HLTH 8050 Week 9 Discussion
The Globalization of Health
Cell phones, video cameras, and other technologies are changing the way we live today. It is difficult to avoid the stories and images of poverty, human rights abuses, disasters, diseases, and other tragedies that plague people in rich and poor countries alike.
It is not just communications technology that is making the world a “smaller” place. Globalization is also exerting a powerful effect on the conditions in which people live and work, (i.e., the social determinants of health) and, thus, on health itself.
Discussion questions:
A brief summary on the effects of globalization on health in Russia.
Discuss one change in quality of life in post-transition Russia.
Also, explain one change in mortality in post-transition Russia.
Provide examples for both. Expand on your insights utilizing the Learning Resources.
Articles:
• Wilkinson, R., & Pickett, K. (2010). The spirit level: Why greater equality makes societies stronger. New York, NY: Bloomsbury Press.
o Chapter 13, “Dysfunctional Societies” (pp. 173–196)
• Averina, M., Nilssen, O., Brenn, T., Brox, J., Arkhipovsky, V. L., & Kalinin, A. G. (2005). Social and lifestyle determinants of depression, anxiety, sleeping disorders and self-evaluated quality of life in Russia: A population-based study in Arkhangelsk. Social Psychiatry and Psychiatric Epidemiology, 40(7), 511–518.
• Frieden, T. R. (2010). A framework for public health action: The health impact pyramid. American Journal of Public Health, 100(4), 590–595.
• Jones, C. P., Jones, C. Y., Perry, G. S., Barclay, G., & Jones, C. A. (2009). Addressing the social determinants of children’s health: A cliff analogy. Journal of Health Care for the Poor and Underserved, 20(Suppl. 4), 1–12.
• Perlman, F., & Bobak, M. (2008). Socioeconomic and behavioral determinants of mortality in post transition Russia: A prospective population study. Annals of Epidemiology, 18(2), 92–100.
Ray, R., Gornick, J. C., & Schmitt, J. (2010, July). Who cares? Assessing generosity and gender equality in parental leave policy designs in 21 countries. Journal of European Social Policy, 20(3), 196–216.
• Stuckler, D., King, L., & McKee, M. (2009). Mass privatization and the post-communist mortality crisis: A cross-national analysis. Lancet, 373(9661), 399–407.
• The PLoS Medicine Editors. (2010). Social relationships are key to health, and to health policy. PLoS Medicine, 7(8), 1–2.
• National Rural Health Mission. (2012). RSBY-Rashtriya Swasthya Bima Yojnab. Retrieved from http://www.rsby.gov.in/
Note: In the Search box, enter “China health outcomes” to locate various articles on this topic.
Please apply the Application Assignment Rubric when writing the Paper.
I. Paper should demonstrate an excellent understanding of all of the concepts and key points presented in the texts.
II. Paper provides significant detail including multiple relevant examples, evidence from the readings and other sources, and discerning ideas.
III. Paper should be well organized, uses scholarly tone, follows APA style, uses original writing and proper paraphrasing, contains very few or no writing and/or spelling errors, and is fully consistent with doctoral level writing style.
IV. Paper should be mostly consistent with doctoral level writing style.
SAMPLE ANSWER
The Globalization of Health
Globalization influences not only trade, finance, science, and environment, but also health and medical care. Communicable diseases like HIV, SARS, H1N1, and swine flu are some of the examples of the diseases that have spread globally. All these spread due to changes in the environment and lifestyle, which is a sufficient evidence that lifestyles are also rapidly changing. Some of the unhealthy ways of living include smoking and obesity. Other examples of globalization of health include international trade of health services, international movement of physicians and nurses, and movement of healthcare consumers (World Health Organization Western Pacific Region, 2009).
Globalization of health has directly affected the wellbeing of Russian population. From the onset, there are high rates of low mood and anxiousness among the Russian population. These health problems are as a result of poor nutrition due to low consumption of food and low payment of professionals. The depression is due to cigarette smoking and taking of alcohol in very large amounts. These health complications have greater influence on circulatory and gastrointestinal diseases (Averina et al., 2005). According to Frieden (2010), clinical interventions that need very small amount of interaction, day-to-day clinical care, health education, and counseling are some of the ways to sort out these health challenges.
The quality of life in post transition Russia has changed drastically. The people have developed poor eating habits. Most people depend on high levels of energy intake from fat. Consequently, this has resulted into increase in weight of individuals, hence, obesity in the older people. Health status of children is equally worrying, with most children having chronic malnutrition. This is also reflected in primary school going children whose health conditions are very poor. At birth, newborns develop disabilities and a high number of children are having physical complications. Poor quality of life is as a result of high poverty levels amongst the citizens. There is high inflation and decline in wages as a result of fluctuation in employment and income patterns (Wilkinson & Pickett, 2010). In order to address some of these challenges, Jones et al., (2009) give a summary of how to handle them. Perhaps, this problem could be solved by having improved health facilities and addressing both equity and factors that promote good health. Therefore, in order to realize low mortality rate post transition Russia ought to address the social determinants of health like empowering its citizens economically and also ensuring that there is equity. Equity involves improving the policies, practices, norms and values that control the distribution of resources. Furthermore, Jones et al., (2009) states that social determinants of health like poverty, automatically eliminate any health inequity.
There is a rise in mortality rate in post transition Russia due to income inequality, unemployment, labor turnover, migration, crime and divorce. These factors resulted into stress which is a major cause of death. Consequently, there was high death of men who were still very young and productive. Another factor that promoted increased death rate is huge increase the number of people and the amount of alcohol taken. The increased use of alcohol resulted into people killing themselves and some involving themselves in road accidents. The increased intake of alcohol is basically as a result of reduction in the amount of money used to buy the substance. According to Stuckler, King, & McKee (2009), the solution to high mortality rate is privatization of institutions especially in post Russian nation.
References
Averina, M., Nilssen, O., Brenn, T., Brox, J., Arkhipovsky, V. L., & Kalinin, A. G. (2005). Social and lifestyle determinants of depression, anxiety, sleeping disorders and self-evaluated quality of life in Russia: A population-based study in Arkhangelsk. Social Psychiatry and
Psychiatric Epidemiology, 40(7), 511–518.
Frieden, T. R. (2010). A framework for public health action: The health impact pyramid. American Journal of Public Health, 100(4), 590–595.
Jones, C. P., Jones, C. Y., Perry, G. S., Barclay, G., & Jones, C. A. (2009). Addressing the social determinants of children’s health: A cliff analogy. Journal of Health Care for the Poor and Underserved, 20(Suppl. 4), 1–12.
Stuckler, D., King, L., & McKee, M. (2009). Mass privatization and the post-communist mortality crisis: A cross-national analysis. Lancet, 373(9661), 399–407.
Wilkinson, R., & Pickett, K. (2010). The spirit level: Why greater equality makes societies stronger. New York, NY: Bloomsbury Press. o Chapter 13, “Dysfunctional Societies” (pp. 173–196).
The World Health Organization and European Union (EU) DETERMINE Consortium has acknowledged gaps in health equities within and between member countries. A variety of efforts are underway to help close those gaps.
Discussion questions:
A brief comparison of the health status of the two EU countries you selected with that of the U.S. Then, describe two efforts in those EU countries to reduce health inequities. Explain what lessons can be learned from the EU efforts you selected that can be implemented in the U.S. nationally or by individual states. Explain how the community you live in might adapt these interventions. Expand on your insights utilizing the Learning Resources.
Articles:
• Gele, A. A., & Harsløf, I. (2010). Types of social capital resources and self-rated health among the Norwegian adult population. International Journal for Equity in Health, 9, 8–16.
Retrieved from the Walden Library databases.
Please apply the Application Assignment Rubric when writing the Paper.
I. Paper should demonstrate an excellent understanding of all of the concepts and key points presented in the texts.
II. Paper provides significant detail including multiple relevant examples, evidence from the readings and other sources, and discerning ideas.
