Preventive MedicinePreventive Medicine

• The best way to avoid medical procedures and The best way to avoid medical procedures and medications, which include inherent risks, is to medications, which include inherent risks, is to avoid becoming sick in the first place; avoid becoming sick in the first place; prevention and early intervention are also cost prevention and early intervention are also cost effectiveeffective

• Type II Diabetes, for example, can be related to Type II Diabetes, for example, can be related to poor diet and lack of exercisepoor diet and lack of exercise

• VaccinesVaccines• Inoculations are an important way to prevent the Inoculations are an important way to prevent the

spread of contagious diseasesspread of contagious diseases• From Jan. - June, 2011 there have been more cases From Jan. - June, 2011 there have been more cases

of measles in the U.S. than at any other time since of measles in the U.S. than at any other time since 1996, and most of the cases were linked to foreign 1996, and most of the cases were linked to foreign travel and involved U.S. residents who were not travel and involved U.S. residents who were not vaccinatedvaccinated

Preventive Medicine Preventive Medicine (cont.)(cont.)• ScreeningsScreenings

• An important weapon against cancers and An important weapon against cancers and diseases is to identify and treat them early ondiseases is to identify and treat them early on

• i.e., screenings for colorectal cancer, breast i.e., screenings for colorectal cancer, breast cancer, and cervical cancer could potentially cancer, and cervical cancer could potentially save thousands of livessave thousands of lives

• Prevention programs & OutreachPrevention programs & Outreach• Multidisciplinary programs are most effective Multidisciplinary programs are most effective

(e.g., target at-risk groups through various (e.g., target at-risk groups through various forms of media, educational classes and forms of media, educational classes and workshops, screening days, free clinic days, workshops, screening days, free clinic days, etc.)etc.)

Prevention Programs & Outreach Prevention Programs & Outreach (cont.)(cont.)

• Programs should be mindful of the target Programs should be mindful of the target population, e.g.:population, e.g.:• Should media efforts be in multiple languages?Should media efforts be in multiple languages?• What are some region-specific exercise activities What are some region-specific exercise activities

or healthy food options that make sense for this or healthy food options that make sense for this population and its existing culture?population and its existing culture?

• Remember that small behavioral changes are Remember that small behavioral changes are easier for people to make than drastic behavioral easier for people to make than drastic behavioral changeschanges

• Outreach involves professionals going out Outreach involves professionals going out into the community—in this case—to promote into the community—in this case—to promote physical healthphysical health

• Free Clinics of America sets up massive, one-Free Clinics of America sets up massive, one-day free clinic events with volunteers to day free clinic events with volunteers to serve the community: serve the community: http://freeclinics.us/

Getting the StatsGetting the Stats• In order to target efforts, we need to know how In order to target efforts, we need to know how

many people have a disease/illness/condition, many people have a disease/illness/condition, where they are located, whether the disease is where they are located, whether the disease is spreading, how to prevent and/or treat it, spreading, how to prevent and/or treat it, whether there are many new cases of it, etc.whether there are many new cases of it, etc.

• Epidemiology: “the study of the occurrence Epidemiology: “the study of the occurrence and distribution of diseases and other health-and distribution of diseases and other health-related conditions in populations”related conditions in populations”• In conducting this research, we can determine the In conducting this research, we can determine the

prevalence of diseases (how many total cases) and prevalence of diseases (how many total cases) and the incidence of diseases (how many new cases)the incidence of diseases (how many new cases)

• The Centers for Disease Control (CDC) and the The Centers for Disease Control (CDC) and the World Health Organization (WHO) work to keep World Health Organization (WHO) work to keep track of these statistics to inform treatment and track of these statistics to inform treatment and prevention effortsprevention efforts

Health InsuranceHealth Insurance• Literally a life-or-death issue, healthcare Literally a life-or-death issue, healthcare

is an area of serious debate in the U.S., is an area of serious debate in the U.S., partly because there is so much money partly because there is so much money involved; i.e., if medical treatment was involved; i.e., if medical treatment was very cheap, people might just pay out of very cheap, people might just pay out of pocket or we might decide to create pocket or we might decide to create universal coverage through tax dollars, universal coverage through tax dollars, and it wouldn’t be such an issueand it wouldn’t be such an issue

• But, medical treatment and medications But, medical treatment and medications are expensive, and there are several are expensive, and there are several powerful players involved: insurance powerful players involved: insurance companies, employers/companies who companies, employers/companies who provide health insurance to their provide health insurance to their workers, pharmaceutical companies, workers, pharmaceutical companies, doctors/nurses/staff/administrators, and doctors/nurses/staff/administrators, and legislators; individual patients seem to legislators; individual patients seem to have less power than these entitieshave less power than these entities

Health Insurance Health Insurance (cont.)(cont.)

