Podcast
Questions and Answers
What was one of the primary objectives of the Healthy People 2010 initiative?
What was one of the primary objectives of the Healthy People 2010 initiative?
What significant action was mandated by the Affordable Care Act (ACA) regarding minority health?
What significant action was mandated by the Affordable Care Act (ACA) regarding minority health?
Which of the following is NOT one of the three essential public health services as described by the CDC?
Which of the following is NOT one of the three essential public health services as described by the CDC?
What is a key benefit of the Patient-Centered Medical Home (PCMH) model?
What is a key benefit of the Patient-Centered Medical Home (PCMH) model?
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Which initiative was launched in 2011 to specifically address health disparities among racial and ethnic groups?
Which initiative was launched in 2011 to specifically address health disparities among racial and ethnic groups?
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What type of health difference is defined as closely linked with social, economic, and environmental disadvantages?
What type of health difference is defined as closely linked with social, economic, and environmental disadvantages?
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Low-income and minority groups have less access to which of the following?
Low-income and minority groups have less access to which of the following?
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Which policy development activity is part of the essential public health services?
Which policy development activity is part of the essential public health services?
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Which factor contributed to decreasing out-of-pocket expenses as mentioned in the ACA?
Which factor contributed to decreasing out-of-pocket expenses as mentioned in the ACA?
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What role does the Office of Minority Health (OMH) play since its creation?
What role does the Office of Minority Health (OMH) play since its creation?
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What is a key responsibility of FEMA during disaster relief efforts?
What is a key responsibility of FEMA during disaster relief efforts?
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Which act established a National Emergency Family Registry and Locator System?
Which act established a National Emergency Family Registry and Locator System?
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Which of the following challenges affects healthcare provisions in rural settings?
Which of the following challenges affects healthcare provisions in rural settings?
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Which determinant area includes issues like food insecurity and employment?
Which determinant area includes issues like food insecurity and employment?
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What is an important role of nurses in addressing rural health challenges?
What is an important role of nurses in addressing rural health challenges?
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What is a function of the National Response Framework?
What is a function of the National Response Framework?
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Which organization was created in response to the events of September 11, 2001?
Which organization was created in response to the events of September 11, 2001?
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Which aspect is NOT a focus of 'Neighborhood and built environment' determinants?
Which aspect is NOT a focus of 'Neighborhood and built environment' determinants?
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The Pandemic and All-Hazard Preparedness Act focuses on which of the following?
The Pandemic and All-Hazard Preparedness Act focuses on which of the following?
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Which of the following is a responsibility of state or territorial health agencies?
Which of the following is a responsibility of state or territorial health agencies?
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Study Notes
Heckler report and Minority Health
- The Heckler Report (1985) highlighted health disparities in Black and minority populations.
- The report led to the creation of the Office of Minority Health (OMH) within the Department of Health and Human Services (HHS) in 1986.
Healthy People Initiatives
- Healthy People 2010 aimed to eliminate health disparities.
- Healthy People 2020 shifted the focus to achieving health equity.
- The Affordable Care Act (ACA) mandated the establishment of offices of minority health within all HHS agencies.
- The HHS Action Plan to Reduce Racial and Ethnic Health Disparities was launched in 2011.
Health Disparities
- Health disparities are differences in health that are linked to social, economic, and/or environmental disadvantage.
The ACA and Health Disparities
- The ACA has the potential to reduce health disparities by increasing access to coverage and promoting more efficient healthcare delivery models for preventive services and wellness.
- The ACA permanently reauthorized the Indian Health Care Improvement Reauthorization Extension Act, which aims to improve health services for Native Americans.
- The ACA decreased out-of-pocket expenses for many Americans.
Patient-Centered Medical Home (PCMH) Model
- PCMH is a model of care focused on improving outcomes and lowering healthcare costs.
- It is implemented nationwide by the VA.
- Studies show associations between PCMH membership and lower utilization of emergency departments, hospitals, and ambulatory care.
- PCMH membership has been associated with a lower probability of inpatient hospitalization from the emergency department among behavioral health patients.
- PCMH leads to reduced pharmacy spending for those aged 65 and older.
- It also promotes an increased use of advanced practice staff.
- Low-income and minority groups often face challenges accessing PCMH services.
Essential Public Health Services
- The CDC identifies three essential public health services:
- Assessment: This involves public health monitoring, diagnosis, and investigation of health problems.
- Policy Development: It encompasses creating and advocating for policies to improve population health outcomes, informing and educating the public, and developing community partnerships to sustain interventions.
