History Of American Public Health

In order to understand current health delivery services changes and formulate predictions, one must thoroughly comprehend the three developmental eras of the health care system. The evolution of our current health care system began in 1850, and has metamorphosed in three time periods, 1850 to 1900, 1900 to World War II (WW II), and WW II to 2009. Significant distinct and overlapping trends in disease prevalence, availability of health care resources, social organizations, and the public's knowledge and perception of health and illness and technology.

Over the course of our countries history, the delivery of our health care system has tried to meet the needs of our growing and changing population. However, we somehow seem to fall short in delivering our goals of providing quality, affordable and accessible healthcare to our citizens. The history of our delivery system will show we continuously changed the delivery of our system however never mange to control cost. If we can come up with efficient ways to cut cost, the delivery of quality care will follow.

rehend the PPACA, one must understand the history of the United States’ health care system. The most successful and known reform would be the passage of Medicare and Medicaid. President Johnson’s main objective with his program was to provide health insurance to those over 65 years old, who otherwise wouldn’t be able to receive coverage due to retirement or being financially unfit to purchase health insurance. It has since been expanded to cover those with disabilities, and lower income families (“Overview,” 2015). Brady (2015) examines President Clinton’s attempt to massively overhaul health care in the United States. His plan, the Health Security Act (HSA), required employers to offer health insurance to their employees, and mandated that every US citizen purchase health insurance. This plan would have most likely expand health insurance to many more Americans; however, many feared the large tax increases, restricted options for patients, and with the lack of general support for the bill, it failed in Congress and was never implemented (p. 628). President Clinton’s failed attempt at health care reform opened up the door to future reforms, and it even shared multiple similarities to the PPACA. Smith (2015) updates the history of the health care system in America stating that “In the mid-2000s, America’s uninsured population swelled to nearly 47 million, representing about 16 percent of the population” and how “16 million Americans […] were underinsured” (p. 2). People

In Bly’s time, mental illnesses were not taken seriously. Bly described the asylum she was admitted to as overcrowded, cold, and dirty (ch. 7). It defeated the purpose of trying to give extra attention to those in need. It was easy to get admitted into an institution, but nearly impossible to make it out because the treatment was not treatment.

There are four evolutionary phases in healthcare. The first phase was the preindustrial era, which started in the middle 18th century to the beginning of the 19th century. At this time, American medicine was not developing as fast as other countries; in Britain, France, and Germany, medical science and research was much more advanced than America. The postindustrial era began in the late 19th century, physicians in America were becoming more successful than others in the world. The third phase was the corporate era, which was marked by the growth of managed care, organizational integration, the information revolution and globalization. Finally, the fourth phase is the one in which we are in today, it is still fairly new and is characterized by the health care reform, which was brought about by the Affordable Care Act.

Psychiatry and psychology have struggled in the past to contextualize the nature of mental illness. Through this struggle, mental illnesses and their symptoms have been used as a means of controlling deviance and pathologizing emotions felt by certain groups of people. Social, political, and historical factors create the boundaries of sanity and insanity in which hegemonic, institutional power control minority groups, however, the manner in which these boundaries manifest have shifted over time. Jonathan Metzl in his book The Protest Psychosis: How Schizophrenia Became a Black Disease explores the manner in which mental illness is used by institutions to control deviance through his examination of how the anti-psychiatry movement, subsequence

The theory of ‘deinstitutionalization’ began arising with the theory of providing more freedom to the mentally ill and less spending on full time care facilities. The widespread use of drugs to control the mentally ill in the 1900s led to a mass release of patients and an emptying of asylums. Outpatient Psychiatric Clinics were established. Case Law in the United States began to be generated to provide the mentally ill with greater rights. Shelton v. Tucker 1960 provided that the mentally ill should receive care in the “least restrictive alternative”, which is a practice still utilized. O’Connor v. Donaldson 1975 ruled that non-dangerous mental patients have the right to be treated or discharged if they have been institutionalized against their will. This new approached permitted the mass exodus

As though hearing the pleas made in such academic journals, the government began to take initiatives to assure that it was proactive in battling this emerging problem. The government began to act on the popular sentiments and studies and designed immigration laws so that those who were deemed to be unfit in any way to perform as a part of the workforce were deported upon arrival and eventually, even making it past these initial tests were not enough to secure their stay in the country. By 1922, an intricate system of deportation existed so that any immigrant admitted to a state mental hospital would be returned to their country of origin. The Bureau of Immigration made a statement summarizing this procedure.

