panel or intervention designs. The increased health risks observed among Chinese population are somewhat lower in magnitude, per amount of pollution, than the risks found in developed countries. However, the importance of these increased health risks is greater than that in North America or Europe, because the levels of air pollution in China are very high in general and Chinese population accounts for more than one fourth of the world's totals. Meanwhile, evidence is mounting that climate change has already affected human health directly and indirectly in China, including mortality from extreme weather events; changes in air and water quality; and changes in the ecology of infectious diseases. If China acts to reduce the combustion of fossil fuels and the resultant air pollution, it will reap not only the health benefits associated with improvement of air quality but also the reduced GHG emissions. Consideration of the health impact of air pollution and climate change can help the Chinese government move forward towards sustainable development with appropriate urgency. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. IMPROVEMENT OF HEALTH AND LIFE QUALITY IN POPULATION THROUGH SOCIAL SUPPORT FOR DEVELOPMENT OF PHYCICAL CULTURE

    Directory of Open Access Journals (Sweden)

    Dragan Krivokapić

    2010-09-01

    Full Text Available Social support for every aspect of physical culture represents one of the best investments aimed at improvement of health and life quality of population in each country. It is demonstrated through the individual and population approach. Individual approach is mainly directed at the increase of motivation for doing regular physical exercise by raising awareness of the positive impacts that physical activity exerts on the overall health status. Population approach comprises processes aimed at the change of attitudes and norms within a society, as well as legislation strategies that could provide long term effect and persistence of the changes achieved. It all requires legal, organizational, institutional and social levels of change. Through the activities of its legislative and executive authorities, the state is to encourage individual and social support for the implementation of such measures that will contribute to gradual integration of regular physical activity into daily life. In the same sense, the making of the Action Plan with precise guidelines and provisions is the best mode to stimulate the majority of population to adopt a way of living that improves health and life quality, which is in turn a benefit for the individual, family and society as a whole.

  16. Integrating Health and Fairness into Duluth’s Comprehensive Plan

    Science.gov (United States)

    Cities of the Great Lakes are innovators in comprehensive ecosystem-focused urban planning. Beginning with the Plan of Chicago, comprehensive plans have been expressions of a community’s vision for the future, particularly regarding the use of waterfronts. Like Chicago in 1...

  17. [Use of social marketing in population health programs (literature review)].

    Science.gov (United States)

    Kholmogorova, G T; Gladysheva, N V

    1991-01-01

    At present health education programmes abroad make wide use of social marketing strategy. Unlike commercial marketing whose purpose is competition and struggle for the expansion of commodity markets, social marketing is aimed at disseminating certain ideas or introducing certain practices, using largely the technological base and strategy of commercial marketing. The authors give 8 fundamental principles of social marketing (consumer orientation, the theory of barter, the analysis of audience and segmentation, special surveys to detect the orientation of population, the choice of channels for information transmission application of "marketing mixture", control of ongoing programme and marketing management). Application fields of social marketing in public health are discussed.

  18. Population Aging in Iran and Rising Health Care Costs

    Directory of Open Access Journals (Sweden)

    Mohammad Mirzaie

    2017-09-01

    Conclusion Based on the results of this research, it can be said that people throughout their life cycle always allocate a percentage of their total spending to health care costs, but the percentage of this allocation is different at different ages. In a way the demand for healthcare costs increases with aging, it rises significantly in the old age. At the macro level, due to an increase in the percentage of elderly in the population over the next decade, there will also be an increase in the share of health care costs.

  19. Surfing the internet for health information: an italian survey on use and population choices.

    Science.gov (United States)

    Siliquini, Roberta; Ceruti, Michele; Lovato, Emanuela; Bert, Fabrizio; Bruno, Stefania; De Vito, Elisabetta; Liguori, Giorgio; Manzoli, Lamberto; Messina, Gabriele; Minniti, Davide; La Torre, Giuseppe

    2011-04-07

    Recent international sources have described how the rapid expansion of the Internet has precipitated an increase in its use by the general population to search for medical information. Most studies on e-health use investigated either through the prevalence of such use and the social and income patterns of users in selected populations, or the psychological consequences and satisfaction experienced by patients with particular diseases. Few studies have been carried out in Europe that have tried to identify the behavioral consequences of Internet use for health-related purposes in the general population.The aims of this study are to provide information about the prevalence of Internet use for health-related purposes in Italy according to demographic and socio-cultural features, to investigate the impact of the information found on health-related behaviors and choices and to analyze any differences based on health condition, self-rated health and relationships with health professionals and facilities. A multicenter survey was designed within six representative Italian cities. Data were collected through a validated questionnaire administered in hospital laboratories by physicians. Respondents were questioned about their generic condition, their use of the Internet and their health behaviors and choices related to Internet use. Data were analyzed using descriptive statistics and logistic regression to assess any differences by socio-demographic and health-related variables. The sample included 3018 individuals between the ages of 18 and 65 years. Approximately 65% of respondents reported using the Internet, and 57% of them reported using it to search for health-related information. The main reasons for search on the Internet were faster access and a greater amount of information. People using the Internet more for health-related purposes were younger, female and affected by chronic diseases. A large number of Internet users search for health information and

  20. Jefferson Proving Ground, South of the Firing Line Health and Safety Plan, Volume 4

    National Research Council Canada - National Science Library

    1992-01-01

    .... The purpose of this Site Health and Safety Plan (SHSP) is to assign SECD personnel health and safety responsibilities, to prescribe mandatory operating procedures, and to establish personal-protective-equipment (PPE...

  1. 5 CFR 890.201 - Minimum standards for health benefits plans.

    Science.gov (United States)

    2010-01-01

    ... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.201... dentistry or cosmetic surgery, or both, limited to conditions arising after the effective date of coverage...

  2. Fertility, knowledge, attitude and practice (KAP) study in relation to family planning in a selected population of the Armed Forces.

    Science.gov (United States)

    Taneja, R N

    1972-01-01

    A study was carried out among the civil and military population in Poona, India, to determine their knowledge, attitude, and practices in relation to family planning and the fertility rates of women aged 15-44 in the following catagories: 1) total and age specific marital fertility rate; 2) order of birth of the children born during the previous year; 3) average number of living children per couple; and 4) percentage of currently pregnant women. 251 civilian wives and 230 military wives were interviewed. Both total marital fertility rates and age specific marital fertility rates were high among the Service families, due perhaps to the predominance of young people in the military. Most of the live births occurring in the previous year were of the 1-3 order. Similarly, the average number of children per couple was low, only 1.7, although the number of children in completed families (4.4) was not too much lower than in civilian Poona families (4.8) and in India in general (5.5). Nearly 2/3 considered 3 children the ideal, although the desire for boys was intense and could lead couples to seek more than 3 children. Only 10% favored abortion on demand. More Service than civilian families knew about and practiced family planning, though the number practicing was only 27.8%. The most widely known methods were sterilization, the condom, and the IUD. The image of family planning among the civilian population was of family limitation, whereas some Service personnel regarded it as a means of child spacing. Practice of family planning was highest among Junior Commissioned Officers, the more literate, and those in the 30-34 age group. There was a positive correlation between family planning practice and number of living children. It is recommended that fertility statistics on military personnel be maintained annually. Further, as it was discovered that 20% of the military wives were currently pregnant, the family welfare planning staff and maternal health services and the

  3. Planning oral health and clinical discharge in primary care: the comprehensive dental care protocol outcome.

    Science.gov (United States)

    Cavalcanti, Yuri Wanderley; Dantas de Almeida, Leopoldina de Fátima; Barbosa, Ailma de Souza; Nascimento Padilha, Wilton Wilney

    2015-03-01

    The dental care must be driven by preventive and curative measures that can contribute to the population's oral health promotion. To evaluate the impact of the actions proposed by a comprehensive dental care protocol (CDCP) on the oral health condition of primary care users. The sample consisted of 32 volunteers, assisted throughout the six phases proposed by the CDCP: diagnosis of dental needs; resolution of urgencies; restorative interventions; application of promotional measures; evaluation of the achieved health level; and periodic controls. Data were collected through clinical exams, which measured the simplified oral hygiene index (OHI-S), gingival bleeding index (GBI) and the decayed, missing and filled teeth (DMFT) Index, before and after the CDCP was implemented. Statistical analysis consisted of the Wilcoxon test, at 5% significance level (α = 0.05). The OHI-S and GBI indices showed a significant reduction (p 0.05), showing final values equal to 12.7 ± 9.6 and 5.6 ± 7.8, respectively. Decayed elements were fully converted into filled elements, and the final values of the decayed and filled elements were, respectively, 0.0 ± 0.0 and 7.3 ± 5.7 (p health of the population assisted by the dental services offered in primary care and this protocol seems to ft the public dental service demands. The CDCP can be useful to public dental service planning since it showed an efficient clinical outcome to the patients. We consider that this protocol should be employed in primary care oral health services in order to achieve overall upgrade, access enlargement and public oral health promotion.