• Health insurance becomes more expensive Health insurance becomes more expensive for everyone who still pays for it when more for everyone who still pays for it when more people don’t have or lose their insurance people don’t have or lose their insurance because the non-insured do not get because the non-insured do not get preventive treatment and wait until their preventive treatment and wait until their condition is so severe that they require condition is so severe that they require expensive procedures, emergency room expensive procedures, emergency room visits, and even hospital staysvisits, and even hospital stays

• Half of all personal bankruptcies in the Half of all personal bankruptcies in the United States are caused by health problemsUnited States are caused by health problems

• Under the 1986 Emergency Medical Under the 1986 Emergency Medical Treatment and Active Labor Act (EMTALA), Treatment and Active Labor Act (EMTALA), hospitals are required to provide emergency hospitals are required to provide emergency treatment to anyone, regardless of treatment to anyone, regardless of citizenship or ability to pay; this has left citizenship or ability to pay; this has left hospitals with extra expenseshospitals with extra expenses

Health Insurance Health Insurance (cont.)(cont.)

• From the U.S. Census BureauFrom the U.S. Census Bureau::• The percentage of uninsured The percentage of uninsured

individuals is growingindividuals is growing• In 2008, 46.3 million people were In 2008, 46.3 million people were

uninsured (15.4% of the population)uninsured (15.4% of the population)• In 2009, 50.7 million people were In 2009, 50.7 million people were

uninsured (16.7% of the population)uninsured (16.7% of the population)• The percentage of people with The percentage of people with

employment-based health employment-based health insurance coverage in 2009 was the insurance coverage in 2009 was the lowest since 1987lowest since 1987

Health Insurance Health Insurance (cont.)(cont.)

• Medicare and Medicaid (established Medicare and Medicaid (established 1965 under LBJ):1965 under LBJ):

• Medicare is a federally funded Medicare is a federally funded insurance program for people 65 years insurance program for people 65 years of age or older or for individuals with of age or older or for individuals with certain disabilitiescertain disabilities

• Medicaid is a partially federally and Medicaid is a partially federally and partially state funded program that is partially state funded program that is designed to serve healthcare needs of designed to serve healthcare needs of poor populations that fall into a specific poor populations that fall into a specific eligibility category, such as children eligibility category, such as children and/or their parents, pregnant women, and/or their parents, pregnant women, individuals with disabilities, and elderly individuals with disabilities, and elderly who are in need of nursing home carewho are in need of nursing home care

• Individuals may qualify for Medicare or Individuals may qualify for Medicare or Medicaid or bothMedicaid or both

Healthcare Around the GlobeHealthcare Around the Globe• Although the U.S. spends more money than Although the U.S. spends more money than

any other country in the world on medical any other country in the world on medical expenses, we rank 26expenses, we rank 26thth in life expectancy in life expectancy and 29and 29thth in low newborn mortality in low newborn mortality

• According to the World Health Organization According to the World Health Organization (WHO), currently, 27 countries from the (WHO), currently, 27 countries from the Organization for Economic Co-operation Organization for Economic Co-operation and Development (OECD) cover all of their and Development (OECD) cover all of their citizens with health services from pooled citizens with health services from pooled funds supplemented with limited direct out-funds supplemented with limited direct out-of-pocket paymentsof-pocket payments

Healthcare Around the Globe Healthcare Around the Globe (cont.)(cont.)