Although the 19th century expansion of asylums in Europe and The United States was a movement initially based on moral principles, it led to significant negative implications for individuals, who were institutionalized as asylums became overcrowded, lacking hygiene, neglectful of patients and an overall place for poor living conditions (Wright, 1997). The rise in in-patient population in the early 19th century and patients’ inabilities to reintegrate into the community as a result of institutionalization have often been explained in terms of the mental health system and developments in psychology at the time. Sociologists on the other hand, have argued that these institutions have caused people to remain institutionalized. A compelling

The mentally ill were cared for at home by their families until the state recognized that it was a problem that was not going to go away. In response, the state built asylums. These asylums were horrendous; people were chained in basements and treated with cruelty. Though it was the asylums that were to blame for the inhumane treatment of the patients, it was perceived that the mentally ill were untamed crazy beasts that needed to be isolated and dealt with accordingly. In the opinion of the average citizen, the mentally ill only had themselves to blame (Surgeon General’s Report on Mental Health, 1999). Unfortunately, that view has haunted society and left a lasting impression on the minds of Americans. In the era of "moral treatment", that view was repetitively attempted to be altered. Asylums became "mental hospitals" in hope of driving away the stigma yet nothing really changed. They still were built for the untreatable chronic patients and due to the extensive stay and seemingly failed treatments of many of the patients, the rest of the society believed that once you went away, you were gone for good. Then the era of "mental hygiene" began late in the nineteenth century. This combined new concepts of public health, scientific medicine, and social awareness. Yet despite these advancements, another change had to be made. The era was called "community mental health" and

What aspects and characteristics of American health care of the 18th and 19th centuries have had a major impact on shaping today’s U.S. health care system?”

Unfortunately, asylum founders could only guess at the causes of insanity. Patient after patient was admitted into the state hospitals, but the cause of their disturbance was often a mystery. Many were inflicted with various organic diseases, like dementia, Huntington’s disease, brain tumors, and many were in the third stage of syphilis. With no treatments available, providing humane care was all that could be done. In the years following the civil war American cities boomed and the asylum began struggling to keep up. Soldiers, freed slaves, and immigrants were stranded in a strange land. The asylum became organized more like a factory or small town. There were upper and lower classman, bosses and workers, patients with nothing, and patients with privileges. Sarah Burrows, a schizophrenic and daughter of a wealthy doctor had a ten bedroom house that was built for her on the hospital grounds. Burrows home was just a stone’s throw away from the hospital’s west wing, where over sixty black women slept side by side. (Asylum: A History of the Mental Institution in America). The hospital began to rely on the free labor the patients provided. However, isolating the hospital from the community meant there was no way of knowing what was happening inside the asylum. The asylum became a world apart. In the 1870’s, Elizabeth Packard, a former patient of St. Elizabeth’s, wrote about her mistreatment and abuse

Dominique Robert’s (2008) theoretical framework in the article “Prison and/as Public Health. Prison and Inmates as Vectors of Health in the New Public Health Era. The Case of Canadian Penitentiaries” focuses on structural elements that explain the use of correctional health care in the prison setting today and how this plays a role in the broader public health strategies in the outside community. He does this by explaining factors such as “the mobilisation of prison as a tool for the new public health” and "the production of inmates into healthcare ‘consumers’, along with the role of actuarial justice.”

During the mid-1800’s the mentally ill were either homeless or locked in a cell under deplorable conditions. Introduction of asylums was a way to get the mentally ill better care and better- living conditions. Over a period of years, the admissions grew, but staff to take care of their needs did not. Asylums became overcrowded and treatments that were thought to cure, were basically medieval and unethical

This essay will describe public health policies within the UK from 19th, 20th and 21st century, to show the development over these time periods to the health policies. The 19th Century The poor law (1834 ) This was a law set up by the government as of many commissions made as recommendations.