  4. Discrimination, work and health in immigrant populations in Spain.

    Science.gov (United States)

    Agudelo-Suárez, Andrés; Gil-González, Diana; Ronda-Pérez, Elena; Porthé, Victoria; Paramio-Pérez, Gema; García, Ana M; Garí, Aitana

    2009-05-01

    One of the most important social phenomena in the global context is the flow of immigration from developing countries, motivated by economic and employment related issues. Discrimination can be approached as a health risk factor within the immigrant population's working environment, especially for those immigrants at greater risk from social exclusion and marginalisation. The aim of this study is to research perceptions of discrimination and the specific relationship between discrimination in the workplace and health among Spain's immigrant population. A qualitative study was performed by means of 84 interviews and 12 focus groups held with immigrant workers in five cities in Spain receiving a large influx of immigrants (Madrid, Barcelona, Valencia, Alicante and Huelva), covering representative immigrant communities in Spain (Romanians, Moroccans, Ecuadorians, Colombians and Sub-Saharan Africans). Discourse narrative content analysis was performed using pre-established categories and gradually incorporating other emerging categories from the immigrant interviewees themselves. The participants reported instances of discrimination in their community and working life, characterised by experiences of racism, mistreatment and precarious working conditions in comparison to the Spanish-born population. They also talked about limitations in terms of accessible occupations (mainly construction, the hotel and restaurant trade, domestic service and agriculture), and described major difficulties accessing other types of work (for example public administration). They also identified political and legal structural barriers related with social institutions. Experiences of discrimination can affect their mental health and are decisive factors regarding access to healthcare services. Our results suggest the need to adopt integration policies in both the countries of origin and the host country, to acknowledge labour and social rights, and to conduct further research into individual

  5. Consumer-driven health plans: are they more than talk now?

    Science.gov (United States)

    Gabel, Jon R; Lo Sasso, Anthony T; Rice, Thomas

    2002-01-01

    This paper reports marketplace developments for consumer-driven health plans in spring 2002. Findings are from interviews with executives from start-up and health insurance firms, benefit consultants, employee benefit managers, Wall Street analysts, consumer organizations, thought leaders, and policymakers. We detail available evidence about the performance of consumer-driven health plans concerning access to care, risk selection, cost containment, use of information, and legal issues. We find that these health plans are now a central pillar of health insurers' business strategy and that an estimated 1.5 million persons are enrolled in them.

  6. The Value of College Health Promotion: A Critical Population and Setting for Improving the Public's Health

    Science.gov (United States)

    Lederer, Alyssa M.; Oswalt, Sara B.

    2017-01-01

    College students are an important priority population, and higher education is an opportune setting for chronic disease prevention and health promotion. Yet many people do not understand why enhancing the well-being of college students is of value. In this commentary, we address 3 common misperceptions about college health promotion: (1) College…

  7. Health insurance coverage and use of family planning services among current and former foster youth: implications of the health care reform law.

    Science.gov (United States)

    Dworsky, Amy; Ahrens, Kym; Courtney, Mark

    2013-04-01

    This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population.

  8. Considerations for planning and evaluating economic analyses of telemental health.

    Science.gov (United States)

    Luxton, David D

    2013-08-01

    The economic evaluation of telemental health (TMH) is necessary to inform ways to decrease the cost of delivering care, to improve access to care, and to make decisions about the allocation of resources. Previous reviews of telehealth economic analysis studies have concluded that there are significant methodological deficiencies and inconsistencies that limit the ability to make generalized conclusions about the costs and benefits of telehealth programs. Published economic evaluations specific to TMH are also limited. There are unique factors that influence costs in TMH that are necessary for those who are planning and evaluating economic analyses to consider. The purpose of this review is to summarize the main problems and limitations of published economic analyses, to discuss considerations specific to TMH, and to inform and encourage the economic evaluation of TMH in both the public and private sectors. The topics presented here include perspective of costs, direct and indirect costs, and technology, as well as research methodology considerations. The integration of economic analyses into effectiveness trials, the standardization of outcome measurement, and the development of TMH economic evaluation guidelines are recommended. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  9. World Health Organization Global Disability Action Plan: The Mongolian Perspective.

    Science.gov (United States)

    Khan, Fary; Amatya, Bhasker; Avirmed, Baljnnyam; Yi, Yoon Kyoung; Shirmen, Batchimeg; Abbott, Geoff; Galea, Mary P

    2017-02-16

    To provide an update on disability and rehabilitation in Mongolia, and to identify potential barriers and facilitators for implementation of the World Health Organization (WHO) Global Disability Action Plan (GDAP). A 4-member rehabilitation team from the Royal Melbourne Hospital conducted an intensive 6-day workshop at the Mongolian National University of Medical Sciences, for local healthcare professionals (n = 77) from medical rehabilitation facilities (urban/rural, public/private) and non-governmental organizations. A modified Delphi method (interactive sessions, consensus agreement) identified challenges for rehabilitation service provision and disability education and attitudes, using GDAP objectives. The GDAP summary actions were considered useful for clinicians, policy-makers, government and persons with disabilities. The main challenges identified were: limited knowledge of disability services and rehabilitation within healthcare sectors; lack of coordination between sectors; geo-topographical issues; limited skilled workforces; lack of disability data, guidelines and accreditation standards; poor legislation and political commitment. The facilitators were: strong leadership; advocacy of disability-inclusive development; investment in local infrastructure/human resources; opportunities for coordination and partnerships between the healthcare sector and other stakeholders; research opportunities; and dissemination of information. Disability and rehabilitation is an emerging priority in Mongolia to address the rights and needs of persons with disabilities. The GDAP provides guidance to facilitate access and strengthen rehabilitation services.

  10. Land-use, transport and population health: estimating the health benefits of compact cities

    Science.gov (United States)

    Stevenson, Mark; Thompson, Jason; de Sa, Thiago Herick; Ewing, Reid; Mohan, Dinesh; McClure, Rod; Roberts, Ian; Tiwari, Geetam; Giles-Corti, Billie; Sallis, Jim; Sun, Xiaoduan; Wallace, Mark; Woodcock, James

    2017-01-01

    Using a Health Impact Assessment Framework, we estimated the population health effects arising from alternative land-use and transport policy initiatives in six cities. Land-use changes were modelled to reflect a compact city in which land-use density and diversity were increased and distances to public transport were reduced to produce low motorised mobility, namely a modal shift from private motor vehicles to walking, cycling, and public transport. The modelled compact city scenario resulted in health gains for all cities (for diabetes, cardiovascular disease, and respiratory disease) with the overall health gains ranging from 420 disability-adjusted life years (DALYs) per 100 000 population to 826 DALYs per 100 000 population. However, for moderate to highly motorised cities, such as Melbourne, London, and Boston, the compact city scenario predicted a small increase in road trauma for cyclists and pedestrians (health loss of between 34 to 41 DALYs per 100 000 population). The findings suggest that government policies need to actively pursue land-use elements (particularly a focus towards compact cities) that support a modal shift away from private motor vehicles towards walking, cycling, and low-emission public transport. At the same time, these policies need to ensure the provision of safe walking and cycling infrastructure. The findings highlight the opportunities for policymakers to positively influence the overall health of city populations. PMID:27671671

  11. Geospatial Technology in Disease Mapping, E- Surveillance and Health Care for Rural Population in South India

    Science.gov (United States)

    Praveenkumar, B. A.; Suresh, K.; Nikhil, A.; Rohan, M.; Nikhila, B. S.; Rohit, C. K.; Srinivas, A.

    2014-11-01

    Providing Healthcare to rural population has been a challenge to the medical service providers especially in developing countries. For this to be effective, scalable and sustainable, certain strategic decisions have to be taken during the planning phase. Also, there is a big gap between the services available and the availability of doctors and medical resources in rural areas. Use of Information Technology can aid this deficiency to a good extent. In this paper, a mobile application has been developed to gather data from the field. A cloud based interface has been developed to store the data in the cloud for effective usage and management of the data. A decision tree based solution developed in this paper helps in diagnosing a patient based on his health parameters. Interactive geospatial maps have been developed to provide effective data visualization facility. This will help both the user community as well as decision makers to carry out long term strategy planning.

