Chapter 18: Workplace Safety

Abstract
One of the most dangerous places anyone can be, besides at home, is at work. t is well known that there are many work places that are not exactly safe, such as the environment that loggers work in, or fisherman, or police officers and firemen. However, more recently there has also been a surge of safety measures being implemented to aid those who work in office settings. Things like arthritis, poor vision, poor posture, joint pain and depression are all being scrutinized as they may be caused by a sedentary lifestyle that is being perpetuated at the work place. That's not to say that the safety of the other workers has fallen by the wayside, on the contrary more work than ever is going into trying to make work a safe place for people, but unfortunately, danger is waiting around every corner especially when you least expect it.

Reflection
As someone who has worked in many unsafe work environments, I understand wholeheartedly the importance of workplace safety and ergonomics. I worked at a waste water treatment plant for about a year and as much effort as they put into trying to make it as safe as they could, it's nearly impossible to plan for every problem. One of the biggest issues is quite simply the human element. People make mistakes and that accounts for an extremely large percentage of the accidents that lead to workplace injury and death. But an unsafe environment only invites disaster and as such it is most assuredly not a useless effort.

Chapter 17: Injuries as a Community HEalth Problem

Abstract
Accidents do happen, all around us, all the time. It is a very real and palpable danger to the well being of every person on the planet. Accidental injury is one of the leading causes of death in the world and it accounts for billions of dollars spent on medical costs and emergency services in the U.S. alone.Injuries occur when we least expect them, and usually in places we wouldn't expect, such as our homes, because of the feeling of safety home tends to give us. Car accidents also raise the toll in accidental injuries and death with over 42% of accidental deaths occurring due to motor vehicle accidents. Intentional injuries in congruence with unintentional come to be the 5th leading cause of death in the United States. Intentional injury is even more heinous than accidental due to the very nature of the acts themselves. Overall these preventable disasters really take their toll on our society, financially, physically, and mentally.

Reflection
The real problem with these types of injuries and the deaths that they can lead to are entirely preventable. It's infuriating to lose a loved one to something as simple as a forgotten seat belt or a lose rug at the top of the stairs. Even worse is when a loved one is taken from you by the actions of another person or by themselves. We do have systems and education in place to try and stem the tide of this issue, but no matter what, when people get home or behind the wheel of their car, they simply get that human sensation of comfort. In the same vein, do we want to take away that feeling of security for people, do we really want all Americans living in fear and scrutinizing every tiny aspect of their lives? Absolutely not; and also, at what point does our efforts to stop these incidents become too invasive? Realistically, what we are doing now is somewhat effective, and I believe efforts should be kept up, but what will it take to make everyone safe?

Chapter 14

Abstract:

This chapter cover health care function and opens with Kissick's equilateral triangle, the triangle has three 60 angles; Cost containment, access, and quality. The United States has trouble keeping this and equilateral triangle. 83% of Americans have health insurance, but 43 million are not covered. 8 of 10 uninsured people are in working families whose jobs do not provide insurance.

Health care is the best in America, but the most costly. Americans pay 17% out of pocket and third parties foot the rest. Third parties are; Private insurance, public/gov, and a small percentage is covered by private parties. People can be covered by fee-for-service or prepaid, fee-for-service people pay back after using services and prepaid people pay a coverage. Prepaid is working better for big business. The book follows and talks about SCHIP and its 40 billion dollar cost and how this cover uninsured children. SCHIP looks at low income children first who are not previously covered. Even with SCHIP working 8.3% of children under 18 are not covered.

Then this chapter moves into the terms of insurance talking about co-payments, deductibles, exclusion, pre-existing condition and fixed indemnity. All of these have different meanings and have to do with what the insurance will give you after you have been treated and what you will pay. There are eight different kinds of coverage for different parts of the body. The ways these different areas are covered is changing every day and fewer companies are covering them. The cost of overage varies on what the people covered do in their life and how much coverage they need.