• The WHO performed an international ranking of The WHO performed an international ranking of healthcare systems in 2000; France ranked #1: they healthcare systems in 2000; France ranked #1: they provide universal coverage that covers about 70% of provide universal coverage that covers about 70% of costs (employer/private insurance covers the rest of costs (employer/private insurance covers the rest of the costs); 42% can get a same-day doctor’s appt., the costs); 42% can get a same-day doctor’s appt., they can see any doctor they want, their life they can see any doctor they want, their life expectancy and mortality rates are more favorable expectancy and mortality rates are more favorable than the U.S., and their government spends half of than the U.S., and their government spends half of what the U.S. does per person on healthcarewhat the U.S. does per person on healthcare

• In the same WHO ranking, the U.S. ranked 37In the same WHO ranking, the U.S. ranked 37thth • In Taiwan, citizens have a “smart card” that has all of In Taiwan, citizens have a “smart card” that has all of

their medical information on it that has reduced their medical information on it that has reduced paperwork and has cut costs substantially; the card is paperwork and has cut costs substantially; the card is also used to efficiently bill the government for their also used to efficiently bill the government for their health serviceshealth services

• Click this link for more info. on healthcare around the Click this link for more info. on healthcare around the globe: globe: http://health.howstuffworks.com/medicine/healthcare/insurance/10-health-care-systems.htm

Health DisparitiesHealth Disparities

• An important area of research, health disparities An important area of research, health disparities refers to different health outcomes for different refers to different health outcomes for different groups, usually racial and/or SES groups in the U.S.groups, usually racial and/or SES groups in the U.S.

• Ethnic minorities and those with a lower SES tend Ethnic minorities and those with a lower SES tend to have less insurance coverage and higher rates to have less insurance coverage and higher rates of illness and even higher mortality rates, of illness and even higher mortality rates, particularly among adults and infants/newbornsparticularly among adults and infants/newborns

• Health disparities among African-American women: Health disparities among African-American women: http://www.youtube.com/watch?v=4le46UCmL4c&feature=related

Health Disparities Health Disparities (cont.)(cont.)

• A landmark study (Schulman et al., 1999) showed A landmark study (Schulman et al., 1999) showed that when presented with fictitious patients with that when presented with fictitious patients with identical cardiac symptoms, doctors were less likely identical cardiac symptoms, doctors were less likely to refer African-American patients and female to refer African-American patients and female patients for additional cardiac testing compared to patients for additional cardiac testing compared to White patients and male patients; this reflects bias White patients and male patients; this reflects bias among physicians that may contribute to health among physicians that may contribute to health disparities among ethnic minoritiesdisparities among ethnic minorities

• One explanation for this finding is that some One explanation for this finding is that some physicians don’t believe ethnic minority patients will physicians don’t believe ethnic minority patients will follow through on additional testing anyway, so the follow through on additional testing anyway, so the physicians don’t recommend itphysicians don’t recommend it

• Addressing health disparities (an example from the Addressing health disparities (an example from the bay area): http://www.youtube.com/watch?bay area): http://www.youtube.com/watch?v=5wQv4xUwtEQ&feature=relatedv=5wQv4xUwtEQ&feature=related

Stress, SES, and HealthStress, SES, and Health• Health Psychology is a field that addresses the Health Psychology is a field that addresses the

interplay of psychological and physiological factorsinterplay of psychological and physiological factors• Being physically ill makes psychological coping more Being physically ill makes psychological coping more

difficult, and difficulty with coping (e.g., higher difficult, and difficulty with coping (e.g., higher stress) makes one more vulnerable to physical stress) makes one more vulnerable to physical illnessesillnesses

• Psychoneuroimmunology is the field of study Psychoneuroimmunology is the field of study devoted to understanding the connection between devoted to understanding the connection between psychological factors, the nervous system and psychological factors, the nervous system and immune functionimmune function

• Major stressor events, as well as chronic stressors, Major stressor events, as well as chronic stressors, such as low SES, can have a negative impact on such as low SES, can have a negative impact on immune function, partly due to stress hormonesimmune function, partly due to stress hormones

• Reduced access to healthcare services, healthy Reduced access to healthcare services, healthy foods, and health information among low SES foods, and health information among low SES individuals may also partially explain poorer health individuals may also partially explain poorer health outcomes among the pooroutcomes among the poor

Stress Stress ResponseResponse

Major Health IssuesMajor Health Issues

• We will address:We will address:• ObesityObesity• Teen PregnancyTeen Pregnancy• HIV/AIDSHIV/AIDS• Alcohol, tobacco, and other drugsAlcohol, tobacco, and other drugs• The elderlyThe elderly

ObesityObesity • From 2007-2008, From 2007-2008, U.S. prevalence of U.S. prevalence of obesity among obesity among adults was approx. adults was approx. 34%; the combined 34%; the combined prevalence of prevalence of overweight and overweight and obesity was approx. obesity was approx. 68%!68%!