- Assurance: Ensuring policies are implemented and evaluated, enforcing laws and codes, linking to/providing care, and assuring a competent workforce.
Levels of Public Health Services
- Public health services are implemented on various levels, with different responsibilities at each level.
- Local: Focuses on immunization provision, communicable disease surveillance, tuberculosis screening, food service inspection, environmental health surveillance, and school/daycare inspections.
- State/Territorial: Involves disease surveillance, data collection, state lab services, disaster preparedness and response, primary prevention programs, health care services, regulation of licensed professionals, environmental health services, and providing technical assistance and training for partners.
- Federal: Coordinates public health policy and serves as the main repository for public health knowledge and action. Key federal agencies include DHHS, CDC, EPA, HRSA, HIS, NIH, USDA, and FDA.
Disaster Relief Policies
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Stafford Disaster Relief and Emergency Assistance Act (1988): This law provides the foundation for most federal disaster response activities and authorizes FEMA to coordinate relief efforts.
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FEMA: FEMA is responsible for coordinating and conducting disaster relief efforts, working with 28 federal agencies and non-governmental organizations. It emphasizes the importance of preparedness for local and state organizations.
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Post Katrina Emergency Reform Act (PKEMRA) (2006): This legislation was enacted following Hurricane Katrina. It addresses aspects of preparedness, response, and recovery. Key features include:
- Establishing a disability coordinator and developing guidelines to accommodate people with disabilities.
- Establishing the National Emergency Family Registry and Locator System to reunite separated families.
- Providing transportation assistance for those displaced by disasters.
- Coordinating precautionary evacuations and recovery efforts.
- Providing case management assistance to address unmet needs of disaster survivors.
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Homeland Security Act (2002): Passed in response to 9/11, this act created the Department of Homeland Security (DHS) and established Cyber Security.
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Pandemic and All-Hazard Preparedness Act (PHPA) (2006): This act is focused on improving public health and medical preparedness and response capabilities. It mandates the Secretary of HHS to organize a national public health situational awareness communication network.
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National Response Framework (NRF) (2008, 2013): Provides a framework for managing natural and manmade disasters.
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Sandy Recovery Improvement Act (SRIA) (2013): Aimed at reducing costs and improving the effectiveness of disaster assistance programs authorized by the Stafford Act.
Rural Health Care Challenges
- Rural areas face unique challenges in providing healthcare services.
- Demographics: Rural populations have an increasing proportion of older adults and chronically ill individuals.
- Healthcare Workforce: Rural areas often have fewer primary care providers, which can lead to less preventive screening and health education. Fewer opportunities for career advancement and education can make it difficult to attract and retain healthcare providers.
- Work Environment: Rural healthcare workers often face lower staffing ratios, longer shifts, and less flexible work schedules.
- Healthcare Facilities: Rural areas typically have fewer healthcare facilities, leading to longer travel distances for patients.
- Financial Considerations: Rural healthcare providers often earn lower salaries, and their work may be seasonal, making it challenging to maintain a stable income.
- Scope of Practice: State-to-state variations in APRN's scope of practice can limit their ability to provide services in rural areas.
- Privacy Issues: In small rural communities, healthcare providers may encounter challenges maintaining patient privacy due to the close-knit nature of the population.
- Rural Health Problems: Rural residents face higher rates of chronic illness, are less likely to receive annual dental exams, and have increased opioid drug use. Age-adjusted death rates are generally higher in rural areas.
Nurses in Rural Settings
- Nurses play a crucial role in addressing rural healthcare challenges.
- They can volunteer at clinics, join task forces on rural health, and educate children about health issues.
- Only 16% of nurses work in rural areas. Rural nurses tend to be less diverse, less likely to hold bachelor's degrees, and closer to retirement age.
Social Determinants of Health
- Five key areas influence health outcomes:
- Economic Stability: Employment, food security, housing stability, and poverty levels impact health.
- Education: Access to quality education, including early childhood education, higher education, and literacy skills, is crucial for health.
- Social and Community Context: Civic participation, discrimination, incarceration rates, and social cohesion contribute to health outcomes.
- Health and Healthcare: Access to healthcare, primary care services, and health literacy are essential for good health.
- Neighborhood and Built Environment: Access to healthy foods, crime rates, environmental conditions, and quality of housing all impact health.
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Description
This quiz explores the key findings of the Heckler Report and various Healthy People initiatives aimed at addressing health disparities. It discusses the roles of the Affordable Care Act and the Office of Minority Health in promoting health equity among minority populations. Test your understanding of how these historical and legislative efforts aim to reduce health inequalities.