The governmental agencies covered are Medicare( for people 65 and older with some exceptions for younger people), and Medicaid( for poor). These programs are made to cover people who do not have the finances to cover themselves. Adding on to this the book talks about Medigap which is supplemental coverage that fills the "gap" that Medicare does not cover. There are other supplemental plans which cover different diseases and different hospitals. Long term care is for when people need to be taken care of, these plans set care at home and provide caregivers. Some of these plans can cost up to 4000 dollars a month.

Managed care was brought in by Bill Clinton in 1993 to help stop the soaring costs of insurance. What this does is get groups of providers, deals with amounts of patients, financial incentives for users, and care is looked into by outsiders to provide best means. PPO, EPO, HMO are forms of managed care all of these have different plans and incentives for their consumers. There are lots of advantages and disadvantages in managed care.

National coverage was looked into next. This talked about plans to cover our nation, the US is the only developed nation without national coverage. Coverage would be paid through taxes and people would not pay out of pocket. The Canadian model is a good example of how this works. Even though is is not an example of national care it is on the right wave.

Reflection:

This chapter had a lot to talk about, there was a ton of information. The biggest thing our group got out of the was confusion. There was just so much information and so many term. We all believe there needs to be a change in health care in America. There needs to be reform, it is a burden on people and the money is too much. All people in the United States need to be covered in some way and the big companies should not be the ones deciding peoples fates. I got heated after watching the movie in class and feel like this is a huge issue.

Chapter 17- Injuries

Chapter 17- Injuries
The word injury is derived from the Latin word for “not right.” Injuries occur due to acute exposure to physical agents such as mechanical energy, heat, electricity, chemicals, and ionizing radiation interacting with the body in amounts or at rates that exceed the threshold of human tolerance. Unintentional injuries are injuries that are judged to have occurred without anyone intending for harm to be done. An intentional injury is an injury where it has been purposely inflicted, such as assaults, and intentional stabbings or shootings. An unsafe act is an behavior that would increase the probability of an unintentional injury. An unsafe condition is any environmental factor that would increase the probability of an unintentional injury. Unsafe acts and unsafe conditions are hazards. Each year in the United States more than 150,000 people die from fatal injuries. That is the fifth leading cause of death in the United States. Disabling injuries are injuries that restrict activity beyond the day of the injury. Children and teenagers are more at risk to die from a firearm injury than anyone else. Falls are the leading cause of unintentional injury for those 80 years and older. Males at any age are more likely than females to suffer from an unintentional injury. 47.4% of all unintentional injuries and poisoning occurred in the persons home. More people die in bedrooms where they may be sleeping during a fire than any other room. The workplace is the fourth leading place where unintentional injuries occur. More than 13% of all injuries reported in the National Health Interview survey in 2004 were sustained on streets, highways, and parking lots. It is proven that the deaths that occur in the six major holidays from car accidents is not any higher than any other time of the year. However, the proportion of fatal crashes that are alcohol related is higher during holiday periods. Injury prevention education is the process of changing peoples health directed behavior in such a way as to reduce unintentional injuries. The speed limit law change is an example of regulation- the enactment and enforcement of laws to control conduct as a means of reducing the number and seriousness of unintentional injuries. The technique of improving product or environmental design to reduce unintentional injuries is called automatic protection. Litigations are lawsuits filed by injured victims or their families. Firearms were the 2nd leading cause of injury deaths in 2002. Child maltreatment is an act or failure to act by a parent or caretaker defined by the law that results in physical abuse, neglect, medical neglect, sexual abuse, or emotional abuse. Child abuse can be physical, emotional, verbal, or sexual. Child neglect is a type of maltreatment that refers to the failure by the parent or legal caretaker to provide necessary, age appropriate care when financially able.