• From 2007-2008, From 2007-2008, among children and among children and adolescents in the adolescents in the U.S., obesity was U.S., obesity was approx. 17%, a approx. 17%, a large increase since large increase since the 1970’sthe 1970’s

• Obesity is linked to Obesity is linked to a variety of health a variety of health problems, including problems, including cardiovascular cardiovascular disease, Type II disease, Type II Diabetes, certain Diabetes, certain cancers, and overall cancers, and overall reduced life reduced life expectancyexpectancy

Obesity (cont.)Obesity (cont.)• With proper diet and exercise, obesity can be With proper diet and exercise, obesity can be

prevented in most individuals and is a major, prevented in most individuals and is a major, preventable cause of death worldwidepreventable cause of death worldwide

• When was the last time you saw a commercial for When was the last time you saw a commercial for fruits and veggies (i.e., carrots, apples, or squash), fruits and veggies (i.e., carrots, apples, or squash), whole grain bulgur, celery, or spinach?whole grain bulgur, celery, or spinach?

• When was the last time you saw a commercial for When was the last time you saw a commercial for cheeseburgers, pizza, soda, or burritos?cheeseburgers, pizza, soda, or burritos?

• What do you think kids watching TV are going to want What do you think kids watching TV are going to want to eat? (or adults, for that matter!)to eat? (or adults, for that matter!)

• Since diet and exercise are behavioral choices, think Since diet and exercise are behavioral choices, think about the role Community Psychologists can play in about the role Community Psychologists can play in influencing these behaviors and making influencing these behaviors and making environments healthier (to encourage exercise and environments healthier (to encourage exercise and make healthy foods more accessible)make healthy foods more accessible)

• Community norms that promote healthy behaviors Community norms that promote healthy behaviors can include farmer’s markets and bicycling, for can include farmer’s markets and bicycling, for exampleexample

Teen PregnancyTeen Pregnancy• Scope of the problem: Scope of the problem:

http://www.cdc.gov/VitalSigns/TeenPregnancy/LatestFinhttp://www.cdc.gov/VitalSigns/TeenPregnancy/LatestFindings.htmldings.html

• Approx. 400,000 adolescent girls give birth every year Approx. 400,000 adolescent girls give birth every year in the U.S. (and approx. 750,000 to 1 million become in the U.S. (and approx. 750,000 to 1 million become pregnant every year)pregnant every year)

• Teen birth rates in the U.S. are up to 9 times higher Teen birth rates in the U.S. are up to 9 times higher than in most other developed countries, which is mainly than in most other developed countries, which is mainly explained by less contraceptive use (not lower rates of explained by less contraceptive use (not lower rates of sexual activity) in the U.S.sexual activity) in the U.S.

• Teen motherhood leads to an increased risk of school Teen motherhood leads to an increased risk of school dropout, lower employment security, and they are more dropout, lower employment security, and they are more likely to live and raise the child in povertylikely to live and raise the child in poverty

• Teen fathers are also less likely to complete their Teen fathers are also less likely to complete their education and tend to earn less money than adolescent education and tend to earn less money than adolescent boys who are not fathersboys who are not fathers

Causes and Strategies Causes and Strategies to Address Teen to Address Teen

PregnancyPregnancy• Causal Factors from an Ecological Causal Factors from an Ecological ViewpointViewpoint::

• Media messages that emphasize sex and Media messages that emphasize sex and rarely include contraceptionrarely include contraception

• Peer and cultural messages may condone or Peer and cultural messages may condone or promote sex at an early agepromote sex at an early age

• Adolescents may be lacking parental or Adolescents may be lacking parental or other adult role models and other adult role models and support/supervisionsupport/supervision

• Adolescents may lack education about sex Adolescents may lack education about sex and access to contraceptionand access to contraception