  12. Manager's leadership is the main skill for ambulatory health care plan success.

    Science.gov (United States)

    Marin, Gustavo Horacio; Silberman, Martin; Colombo, Maria Virginia; Ozaeta, Belen; Henen, Jaime

    2015-01-01

    To demonstrate effectiveness of ambulatory health care plan implementation among institutions and variables associated with the differences observed. Randomized selection of primary health care (PHC) centers was done. Leadership ability of the plan manager was explored. Univariate/bivariate analyses were performed to observe correlation between variables. Two groups of PHC centers were established according to the efficacy of plan implementation: high and low performance. Differences between groups were observed (592%-1023% more efficacy in controls and practices; P Leadership was responsible for the main differences observed. Leadership of manager for implementation of the health care plan was the major important variable to reach the best efficacy standards.

  13. Urban regeneration as population health intervention: a health impact assessment in the Bay of Pasaia (Spain).

    Science.gov (United States)

    Serrano, Elena; Larrañaga, Isabel; Morteruel, Maite; Baixas de Ros, María Dolores; Basterrechea, Mikel; Martinez, Dolores; Aldasoro, Elena; Bacigalupe, Amaia

    2016-09-15

    An important health issue in urban areas is how changes arising from the regeneration of city-areas affect social determinants of health and equity. This paper examines the impacts attributable to a new fish market and to delays in the regeneration of a port area in a deteriorated region of the Bay of Pasaia (Spain). Potential differential impacts on local residents and socially vulnerable groups were evaluated to determine health inequalities. An in-depth, prospective and concurrent Health-Impact-Assessment (HIA) focused on equity was conducted by the regional Public Health Department, following the Merseyside guidelines. Data from different sources was triangulated and impacts were identified using qualitative and quantitative methods. The intervention area is characterised by poor social, environmental, and health indicators. The distinctness of the two projects generates contrasting health and inequality impacts: generally positive for the new fish market and negative for the port area. The former creates recreational spaces and improves urban quality and social cohesion. By contrast, inaction and stagnation of the project in the port area perpetuates deterioration, a lack of safety, and poor health, as well as increased social frustration. In addition to assessing the health impacts of both projects this HIA promoted intersectoral partnerships, boosted a holistic and positive view of health and incorporated health and equity into the political discourse. Community-level participatory action enabled public health institutions to respond to new urban planning challenges and responsibilities in a more democratic manner.

  14. Action planning as predictor of health protective and health risk behavior: an investigation of fruit and snack consumption

    Directory of Open Access Journals (Sweden)

    Candel Math

    2009-10-01

    Full Text Available Abstract Background Large discrepancies between people's intention to eat a healthy diet and actual dietary behavior indicate that motivation is not a sufficient instigator for healthy behavior. Research efforts to decrease this 'intention - behavior gap' have centered on aspects of self-regulation, most importantly self-regulatory planning. Most studies on the impact of self-regulatory planning in health and dietary behavior focus on the promotion of health protective behaviors. This study investigates and compares the predictive value of action planning in health protective behavior and the restriction of health risk behavior. Methods Two longitudinal observational studies were performed simultaneously, one focusing on fruit consumption (N = 572 and one on high-caloric snack consumption (N = 585 in Dutch adults. Structural equation modeling was used to investigate and compare the predictive value of action planning in both behaviors, correcting for demographics and the influence of motivational factors and past behavior. The nature of the influence of action planning was investigated by testing mediating and moderating effects. Results Action planning was a significant predictor of fruit consumption and restricted snack consumption beyond the influence of motivational factors and past behavior. The strength of the predictive value of action planning did not differ between the two behaviors. Evidence for mediation of the intention - behavior relationship was found for both behaviors. Positive moderating effects of action planning were demonstrated for fruit consumption, indicating that individuals who report high levels of action planning are significantly more likely to translate their intentions into actual behavior. Conclusion The results indicate that the planning of specific preparatory actions predicts the performance of healthy dietary behavior and support the application of self-regulatory planning in both health protective and health

  15. Perceptions of the population and health professionals regarding visceral leishmaniasis.

    Science.gov (United States)

    Carmo, Rose Ferraz; da Luz, Zélia Maria Profeta; Bevilacqua, Paula Dias

    2016-02-01

    Based on theoretical qualitative research reference methodology, this study sought to investigate the perception of visceral leishmaniasis (VL) by social actors directly involved in the prevention and control of the disease. Thirty-eight semi-structured interviews were conducted with residents, focus groups were staged with 18 health workers in an endemic VL area and depositions were collected, which after being processed by content analysis revealed shortcomings and challenges. The population associated VL with dogs, acknowledged their co-responsibility in tackling the disease and demanded information. Health workers identified environmental sanitation as an essential factor for VL prevention. Among the shortcomings, the lack of information about the disease and culpability of the individual because of non-adherence to prevention measures were observed, especially environmental management. Probably, approaches emphasizing the role of the environment as a health promotion agent and the timely definition of specific environmental measures against VL, constitute a prospect for overcoming these shortcomings. The consensus is that the main challenge for enhancing the prevention and control might be the participatory and dialogical construction of these approaches between health professionals and the population.

  16. Salubridad Chicana: Su Preservacion Y Mantenimiento -- The Chicano Plan for Mental Health.

    Science.gov (United States)

    Duran, Ruben, Ed.; And Others

    In devising the mental health plan for Chicanos, the social, economic, and political forces that adversely affect their emotional well-being must be considered. While defining mental health needs and proposing ways to meet those needs, the cultural background of the Chicano people must seriously be considered. The plan should stress the importance…

  17. On the importance of planned health education: Prevention of ski injury as an example

    NARCIS (Netherlands)

    Kok, G.; Bouter, L. M.

    1990-01-01

    The planning of health education aimed at preventing sports injuries is often incomplete and not stated explicitly. In most instances, the evaluation is incomplete or nonexistent. We present a theoretical framework for planning and evaluating health education, illustrating the main points by using

  18. 77 FR 31513 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Science.gov (United States)

    2012-05-29

    ...; Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers; Correction AGENCY... of Exchanges and Qualified Health Plans; Exchange Standards for Employers.'' DATES: Effective Date... Sec. 155.205(b), respectively, which are the provisions discussing the Exchange call center and Web...

  19. Using a 401(h) account to fund retiree health benefits from your pension plan.

    Science.gov (United States)

    Lee, David; Singerman, Eduardo

    2003-06-01

    If a health and welfare plan covering retirees faces financial shortfalls, administrators and trustees can fund retiree health benefit payments from a related pension plan that may be in better condition. This method is legal and ethical, but it requires sophisticated accounting techniques for creating an account that provides retiree members with promised benefits while meeting statutory and regulatory requirements.

  20. The Highland Park Environmental Health Plan: Evaluation and Recommendations for Improving the Urban Environment.

    Science.gov (United States)

    Michigan State Dept. of Commerce, Lansing. Community Planning Div.

    The Highland Park environmental health plan includes the following components: Legal and administrative and programmatic relationships, planning studies, residential environment, disease vector control, water and sewage systems, sanitation, air pollution, food protection, industrial and radiological health, and solid waste facilities. (JR)

  1. 41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service...

  2. Health Plans Can't Ignore The Customer Experience Any Longer.

    Science.gov (United States)

    Swanson, Erik

    2017-10-01

    With regulations limiting differentiation between products, health plans must rethink consumer experience to meet expectations of today's consumers, who seek convenience, quality, and speed from their health care organizations. Many plans understand they need to connect more effectively with their end customers, but technological, cultural, and other obstacles are in the way.

  3. 20 CFR 1002.165 - How does the employee elect continuing health plan coverage?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How does the employee elect continuing health plan coverage? 1002.165 Section 1002.165 Employees' Benefits OFFICE OF THE ASSISTANT SECRETARY FOR... elect continuing health plan coverage? USERRA does not specify requirements for electing continuing...

  4. Linking a Population Biobank with National Health Registries—The Estonian Experience

    Directory of Open Access Journals (Sweden)

    Liis Leitsalu

    2015-04-01

    Full Text Available The Estonian population-based biobank, with 52,000 participants’ genetic and health data, is the largest epidemiological cohort in the Baltic region. Participants were recruited through a network of medical professionals throughout Estonia (population 1.34 million. Unique legislation as well as a broad consent form give the Estonian Genome Center, a research institute of the University of Tartu, permission to re-contact participants and to retrieve participants’ data from national registries and databases. In addition to two re-contacting projects to update the health data of participants, extensive clinical characterizations have been retrieved from national registries and hospital databases regularly since 2010. Acquiring data from electronic health records and registries has provided a means to update and enhance the database of the Genome Center in a timely manner and at low cost. The resulting database allows a wide spectrum of genomic and epidemiological research to be conducted with the aim of benefitting public health. Future plans include linking the genome center database with the national health information system through X-road and exchanging data in real time, as well as using the genetic data and the technical infrastructure available for piloting personalized medicine in Estonia.