III. Paper should be well organized, uses scholarly tone, follows APA style, uses original writing and proper paraphrasing, contains very few or no writing and/or spelling errors, and is fully consistent with doctoral level writing style.
IV. Paper should be mostly consistent with doctoral level writing style.
SAMPLE ANSWER
Is the EU Closing the Gap on Health Inequities?
A comparison of the health status of Belgium and Germany – two EU member states – with that of the United States reveals that in Germany, the life expectancy for women is 83 years and ranks 15th worldwide, and that of men is 78 years and ranks 16th. Rate of infant mortality is 3.54 deaths for every 1,000 births and ranks 212 globally (NationMaster, 2014). In Belgium, the life expectancy at birth for women is 83 years and ranks 16th globally, and for men is 77 years, and ranks 25th worldwide. The rate of infant mortality is 4.33 deaths for every 1,000 live births (NationMaster, 2014). In USA, life expectancy for women is 81 years and ranks 33rd and for men is 76 years, ranking 30th worldwide. Infant mortality rate in America is 6.06 per 1,000 live births, ranks 179 globally (NationMaster, 2014). As illustrated in the health status statistics, Europeans in the selected EU countries have higher life expectancies than Americans and infant mortality is higher in the United States than in Belgium and Germany.
The two efforts in both Belgium and Germany to reduce health inequities are as follows: (i) the actions taken concerning healthcare access include the improvement of quality as well as accessibility of healthcare, and the focus is on affordability (Commission of the European Communities, 2007). Moreover, the governments of Germany and Belgium have taken actions to ensure emergency medical aid for everyone, and they provide increased reimbursement to vulnerable groups who include cancer patients and those with chronic illnesses. They also undertake initiatives that target the decrease in price of drugs; maximum bill for costs of healthcare; and improving proximity of healthcare services (Equity Action, 2013). Furthermore, there is cross-sector policy plan aimed at fighting poverty and guarantee the right to health. The plan encompasses 12 measures including measures to increase the use of the 3rd party payer system by the healthcare providers, and measures to increase hospital admission of poor people (Wevers et al., 2007).
(ii) Actions taken concerning prevention and health promotion include providing affordable, quality and durable housing for everyone, and stress management for persons living in poverty. They also include providing preventive health checks at school, and promotion of balanced and healthy nutrition in vulnerable groups and in the general population. There is also focus on occupational diseases and industrial accidents and in combating drug and alcohol use in working settings (Equity Action, 2013).
Lessons that Americans may learn from the EU efforts selected and that can be implemented in the United States by individual states or nationally are as follows: first, governments in the United States, be they state governments or the federal government, should establish a policy plan aimed at reducing poverty and guarantee every person’s right to health. This policy plan should include among others, measures to increase hospital admission for the poor Americans. Secondly, to reduce inequities in health, state governments in the U.S should provide increased reimbursement for groups that are vulnerable such as patients with chronic sicknesses. State governments should promote a balanced and healthy nutrition. Thirdly, stress management should be provided to poor people to reduce cases of suicide; preventive health checks be provided in American schools; and the federal government should ensure the availability of affordable, durable, and quality housing for all Americans. The federal government should also develop policies intended to reduce the price of medicines. The community that I live in might adapt these interventions by consuming more balanced and healthy nutrition; seeking durable and quality housing; and the poor in the community would get help to manage their stress. Community members would also be able to purchase medicines at affordable prices.
Wevers, S., Lehmann, F., Nurnberger, M., Reemann, H., Altgeld, T., Hommes, M., Luig, H., & Mielk, A. (2007). Strategies for Action to Tackle Health Inequalities in Germany. BGG, 50(4): 484-91
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Comparing the US and Canada Healthcare Systems under Current Public Policy Reform Order Instructions: This assignment comes in two section A and B, each section should have a separate references list at the end of that particular section, and secondly, the references should be a minimum of 4 for each section.
Comparing the US and Canada Healthcare Systems
Also, note that for section A the will be a power point presentation written from what will be done this week so the writer must pay attention to the instruction on that section. Also, the paper should be written in an expository manner, it should be more concise.
SECTION A (2 pages minimum)
Comparing Health Systems under Current Public Policy Reform
Take note that each section for this assignment must have its own reference list at the end of that section. And each section must have at least 4 references. The entire paper must be in APA.
For your next week assignment, you will create a PowerPoint® presentation to compare the U.S. health system to a system in another country. In the main time for this week, debate, which country compares the best in terms of operations, financing, and outcomes, and tell us why.
SECTION B (2 pages minimum)
Comparing the History of Health Systems and Health Reform
This section must have its own reference list at the end of this section all in APA format and must be at least 4 references minimum.
Compare the history of U.S. health, financial, and system reform from President Roosevelt through the current U.S. President’s administration to the history of health reform in another country.
Comparing the US and Canada Healthcare Systems Resources
Required Reading
Policy and politics in nursing and health care
• Unit 7: “Policy and Politics in the Community” (Chapters 101–104)
Articles
Reader-Friendly Patient Protection and Affordable Care Act PL 111-148
< http://www.hhs.gov/healthcare/rights/law > [9/24/2014]
Here is a very reader-friendly website that offers a breakdown of the Patient Protection and Affordable Care Act PL 111-148
Teladoc
< http://fortune.com/2014/09/24/obamacare-telemedicine-doctors-booming/ > [9/26/2014]
Impact of Hobby Lobby Decision
< http://www.newyorker.com/news/daily-comment/hobby-lobbys-troubling-aftermath > [10/1/2014]
Comparing the US and Canada Healthcare Systems Sample Answer
Comparing the U.S. and Canadian Healthcare Systems under Current Public Policy Reform
Whenever there are arguments about health care reform, the Canadian system is frequently chosen as the possible model for the United States. This is because the health care system of the United States is completely different from the Canadian System. Canada features a single-payer, which is mostly the publicly funded system, while the United States features a multi-payer, a greater percentage of which is a private system. Despite these differences, the two countries have been noted to be culturally similar, thus one may adopt the system of the other. Since the United States is not performing as expected, chances are high that it may benefit from the Canadian system. Thus, this section champions the thesis that the Canadian Health System is better than that of the United States.
While comparing the health systems from these two countries, it is clear that the United States has better operations than Canada, a factor that may be attributed to the presence of enough equipment needed for health care. The United States has a better availability to healthcare resources such as those required for cancer screenings (Kuan-Chou & Keh-Wen “Carin”, 2013). This availability ensures that health care operations are not interrupted or stopped due to their absence. Thus, the United States is constantly presenting patients with the health care they need since their operations are always running. This is one reason why cancer screenings have been noted to be much higher for the U. S than in Canada. For instance, 86% of U.S women aged 40 to 69 have already had a mammogram, as compared to a lower value of 73% of Canadian women (Kuan-Chou & Keh-Wen “Carin”, 2013).
When it comes to health care financing, the Canadian system is way better than that of the United States. This is because it provides more care to patients for less. A provision of universal access to health care for all citizens is the case in Canada (Zinszer et al., 2013). The United States, on the other hand, fails to do so like one in every five elderly individuals is left uninsured (Kuan-Chou & Keh-Wen “Carin”, 2013). The U.S is, however, trying to deal with this issue by encouraging insurers to offer to fund even to the new institutions bound to open under the Obamacare (Wieczner, 2014). This would better the chances of individuals getting affordable care online, without worrying about not being insured. Canada is better than the U.S when it comes to funding, also because it spends less of its GDP on healthcare compared to the U.S, and it still manages to show better performance as noted when analyzing health outcomes such as infant mortality rate and life expectancy (Zinszer et al., 2013). Canada allocates 10.4 %, while the U.S allocates 16% to health care (Zinszer et al., 2013).