• Also see Chapter 7 of your text for more infoAlso see Chapter 7 of your text for more info

Strategies to Address Strategies to Address Teen PregnancyTeen Pregnancy

• Abstinence only programs: can be helpful Abstinence only programs: can be helpful when introduced to children at a younger when introduced to children at a younger age, but the majority of adolescents have age, but the majority of adolescents have had sex by age 18had sex by age 18

• Sex education and/or access to Sex education and/or access to contraception alone is probably not enoughcontraception alone is probably not enough

• More holistic programs are ideal, from a More holistic programs are ideal, from a Community Psychology perspective: Community Psychology perspective: encourage parental involvement and encourage parental involvement and education, healthy family communication, education, healthy family communication, the value of education in general and future the value of education in general and future employment for the adolescent; education employment for the adolescent; education about gender roles, sexual about gender roles, sexual harassment/assault, and sex in the media; harassment/assault, and sex in the media; provision of medical and mental health provision of medical and mental health services, and extracurricular activities.services, and extracurricular activities.

HIV/AIDSHIV/AIDS• Scope of the Problem:Scope of the Problem:• Originally, HIV/AIDS in the U.S. was almost Originally, HIV/AIDS in the U.S. was almost

exclusively in the MSM (men who have sex with exclusively in the MSM (men who have sex with men) population, but now slightly less than half men) population, but now slightly less than half are due to IV drug-users or heterosexual sex; rates are due to IV drug-users or heterosexual sex; rates are higher in ethnic minority populations than are higher in ethnic minority populations than among Whites; globally, more than half of those among Whites; globally, more than half of those infected are femaleinfected are female

• From 2003 to 2007, deaths due to HIV in the U.S. From 2003 to 2007, deaths due to HIV in the U.S. decreased by 17% and the average life decreased by 17% and the average life expectancy for those diagnosed with HIV in 2005 expectancy for those diagnosed with HIV in 2005 is approximately 23 years after diagnosisis approximately 23 years after diagnosis

• Note: your textbook is WRONG on page 262 when Note: your textbook is WRONG on page 262 when it says “Once you have tested positive for HIV, it is it says “Once you have tested positive for HIV, it is certain that you will develop AIDS.” This used to certain that you will develop AIDS.” This used to be true, but is no longer the case.be true, but is no longer the case.

HIV/AIDS (scope of the problem, HIV/AIDS (scope of the problem, cont.)cont.)

• Globally, in 2009, approx. 2.6 million people Globally, in 2009, approx. 2.6 million people became infected with HIV; approx. 33 million became infected with HIV; approx. 33 million total adults and children are living with HIVtotal adults and children are living with HIV

• Globally, since 1999, the number of new Globally, since 1999, the number of new infections has decreased by 19%; the majority of infections has decreased by 19%; the majority of new HIV infections still occur in sub-Saharan new HIV infections still occur in sub-Saharan Africa, although rates of new infections there are Africa, although rates of new infections there are decliningdeclining

• While rates of HIV infection have decreased or While rates of HIV infection have decreased or stabilized in most areas of the world, in Eastern stabilized in most areas of the world, in Eastern Europe and Central Asia, the number of people Europe and Central Asia, the number of people living with HIV has almost tripled since 2000 and living with HIV has almost tripled since 2000 and reached an estimated total of 1.4 million in 2009, reached an estimated total of 1.4 million in 2009, compared with 760,000 in 2001compared with 760,000 in 2001• This increase has primarily been blamed on injecting This increase has primarily been blamed on injecting

drug users who share needles and sex workersdrug users who share needles and sex workers

Changes in the Changes in the incidence of HIV incidence of HIV

infection worldwideinfection worldwide

HIV/AIDS: Prevention & HIV/AIDS: Prevention & TreatmentTreatment• Stigma: HIV is different from many other health Stigma: HIV is different from many other health

problems because it has considerable stigma problems because it has considerable stigma associated with it and methods of prevention (e.g., associated with it and methods of prevention (e.g., giving out condoms or clean needles) are controversialgiving out condoms or clean needles) are controversial• The stigma of HIV also can make disclosure of HIV status to The stigma of HIV also can make disclosure of HIV status to

a partner or even HIV testing more difficulta partner or even HIV testing more difficult• Many prevention campaigns have focused on condom Many prevention campaigns have focused on condom

use and getting tested for HIVuse and getting tested for HIV• ““No glove, no love” is a slogan used in many HIV prevention No glove, no love” is a slogan used in many HIV prevention

campaignscampaigns• Unlike diet and exercise, which are individual health-Unlike diet and exercise, which are individual health-

related behaviors, condom use is a behavioral decision related behaviors, condom use is a behavioral decision that involves two peoplethat involves two people

