1. In adopting a population health approach that considers the multiple determinants of health I would implement a community wide initiative within a county in Georgia, where there are high health risks for serious conditions like heart disease, obesity and diabetes, and would encourage community members to invest in their personal and overall well-being by keying in on being physically active, eating right, mental and emotional wellness and social wellness. Programs would be developed that would take a practical approach to address the avertible illnesses that effect the individuals within that community. By promoting healthy living values, such as eating more vegetables and drinking more water, encouraging participation of regular physical activity, getting physically checked by physicians regularly and maintaining your mental and social health, this can improve the health of the population.
B.) By developing community inter-sectoral partnerships, the health population approach that was mentioned above could be implemented in a very effective and efficient way, through active participation of all community partners and resources. Community partners could entail, professionals from the county health department, local hospitals or clinics, dieticians, fitness coaches and trainers, parks and recreation staff members and facilities, state and local governmental agencies and various nonprofit organizations and ministries. By providing access to better foods, such as farmers market, and working closely with a licensed dietician, the initiative would be promoting and improving healthy eating habits. By making known the healthcare resources and professionals within the community, the initiative would be promoting better health and encouraging community members to get checked out regularly. In addition, by utilizing parks and recreation facilities, community members are able to have access park grounds and walking trails and benefit from recreational activities to fulfill their physical activity needs and improve their health overall. By partnering with nonprofit organizations and ministries, they can be the most influential within the community by encouraging and motivating the people to take action and organizing further initiatives to help combat the issues at hand. Inter-sectoral partnerships can also be developed with members of different cultures, such as those in the Pan-Asian communities. Building relationships with various cultural community members it can provide opportunities for sharing information and can further advance the implementation of a health and wellness program within a community along with reconciling cultures and bringing unity.
C.) Evidence that has been found in relation to community wide wellness programs has been done in other counties, such as Baldwin County, where they addressed childhood obesity and developed program initiatives to tackle that health concern. Majority of their work dealt with making changes to the environment, increasing opportunities for healthy eating and access physical activity. With evidence of this type of work already being done, it increases the potential of my initiative to work within a county in Georgia where there is high risk of chronic illnesses. Providing wellness programs and resources for the community, I believe that the major health risks and chronic illnesses will begin to decrease as this initiative is implemented.
2. A program that could be led by MPH students for the Atlanta campus could be mindfulness meditation classes to affect lifestyle/behavioral changes and reduce stress from everyday life. We have mental and physical demands from jobs, school and home life and we all experience varying degrees of demands and stress throughout the day spending long hours trying to manage a never-ending cycle of project deadlines, presentations, exams, children, spouses, dealing with coworkers and classmates and sometimes bad bosses and professors. This relaxation program has the potential to impact not only students, but faculty, staff and the Mercer Atlanta community in a positive way. You cannot see or touch stress but you can feel its effects on your mind and body. Chronic stress can contribute to headaches, heart-disease and even premature death. One of the easiest and most achievable stress relieving techniques is meditation. With this program, you can focus your attention inward to induce a state of deep relaxation through concentration and heart-centered meditation or walking meditation where you focus to both body and mind as you breathe in time with your footsteps. Mindfulness meditation rooms can be placed in various department buildings across the Atlanta campus, where students can come in, in-between classes or after classes, to relax their minds and take time away from everything else that distracts, pollutes and stresses their minds. These rooms will induce a positive and calming atmosphere, with low-lighting and soft background instrumental music or white noise. Electronic devices will not be allowed to be turned on in these rooms, as well as other distracting means. With this program, I believe that it can bring new insights and solutions to minor health problems that can potentially lead to major health problems.