  5. Linking a population biobank with national health registries-the estonian experience.

    Science.gov (United States)

    Leitsalu, Liis; Alavere, Helene; Tammesoo, Mari-Liis; Leego, Erkki; Metspalu, Andres

    2015-04-16

    The Estonian population-based biobank, with 52,000 participants' genetic and health data, is the largest epidemiological cohort in the Baltic region. Participants were recruited through a network of medical professionals throughout Estonia (population 1.34 million). Unique legislation as well as a broad consent form give the Estonian Genome Center, a research institute of the University of Tartu, permission to re-contact participants and to retrieve participants' data from national registries and databases. In addition to two re-contacting projects to update the health data of participants, extensive clinical characterizations have been retrieved from national registries and hospital databases regularly since 2010. Acquiring data from electronic health records and registries has provided a means to update and enhance the database of the Genome Center in a timely manner and at low cost. The resulting database allows a wide spectrum of genomic and epidemiological research to be conducted with the aim of benefitting public health. Future plans include linking the genome center database with the national health information system through X-road and exchanging data in real time, as well as using the genetic data and the technical infrastructure available for piloting personalized medicine in Estonia.

  6. Experts' Perspectives Toward a Population Health Approach for Children With Medical Complexity.

    Science.gov (United States)

    Barnert, Elizabeth S; Coller, Ryan J; Nelson, Bergen B; Thompson, Lindsey R; Chan, Vincent; Padilla, Cesar; Klitzner, Thomas S; Szilagyi, Moira; Chung, Paul J

    2017-08-01

    Because children with medical complexity (CMC) display very different health trajectories, needs, and resource utilization than other children, it is unclear how well traditional conceptions of population health apply to CMC. We sought to identify key health outcome domains for CMC as a step toward determining core health metrics for this distinct population of children. We conducted and analyzed interviews with 23 diverse national experts on CMC to better understand population health for CMC. Interviewees included child and family advocates, health and social service providers, and research, health systems, and policy leaders. We performed thematic content analyses to identify emergent themes regarding population health for CMC. Overall, interviewees conveyed that defining and measuring population health for CMC is an achievable, worthwhile goal. Qualitative themes from interviews included: 1) CMC share unifying characteristics that could serve as the basis for population health outcomes; 2) optimal health for CMC is child specific and dynamic; 3) health of CMC is intertwined with health of families; 4) social determinants of health are especially important for CMC; and 5) measuring population health for CMC faces serious conceptual and logistical challenges. Experts have taken initial steps in defining the population health of CMC. Population health for CMC involves a dynamic concept of health that is attuned to individual, health-related goals for each child. We propose a framework that can guide the identification and development of population health metrics for CMC. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  7. A model linking clinical workforce skill mix planning to health and health care dynamics.

    Science.gov (United States)

    Masnick, Keith; McDonnell, Geoff

    2010-04-30

    In an attempt to devise a simpler computable tool to assist workforce planners in determining what might be an appropriate mix of health service skills, our discussion led us to consider the implications of skill mixing and workforce composition beyond the 'stock and flow' approach of much workforce planning activity. Taking a dynamic systems approach, we were able to address the interactions, delays and feedbacks that influence the balance between the major components of health and health care. We linked clinical workforce requirements to clinical workforce workload, taking into account the requisite facilities, technologies, other material resources and their funding to support clinical care microsystems; gave recognition to productivity and quality issues; took cognisance of policies, governance and power concerns in the establishment and operation of the health care system; and, going back to the individual, gave due attention to personal behaviour and biology within the socio-political family environment. We have produced the broad endogenous systems model of health and health care which will enable human resource planners to operate within real world variables. We are now considering the development of simple, computable national versions of this model.

  8. A model linking clinical workforce skill mix planning to health and health care dynamics

    Directory of Open Access Journals (Sweden)

    McDonnell Geoff

    2010-04-01

    Full Text Available Abstract Background In an attempt to devise a simpler computable tool to assist workforce planners in determining what might be an appropriate mix of health service skills, our discussion led us to consider the implications of skill mixing and workforce composition beyond the 'stock and flow' approach of much workforce planning activity. Methods Taking a dynamic systems approach, we were able to address the interactions, delays and feedbacks that influence the balance between the major components of health and health care. Results We linked clinical workforce requirements to clinical workforce workload, taking into account the requisite facilities, technologies, other material resources and their funding to support clinical care microsystems; gave recognition to productivity and quality issues; took cognisance of policies, governance and power concerns in the establishment and operation of the health care system; and, going back to the individual, gave due attention to personal behaviour and biology within the socio-political family environment. Conclusion We have produced the broad endogenous systems model of health and health care which will enable human resource planners to operate within real world variables. We are now considering the development of simple, computable national versions of this model.

  9. Telemedicine in the Malaysian Multimedia Super Corridor: towards personalized lifetime health plans.

    Science.gov (United States)

    Abidi, S S; Yusoff, Z

    1999-01-01

    The Malaysian Telemedicine initiative advocates a paradigm shift in healthcare delivery patterns by way of implementing a person-centred and wellness-focused healthcare system. This paper introduces the Malaysian Telemedicine vision, its functionality and associated operational conditions. In particular, we focus on the conceptualisation of one key Telemedicine component i.e. the Lifetime Health Plan (LHP) system--a distributed multimodule application for the periodic monitoring and generation of health-care advisories for all Malaysians. In line with the LHP project, we present an innovative healthcare delivery info-structure--LifePlan--that aims to provide life-long, pro-active, personalised, wellness-oriented healthcare services to assist individuals to manage and interpret their health needs. Functionally, LifePlan based healthcare services are delivered over the WWW, packaged as Personalised Lifetime Health Plans that allow individuals to both monitor their health status and to guide them in healthcare planning.

  10. Community Characteristics and Qualified Health Plan Selection during the First Open Enrollment Period.

    Science.gov (United States)

    Boudreaux, Michel; Blewett, Lynn A; Fried, Brett; Hempstead, Katherine; Karaca-Mandic, Pinar

    2017-06-01

    To examine state and community factors that contributed to geographic variation in qualified health plan selection during the first open enrollment period. Administrative data on qualified health plan selections at the ZIP code area merged with survey estimates from the American Community Survey. Descriptive and regression analyses. Data were generated by healthcare.gov and from a household survey. Thirty-one percent of the variation in qualified health plan selection ratios resulted from between-state differences, and the rest was driven by local area differences. Education, language, age, gender, and the ethnic composition of communities contributed to disparate levels of plan selection. Medicaid expansion states had a qualified health plan selection ratio that was 4.4 points lower than non-Medicaid expansion states, controlling for covariates. Our results suggest community-level differences in the intensity or receptiveness to outreach and enrollment activities during the first open enrollment period. © Health Research and Educational Trust.

  11. Strategies for expanding health insurance coverage in vulnerable populations

    Science.gov (United States)

    Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue

    2014-01-01

    Background Health insurance has the potential to improve access to health care and protect people from the financial risks of diseases. However, health insurance coverage is often low, particularly for people most in need of protection, including children and other vulnerable populations. Objectives To assess the effectiveness of strategies for expanding health insurance coverage in vulnerable populations. Search methods We searched Cochrane Central Register of Controlled Trials (CENTRAL), part of The Cochrane Library. www.thecochranelibrary.com (searched 2 November 2012), PubMed (searched 1 November 2012), EMBASE (searched 6 July 2012), Global Health (searched 6 July 2012), IBSS (searched 6 July 2012), WHO Library Database (WHOLIS) (searched 1 November 2012), IDEAS (searched 1 November 2012), ISI-Proceedings (searched 1 November 2012),OpenGrey (changed from OpenSIGLE) (searched 1 November 2012), African Index Medicus (searched 1 November 2012), BLDS (searched 1 November 2012), Econlit (searched 1 November 2012), ELDIS (searched 1 November 2012), ERIC (searched 1 November 2012), HERDIN NeON Database (searched 1 November 2012), IndMED (searched 1 November 2012), JSTOR (searched 1 November 2012), LILACS(searched 1 November 2012), NTIS (searched 1 November 2012), PAIS (searched 6 July 2012), Popline (searched 1 November 2012), ProQuest Dissertation &Theses Database (searched 1 November 2012), PsycINFO (searched 6 July 2012), SSRN (searched 1 November 2012), Thai Index Medicus (searched 1 November 2012), World Bank (searched 2 November 2012), WanFang (searched 3 November 2012), China National Knowledge Infrastructure (CHKD-CNKI) (searched 2 November 2012). In addition, we searched the reference lists of included studies and carried out a citation search for the included studies via Web of Science to find other potentially relevant studies. Selection criteria Randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA

  12. Urban and Transport Planning Related Exposures and Mortality: A Health Impact Assessment for Cities.

    Science.gov (United States)

    Mueller, Natalie; Rojas-Rueda, David; Basagaña, Xavier; Cirach, Marta; Cole-Hunter, Tom; Dadvand, Payam; Donaire-Gonzalez, David; Foraster, Maria; Gascon, Mireia; Martinez, David; Tonne, Cathryn; Triguero-Mas, Margarita; Valentín, Antònia; Nieuwenhuijsen, Mark

    2017-01-01

    By 2050, nearly 70% of the global population is projected to live in urban areas. Because the environments we inhabit affect our health, urban and transport designs that promote healthy living are needed. We estimated the number of premature deaths preventable under compliance with international exposure recommendations for physical activity (PA), air pollution, noise, heat, and access to green spaces. We developed and applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) tool to Barcelona, Spain. Exposure estimates and mortality data were available for 1,357,361 residents. We compared recommended with current exposure levels. We quantified the associations between exposures and mortality and calculated population attributable fractions to estimate the number of premature deaths preventable. We also modeled life-expectancy and economic impacts. We estimated that annually, nearly 20% of mortality could be prevented if international recommendations for performance of PA; exposure to air pollution, noise, and heat; and access to green space were followed. Estimations showed that the greatest portion of preventable deaths was attributable to increases in PA, followed by reductions of exposure to air pollution, traffic noise, and heat. Access to green spaces had smaller effects on mortality. Compliance was estimated to increase the average life expectancy by 360 (95% CI: 219, 493) days and result in economic savings of 9.3 (95% CI: 4.9, 13.2) billion EUR/year. PA factors and environmental exposures can be modified by changes in urban and transport planning. We emphasize the need for a) the reduction of motorized traffic through the promotion of active and public transport and b) the provision of green infrastructure, both of which are suggested to provide opportunities for PA and for mitigation of air pollution, noise, and heat. Citation: Mueller N, Rojas-Rueda D, Basagaña X, Cirach M, Cole-Hunter T, Dadvand P, Donaire-Gonzalez D, Foraster M

  13. Measuring Sexual and Gender Minority Populations in Health Surveillance

    Science.gov (United States)

    Jabson, Jennifer M.; Bowen, Deborah J.

    2017-01-01

    Abstract Purpose: Sexual and gender minorities (SGMs) are underrepresented and information about SGMs is difficult to locate in national health surveillance data, and this limits identification and resolution of SGM health disparities. It is also not known how measures of sexual orientation and transgender-inclusive gender identity in health surveillance compare with best practice recommendations. This article reviews and summarizes the publicly available, English language, large-scale, rigorously sampled, national, international, and regional data sources that include sexual orientation or transgender-inclusive gender identity and compares measures with best practice guidelines. Methods: A systematic review was undertaken of national, international, state, and regional health surveillance data sources. Data sources that measured sexual orientation or transgender-inclusive gender identity and met seven inclusion criteria were included. Results: Forty-three publicly accessible national, international, and regional data sources included measures of sexual orientation and transgender-inclusive gender identity and health. For each data source, sampling design, sample characteristics, study years, survey questions, contact persons, and data access links are provided. Few data sources met best practice recommendations for SGM measurement: 14% measured all three dimensions of sexual orientation (identity, behavior, attraction) as recommended by the Sexual Minority Assessment Research Team. No data sources measured transgender-inclusive gender identity according to the Gender Identity in U.S. Surveillance-recommended two-step method of measuring sex assigned at birth and current gender identity. Conclusions: This article provides a much needed detailed summary of extant health surveillance data sources that can be used to inform research about health risks and disparities among SGM populations. Future recommendations are for more rigorous measurement and oversampling to

  14. Measuring Sexual and Gender Minority Populations in Health Surveillance.

    Science.gov (United States)

    Patterson, Joanne G; Jabson, Jennifer M; Bowen, Deborah J

    2017-04-01

    Sexual and gender minorities (SGMs) are underrepresented and information about SGMs is difficult to locate in national health surveillance data, and this limits identification and resolution of SGM health disparities. It is also not known how measures of sexual orientation and transgender-inclusive gender identity in health surveillance compare with best practice recommendations. This article reviews and summarizes the publicly available, English language, large-scale, rigorously sampled, national, international, and regional data sources that include sexual orientation or transgender-inclusive gender identity and compares measures with best practice guidelines. A systematic review was undertaken of national, international, state, and regional health surveillance data sources. Data sources that measured sexual orientation or transgender-inclusive gender identity and met seven inclusion criteria were included. Forty-three publicly accessible national, international, and regional data sources included measures of sexual orientation and transgender-inclusive gender identity and health. For each data source, sampling design, sample characteristics, study years, survey questions, contact persons, and data access links are provided. Few data sources met best practice recommendations for SGM measurement: 14% measured all three dimensions of sexual orientation (identity, behavior, attraction) as recommended by the Sexual Minority Assessment Research Team. No data sources measured transgender-inclusive gender identity according to the Gender Identity in U.S. Surveillance-recommended two-step method of measuring sex assigned at birth and current gender identity. This article provides a much needed detailed summary of extant health surveillance data sources that can be used to inform research about health risks and disparities among SGM populations. Future recommendations are for more rigorous measurement and oversampling to advance what is known about SGM health disparities

  15. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

  16. Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations.

    Science.gov (United States)

    Anderson, Laurie M; Adeney, Kathryn L; Shinn, Carolynne; Safranek, Sarah; Buckner-Brown, Joyce; Krause, L Kendall

    2015-06-15

    Racial and ethnic disparities in health status are pervasive at all stages of the life cycle. One approach to reducing health disparities involves mobilizing community coalitions that include representatives of target populations to plan and implement interventions for community level change. A systematic examination of coalition-led interventions is needed to inform decision making about the use of community coalition models. To assess effects of community coalition-driven interventions in improving health status or reducing health disparities among racial and ethnic minority populations. We searched MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Social Science Citation Index, Dissertation Abstracts, System for Information on Grey Literature in Europe (SIGLE) (from January 1990 through September 30, 2013), and Global Health Library (from January 1990 through March 31, 2014). Cluster-randomized controlled trials, randomized controlled trials, quasi-experimental designs, controlled before-after studies, interrupted time series studies, and prospective controlled cohort studies. Only studies of community coalitions with at least one racial or ethnic minority group representing the target population and at least two community public or private organizations are included. Major outcomes of interest are direct measures of health status, as well as lifestyle factors when evidence indicates that these have an effect on the direct measures performed. Two review authors independently extracted data and assessed risk of bias for each study. Fifty-eight community coalition-driven intervention studies were included. No study was considered to be at low risk of bias. Behavioral change outcomes and health status change outcomes were analyzed separately. Outcomes are grouped by intervention type. Pooled effects across intervention types are not presented because the diverse

  17. National Surveys of Population Health: Big Data Analytics for Mobile Health Monitors.

    Science.gov (United States)

    Schatz, Bruce R

    2015-12-01

    At the core of the healthcare crisis is fundamental lack of actionable data. Such data could stratify individuals within populations to predict which persons have which outcomes. If baselines existed for all variations of all conditions, then managing health could be improved by matching the measuring of individuals to their cohort in the population. The scale required for complete baselines involves effective National Surveys of Population Health (NSPH). Traditionally, these have been focused upon acute medicine, measuring people to contain the spread of epidemics. In recent decades, the focus has moved to chronic conditions as well, which require smaller measures over longer times. NSPH have long utilized quality of life questionnaires. Mobile Health Monitors, where computing technologies eliminate manual administration, provide richer data sets for health measurement. Older technologies of telephone interviews will be replaced by newer technologies of smartphone sensors to provide deeper individual measures at more frequent timings across larger-sized populations. Such continuous data can provide personal health records, supporting treatment guidelines specialized for population cohorts. Evidence-based medicine will become feasible by leveraging hundreds of millions of persons carrying mobile devices interacting with Internet-scale services for Big Data Analytics.

  18. [Design of the general population study NEMESIS-2: Netherlands Mental Health Survey and Incidence Study-2].