• Antiretroviral Therapy (ARV’s or ART’s) has had a Antiretroviral Therapy (ARV’s or ART’s) has had a dramatic impact on life expectancy and quality of life, dramatic impact on life expectancy and quality of life, with many patients on ARV’s having few or even no with many patients on ARV’s having few or even no symptomssymptoms

• Those on ARV’s can have an undetectable viral load, Those on ARV’s can have an undetectable viral load, which also decreases the risk of HIV transmission to which also decreases the risk of HIV transmission to othersothers

Alcohol, Tobacco, and Other Alcohol, Tobacco, and Other DrugsDrugs

TobaccoTobacco• From 2000 to 2004, the average From 2000 to 2004, the average annualannual number of number of

deaths due to cigarette smoking was approx. 443,000 deaths due to cigarette smoking was approx. 443,000 in the U.S.; to put this into perspective, in the entire in the U.S.; to put this into perspective, in the entire Civil War (considered the deadliest conflict in U.S. Civil War (considered the deadliest conflict in U.S. history) 620,000 soldiers died.history) 620,000 soldiers died.

• FDA’s latest efforts include graphic images posted on FDA’s latest efforts include graphic images posted on cigarette packages, including corpses, cancer cigarette packages, including corpses, cancer patients, and diseased lungs: patients, and diseased lungs: http://abcnews.go.com/Health/Wellness/cigarette-http://abcnews.go.com/Health/Wellness/cigarette-packaging-graphic/story?id=12109439packaging-graphic/story?id=12109439

• Do you think these graphic images will help to deter Do you think these graphic images will help to deter people from smoking?people from smoking?

• Take a look at this anti-smoking tour (click the video Take a look at this anti-smoking tour (click the video on the website): http://www.thetruth.com/on the website): http://www.thetruth.com/

• Tobacco not only endangers the life of the smoker, Tobacco not only endangers the life of the smoker, but also of anyone near the smoker (second-hand but also of anyone near the smoker (second-hand smoke), and can cause serious health problems or smoke), and can cause serious health problems or even death in developing fetuseseven death in developing fetuses

AlcoholAlcohol• If you’ve noticed posters on the SHU campus with If you’ve noticed posters on the SHU campus with

drinking statistics, it’s part of the Counseling Center’s drinking statistics, it’s part of the Counseling Center’s campaign to promote responsible behaviors among campaign to promote responsible behaviors among studentsstudents• It’s based on social norms theory, which asserts that we It’s based on social norms theory, which asserts that we

should focus on how popular responsible behaviors are, should focus on how popular responsible behaviors are, rather than focusing on scare tactics: www.mostofus.orgrather than focusing on scare tactics: www.mostofus.org

• Unlike tobacco, which primarily has direct, negative Unlike tobacco, which primarily has direct, negative health effects, alcohol has not only direct, negative health effects, alcohol has not only direct, negative health effects, but also indirect effects in that it can health effects, but also indirect effects in that it can lead to risky and potentially fatal behaviors:lead to risky and potentially fatal behaviors:• i.e., unprotected sex, experimenting with drugs, and i.e., unprotected sex, experimenting with drugs, and

driving while intoxicated; alcohol use has also been linked driving while intoxicated; alcohol use has also been linked to sexual assault and physical assault, including domestic to sexual assault and physical assault, including domestic violenceviolence

• Do you think the news attention on celebrities and Do you think the news attention on celebrities and DWI’s and rehab affects people’s perception of drug DWI’s and rehab affects people’s perception of drug and alcohol use? Are the effects positive, negative, and alcohol use? Are the effects positive, negative, or neutral?or neutral?