Health care operations in Canada have been noted to be poor, owing to the fact that they do not have access to sufficient health care resources, as well as enough hospitals for all patients. This is because the country is only dependent on public hospitals as private health care facilities were banned from operating (Zinszer et al., 2013). Thus, when patients go to a hospital to seek treatment for minor medical situations, they are often kept waiting for hours on end. Hence, because of relying solely on public hospitals, most patients feel like their needs are not met since there is a shortage of facilities, and patients are many. Therefore, Canadian operations are poor compared to that of the United States.
Although health outcomes are affected by other factors aside from the health care system, such as substance abuse, it is also possible for the systems to regulate these outcomes. In the U.S., most individuals are suffering from various diseases, which could be avoided in the first place. For example, 33% of U.S. women have Obesity, compared to 19% of them in Canada (Kuan-Chou & Keh-Wen “Carin”, 2013; Mason, Leavitt & Chaffee, 2012). This poor outcome from the U.S health system proves that the country is not doing well to try and control these diseases. This may be attributed to the fact that the system is not considering the community in forming policies affecting their health (Toobin, 2014). It is important to understand and consider the different forms of cultures so as to result with a healthy public policy that will ensure everyone receives treatment without affecting their cultural beliefs.
Comparing the US and Canada Healthcare Systems References
Kuan-Chou, C., & Keh-Wen “Carin”, C. (2013). Using Systems Thinking To Analyze Health Care In The United States: Should We Move To A Government Sponsored Health Care System?. Academy Of Health Care Management Journal, 9(1/2), 3-12.
Policy and Politics in the Community (2012). In D. Mason, J. Leavitt, & M. Chaffee. Policy & Politics in Nursing and Health Care, 6th Edition. Elsevier Saunders.
Toobin, J. (2014, September 30). On Hobby Lobby, Ginsburg Was Right. Retrieved October 2, 2014, from The New Yorker: http://www.newyorker.com/news/daily-comment/hobby-lobbys-troubling-aftermath
Wieczner, J. (2014, September 24). Thanks to Obamacare, virtual-reality doctors are booming. Retrieved October 2, 2014, from Fortune: http://fortune.com/2014/09/24/obamacare-telemedicine-doctors-booming/
Zinszer, K., Tamblyn, R., Bates, D. W., & Buckeridge, D. L. (2013). A qualitative study of health information technology in the Canadian public health system. BMC Public Health, 13(1), 1-7. doi:10.1186/1471-2458-13-509.
Comparing the History of Health Systems and Health Reform
Canada is similar to the United States as they both have a national health insurance program. This is basically an insurance program run by the government, and it covers the whole population. The Predecessor of President Truman, Franklin D. Roosevelt, never took any initiative to improve the healthcare system of the United States. In the New Deal programs, healthcare accessibility was one of the few issues, which were left out. In a proposal recommended to Congress, Truman was suggesting the implementation of a universal health insurance coverage, which would be administered and funded by the National Health Insurance Board (Carpenter, 2009).
This administration only supported a few health care reform proposals as most of its focus was on the Cold War. The Military Medicare, intended for the provision of military dependents with healthcare services payments, was enacted in 1956. Ever since this time, the Military Medicare program has been reformed by most of the presidents, such that currently, it supports the elderly and not only the military personnel (Compilation Of Patient Protection and Affordable Care Act., 2010). A bill that died was the Forand bill that was supposed to provide health insurance for the beneficiaries of the Social Security. In Canada, only a few programs were being declined, contrary to the case in the United States.
The Johnson administration managed to pass the legislation that would establish Medicare and Medicaid programs in 1965. As it was previously enacted, the Social security Amendments during this year ensured health coverage to individuals 65 years and older, as well as to the poor, blind and disabled. The healthcare services covered included hospitals, nursing facilities, physicians, and also the home care providers. This is yet another similarity between the two countries, as they both managed to support health reforms that would eventually lead to the establishment of a program known as Medicare. This, however, is just a name for the program; the difference is that the United States program supports the elderly aged 65 and older. While the other supports the whole population of Canada.
Canada’s health system reform happened during the 1960s and 1970s, but before this time, it featured a similar system to that of the United States. When considering the per capita basis and GDP percentage, it is clear that the United States spends so much more on its health care system than that of Canada. In 2006, per capita expenditures on health care in Canada was recorded at $ 3678, while the U.S used $ 6714 (Duffin, 2011). This difference, however, may be attributed to the fact that Canada has been experiencing financial issues, while the U.S is more stable. Contrary to the situation in the U.S., where healthcare funding was excessive to the point that it as being contested, Canada was facing issues trying to receive enough funds to facilitate the reform of its system. As a result of this, most of the healthcare reforms were focused on improving the financing of the health system of Canada, unlike in the U.S where these reforms were supposed to better the provision of care. For example, the Hospital Insurance and Diagnostic Services Act of 1957, and The 1966 Medical Care Act (Duffin, 2011). Most of these proposals were enacted with the approval of all parties, unlike the case in the U.S whereby most proposals were contested.
Comparing the US and Canada Healthcare Systems References
Carpenter, C. E. (2009). We’ve Been Down This Road Before– Health Reform in the United States. Journal Of Financial Service Professionals, 63(4), 23-26.
Compilation Of Patient Protection and Affordable Care Act. (2010). Office of the Legislative Counsel.
Duffin, J. (2011). The Impact of Single-Payer Health Care on Physician Income in Canada, 1850-2005. American Journal Of Public Health, 101(7), 1198-1208. doi:10.2105/AJPH.2010.300093
Jost, T. (2012). Eight Decades of Discouragement: The History of Health Care Cost Containment in the USA. Forum For Health Economics & Policy, 15(3), 53-82. doi:10.1515/fhep-2012-0009
Select one of the following ethical issues in healthcare:
Foregoing curative medical treatment due to religious beliefs
Use the CSU Global Library and select Internet sources to conduct research on your chosen topic. Based on your research, provide the history of the issue from a legal, ethical, and moral perspective. In your paper address the following questions:
Do the consequences of actions always direct what is morally required?
What should happen when two principles come into conflict? For example, should patient autonomy be considered more important than beneficence? Defend your position.
Are moral and ethically rules always binding, or are they only guidelines to be assessed in each case? Defend your position.
Your paper should be 10-12 pages in length, well-written, and formatted per CSU-Global specifications for APA Style. Support your analysis by referencing and citing at least six (6) credible, peer-reviewed sources other than the course textbook (Ethics in Health Administration: A Practical Approach for Decision Makers, 2nd ed, by Eileen E. Morrison).
SAMPLE ANSWER
Foregoing Curative Medical Treatment Due to Religious Beliefs
Introduction
Healthcare professionals frequently find themselves in dilemmas as they undertake their chores at the workplace, with some directly confronting the ethical issues while others turning away. Usually, the moral courage that one possesses is what matters most as it, more often than not, helps the practitioners in addressing the various ethical issues that may present themselves; which could even involve doing something otherwise considered wrong. Inasmuch as there usually are predetermined courses of action considered ethically moral or otherwise, the consequences of the course of the action taken is what really matters (Stewart, Adams, Stewart, & Nelson, 2013). Because of this, an action that is otherwise not acceptable may have to be carried out in order to get to achieve a desirable consequence; for instance, according to most religious doctrines, abortion is not acceptable, even the conscience of the individual that may be involved may not allow it. However, if done for the sake of good will remains morally binding, for instance, the case of complications in pregnancy.
In order for us to get to understand the implications of the ethical issues pertinent with the health care practice, there is the need to understand the definition of nursing by the International Council of Nurses (ICN). Under it, the profession is defined as: “Nursing encompasses autonomous and collaborative care and communities of all ages, groups, families and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention f illness and the care of ill, disabled, and the dying people. Advocacy, promotion of safe environment, research, participation in shaping the health policy and in patient and health systems management, and education are also key nursing roles.” (ICN, 2011). As outlined by Morrison (2011), the definition incorporates the three fundamental components of bioethics. It is, thus, conceivable to say that the health practitioners have the obligation of developing a well-founded ground of ethical understanding with regards to the protection of the people; which is their sole duty.