3. With the obvious differences in the Obama Administration and the Trump Administration many social attitudes and conflicts have risen in the past couple of months as Obama transitioned out of the White House and Trump transitioned into the White House. I believe that the most relevant issue at hand with differences in beliefs and attitudes would have to be in relation to gun violence. During Obama’s first term, he aimed more at gun rights than gun control. Yet throughout his term, and through many horrific mass shootings, Obama wanted to place more laws on gun control, however it brought resistance from congress. Regardless, Obama was still able to strengthen existing laws on gun control and part of his initiative in reducing gun violence was directed towards mental health treatments, stronger background checks, and restarting federal gun research (Congress blocked Obama’s call for new gun laws after mass shootings, n.d.). However, under the Trump Administration, he stands for gun control and many are in favor of that. Leading a public health team to address these social norms and beliefs would be difficult, due to the differences of attitudes and beliefs of people. The social norms theory suggests that our actions can be influenced by our perceptions or misperceptions. Many believe that because guns have been permitted to be carried by most states, that is the reason for these mass shootings. On the other hand, other believe that being permitted to carry a gun or own a gun is not the reason, but people with evil intentions and lack of better judgements are. Interventions based on social norms theory try to address difficult behaviors by initially being aware and understanding the misconceptions between perceived and actual norms. This issue can then be addressed by the public health team by educating the population about such misconceptions through means of media campaigns, open discussions and meetings about gun violence and educational information about mental health treatments. Through this approach the public health team can reach the goal of addressing the social norms and attitudes and bringing about change within society.
4. Indian Health Services: Executive Briefing
Background: The Indian Health Service is an agency within the Department of Health and Human Services. This service was founded on July 1st, 1955, a year after the transfer of Native American Health services from the Bureau of Indian Affairs to the Public Health Service (Indian Health Service Today, 2010). However, reports appeared with greater occurrences in the 1970 (Indian Health Service Today, 2010). Relationships and treaties between the United States Government and Indian Tribes have oftentimes required the assistance of medical services, physicians and hospital care for Indian people (Basis for Health Services Fact Sheets, 2015). Yet, before the present treaties, the United States Constitution has precisely addressed the federal government’s important role in dealing with Indians in the commerce and treaty clauses (Basis for Health Services Fact Sheets, 2015). As part of the 2010 Patient Protection and Affordable Care Act, authority has been given to congress to provide applicable funds distinctively for the health protection of Indian people.
Purpose: The Indian Health Service offers an all-inclusive health service delivery system for approximately 2 million American Indians and Alaska Natives who belong to 566 federally recognized tribes in 35 states (Indian Health Service, U.S. Department of Health and Human Services, 2011). This public health service agency provides health services directly and by contract with tribal organizations (Novick, Morrow, Shi & Johnson, 2008). The health services offered consists of medical, dental and environmental health programs. Special program concentrations are in disease prevention and health promotion, alcoholism, substance use and abuse, suicide, accidents, maternal and child health, nutrition and public health services (Indian Health Service, U.S. Department of Health and Human Services, 2011). The goal of the Indian Health Services is to raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level. Their intention is to certify that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indian and Alaska Native people (Indian Health Service, n.d.).
Responsibilities: The Indian Health Services is responsible for administering federal health services to American Indians and Alaska Natives (Basis for Health Services Fact Sheet, 2015). This program became a fundamental responsibility of the Department of Health and Human Services after the Transfer Act. American Indians and Alaska Natives are continuously confronted with health challenges from lifestyle choices such as physical inactivity, poor diet and substances abuse and from conditions such as obesity and injury. The Indian Health Services health promotion and disease prevention program focuses to reform and enhance health by developing preventative efforts at local, regional, and national levels (Indian Health Service Today, 2010). By enhancing and enforcing effective health promotion and chronic disease prevention programs, health promotion and disease prevention can expand the health of individuals, families and communities across the Indian and Alaskan communities (Indian Health Service, n.d.). The Indian Health Services also carry out responsibilities through expanding and utilizing a health services delivery system which desires to offer an all-inclusive program of preventative, medicinal, rehabilitative and environmental services.