Preventing Alcohol and other Preventing Alcohol and other Drug UseDrug Use

• Building up supportive family and social networks Building up supportive family and social networks so that living a drug-free life is “the norm”so that living a drug-free life is “the norm”

• Encouraging healthy activities that don’t involve Encouraging healthy activities that don’t involve drinking, smoking, or drug usedrinking, smoking, or drug use

• Targeting adolescents in these effortsTargeting adolescents in these efforts• Legal enforcement to reduce underage drinking Legal enforcement to reduce underage drinking

and smoking, to stop drug trafficking, and to and smoking, to stop drug trafficking, and to eliminate advertising and selling substances near eliminate advertising and selling substances near schoolsschools

• Encouraging parents to lock medicine and liquor Encouraging parents to lock medicine and liquor cabinets (e.g., a new issue is prescription drug cabinets (e.g., a new issue is prescription drug abuse)abuse)

• Encouraging responsible behaviors, such as being Encouraging responsible behaviors, such as being or using a designated driver, alternating alcohol or using a designated driver, alternating alcohol with water/soda, setting a limit on drinking, looking with water/soda, setting a limit on drinking, looking out for one’s friends to reduce their risky out for one’s friends to reduce their risky behaviors, and “safe rides” programs that offer behaviors, and “safe rides” programs that offer intoxicated individuals a safe ride homeintoxicated individuals a safe ride home

Baby Boomers and The Baby Boomers and The ElderlyElderly

• With advances in medicine, life expectancy With advances in medicine, life expectancy is relatively high for the Baby Boomersis relatively high for the Baby Boomers

• The term “sandwich generation” has been The term “sandwich generation” has been applied to Baby Boomers because many of applied to Baby Boomers because many of them were/are caring for their own children them were/are caring for their own children and/or grandchildren, as well as their own and/or grandchildren, as well as their own elderly parentselderly parents

• In 10-15 yrs., Baby Boomers will be in their In 10-15 yrs., Baby Boomers will be in their 70’s; our healthcare system will be 70’s; our healthcare system will be increasingly strained by this large increasingly strained by this large generation, and the subsequent generation generation, and the subsequent generation (Gen. X—my generation!) may not have the (Gen. X—my generation!) may not have the physical or financial resources to care for physical or financial resources to care for themthem

Improving HealthcareImproving Healthcare• Electronic Medical Records (EMR’s) allow for quick access Electronic Medical Records (EMR’s) allow for quick access

to patient data and improved continuity of care between to patient data and improved continuity of care between different doctorsdifferent doctors• Under the ARRA (Stimulus Package), billions of dollars have Under the ARRA (Stimulus Package), billions of dollars have

been set aside to assist with modernizing health information been set aside to assist with modernizing health information technology systems, with the goal of creating seamless EMR’stechnology systems, with the goal of creating seamless EMR’s

• Allocation of Resources:Allocation of Resources:• Our current system rewards expensive surgeries and Our current system rewards expensive surgeries and

procedures, rather than prevention (i.e., a Cesarean section procedures, rather than prevention (i.e., a Cesarean section can be double the cost compared to a natural childbirth and can be double the cost compared to a natural childbirth and can therefore incentivize more C-sections for greater can therefore incentivize more C-sections for greater reimbursement to the hospital)reimbursement to the hospital)

• This could be changed through a change in Medicare This could be changed through a change in Medicare reimbursement fee structures because most insurance reimbursement fee structures because most insurance companies use pricing similar to Medicare, which reimburses companies use pricing similar to Medicare, which reimburses procedures more than preventionprocedures more than prevention

• See these ideas for cost control, especially focusing on C-See these ideas for cost control, especially focusing on C-sections: http://hrsa.dshs.wa.gov/news/fact/FS009-sections: http://hrsa.dshs.wa.gov/news/fact/FS009-007Hospitalpurchasing-rates-C-sections4-8-09.pdf007Hospitalpurchasing-rates-C-sections4-8-09.pdf

• Taxing unhealthy substances, including cigarettes, alcohol, Taxing unhealthy substances, including cigarettes, alcohol, and even soda, is another strategy to assist with healthcare and even soda, is another strategy to assist with healthcare fundingfunding

Improving Healthcare Improving Healthcare (cont.)(cont.)