Moral Courage
The ability of one to make the right decisions in such situations that involve moral and ethical issues is what is called moral courage. According to Day (2007), moral courage is “a trait displayed by individuals, who, despite adversity and personal risks, decide to act upon their ethical values to help others during difficult ethical dilemmas. As Hall (2014) asserts, such individuals tend to strive to see to it that the only do what is right, even in cases whereby most are expected to choose least ethical behavior, which could even be not taking any action.
Conflict of Principles
Religious, spiritual and cultural beliefs and practices remain very crucial in the lives of most patients, yet most health practitioners usually find themselves at the dilemma of whether to, how and when to address such issues when dealing with patients. In the past, the physicians were basically trained on the various ways of diagnosing and treating the various diseases, but with very little or no training on the spiritual approach to the ordeal. Besides, the professional ethics allows the professionals no chance of impinging their personal beliefs on their patients who are usually very vulnerable (Brierley, Linthicum, & Petros, 2013). The matter is even complicated further by the characteristic nature of most nations of religious pluralism, having a wide range of systems of beliefs: agnosticism, atheism to the very many religious assortments. Because of this, it tends to be very difficult getting to fully understand the religious beliefs of all the patients from all walks of life.
The very first temptation that would prove worthwhile in this case is for the professionals to fully avoid the doctor patient interactions with respect to their spiritual or religious beliefs. This simplest solution may never be the best as several studies have shown that the spiritual and cultural beliefs f various patients have been proved to be very important factors for the patients to be in a position of coping with relatively serious illnesses (McCormick et al, 2012). McCormick et al (2012), assert that the engagement of the spiritual beliefs of the patients in their healing process may be devised by the health practitioners through comparison of their own beliefs against those of the patients.
Case Scenario: Foregoing Curative Drugs due to Religious Beliefs
In some communities, there is too much belief in the traditional practices that accepting the modern medicines becomes very difficult. Such communities have a belief system in which they believe and may recognize the move towards accepting the western medicine as evil. In such a case, the patient may never be taken to the hospital, or worse still, after getting to the hospital refuse to take the prescribed medicine on the belief that it is against the doctrines of their religion. The most common cases, include, but not limited to; blood transfusion, abortion, taking of family planning pills and even the normal tablets.
Conflict in Principles
In case of the principles coming into conflict, there usually is the need to be very flexible as there are so many ways in which the situations may present themselves. For effective resolution of such conflicts, the ethical and professional principles, rather than the personal preconceived ideas, should always form the pillar for the effective decision making when it comes to ethics (ANA, 2011). The ethical behavior of nurses is usually guided by a set of principles contained in the American Nurses Association (ANA) Code of Ethics of Nurses (2001). It is expected of all the nurses that they uphold all the principles in the course of their practice of professional nursing, while, at the same time, the Cord of Ethics for Nurses encourages them to ensure consistency with their personal values. There is also emphasis on the need to hold open discussion with regards to conflicting ethical principles in such a manner that all the principles are placed at the same level and treated equally.
Autonomy versus Beneficence
Autonomy
Autonomy refers to the personal self-rule that is both free from controlling such interferences that may result from others and the personal imitations that my put meaningful choices at jeopardy. In the health care, autonomy forms one of the key guidelines for the clinical ethics. A point that must be noted is that when speaking of autonomy, it does not merely imply leaving the patients the freedom of making their own choices. Rather, the health practitioners are under an obligation to see to it that they create the conditions that provide room for the independent choices, thought under some guidance. The respects for autonomy scenarios include giving room for autonomous choices as well as respecting the right to self-determination of an individual.
It must be noted that the doctors are usually visited by the people because they may not be equipped with the necessary information or background necessary for the making of informed choices. Hence, it is the physicians that educate the patients in order for them to adequately understand the situations, including; addressing the fears and emotions that may interfere with the decision making ability of the patients. Confidentiality is another form of autonomy very crucial in administering the treatment to the patients.
Beneficence
Usually, this is an action done purely for the benefit of others through either removing harm or simply by improving their situations. Apart from being refrained from causing harm, the health practitioners are expected to see to it that they help the patients. Due to the nature of the relationship inherent between the patients and the physicians, the doctors have the obligation removing or preventing harm and balancing and weighing the possible risks against the possible benefits of any action.
Balancing of autonomy and beneficence
Amongst the most difficult and common ethical issues to tackle comes in when the patient’s autonomous decision comes into conflict with the beneficent duty of the physician, which is mainly looking after the best interest of the patient. For instance, a patient who has very strict religious background may refuse to take medicine, simply because they believe in spiritual healing. This may be so challenging, especially when the physician has successfully diagnosed the ailment and knows its cause well, hence, its prescription (ANA, 2011). At such a point, the physician may be under the challenge of whether to maintain the autonomy of the patient or take a beneficence action, which will violate the autonomous requirement of the patient. More often than not, the two are equally important, however, beneficence comes first as it is a matter of life and death.
Basically, the modern biomedical ethics are grounded on four principles, which balance categorical Imperative of Emmanuel Kant: you must always do the right thing no matter what it takes, and Utilitarianism of John Stuart Mill and Jeremy: make the best decision for everyone all around. When in combination, the principles are usually called Principalism.
Respect for autonomy: giving priority to the informed choices of the patient. This theory asserts that the practitioners need to see to it that the wishes of the patients are taken into consideration. As such, the wish by a patient to have a kind of special attention with regards to choice of the health care services administered should solely depend on the patient’s wish.
Non-malfeasance: do no harm
Beneficence: do what is best for the patient, regardless of their consent. This principle asserts that the consent of the patient may be overlooked in order to see to it that the course of action is for their own good. With this, the health care practitioners are expected to ensure the good of the patients even if it means doing what they don’t wish for. The ultimate consideration of the morality will lie in the consequences, and at times, even if a patient requested for the end not to have blood transfusion due to religious beliefs, they may eventually end up thanking the physician, rather than suing them (Morrison, 2011).
Justice: always balancing the social and individual costs, risks and benefits. The physician has the obligation of seeing to it that they properly advise the patients with respect to the possible risks involved to ensure they are well informed before getting to a medical ordeal.
Morals and Ethics
Most of the moral dilemmas that tend to arise in medicine are usually analyzed using the four aforementioned principles but with some consideration given to the resultant consequences, though the frameworks may have limitations. The judgment of the best consequences is not always clear, and din case the principles conflict, the ease of deciding on the best dominant is always very hard. Virtue ethics usually focuses on the nature of the moral agent rather than how right the course of action taken is. Usually, as a practitioner, the ethical principles, which guide what action to be taken do not usually take into account the moral agent’s nature (Cordella, 2012). To look into how binding the morals usually are, the “standard” Jehovah’s Witness case may be used.
A very competent adult believer loses too much blood due to bleeding in a vessel in an acute duodenal ulcer, and the only best chances of saving his life is by having a blood transfusion together with some operation done on him. In exercising his autonomous decision, the patient requests for surgery and treatment with the best non-blood products available, and refuses blood transfusion. He even accepts the risks that are pertinent with surgery without blood transfusion.
It is very important for the health practitioners to get to distinguish between morality and legally binding courses of actions as an action may be legal but not moral and vice versa. For instance, the resuscitation of a dying patient may be considered legal, but not moral. On the other hand, when a patient falls too sick at home, it may be moral to over speed to the hospital but illegal. Also, the physicians have the obligation of distinguishing between religion and morality. From instance, some of the religions believe in circumcising women while others recognize it as a sin.