I was unaware that injuries have so many different categories. The unintentional injuries or intentional injures. Previously I thought that all injuries were just under one category. It makes a lot more sense the way things are done now though. By categorizing the injuries it helps specialist know where they have to put more focus on. It was surprising that the fifth leading cause of death was from fatal injuries. I would have thought that it would have been a lot lower because there are so many diseases in the world today I didn’t think an accidental injury would be near the too. It made a lot of sense that most of the injuries suffered by people over the age of 80 are from falls. That wasn’t very surprising at all. Older people have a hard time getting around and need more help so they can reduce the number of falls they suffer. More people dieing in the bedroom wasn’t all that shocking either. The bedroom is where the majority of the people spend the most of their time so it would make sense that is where the most injuries occur. Also when people are sleeping they are unaware of fires and other harmful things. Males suffer more from females makes a lot of sense. Car insurance companies are obviously aware of this and that is why boys are charged more for car insurance than females. It is very surprising to see that the speed limit law was changed even after all the preaching that speed kills. You would expect the speed limit to be increased if that is the case.

Chapter 13: Health Care System - Structure

Abstract:

Chapter 13 began with a "A Brief History of Health Care Delivery in the United States." This section explained how health care went from being provided from family, friends and neighbors, to qualified personal such as doctors and nurses. We learned how the quality of hospitals and health care facilities improved from being dirty and unhygienic to clean and sanitary with more improved procedures. In more detail we learned that in the year 1920 x-rays, chemotherapy, and specific/specialized surgical procedures were invented. In 1946 the Hill-Burton act was established and health care facilities began to become more adequate and funds were provided for hospital construction. With better facilities, procedures and equipment available to the public the cost of health care began to rise. In the 1960's health insurance began to become a popular idea and employees started to work harder in getting their agents to provide better health care policies. The third party system was developed. This system became the norm on how to pay for medical care in the United States. Most recently in the years of 1980 and the 1990's there were changes. In 1980's people were allowed to start decide where they want to receive their health care and by who, when. Also, there was another advance in technology with MRIs and ultrasounds now available. In 1990 manage care was introduced. In 1996 total health care topped 1 trillion dollars. In 1997 President Clinton wanted to start reforming health care and providing it for all, insured or not insured, but it was unsuccessful in starting.

The rest of the chapter was describing "The Spectrum of Health Care Delivery." There are four levels of practice: Population-based Public Health practice (aimed at disease prevention and health promotion; education) , Medical Practice (first-contact treatment, ongoing care for medical conditions, prevention, early detection), Long-term Practice (follow-up care; surgical post-operative care) and End of Life Practice (care for those with 6 months or less to live).

We also learned about the types of health care providers: allopathic and osteopathic (traditional - ex. for physicians), non-allopathic (not traditional - ex. for chiropractors). More about these will be explained in class during our brochure presentation.

Lastly we also learned about specific health care professionals in the sense of a nurse, non-physician practitioners, allied health care professionals, and public health professionals.

Reflection:

The first thing our group that was "wow this chapter had SO much information," and it really did. We talked mostly though about Bill Clinton and what we thought about reforming America's health care system and making it universal for everyone. We had differing views. Some of us thought we only needed to fix private insurance and we would be fine, others thought it was really important, especially for children, to make sure everyone has a change to receive health care and medical attention. In the end we all agreed children need to be a priority in this country and that they all should, no matter what, until they're 18 be able to receive some form of health insurance.

Our group also talked about the different types of Health Care Delivery. We all knew that Medical Practice and Long-Term practice existed but Population-based public health practice and End-of-Life practice we weren't aware of. We had always thought that End-of-Life practice was just a part of Long-Term practice and that Population-based public health practice was more of a community and education delivery, not a health care delivery, although we saw where it tied in together. We also liked learning that our major now ties into a piece of the Health Care Delivery Spectrum because many of us are interested in the medical side of community health.

Chapter 12

Abstract
This chapter discusses the very serious issue of drug and alcohol abuse as well as efforts to try and stop it from happening. There are a large number of programs targeted at stemming the tide of drug and alcohol abusers and trying to get those that do abuse to stop. It is a serious issue for people of all walks of life, be it a senior citizen, a high school student, a rich man or a poor man; drugs and alcohol effect everyone. There are many ways to educate people on these dangers such health classes in schools, ad programs, local groups that support reforming alcoholics and drug addicts. the chapter brings to light the extremely high number of cases of underage binge drinking and drug use. While there are many programs out there, the problems still persist.