    Science.gov (United States)

    de Graaf, Ron; Ten Have, Margreet; van Dorsselaer, Saskia

    2012-01-01

    The longitudinal epidemiological population study NEMESIS-2 (Netherlands Mental Health Survey and Incidence Study-2) replicates the first study conducted from 1996 to 1999, and expands it by adding new subjects such as impulse-control disorders. To describe the aims and design of nemesis-2, particularly of its first round of measurements, to provide up-to-date figures on prevalence, incidence, course and consequences of mental disorders and associated factors, and to study trends in the mental health of the population aged 18-64 years and the use these people make of psychiatric services. Face-to-face interviews were conducted (November 2007-July 2009) by means of the Composite International Diagnostic Interview 3.0. The response was 65.1% (n = 6646). Respondents were reasonably representative for the population, but young persons were somewhat underrepresented. Two follow-up rounds of measurements are planned with three-year intervals between the rounds. The second round of measurements began in November 2010. A qualitatively good dataset was built up. This will allow several mental health topics to be studied in the future.

  19. Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa?

    Directory of Open Access Journals (Sweden)

    Barthélémy Kuate Defo

    2014-05-01

    Full Text Available Background: Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. Objective: The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Results: Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1 theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2 simple summary indicators that can be used to evaluate their descriptive and predictive features; 3 marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4 the rapid decline in infant

  20. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior.

    Science.gov (United States)

    Akulume, Martha; Kiwanuka, Suzanne N

    2016-01-01

    Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation). Results. For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers' segregation behavior, but intention emerged as the strongest and most significant (r = 0.524, P theory of planned behavior model explained 52.5% of the variance in health workers' segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion. Generally, health workers' health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers' health care waste segregation behaviors.

  1. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Martha Akulume

    2016-01-01

    Full Text Available Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation. Results. For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers’ segregation behavior, but intention emerged as the strongest and most significant (r=0.524, P<0.001. The theory of planned behavior model explained 52.5% of the variance in health workers’ segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion. Generally, health workers’ health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers’ health care waste segregation behaviors.

  2. Land use, transport, and population health: estimating the health benefits of compact cities.

    Science.gov (United States)

    Stevenson, Mark; Thompson, Jason; de Sá, Thiago Hérick; Ewing, Reid; Mohan, Dinesh; McClure, Rod; Roberts, Ian; Tiwari, Geetam; Giles-Corti, Billie; Sun, Xiaoduan; Wallace, Mark; Woodcock, James

    2016-12-10

    Using a health impact assessment framework, we estimated the population health effects arising from alternative land-use and transport policy initiatives in six cities. Land-use changes were modelled to reflect a compact city in which land-use density and diversity were increased and distances to public transport were reduced to produce low motorised mobility, namely a modal shift from private motor vehicles to walking, cycling, and public transport. The modelled compact city scenario resulted in health gains for all cities (for diabetes, cardiovascular disease, and respiratory disease) with overall health gains of 420-826 disability-adjusted life-years (DALYs) per 100 000 population. However, for moderate to highly motorised cities, such as Melbourne, London, and Boston, the compact city scenario predicted a small increase in road trauma for cyclists and pedestrians (health loss of between 34 and 41 DALYs per 100 000 population). The findings suggest that government policies need to actively pursue land-use elements-particularly a focus towards compact cities-that support a modal shift away from private motor vehicles towards walking, cycling, and low-emission public transport. At the same time, these policies need to ensure the provision of safe walking and cycling infrastructure. The findings highlight the opportunities for policy makers to positively influence the overall health of city populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Health Needs Assessment of Plain Populations in Lancaster County, Pennsylvania.

    Science.gov (United States)

    Miller, Kirk; Yost, Berwood; Abbott, Christina; Thompson, Scottie; Dlugi, Emily; Adams, Zachary; Schulman, Meryl; Strauss, Nicole

    2017-02-01

    We performed a health needs assessment for three Plain communities in Lancaster County, Pennsylvania from a random sample of households. Compared with the general population of adults, Plain respondents were more likely to be married, to have children, and they had large families; they were more likely to drink well water, to eat fruit and vegetables, to drink raw milk, and to live on a farm. Plain respondents had better physical and mental health and were less likely to have been diagnosed with various medical conditions compared with the general population of adults in Lancaster County but Old Order Mennonite respondents were more likely to have been diagnosed compared with Old Order Amish respondents. Plain respondents usually have a regular doctor and often receive preventive care but Old Order Mennonite respondents were more likely to have a regular doctor, to receive preventive care, to have had their children vaccinated, and to receive routine dental care compared with Old Order Amish respondents. Despite their relative geographic and genetic isolation, and despite the small, relative differences noted, the health of Plain communities in Lancaster County is similar to that of other adults in the County.

  4. Self-perception of oral health in older adults from an urban population in Lisbon, Portugal

    Directory of Open Access Journals (Sweden)

    Catarina Carvalho

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To analyze if the self-perception of oral health in the urban context is associated with sociodemographic factors that interfere in the life quality of oral health. METHODS Cross-sectional study with convenience sample of older individuals (65 years old or more enrolled in the Agrupamento de Centros de Saúde de Lisboa Norte (ACES Lisboa Norte – Health Centers Groupings North Lisbon. The self-perception of oral health and associated life quality was evaluated by the Geriatric Oral Health Assessment Index and the individuals were classified according to sociodemographic characteristics. The internal consistency of the questionnaire was evaluated by Cronbach’s alpha (α. Later, we used binary logistic regression models to characterize the factors associated with the self-perception of oral health, considering the sociodemographic variables and the older adults’ clinical conditions of oral health and establishing the crude and adjusted (to age odds ratios and their 90% confidence intervals. RESULTS A total of 369 older adults participated in this study, with an average age of 74.2 years (SD = 6.75; 62.9% were female. On average, the index was moderated, with tendency to be high: 32.9 (SD = 3.6; 12-36 interval. The Cronbach’s alpha was high: 0.805. Age, marital status, and the last dental appointment were the factors significantly associated with self-perception of oral health. CONCLUSIONS The study shows that these individuals have a moderate, with tendency to high, self-perception of oral health. The self-perception of oral health assessment allowed us to identify the main associated sociodemographic factors. This instrument can help guiding planning strategies and oral health promotion directed toward a better life quality for this population group.

  5. Family planning in contermporary reproductive health and rights ...

    African Journals Online (AJOL)

    Family planning has profound sexual and reproductive rights implications which have been recognised over the years at several international conferences. Access to family planning is a major approach to maternal mortality reduction. Social and political factors, such as religion and politically-motivated funding restrictions ...

  6. Successful business process design. Business plan development for the occupational health services unit.

    Science.gov (United States)

    Kalina, C M; Fitko, J

    1997-02-01

    1. The occupational health nurse is often mandated by management to validate health services offered and programs developed for employees as valuable to the business and company mission. 2. The business plan of the occupational health service is a working document, changing as needs of the client/customer and internal and external business and socio-economic environment evolve. 3. Alignment with and support of the company mission, goals, and objectives is another method of proving good occupational health is good business. 4. Business planning is a basic business tool the wise and prudent occupational health nurse can use in proving good occupational health is vital to the success of a company.

  7. The level of health education in the Polish population.

    Science.gov (United States)

    Olszanecka-Glinianowicz, Magdalena; Chudek, Jerzy

    2013-01-01

    The study assessed factors influencing awareness of Poles concerning lifestyle factors that affect development of obesity, type 2 diabetes and cardiovascular diseases (CVD). A questionnaire survey covering awareness of lifestyle factors performed by general practitioners in 37,557 unselected patients. 96.1% of respondents believed that lifestyle has an impact on the occurrence of CVDs, especially: tobacco smoking (91.4%), excessive intake of fat (81.3%), alcohol (67.5%), salt (64.9%), and stress (64.9%). 79.0% respondents believed the smoking cessation, 77.5% weight loss and 66.8% healthy diet are most important to prevent diseases. Additionally, the belief in the need for an early weight reduction decreased with increasing BMI (82.9% with normal weight vs. 77.5% overweight and 70.4% obese). The most common source of health education was a physician (75.8%), the mass media, such as television and the press (62.0% and 64.8%, respectively), less often were educational materials (37.8%) and books (20.3 %), the Internet (3.8%) and radio (0.8%). Younger respondents presented a higher level of awareness about all analysed aspects of healthy lifestyle. The multiple regression analysis revealed that low education level and rural residence are the most important factors decreasing awareness of the lifestyle effect on health. 1. The level of knowledge about non-pharmacological methods of preventing lifestyle diseases in the Polish population is high except of the role of physical activity and daily vegetables consumption. This, however, has no impact on reducing the percentage of overweight and obese people and on increasing the tendency to pursue lifestyle changes. 2. Frustrating is the fact that more than one fifth of the study population is unaware that excessive weight reduction prevents development of cardiovascular diseases. Moreover, the convince to early weight decreases with increasing BMI. 3. The highest level of the knowledge among younger subjects reflect

  8. 76 FR 46621 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Science.gov (United States)

    2011-08-03

    ...-AQ07 Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under... the Patient Protection and Affordable Care Act regarding preventive health services. DATES: Effective... effect a rating of A or B in the current recommendations of the United States Preventive Services Task...