Moral Frameworks
However, the moral theories tend to provide different frameworks upon which the nurses may be able to get clarification as well as view the patients’ disturbing situations. Widely used and applicable are three frameworks that may guide the physicians. The three basic broad categories of the moral frameworks are: virtue theory, deontological and utilitarianism theory.
Virtue theory
This theory exclusively probes the human morality. It gives very little attention to the regulations that people need to adhere to; rather, it puts more emphasis on what is deemed necessary in development of human characteristics considered as good, just like living a generous and kind life.
Deontological ethics
These are usually associated with the ethical and moral standards in the execution of the professional duties by the health professionals.
Utilitarianism theory
This is the belief that any form of action is considered as being right as long as it leads to the greatest good for larger number of people. As such, there usually is a calculation on the outcome of any particular action. As such, if a health practitioner considers an action as having high propensity of bringing good and happiness to larger number of people; it definitely is the right thing to do (Morrison, 2011). In other words, the utilitarianism tends to base its reasoning on the usefulness of the action that may make it be considered as moral or immoral; for the course of action to be considered as moral, the good outcomes have t outweigh the bad ones.
Moral principles
They are the broad and general statements of philosophical concepts that provide the foundations upon which the moral rules are founded.
The health practices usually come with too many challenges which leave the practitioners at a dilemma in more often situations than not. For instance; the debate n abortion, organ transplant, end-of-life issues, management of personal health information and the allocation of the scarce health resources. Looking into each of the aforementioned issues, it usually leaves the platform very open for the practitioner to decide what they deem right course of action to take. As put across by Elliot (2011), “Culture provides the rules or framework that guides us as we negotiate our way through our daily activities of life.” Through the assessment of the heritage of any particular patient helps the nurses to understand well how such a person relates to their surroundings, how they view health and wellness, their various ways of gaining and applying knowledge as well as any other area that may be of interest in health care provision.
Most of the nations of the world, for instance, in America, the populations are characterized by people of vast diversification in the religious, ethnic, sexual orientation and nationality. As such, the patients that visit the health centers present with themselves varied symptoms requiring medical attention, some based on illness while others grounded on the cultural and religious backgrounds of the patients.
As the patients are guided through any healthcare facilities of the dialysis unit, it is very recommended that the practitioners not only concentrate on the clinical needs, but also see to it that they identify the patient’s demographics and religious orientations amongst others. The problem very common is the avoidance of the common mistakes that greatly impact safety and quality and instead, pay too much attention on the nature of the illness and how the patient may be treated. In doing this, they are not really identifying with the patient in order to attend to them as an individual. A point that must be noted is that all patients have diversified characteristics and needs, both the clinical and non-clinical, which affects the manner in which they participate, receive and view their treatment (Morrison, 2011).
Unlike in the past when health provision was mainly limited to a particular community, mostly, where one came from, there have increasingly arisen changes due to the cultural and religious diversity. There is need for the healthcare providers to see to it that they are well conversed with all the possible cultural and religious traditions inherent in the societies within which they work. It is based on this challenge that the terminology ‘cultural competence’ came to be, whereby all the practitioners are expected to be able to work in the various cultural and geographical regions without much trouble (Cordella, 2012). This may only be so through getting to first and foremost understand the various cultures to help learn their beliefs.
A fact that all health care practitioners must come to terms with is the diversity in the religious beliefs inherent in the various cultures and people from different walks of life. The beliefs of the various patients tend to be aligned to their religious backgrounds, which may never be easy to change. Due to this, it is in order that all the professionals fully understand the possible challenges that they may expect, however, they should never let the various beliefs by such patients waver their conscious mind of making the right decisions to do good. Once a person believes in the consequence o the course f action they are about to take, they should do so without any fear.
Conclusion
In conclusion, we as health practitioners are faced everyday with caring for patients of different faiths, cultures and religions. It is important to always keep an open mind and allow yourself to try to understand the faith that our patients believe. Understanding other cultures and beliefs are critical in the healing process. In healthcare today as physicians, we need to keep an open and unbiased mind, treating everyone as equal. Through the development of proper cultural competence, we may help our patients by accepting their beliefs without abandoning our own personal customs. As health practitioners, we may not be able to change the beliefs of the various patients from the different walks of life as the populations continually get diversified, rather, there is need to remain open minded in order to accommodate the diverse beliefs. In addition, as long as we believe that the course of action that we are taking will lead to more good than bad, then the autonomous stake of the patients should always be put at stake. After all, they will eventually appreciate the results.
Brierley, J., Linthicum, J., &Petros, A. (2013). Should religious beliefs be allowed to stonewall a secular approach to withdrawing and withholding treatment in children?. Journal of Medical Ethics, (9). 573. doi:10.1136/medethics-2011-100104.
Conflicts between religious or spiritual beliefs and pediatric care: informed refusal, exemptions, and public funding.(2013). Pediatrics, (5), 962.
Cordella, M. (2012).Negotiating Religious Beliefs in a Medical Setting. Journal Of Religion & Health, 51(3), 837-853.
Elliot G. (2011). Cracking the cultural competency code. Canadian Nursing Home, 22(1), 27-30.
Hall, H. (2014). Faith healing: religious freedom vs. child protection: the medical ethics principle of autonomy justifies letting competent adults reject lifesaving medical care for themselves because of their religious beliefs, but it does not extend to rejecting medical care for children. Skeptical Inquirer, (4). 42.
International council of nurses, (ICN). (2011). Nursing and health professions. 2011.
Krohn E. (2013). Recovering health through Cultural Traditions. Forth World Journal, 12.
Lamparello, A. (2001). Taking God Out of the Hospital: Requiring Parents to Seek Medical Care For Their Children Regardless of Religious Belief. Texas Forum On Civil Liberties & Civil Rights, 647.
Morrison, E. E. (2011). Ethics in health administration : a practical approach for decision makers / Eileen E. Morrison. Sudbury, Mass. : Jones and Bartlett Publishers, c2011.
Stewart, W., Adams, M., Stewart, J., & Nelson, L. (2013).Review of Clinical Medicine and Religious Practice. Journal Of Religion & Health, 52(1), 91-106.
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Closing the gap on health inequities has been an important part of the work of the EU since 1992, when specific competencies for public health were included in the Maastricht Treaty. However, large differences in health still exist between and within all countries in the EU, and some of these inequalities are widening. The consortium report has identified many inequalities among its member states (EU, 2003).
The report examines some of the factors causing health inequalities. The analysis supports the findings of the WHO CSDH (1) that social inequalities in health arise because of inequalities in the conditions of daily life and the fundamental drivers that give rise to them. There are significant differences in mortality between Member States, with higher mortality for males than females in each Member State. In Bulgaria and Romania, the age-standardized death rate for males in 2010 exceeded 1 200 per 100 000, while it was below 800 in 17 Member States, with the lowest values being 561 for Greece and 619 for Sweden. A similar pattern was seen for females, but at a lower level of mortality. In six Member States the female rate exceeded 600 per 100 000 and in 16 Member States it was below 500 per 100 000. In this case, the highest values were seen in Bulgaria and Romania. Inequalities in life expectancy between Member States were smaller for females than for males. Female life expectancy was lowest in Bulgaria — 5.5 years below that for the EU – and 7.9 years or 10 % higher than in Bulgaria, 2.4 years above the EU average (EU, 2010).
EU (2012) has indentified many actions for strengthening the existing actions to reduce health inequalities. They include:
Distributing health equitably as part of the overall social and economic development;
Improving the data and knowledge base and mechanisms for measuring, monitoring evaluation and reporting;
Improving the exchange of information and coordination of policies between levels of government and across departments, and creating partnerships that are more effective with stakeholders:
Meeting the needs of vulnerable groups; and
Evaluating the effectiveness of EU policies in tackling health inequalities, directly or indirectly.