Reflection
The abuse of drugs and alcohol is a very serious danger to society as they are hazardous to both the abusers health and those around them. It effects both physical and mental health especially depending on the nature of the drugs being abused. The fact that there is such a high number of young people engaging in activities like binge drinking, partying, drug use, begs the question, why? Is it because it's such a taboo thing for them to be doing? Is it just to fit in? Why do they feel the need to do these things and what can we, as educators and as neighbors, do to dissuade them? Still we search for the answer to these questions and ultimately the answer lies with these young adults.

Chapter 6- School Health Programs

Chapter 6- School Health Programs
Chapter six focused on the school health programs. The school health programs are an important part of community health. Schools have a huge affect on each students health. They can either work to improve it or they can disregard the health of the kids and make it worse.
A coordinated school health program is defined as, an organized set of policies, procedures, and activities to protect, promote and improve the health and well being of students and staff, thus improving students a ability to learn. In the majority of the United States school health programs are not well coordinated. In some schools the health teacher will talk about getting proper exercise, but the gym teacher was never told of what the proper exercise is needed for the students. So the students are told what they need to do, but do not get the best teaching they could have got if the health teacher and the physical education teacher were communicating on what was best for the kids. When people work and plan together to implement a school health program they are referred to as school health council. The primary role of the council is to provide coordination of the various components of the CSHP to help students reach and maintain a healthy lifestyle. An interesting fact that shows how big of an impact teachers and faculty really do have over the students is, “teachers spend more waking hours with school aged children than the parents do in most cases.” The health of children and their learning are reciprocally related. One cannot exist without the other. If a student is not healthy, he is going to suffer in the class room. He could also possibly distract other kids from getting the most they could have out of their own education.
A foundation is needed for any school health program. Any good foundation has a school administrator who supports such an effort. A well organized health council that is truly interested in providing a coordinated program for the kids. Written school health policies are also very important. A highly supportive administrator is a must. They are the people who have the connections and can get what is needed. School health policies are written statements that provide a framework to guide all those who work within the program. Well written policies provide a sense of direction for everyone involved. The responsibility of coordinating each program in a district lies on the shoulders of the school health coordinator. The school health coordinator would be a well trained school nurse or a health educator. One half of the states in the United States have school districts who employ school health coordinator, but there are only a few that require it. School health services are those health services provided for students to appraise, protect, and promote health. School health education has been defined as the planned sequential K-12 curriculum that address the physical, mental, emotional, and social dimensions of health. It is designed to motivate and assist students to maintain and improve their health.
　
There are many factors that go into making a good well run school health program. I feel it is often overlooked how much work is really put in and required to have good program in place. It is very important that everyone involved is on the same page. They all need to be communicating, sharing ideas with each other so no one is left out of the loop. That is essential because a team effort is needed to get the kids to live healthy lifestyles. If the health teacher has a great way for the children to stay fit, he has to also share that with the physical education teacher so he can implement that in his class. I was shocked to read that teachers often times spend more waking hours with the kids than do the parents. That fact really proves why there needs to be a well run program in place for the students to benefit from. Also the teachers are going to have to step forward and be role models for the kids. A lot of the time kids look up to what older people are doing and will follow their lead to having a healthy lifestyle. I was surprised to see that most states do not require a school health educator. That is very important that schools have one. Who can teach a kid how to be healthy better than a health expert? Even though they are not required in a lot of states it was good to see many states do have them in place. Hopefully they become required soon and they can continue to make a difference.