5. Summary: Obamacare which is also known as the Affordable Care Act (ACA) was initiated to make healthcare more reasonable, cost-effective and available to an extensive amount of people in the United States. Included in this act, is a law that states that, those in the United States who are not eligible for immunity are obligated to attain the least possible amount of healthcare coverage. The provisions of the Affordable Care Act brings for more suitable and cost-effective healthcare coverage for Americans (Novick, Morrow, Shi & Johnson, 2008). Obamacare or ACA aims on advancing healthcare nationally, making available improved and efficient healthcare to United States citizens. In addition, the ACA also offers reduced healthcare plans to people who lack coverage or for those who are unsatisfied with their current healthcare plans. It also offers improved services which is provided through insurers to keep them honest and to reduce the amount of spending generated through an inflated healthcare system (Obamacare Summary – The Basics of Obamacare, n.d.). Also under this act, incentives are provided such as tax breaks to small businesses in order for their employees to be covered (Obamacare Summary – The Basics of Obamacare, n.d.). Obamacare law has made it possible for millions of those who are without healthcare insurance now have the right to healthcare possibilities and rights that they did not have previously. Obamacare also offers protection of patient rights (Obamacare Summary – The Basics of Obamacare, n.d.). Under this law, insurers and healthcare providers are required to provide obtainable and comprehensive healthcare coverage to those who might have been denied previously before the enactment of the law.
The reason for Obamacare was to straighten out the inconsistencies (Obamacare Summary – The Basics of Obamacare, n.d.). People with prior health conditions now have the option to choose a healthcare plan and insurers are now obligated to offer these plans. Included in the ACA, insurance now has to incorporate more basic treatments and conditions that were not covered previously. Obamacare also aims to care for people from low to middle income families, older citizens, and women who were required to pay for preventative services to impede frequent maladies and health problems.
Continuing, Obamacare offers a number of new benefits, rights and protections for millions of Americans. For example, young adults will be allowed to stay on their parents’ insurance plans until they reach age 26 and also extends them cheaper health insurance due to cost-assistance through their state’s health insurance marketplace. Young adults with fixed incomes will not be liable for the fee and will be eligible for free or low-cost coverage through the health insurance marketplace (Benefits of Obamacare: Advantages of Obamacare, n.d.). All insurance coverage covers many things from mental health, to prescription drugs, to contraception, to STI screenings, to maternity and newborn care as a portion of the Ten Essential Health Benefits (Benefits of Obamacare: Advantages of Obamacare, n.d.).
Another example of what consists of the Obamacare healthcare plan is insurance company not being able to drop you off from your plan when you are ill or have made an error on your application. Since the approving of the Affordable Care Act, it has outlawed insurance companies to cancel your coverage simply because you made an impartial mistake or left out information that has little impact on your health (Benefits of Obamacare: Advantages of Obamacare, n.d.). This act also stops insurance companies from carrying out unfair rate increases. The foremost cause of the insurance premium rate increases under Obamacare is the necessary demand for insurers to cover high-risk consumers (Benefits of Obamacare: Advantages of Obamacare, n.d.). Insurance companies can no longer decline Americans with preceding conditions and cannot charge costly rates depended on health status or gender. However, some regions have seen more increased premium rates than others under the Affordable Care Act, yet those with lower incomes are the most likely to see a decrease in what they pay (Benefits of Obamacare: Advantages of Obamacare, n.d.). Those with expensive insurance plans, who had been in exclusive groups due to being healthy, saw the most extensive premium increase than others. Those earning under 400% of the federal poverty level are eligible for premium tax credits which reduce monthly premium rates. Those who receive tax credits and tax breaks can expect to pay much lower premium costs and some may be allowed to get support on out-of-pocket costs like copays, coinsurance, out-of-pocket maximums and deductibles and over 15 million will get free insurance through Medicaid. Obamacare has helped offset the unaffordable of out-of-pockets costs like deductibles, copays and coinsurance for those making 250% of the Federal Poverty Level (Benefits of Obamacare: Advantages of Obamacare, n.d.).