There are also health differences in USA, just like in EU. In EU, with its publicly funded health care systems, the healthy sustainability gap still exists. In the USA, where only about half of healthcare spending is publicly financed and half privately funded, the excess growth in health care spending still presents the greatest threat to service provision. If the actions, which have been identified by the EU will be implemented in my society, the health inequity gap will be reduced. Distributing health equitably as part of the overall social and economic development and meeting the needs of vulnerable groups in the community will largely reduce this gap.
Most policies with explicit aims to reduce health inequalities should focus on vulnerable groups such as immigrants, ethnic minorities, early school leavers, people from lower socio-economic groups or unemployed or homeless people. Equally, universal policies do not have a proportionate leveling-up component. The policy implications of the social gradient in health, and effective methods of addressing these gradients appear to be poorly understood and acted upon. Greater emphasis should be placed on introducing, monitoring, and evaluating policies that have this component.
References
EU, 2012. ‘Report on reducing health inequalities in the EU’, Committee on the Environment,
EU, 2010. European Economic and Social Committee opinion ‘Solidarity in health: reducing health inequalities in the EU’, 3.5.2010 [date accessed: 8.10.2014]. Available from: http://www.eesc.europa.eu/?i=portal.en.soc-opinions.14245
WHO, 2008. Closing the gap in a generation — Health equity through action on the social determinants of health. Final report of the World Health Organization Commission on Social Determinants of Health, 2008. [date accessed: 8.10.2014]. Available from: http://www.who.int/social_determinants/en
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discuss methods to evaluate the effectiveness of your proposed solution and variables to be assessed when evaluating project outcomes.
Example: If you are proposing a new staffing matrix that is intended to reduce nurse turnover, improve nursing staff satisfaction, and positively impact overall delivery of care, you may decide the following methods and variables are necessary to evaluate the effectiveness of your proposed solution:
Methods:
Survey of staff attitudes and contributors to job satisfaction and dissatisfaction before and after initiating change.
Obtain turnover rates before and after initiating change.
Compare patient discharge surveys before change and after initiation of change.
Variables:
Staff attitudes and perceptions.
Patient attitudes and perceptions.
Rate of nursing staff turnover.
Develop the tools necessary to educate project participants and to evaluate project outcomes (surveys, questionnaires, teaching materials, PowerPoint slides, etc.).
SAMPLE ANSWER
Developing an Evaluation Plan
Project outcomes need to be evaluated to see how effective the applied solutions were or whether they carry any potential. The solutions and variables applied are evaluated resulting to some findings. The greatest contributors to job dissatisfaction with the staff are found to be in relation to the organizational climate, nurse turnover, their health benefits and working conditions. Nurses express satisfaction with the provision of essential drugs. The staff have a negative attitude towards working as they are not put into consideration as individuals whose needs are also to be attended to for the better of the patients and themselves (Needleman, 2006). All these will be analyzed before the initiation of change. The survey will be done and solutions derived. A strong line management and support from it will be found to have improved the staff’s attitude and led to a reduction in job satisfaction (Lankshear, 2005). Support from the management and good communication improve the working state. Essential working instruments like gloves will also be administered to change the working condition.
The rate of nurse turnover is a great concern for healthcare organizations and is likely to become worse. It costs a lot in terms of hiring, orientation and training, compromised quality of care and the lack of organizational knowledge. It can be especially problematic: directly or indirectly. It may be considered direct when the costs are clearly attributable to a specific activity or are more obvious like advertising costs. Those that cannot be attached to a particular activity and may be inappreciable like loss of organizational knowledge are indirect (Finkler et al., 2007). After coming up with solutions like increasing compensation and benefits for nurses, supporting flexible scheduling and job sharing, recognizing and rewarding superior performance, the rate of nurse turnover will reduce remarkably and improve the concerned areas.
A great comparison between patient discharge surveys before change and after initiation of change is a great step to be used in this evaluation. Initially, patients express with great satisfaction their thoughts on clinical service and the public health services but may be less satisfied with the provision of essential drugs and health insurance schemes. Those greatly affected are the elderly, retired, and those with low income. After coming up with ways to solve the issue with the help of the government, a program will be enacted with the sole responsibility of providing supplement support to the disadvantaged by paying health premiums and covering all extra costs. Primary care facilities will also not be allowed to earn any profits on essential drugs thus reducing the prices of essential drugs.
The attitudes and perception of staff in their work place are full of tension as they are not provided with everything they need for job satisfaction in the various departments. They perceive the administration or management to be one that does not care about their wellbeing as individuals and as employees. Recognition is not administered to them for their work done. A positive attitude towards the provision of drugs was registered but with issues like working conditions and organizational climate, a negative attitude was registered. The patients’ perception about the staff, management and activities to be carried out will be of great standard. To them, everything to do with healthcare ought to be of great value and lots of care considered for healthy lives and good working force. The rate of nurse turnover is viewed as an aspect to be considered for the success of flow of activities. The administering of proper measures to resolve the issue save time and efforts that would be highly costly at a later time (Aiken 2007).
To successfully educate project participants and evaluate project outcomes, questionnaires will used. The questionnaires will structured in a way that provides the name of the employer, allowing us to aggregate responses by hospital for the analysis of nurses’ reports and patient satisfaction. They shall also include questions about the work environment, job satisfaction, and experience of nurse turnover.
Finkler, S.A., Kovner, C.T., & Jones, C.B. (2007). Financial management for nurse managers and executives.
Lankshear, A.J., Sheldon, T.A., & Maynard, A. (2005). Nurse staffing and healthcare outcomes: A systematic review of the international research evidence.
Needleman, J., Buerhaus, P.I., Stewart, M., Zelevinsky, K., & Mattke, S. (2006). Nurse staffing in hospitals: Is there a business case for quality? Health Affairs, 25(1), 204-211.
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for this paper, the writer has to follow proper instructions and use examples that have been giving to complete this paper. The paper has to be in the format of the examples, but must be writing base on the propose policy proposal that we are working on that is also included hear in the instructions and the questions.
Policy Change Options
Three existing policy change options include incremental change, major change, or to do nothing. An incremental change, like most U.S. health policy change, would occur when policymakers limit themselves to a small subset of strategies to account for a lack of time or capacity in a highly complex and resource-intensive decision (Mason, Leavitt, & Chafee, 2014). A major change would include a larger-scale, more radical policy change. Finally, selecting the option to do nothing means that no change will be made to the policy.
Reference
Mason, D., Leavitt, J., & Chaffee, M. (2014). Policy & politics in nursing and healthcare (6th ed.). St. Louis, MI: Elsevier Saunders.
Explain three pros and three cons for each policy change option relating to your propose policy change proposal hear below.It is critical that the pros & cons are clearly writing in an expository manner with just enough information to understand your change.
The public policy problem is that section 2713 requires organizations to provide their workers with birth control as part of their insurance coverage. The public policy question is: should the federal government mandate that organizations can choose whether or not to provide contraceptive services to employees as part of their insurance coverage? The public policy resolution is an amendment to section 2713(a) (4) of PL 111-148 that would say: organizations – both for-profit and non-profit organizations – have the option of either offering their employees birth control as part of their insurance coverage or not to offer contraceptive services (Cauchi, 2014).
Here is an example of what the response is supposed to look like, but it should be based on the above propose policy change and not the one use hear in the example. This example is just to show the writer how to response to the paper. It is critical that the pros & cons are clearly writing in an expository manner with just enough information to understand your change.
Example of the pros and cons and how the paper will look like at the end, but it should be based on the above propose change.
Pros and Cons for Policy Change Options
Pros for the Option to Do Nothing
1. If nothing is done, the training demonstration program will offer support to family nurse practitioners.
2. If nothing is done, there will be no additional funding required.
3. If nothing is done, the policy will be implemented without delay.
Cons for the Option to Do Nothing
1. If nothing is done, nurse practitioners specializing in adult/gerontological care will not be included as part of the training demonstration program.
