HAP 445 Final (1)

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George Mason University *

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445

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Health Science

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Dec 6, 2023

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docx

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1. How does the CDC define “social determinants of health?” Explain the force fields in Blum’s model. The CDC defines the social determinants of health as “complex, integrated, and overlapping social structures and economic system that are responsible for most health inequities. These social structures and economic systems include the social environment, the physical environment, health services, and structural and societal factors. They are shaped by the distribution of money, power, and resources.” According to Henry Blum, there are four factors which are responsible for the overall health of an individual: environment, lifestyle, heredity, and medical care. These are called force fields. Environment has little or no control over an individual. Environmental factors which affect health include physical and social dimensions. Physical factors which affect health are air, noise, and water pollution, radiations, and toxic chemicals. Factors of social dimensions include income, education, occupational status, behavior modifications, psychological stress, perceptional problems, and interpersonal relationships. This is the most prominent forcefield and strength of Blum’s model. Lifestyles are behavioral risk factors like individual habits, feelings, emotions, and overall satisfaction which are grouped into leisure activity risks, consumption risks and occupational risks. The impact of heredity on health status includes genetic disorders, congenital malformation, mental retardation, and life expectancy. Access to medical care is the least important forcefield and weakness of Blum’s model. The factors of medical care which affect health are prevention, cure, care, and rehabilitation. This is another consideration because it involves the identification of a disease, treatment, prevention, and rehabilitation.

2. What percentage of premature deaths can be attributed to inadequate access to medical care? In a 1979 study, the Center for Disease Control identified environment, lifestyle, heredity, and medical care contribute to health as identified by Blum. It also identified access to healthcare is the least important factor that affect heath as identified in Blum’s model. The CDC found that 50 % of premature deaths in US were caused by induvial lifestyle and behaviors, 20% premature deaths were resulted from individual inherited profiles, 20% premature deaths were caused by social and environmental factors and only 10% premature death were resulted from inadequate access to healthcare. Inspite of more efforts and expenditures towards the delivery of medical care, health status experienced little improvement by the services provided by healthcare . Access to healthcare depends upon the availability of health insurance and around 16.7 % of the population lack coverage. The ability to pay for services not covered by insurance also affect access to healthcare. The lack for universal access to healthcare in the US increases mortality and reduces life expectancy.

3. What can be done to address this issue? Access to healthcare is an important issue and there are many factors affecting access to medical care: geographical location, socioeconomic status, government action, laws, and regulation. France and Spain have universal health system and people have higher life expectancy. US health system is a fragmented system (mixed system). In spite of spending more on healthcare and after addressing other risk factors, it was found that individuals live longer with lower mortality rate under a universal health system. To increase access and efficiency the United States can adopt some methods from other countries so that life expectancy can be increased in the long run. United States can use national health policies used by France by using state governments. By giving more emphasis to population health universal healthcare can be perceived as more feasible. Universal health care system is not accepted by the healthy and wealthy people of US because they are not willing to pay for other’s care through higher taxes. Americans die in larger quantities due to lack of access to care for preventable reasons. So, United States must acknowledge the need for universal healthcare. Healthcare policies and reforms must ensure our healthcare system to cover the cost for everyone at least for healthcare screening or checkups. The American medical facilities must introduce self-management and self-care improvements among patients since access to healthcare is currently limited in the United States. Educate patients on healthier lifestyle practices. How does access to healthcare affect life expectancy commons.lib.jmu.edu>cgi>view content

4. Describe the “Force Field and Well-Being Paradigms of Health” according to Blum. How do we measure “poor health”? What are the indicators of “poor health”? Find information on the CDC and the World Health Organization websites. “Forcefield and Well- Being Paradigms of Health” is a medical approach by Henry Blum. Environment, lifestyle, heredity, and medical care are the four factors which must be considered while addressing health status of a population. The health or wellbeing of individuals are determined by the physical, mental, and social components. For example, a person’s physical health is affected by some ailments like stomachache, mental health by the stress and social health by the loss of a job. The four forcefields environment, lifestyle, heredity and medical care are shared with CDC as the four factors contributing to health and medical care as the least important factor affecting health. Blum’s model gives more importance to overall wellbeing and the environmental factors whereas the CDC gives importance to lifestyle behaviors and causes leading to premature deaths. The most commonly used indicators can be used to measure poor health because measurements of health status are based on health problems such as diseases, disability and death. Using mortality -based measures, life expectancy, morbidity-based measures, poor health can be measured. We can use ADL to measure functional limitations of elderly and chronically ill and IADL which measures functional capacity. The SF-36 survey is a generic questionnaire survey which is useful for patients of chronic diseases to assist the quality of life and ability to work. Some indicators of poor health are number of times a person has visited the doctor per year, percentage of patients during the last one year who have not seen the doctor , duration between doctor visits, rate of short stay admissions and discharge.

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