Obamacare also made some changes to the Children’s Health Insurance Program (CHIP) by making it more accessible for children to receive. The CHIP program offers free or low-cost coverage to children and teens up to age 19 and other family members. Conjointly, CHIP provides for children whose parents make too much money for Medicaid coverage to be eligible for the program. Over the past decade, CHIP has done a notable job in cutting down the number of children without health insurance (Benefits of Obamacare: Advantages of Obamacare, n.d.). Also, under the Affordable Care Act even more children are covered. Under the Affordable Care Act, CHIP now extends more benefits and advantages, rights and protections for children. CHIP also covers the ten essential health services, which consists of, pediatric, dental and vision care, mental health and substance abuse services, emergency services, maternity and newborn care (Benefits of Obamacare: Advantages of Obamacare, n.d.).
A few changes have also been made for Medicare insurance for older adults under the Affordable Care Act. Nearly all seniors will be pleased with the advantages, freedom and protections of the new health care act, such as extended access to wellness visits, more preventative care, and inexpensive medications with the slightest changes to their insurance costs. However, some higher earning seniors may see their Medicare or Medicare Advantage premiums increase or be affected by some taxes like the capital gains tax (Benefits of Obamacare: Advantages of Obamacare, n.d.). Because of Obamacare, Medicare or Medicare Advantage was revised to weed out some of the wasteful spending and other issues that were adversely affecting the older adult population. Preventative services were expanded for senior citizens under the Affordable Care Act and are now able to obtain preventative services such as mammograms or colonoscopies, without additional charges for deductibles. (Benefits of Obamacare: Advantages of Obamacare, n.d.). Due to false precepts, many believe that the Affordable Care Act replaces Medicare, however, it does not replace Medicare, but broadens its services to those on Medicare and assists those who did not have the funds to attain medical insurance previously.
Contrary to popular belief, Obamacare offers more advantages, rights and protections when it comes to choosing the best healthcare plan for you and your family. There is more coverage for people who were not able to receive coverage and more services are now being offered as well than before. The ACA implements the stabilization of coverage and advantages along with the management of insurers and healthcare providers. Obamacare/Affordable Care Act has the greatest potential to improve the public’s health.
Opinion: After reviewing the New York Times Article, I would not support any efforts to replace Obamacare because there have not been any strong bills to replace it. I believe that keeping parts of the law, while getting rid of the other part would not be an ideal solution for many Americans. While the Act may not be 100 percent perfect, it provides health care coverage to over 20 million Americans along with many benefits and advantages. From my perspective, I see more advantages to Obamacare than disadvantages. For instance, this law permits anyone from being denied coverage for pre-existing conditions diabetes, high blood pressure, or even cancer. Injuries are also not a reasonable action to be denied coverage or declined for you or any family members (Affordable Care Act, n.d.). Your healthcare coverage is also secured under this law. Accidental mistakes or minor errors on applications can no longer give insurance companies reasons to cancel your healthcare coverage. Children and teenagers up to 19 years old are covered by Obamacare through the CHIP program. Young adults are also able to stay on their parent’s health insurance plan until they turn 26 years old. Cheaper health insurance is also extended to young adults due to cost-assistance through their state’s healthcare marketplace. Under the Obamacare law, you are able to get the health care service that you need, without worrying about unexpected medical bills due to the expulsion of dollar limits on your care. Obamacare also requires insurance companies to offer preventative care services as part of your coverage. These services include high blood pressure screenings, diabetes screenings, flu shots, cancer screenings, and STDs/STI screenings. Women services are also included and are able to receive services such as mammograms, cervical cancer screenings, osteoporosis screening, gestational diabetes screening and well-woman visits (Affordable Care Act, n.d.). Senior Citizens are also covered and are able to receive more benefits, rights and protections as well through their Medicare or Medicare Advantage coverage. Seniors are now covered for yearly wellness visits and preventative care services. They are now able to receive their prescription medications at a much lower cost and the “donut- hole†will dissipate completely (Benefits of Obamacare: Advantages of Obamacare, n.d.). Furthermore, Obamacare provides many benefits for low and middle-income families along with small businesses. In all, Obamacare does not create insurance, it just monitors it to protect the consumer and assures that they receive all the benefits and rights that they are paying for. Through this approach, I do believe that it helps millions of Americans get access to better quality health care and insurance, especially those who were not eligible previously. There are more advantages than disadvantages to Obamacare, especially for women, children and low-income families.