2. If nothing is done, the training demonstration program will only offer support to family nurse practitioners.
3. If nothing is done, there may not be an increase in adult/gerontology nurse practitioners to care for the rapidly growing elderly population.
Pros for the Incremental Change Option
1. An incremental change will allow for more time and resources to support the amendment.
2. An incremental change will allow for greater success in producing a nurse work force specializing in adult/gerontological advanced practice care.
3. An incremental change will allow the government time to make adjustments to the budget in order to support the inclusion of adult/gerontological nurse practitioners in the grant demonstration program.
Cons for the Incremental Change Option
1. An incremental change may allow for policymakers to repeal section 5316 of the PPACA.
2. An incremental change will take a longer period of time to implement than a major, radical change, or the option to do nothing.
3. An incremental change will require increased spending as the amendment will be evaluated and adjusted after implementation.
Pros for the Major Change Option
1. A major change will provide clinical training for adult/gerontological nurse practitioners, enabling them to serve as primary care providers in federally qualified health centers and nurse-managed health clinics.
2. A major change can be implemented immediately.
3. A major change will result in an increase in adult/gerontology nurse practitioners to care for the rapidly growing elderly population.
Cons for the Major Change Option
1. A major change may encourage nurses to pursue a career as an adult/gerontology nurse practitioner who are not committed to practicing in the specialty.
2. A major change will result in an immediate increase in government spending within the grant demonstration program.
3. A major change will result in opposition from advance nurse practice specialty groups (other than family nurse practitioners) who wish to be included in the grant training program.
Policy change is the action of changing how a particular task is done. The change can be incremental, major, or plainlyto do nothing at all.Adopting any of these change options has both pros and cons, though in varied measures.
Pros for the Option to Do Nothing
By doing nothing, the decision will save money, especially for the organization to carry out the incorporation of the provision of contraceptives to its employees. An example is when Obama ignored all the warnings from the medical trusteesabout the Medicare being expensive.
In addition, not to do anything will ensure that organizations do not experience deficits every year due to supplementary medical insurance trust fund. This could lead to the organizations not being financially stable.
Moreover, the ‘to do nothing’ will save the future of the organizations. By providing contraceptives to its employees, the organizations might experience double the debt it already has.
The ‘not to do anything’ approach will prevent fiscal imbalance in the organization. The organization will not reduce employees’ salaries in order to provide the contraceptives to every employee(Mason, Leavitt, &Chafee, 2014).
Cons for the Option to Do Nothing
If nothing is done, the company will not spend any money on offering contraceptives to its employees
In addition, the employees will not receive the contraceptives from their employers, hence, not enjoy complete health insurance cover.
Moreover, the organization will not be able to control the birth rate of its employees, hence, leading to increase in expenditure.
Pros for Major Change
Major change will ensure that more organizations are adopting the public policy of providing contraceptives to their employees.
In addition, major change will provide more sensitization to the organization on the relevance of providing contraceptives to its employees. This will in turn enhance more provision of health care.
It will also ensure immediate implementation of the public policy, hence, faster provision of the healthcare.
Cons for major change
Major change will translate to opposition from some of the organizations, which do not have enough funds to provide each employee with contraceptives as part of their insurance policy.
In addition, it will also mean more expenditure on the part of the government in providing contraceptives to nonprofit organization.
In addition, it will promote provision of contraceptives to the employees by the organizations whose interest is not in the provision of such services.
Pros for Incremental change
When companies adopt the incremental change in implementing the public policy, it will allow for more time and resources to support the policy of every organization providing contraceptives to its employees.
In addition, the whole process of providing contraceptives to every employee as part of the health insurance policy will be very successful in both the profit and nonprofit organizations
Moreover, the organizations will have more time to make adjustments to their budgets to cover for all the employees. This will ensure no stopping in the whole exercise of providing contraceptives to its employees.
Cons for incremental change
Incremental change will allow the legislators convenient time to amend the policy to suit all the organizations in the provision of the health care insurance cover to its employees.
Consequently, incremental change will consume more time in its implementation as compared to major change and not to do anything change.
In addition, the whole process is very expensive due to many changes from time to time. This might lead to the whole process of implementation not being very successful (Cauchi, 2014).
Although Canada is contiguous to the United States and has some cultural and historical similarities, Canada’s population enjoys a vastly superior health status. Reasons are many, can be traced historically, and are related to a different view of the role of government. The experience of Canada demonstrates that neither a heterogeneous population, nor a health system that has waiting lines for services, are reasons for poor health. By looking critically at what produces good health in Canada, much can be learned about steps the U.S. might need to take if population health is its goal.
The Canadian Best Practices Portal challenges Canadian public health practitioners and researchers to create upstream interventions aimed at the source of a population health problem or benefit. What is being done to address the influences on population health in Canada?
Search the Internet and scholarly research for examples of Canadian “upstream interventions” that can be put forth as examples of either effective or ineffective efforts to improve population health. This is a 4-5 pages):
The Assignment (4-5 pages):
1. Provide a description of an existing intervention in Canada, intended to improve health inequities. Include an explanation of the inequity and how the intervention targets upstream determinants of health.
2. Describe the organizations involved and/or social policies enacted in the implementation of the intervention.
3.Explain whether or not the intervention was/is successful and what lessons public health practitioners can learn from that experience that might improve population health in the United States.
Articles:
Dinca-Panaitescu, S., Dinca-Panaitescu, M., Bryant, T., Daiski, I., Pilkington, B., & Raphael, D. (2011). Diabetes prevalence and income: Results of the Canadian Community Health Survey. Health Policy, 99(2), 116–123.
Retrieved from the Walden Library databases.
Feeny, D., Kaplan, M. S., Huguet, N., & McFarland, B. H. (2010). Comparing population health in the United States and Canada. Population Health Metrics, 8, 8–18.
Retrieved from the Walden Library databases.
Kirkpatrick, S. I., & McIntyre, L. (2009). The Chief Public Health Officer’s report on health inequalities: What are the implications for public health practitioners and researchers? Canadian Journal of Public Health, 100(2), 93–95.
Retrieved from the Walden Library databases.
Vafaei, A., Rosenberg, M. W. & Pickett, W. (2010). Relationships between income inequality and health: A study on rural and urban regions of Canada. Rural and Remote Health, 10(2), 1430.
Retrieved from the Walden Library databases.
Please apply the Application Assignment Rubric when writing the Paper.
I. Paper should demonstrate an excellent understanding of all of the concepts and key points presented in the texts.
II. Paper provides significant detail including multiple relevant examples, evidence from the readings and other sources, and discerning ideas.
III. Paper should be well organized, uses scholarly tone, follows APA style, uses original writing and proper paraphrasing, contains very few or no writing and/or
spelling errors, and is fully consistent with doctoral level writing style.
IV. Paper should be mostly consistent with doctoral level writing style.
SAMPLE ANSWER
Health inequities are avoidable imbalances that contribute to poor health. Solutions for such inequities may be found in upstream interventions that address social, economic and environmental situations. Social determinants include preventative strategies such as physical activity and proper diet as important ways of preventing chronic diseases and improving overall health (Gore & Kothari, 2012). In Canada, Ontario implements interventions aiming to influence environmental and social factors to address inequities in health.
There is increasing prevalence of chronic disease among certain pockets of the Canadian population. Problems associated with the high cost of treating such diseases necessitate efforts to implement interventions targeting their underlying causes. Canada renewed its commitment to public health in 2003 in a response strategy targeted towards addressing Severe Acute Respiratory Syndrome through healthy living interventions. The associated cost of treating chronic diseases threatens the sustainability of the healthcare system. This realization informs the implementation of a healthy living intervention in Canada through development of chronic diseases prevention guidelines (Gore & Kothari, 2012).