  9. Barriers to quality health care for the transgender population.

    Science.gov (United States)

    Roberts, Tiffany K; Fantz, Corinne R

    2014-07-01

    The transgender community is arguably the most marginalized and underserved population in medicine. A special issue focusing on men's health would be incomplete without mention of this vulnerable population, which includes those transitioning to and from the male gender. Transgender patients face many barriers in their access to healthcare including historical stigmatization, both structural and financial barriers, and even a lack of healthcare provider experience in treating this unique population. Historical stigmatization fosters a reluctance to disclose gender identity, which can have dire consequences for long-term outcomes due to a lack of appropriate medical history including transition-related care. Even if a patient is willing to disclose their gender identity and transition history, structural barriers in current healthcare settings lack the mechanisms necessary to collect and track this information. Moreover, healthcare providers acknowledge that information is lacking regarding the unique needs and long-term outcomes for transgender patients, which contributes to the inability to provide appropriate care. All of these barriers must be recognized and addressed in order to elevate the quality of healthcare delivered to the transgender community to a level commensurate with the general population. Overcoming these barriers will require redefinition of our current system such that the care a patient receives is not exclusively linked to their sex but also considers gender identity. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  10. Pet ownership and adolescent health: cross-sectional population study.

    Science.gov (United States)

    Mathers, Megan; Canterford, Louise; Olds, Tim; Waters, Elizabeth; Wake, Melissa

    2010-12-01

    To determine whether adolescent health and well-being are associated with having a pet in the household (any pet, or specifically dogs, cats or horses/ponies) or average daily time spent caring for/playing with pet(s). Design, setting and participants--Cross-sectional data from the third wave of the Health of Young Victorians Study (HOYVS), a school-based population study in Victoria, Australia. Predictors--Adolescent-reported pet ownership and average daily time spent caring for/playing with pet(s). Outcomes--Self-reported quality of life (KIDSCREEN); average 4-day daily physical activity level from a computerised diary; parent-proxy and self-reported physical and psychosocial health status (PedsQL); measured BMI status (not overweight, overweight, obese) and blood pressure. Statistical Analysis--Regression methods, adjusted for socio-demographic factors, and non-parametric methods. Household pet data were available for 928 adolescents (466 boys; mean age of 15.9 (SD 1.2) years). Most adolescents (88.7%) reported having a pet in their household. Of these, 75.1% reported no activity involving pets over the surveyed days. It appeared that neither owning a pet nor time spent caring for/playing with a pet was related, positively or negatively, to adolescent health or well-being. Despite high rates of pet ownership, adolescents had little interaction with pets. It appears that owning a pet and time spent caring for/playing with a pet was not clearly associated with adolescents' health or well-being. © 2010 The Authors. Journal of Paediatrics and Child Health © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  11. Identifying unique neighborhood characteristics to guide health planning for stroke and heart attack: fuzzy cluster and discriminant analyses approaches.

    Directory of Open Access Journals (Sweden)

    Ashley Pedigo

    Full Text Available BACKGROUND: Socioeconomic, demographic, and geographic factors are known determinants of stroke and myocardial infarction (MI risk. Clustering of these factors in neighborhoods needs to be taken into consideration during planning, prioritization and implementation of health programs intended to reduce disparities. Given the complex and multidimensional nature of these factors, multivariate methods are needed to identify neighborhood clusters of these determinants so as to better understand the unique neighborhood profiles. This information is critical for evidence-based health planning and service provision. Therefore, this study used a robust multivariate approach to classify neighborhoods and identify their socio-demographic characteristics so as to provide information for evidence-based neighborhood health planning for stroke and MI. METHODS AND FINDINGS: The study was performed in East Tennessee Appalachia, an area with one of the highest stroke and MI risks in USA. Robust principal component analysis was performed on neighborhood (census tract socioeconomic and demographic characteristics, obtained from the US Census, to reduce the dimensionality and influence of outliers in the data. Fuzzy cluster analysis was used to classify neighborhoods into Peer Neighborhoods (PNs based on their socioeconomic and demographic characteristics. Nearest neighbor discriminant analysis and decision trees were used to validate PNs and determine the characteristics important for discrimination. Stroke and MI mortality risks were compared across PNs. Four distinct PNs were identified and their unique characteristics and potential health needs described. The highest risk of stroke and MI mortality tended to occur in less affluent PNs located in urban areas, while the suburban most affluent PNs had the lowest risk. CONCLUSIONS: Implementation of this multivariate strategy provides health planners useful information to better understand and effectively plan for

  12. Transferring health and family planning service innovations to the public sector: an experiment in organization development in Bangladesh.

    Science.gov (United States)

    Phillips, J F; Simmons, R; Simmons, G B; Yunus, M

    1984-01-01

    The International Centre for Diarrhoeal Disease Research, Bangladesh, has launched a field experiment in two rural thanas of Bangladesh to test the transferability of its successful health and family planning experiment in Matlab to the Ministry of Health and Population Control service system. This paper reviews the Matlab experiment with particular attention to its organization and identifies elements for transfer. The intervention strategy and operations research design of the new experiment are discussed. The proposed design follows an organization development strategy in which collaborative diagnostic research is used to foster institutional change.

  13. Patient attributes warranting consideration in clinical practice guidelines, health workforce planning and policy

    Directory of Open Access Journals (Sweden)

    Segal Leonie

    2011-09-01

    Full Text Available Abstract Background In order for clinical practice guidelines (CPGs to meet their broad objective of enhancing the quality of care and supporting improved patient outcomes, they must address the needs of diverse patient populations. We set out to explore the patient attributes that are likely to demand a unique approach to the management of chronic disease, and which are crucial if evidence or services planning is to reflect clinic populations. These were incorporated into a new conceptual framework; using diabetes mellitus as an exemplar. Methods The patient attributes that informed the framework were identified from CPGs, the diabetes literature, an expert academic panel, and two cross-disciplinary panels; and agreed upon using a modified nominal group technique. Results Full consensus was reached on twenty-four attributes. These factors fell into one of three themes: (1 type/stage of disease, (2 morbid events, and (3 factors impacting on capacity to self-care. These three themes were incorporated in a convenient way in the workforce evidence-based (WEB model. Conclusions While biomedical factors are frequently recognised in published clinical practice guidelines, little attention is given to attributes influencing a person's capacity to self-care. Paying explicit attention to predictable threats to effective self-care in clinical practice guidelines, by drawing on the WEB model, may assist in refinements that would address observed disparities in health outcomes across socio-economic groups. The WEB model also provides a framework to inform clinical training, and health services and workforce planning and research; including the assessment of healthcare needs, and the allocation of healthcare resources.