In Canada, low economic social status is measured in terms of literacy and income levels. It determines citizens’ vulnerability to cardiovascular disease, diabetes, asthma and chronic obstructive pulmonary disease (Dinca-Panaitescu, Dinca-Panaitescu, Bryant, Daiski, Pilkington, & Raphael, 2011). Studies show higher prevalence of chronic disease and lower life expectancy in low -income areas as compared to wealthier areas. Research also shows that job insecurity, unemployment, part-time employment and temporary employment negatively affects health as it is associated with elevated levels of chronic diseases such as blood pressure and increased risk of death from cardiovascular diseases. Aborigines, immigrants and people of color also have low incomes and are at higher risks of stress that triggers development of chronic diseases (Gore & Kothari, 2012).
Canada implements health policies aimed at preventing chronic illnesses by addressing upstream causes encompassing lifestyle, socioeconomic and environmental factors. One example of the policies is the 2009 Canadian Cardiovascular Society Guidelines advocating for reduced salt and simple sugars intake. It promotes the replacement of saturated and trans-fats with unsaturated, as well as higher consumption of vegetables and fruits. The guideline also recommends greater attention to weight control to prevent obesity and ensure that more citizens maintain a healthy body weight (Raine, 2010).
Health boards received instructions on the appropriate way to evaluate the population needs and tailor interventions to the groups facing the highest risk. Another policy is the Ontario guidelines for healthy eating and active living that informs various interventions to address health inequities in Ontario (Gore & Kothari, 2012). Aboriginal people and new comers in Canada have a higher prevalence of chronic illness often because of poor nutritional decisions and lack of opportunities for physical exercise. To address inequities among aboriginal people, there is an initiative to provide recreation and fitness equipment and youthful fitness ambassadors in their various locations. Other interventions in the Ontario guidelines for healthy eating and active living include provision for a web and phone based dietitian serving populations in remote areas. It also includes providing fruits and vegetables to schools through partnership with the ministry concerned with agriculture. Efforts to encourage physical activity include collaboration with urban planning designers to ensure that cities promote healthy living and that schools have routes that encourage physical exercise through walking and biking. The local public health units also oversee the compulsory programs and 36 heart health community partnerships to reduce cardiovascular disease (Ministry of Health Promotion, 2006).
The Ontario plan on active and healthy living is also referred to as ACTIVE2010 supports communities to implement community sports and physical activity and nutrition projects (Ministry of Health Promotion, 2006). The plan adopted a multi-sectoral approach targeting the population on a variety of levels. It includes actors from NGOs, private industry, service providers, and communities. Partnership between actors in healthcare is imperative in addressing the wide-ranging impact of social determinants in populations residing in diverse settings (Gore & Kothari, 2012).
The government in Ontario supports the intervention through policies that guide enhanced physical activity in schools, providing access to nutritious foods to children and encouraging hygiene and safety in the environment. Community organizations actively participate through facilitating health promotion trainings to prevent the occurrence of chronic illnesses among at risk individuals. Private companies also participate by creating health and wellness programs for their staff including healthier food choices and exercise. Some companies in the food industry are also keen in providing healthier food selection and creating awareness on the same (Ministry of Health Promotion, 2006).
The physical exercise interventions are tenable and have resulted in substantial benefits to the population. The interventions assist Ontarians to become more physically active through community sports and physical activity projects that are largely supported through the communities in action fund. The implementation of the Ontario’s trail strategy also encourages physical activity through provision of outdoor walking spaces in various areas for all (Ministry of Health Promotion, 2006). In as much as interventions targeting to reduce salt content in packaged and restaurant foods are tenable, the dietary recommendations for preventing chronic diseases remain largely unmet in Canada. Only a few companies have positively responded to the guidelines’ recommendations. The industry progress is underwhelming because many other companies are yet to take voluntary measures to reduce salt in their food products. It shows that regulatory controls are necessary to increase the number of companies acting to reduce sodium levels in processed foods (Raine, 2010).
The Canadian Heart and Health strategy and Action Plan recommends that creating heart friendly environments through education, legislation, and policies aimed at promoting healthy eating and physical activity are efficient interventions in addressing upstream determinants of health. An examination of environment-based interventions to prevent cardiovascular diseases in Ontario and indicates that they failed to address the social causes or determinants of illnesses. Interventions in settings at schools, workplaces, government buildings and communities are insufficient in addressing unfavorable living conditions and factors that create inequity. There is need for greater political will to invest more aggressively in prevention to achieve success (Raine, 2010).
Complete success of the Ontario’s healthy eating and active living plan is dependent upon greater political will to support aggressive implementation including legislative measures. Public health practitioners in the United States must ensure that when adopting such interventions, there is a solid legal foundation to ensure success. The US requires implementing strategies that address health inequities emanating from low-income and racial factors are addressed through population specific measures. A multidisciplinary approach is also imperative in ensuring that communities, government agencies and private sector players coordinate their efforts. There must be enforceable laws on wellness programs, food industry parameters and urban planning. These factors coupled with concerted efforts between public health agencies, education, food and agriculture, companies and the communities provide prime conditions for success.
References
Dinca-Panaitescu, S., Dinca-Panaitescu, M., Bryant, T., Daiski, I., Pilkington, B., & Raphael, D. (2011). Diabetes prevalence and income: Results of the Canadian Community Health Survey. Health Policy, 99(2), 116-123.
Gore, D., & Kothari, A. (2012). Social Determinants of Health in Canada: Are Health Initiatives There Yet? A Policy Analysis. Internatinal Journal for Equity in Health, 11(41), 1-14.
Ministry of Health Promotion. (2006). Ontario’s Action Plan for Healthy Eating and Active Living. Retrieved September 24, 2014, from www.mhp.gov.on.ca: http://www.mhp.gov.on.ca/en/heal/actionplan-EN.pdf
Raine, K. D. (2010). Addressing Poor Nutrition to Promote Heart Health: Moving Upstream. Canadian Journal of Cardiology, 21-24.
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For the month of August, 12 new cases of tuberculosis and 12 new cases of West Nile virus infection were reported to a county health department. You are not sure if either group of cases is a cluster or an outbreak.
What additional information might be helpful in making this determination? Why? How would you obtain this information?
SAMPLE ANSWER
Week 4 discussion
Quick response is vital in case of any outbreak of diseases. Health departments and other agencies have the duty to act swiftly to contain these clusters or outbreaks. For instance, in this case where a country’s health department reported 12 new cases of tuberculosis and West Nile virus infections, it becomes critical to collect information quickly to determine whether it is a cluster or an outbreak for immediate action. The author deliberates on additional information required to make determination as well as reasons why and the process of obtaining information in such instances as tuberculosis and West Nile virus outbreaks.
To determine whether these cases are a cluster or an outbreak, it requires adequate information. Information pertaining to these cases will include the rate of occurrence of the diseases, the community or region affected and the frequency of the illness among many others. Outbreak occurs when the number of victims is more than the expected cases (Sterhr-Green, Paul, Voetsch & MacDonald, 2010).
This information is required because it helps to determine the number of people that are affected and in adopting appropriate strategies to counter the same (CIFOR, 2010). A cluster and an outbreak requires different strategies to contain further spread of the disease and therefore being armed with this vital information is essential to approaching the challenge amicably.
Obtaining this information is yet another important aspect in seeking to determine whether the case above is a cluster or an outbreak. One way of obtaining information is partnering with the health agency to come up with appropriate ways to get information on the ground (UIC, 2005). It is also important to partner with the community members and other leaders to help in establishing the causes and the time of the outbreak among other information. Information will also be obtained through interviews and administration of questionnaires with the victims and their close family members.
Every bit of information must be cited
must also write a treatment plan with 2 long term goals and 2 short term goals for each of the long term goals and 2 interventions for each short term goal.
USE PEER REVIEWED SOURCES AND SCHOLARLY SOURCES FOR ACCURATE INFORMATION AND WELL RESEARCHED ASSIGNMENTS FOR VALIDITY.
Review the grading rubric on turntin to avoid penalization which will lead to low grades.
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