  14. Mental health consultations in a prison population: a descriptive study

    Directory of Open Access Journals (Sweden)

    Rustad Aase-Bente

    2006-06-01

    Full Text Available Abstract Background The psychiatric morbidity among prison inmates is substantially higher than in the general population. We do, however, have insufficient knowledge about the extent of psychiatric treatment provided in our prisons. The aim of the present study was to give a comprehensive description of all non-pharmacological interventions provided by the psychiatric health services to a stratified sample of prison inmates. Methods Six medium/large prisons (n = 928 representing 1/3 of the Norwegian prison population and with female and preventive detention inmates over-sampled, were investigated cross-sectionally. All non-pharmacological psychiatric interventions, excluding pure correctional programs, were recorded. Those receiving interventions were investigated further and compared to the remaining prison population. Results A total of 230 of the 928 inmates (25 % had some form of psychiatric intervention: 184 (20 % were in individual psychotherapy, in addition 40 (4 % received ad hoc interventions during the registration week. Group therapy was infrequent (1 %. The psychotherapies were most often of a supportive (62 % or behavioural-cognitive (26 % nature. Dynamic, insight-oriented psychotherapies were infrequent (8 %. Concurrent psychopharmacological treatment was prevalent (52 %. Gender and age did not correlate with psychiatric interventions, whereas prisoner category (remanded, sentenced, or preventive detention did (p Conclusion Our results pertain only to prisons with adequate primary and mental health services and effective diversion from prison of individuals with serious mental disorders. Given these important limitations, we do propose that the service estimates found may serve as a rough guideline to the minimum number of sessions a prison's psychiatric health services should be able to fulfil in order to serve the inmates psychiatric needs. The results rely on the specialist services' own estimates only. Future studies should

  15. Public Health, Population Health, and Epidemiology Informatics: Recent Research and Trends in the United States.

    Science.gov (United States)

    Massoudi, B L; Chester, K G

    2017-08-01

    Objectives: To survey advances in public and population health and epidemiology informatics over the past 18 months. Methods: We conducted a review of English-language research works conducted in the domain of public and population health informatics and published in MEDLINE or Web of Science between January 2015 and June 2016 where information technology or informatics was a primary subject or main component of the study methodology. Selected articles were presented using a thematic analysis based on the 2011 American Medical Informatics Association (AMIA) Public Health Informatics Agenda tracks as a typology. Results: Results are given within the context developed by Dixon et al., (2015) and key themes from the 2011 AMIA Public Health Informatics Agenda. Advances are presented within a socio-technical infrastructure undergirded by a trained, competent public health workforce, systems development to meet the business needs of the practice field, and research that evaluates whether those needs are adequately met. The ability to support and grow the infrastructure depends on financial sustainability. Conclusions: The fields of public health and population health informatics continue to grow, with the most notable developments focused on surveillance, workforce development, and linking to or providing clinical services, which encompassed population health informatics advances. Very few advances addressed the need to improve communication, coordination, and consistency with the field of informatics itself, as identified in the AMIA agenda. This will likely result in the persistence of the silos of public health information systems that currently exist. Future research activities need to aim toward a holistic approach of informatics across the enterprise. Georg Thieme Verlag KG Stuttgart.

  16. Effect of Population Demographics on Strategic Planning in Insurance Industry in Kenya: A Study of Insurance Companies in Nakuru CBD

    OpenAIRE

    Phyllis Njeri; Henry Kombo

    2014-01-01

    The study was conducted to find out the effect of population demographics on strategic planning in insurance companies in Nakuru CBD. A Correlational survey research design was adopted for the study. The target population was all the 21 insurance companies in Nakuru CBD. Census study was conducted for all the 21 Insurance Companies. Primary data was collected using questionnaires. The respondents were managers who are involved in strategic planning in the insurance companies. Data collected w...

  17. Dissemination, Implementation, and Improvement Science Research in Population Health: Opportunities for Public Health and CTSAs.

    Science.gov (United States)

    Kuo, Tony; Gase, Lauren N; Inkelas, Moira

    2015-12-01

    The complex, dynamic nature of health systems requires dissemination, implementation, and improvement (DII) sciences to effectively translate emerging knowledge into practice. Although they hold great promise for informing multisector policies and system-level changes, these methods are often not strategically used by public health. More than 120 stakeholders from Southern California, including the community, federal and local government, university, and health services were convened to identify key priorities and opportunities for public health departments and Clinical and Translational Science Awards programs (CTSAs) to advance DII sciences in population health. Participants identified challenges (mismatch of practice realities with narrowly focused research questions; lack of iterative learning) and solutions (using methods that fit the dynamic nature of the real world; aligning theories of change across sectors) for applying DII science research to public health problems. Pragmatic steps that public health and CTSAs can take to facilitate DII science research include: employing appropriate study designs; training scientists and practicing professionals in these methods; securing resources to advance this work; and supporting team science to solve complex-systems issues. Public health and CTSAs represent a unique model of practice for advancing DII research in population health. The partnership can inform policy and program development in local communities. © 2015 Wiley Periodicals, Inc.

  18. Dissemination, Implementation, and Improvement Science Research in Population Health: Opportunities for Public Health and CTSAs

    Science.gov (United States)

    Gase, Lauren N.; Inkelas, Moira

    2015-01-01

    Abstract Importance The complex, dynamic nature of health systems requires dissemination, implementation, and improvement (DII) sciences to effectively translate emerging knowledge into practice. Although they hold great promise for informing multisector policies and system‐level changes, these methods are often not strategically used by public health. Objectives and Methods More than 120 stakeholders from Southern California, including the community, federal and local government, university, and health services were convened to identify key priorities and opportunities for public health departments and Clinical and Translational Science Awards programs (CTSAs) to advance DII sciences in population health. Main Outcomes Participants identified challenges (mismatch of practice realities with narrowly focused research questions; lack of iterative learning) and solutions (using methods that fit the dynamic nature of the real world; aligning theories of change across sectors) for applying DII science research to public health problems. Pragmatic steps that public health and CTSAs can take to facilitate DII science research include: employing appropriate study designs; training scientists and practicing professionals in these methods; securing resources to advance this work; and supporting team science to solve complex‐systems issues. Conclusions Public health and CTSAs represent a unique model of practice for advancing DII research in population health. The partnership can inform policy and program development in local communities. PMID:26243323

  19. Designing evaluation plans for health promotion mHealth interventions: a case study of the Milk Man mobile app.

    Science.gov (United States)

    White, Becky K; Burns, Sharyn K; Giglia, Roslyn C; Scott, Jane A

    2016-10-26

    Evaluating complex health promotion interventions that use mobile apps requires comprehensive and adaptive evaluation plans. As mobile usage becomes increasingly sophisticated and personalised, broad evaluation plans are important in determining the impact and efficacy of a mobile health (mHealth) app. Evaluation should consider user feedback and outcome measures, as well as examine elements such as the robustness of the technology, the intervention principles and engagement strategies, and the interaction of the user with the technology. This paper introduces four mHealth evaluation models and tools and describes the evaluation plan that has been developed for Milk Man, a breastfeeding app targeting new and expectant fathers. Milk Man is a socially connected, gamified app that is being tested in a large Randomised Control Trial (RCT). While there is a need for mobile apps to be evaluated in adequately powered RCTs, trialling mobile apps over a long period of time presents challenges. Incorporating robust evaluation design will help ensure that technological performance, app intervention principles, as well as health and behavioural outcomes are measured. The detail and scope of the Milk Man app evaluation plan will ensure the findings add to the evidence base and have broad relevance to health promotion practitioners.So what? Evidence about the efficacy of mHealth interventions is an emerging area and appropriate evaluation skills are needed. This paper illustrates an evaluation planning approach for mHealth interventions that could be adapted for use by health promotion practitioners and researchers.

  20. The Primary Care Leadership Track at the Duke University School of Medicine: creating change agents to improve population health.

    Science.gov (United States)

    Sheline, Barbara; Tran, Anh N; Jackson, Joseph; Peyser, Bruce; Rogers, Susan; Engle, Deborah

    2014-10-01

    Physicians need training in community engagement, leadership, and population health to prepare them to work with partners within the community and to adapt medical care to address population health needs. With an overall goal of training primary care practitioners to be change agents for improving population health, the Duke University School of Medicine launched the Primary Care Leadership Track (PCLT) in 2011. The four-year PCLT curriculum requires students to contribute to existing community health initiatives, perform community-engaged research, and participate in leadership training. The clinical curriculum incorporates a longitudinal approach to allow students to follow patient outcomes. In addition, students regularly interact with faculty to explore population health issues, review patient cases, and adjust individual learning opportunities as needed. The first cohort of PCLT students will graduate in 2015. Prospective comparisons with traditional track students are planned on performance on standardized tests and career choices. The authors created the PCLT as a laboratory in which students can engage with the community and explore solutions to address the health of the public and the future delivery of health care. To meet the goal of training change agents, PCLT leaders need to expand opportunities for students to learn from providers and organizations that are successfully bridging the gap between medical care and public health.

  1. Transition Planning for Youth With Special Health Care Needs (YSHCN) in Illinois Schools.

    Science.gov (United States)

    Bargeron, Jodie; Contri, Darcy; Gibbons, Linda J; Ruch-Ross, Holly S; Sanabria, Kathy

    2015-08-01

    "Transition Planning for Youth with Special Health Care Needs (YSHCN)" chronicles the research and work completed by agencies in Illinois to provide examples of best practice in transition planning. Increasing numbers of YSHCN survive into adulthood creating a need for focus on the transition to adult life for these young people, including meeting health care needs. As a part of the Transitions project, the Illinois Chapter of the American Academy of Pediatrics and the University of Illinois at Chicago Division of Special