Chapter 5:
Abstract:
In this chapter the book went through how changes are made in the community. It started by talking about organizing and building of programs and people. Bringing people together is tough and keeping them is even tougher, the book gave ideas on keeping volunteers and getting them to feel ownership. Also getting people involved is hared now than ever because of family situations and the lack of communities, not knowing your neighbors. It is important to get people involved that have stake in the community, important people and people that others will believe and want to work with.
Later the chapter went on to talk about programs that have been implemented and how they work. The examples they gave were Healthy Cities/Healthy Communities, PATCH, and MAPP. Each of these examples has a different purpose in the community, thus each has a different way of functioning. All had different steps of implementation. This chapter went through who, what, and how health programs are formed. It outlined how these programs are made and how they work.
Reflection:
Our group really enjoyed reading this chapter. We talked about how well it outlined the building of programs, and all of us really came out with an understanding of these programs. Barry remembered and example of a community program in his home town, where he was pushed into working on something he really didn't believe in and related that to ownership. He talked about how he just really didn't feel connected to it, so it didn't do anything for him. We also talked about how easy it is for these programs to fail. If the people working on these do not put In all the effort and really look into what they are trying to get done the program will fail.
We cold see how skipping or sliding through the data collection stage would really mess up a program, if you do not have the right information about your constituency then you do not have a program. Then we talked about how much work it is to get a program to work, there is so much to do from the start to the finish. You need to get people, keep people, cater to every ones needs, listen to everyone, and this is just the start. After all of that you need to get into the community and put the programs you have made to work?!?! It was really mind blowing.

Chapter 3: Epidemiology

Abstract: Chapter 3 was about “Epidemiology” which is the study of distribution and determinants of health-related states or events in specified populations. Chapter 3 provided us with a ton of terms. We learn the different terms for types of diseases. There can be an acute disease, which lasts under 3 months such as the common cold or chicken pox, or there can be chronic diseases which lasts longer than 3 months sometimes for life such as diabetes. We learn terms of different rates and what they measure (death, birth, illness among a population, etc). We learn terms about different studies such as an analytic study or a cohort study. We also learn WHY it’s important to have Epidemiologists (people who study outbreaks of disease, injury and death in the human population). They help us to target where and from what people are getting sick and which helps us stop it before an epidemic occurs (also another term given). Along with this there was a brief history on Epidemiology itself. Many statistics were also given this chapter including life expectancy (which also has subcategories like disability-adjusted life years or health-adjusted life expectancy). Lastly we learned about different types of ways Epidemiologists conduct studies on the population to collect the data for the statistics and rates.

Reflection: As a group we collectively agreed this chapter was FULL of many terms. It was very information dense and a lot was thrown at us all at once. Even when trying to write the abstract for our blog I felt like I was missing a ton of information and terms I should've been adding in. The chapter was a bit overwhelming but we all felt like Epidemiology was such an important part of Community Health that it couldn't be a chapter for "light reading."

Our group was really surprised at how in-depth certain parts of Epidemiology were. For example we had no clue that "life expectancy" actually went deeper. There is health adjusted life expectancy or disability-adjusted life years.

Mostly our group reacted and talked about whether or not we would ever want a career involving Epidemiology. All of us concluded that we wouldn't. We believe it's an important part of the field but none of us have an interest in it. Most of us want to work directly with the community not just analyze it. We have respect for epidemiologists, we just wouldn't want to be one.

Chapter 2: Health Organizations

Abstract

In chapter 2 we delve into the world of health organizations. All sorts of organizations and agencies are outlined and discussed in this chapter from the local chapters of health hounds all the way up to the big dogs, most notably The World Health Organization (WHO). The WHO is the largest health organization in the world, so essential it's even a part of the United Nations. Of course the smaller organizations are every bit as essential to the various communities as the WHO, from the governmental, to the quasi-governmental, and of course the private. It illustrates for the reader the vastness of health as a concept and a practice with some agencies going for a broader view and participation where others work toward a focus such as nutrition, cardiac health, anti-drug, etc. There's an agency at the ready for just about everything somewhere.

Reflection
With all of these people working toward the betterment of our health policies and practices we are well on our way to a healthier world but we are still far from that goal. Despite the vast numbers and reach of these various organizations we all know of the poor health and living conditions of many of the peoples of the world. Even in our own country of plenty we have extraordinarily poor health practices in many areas. Even so, this chapter is something of an encouragement especially for those of us with a passion for health and the propagation of it. It shows us many of the opportunities that await us should we continue to pursue that passion as well as a chance to better narrow down what specific area of health to pursue because despite our passion, very few people possess the scope to cover the vastness of the prospect.

Chapter 1

Chapter 1

Abstract: The first chapter was an overview of the history of Community Health spread out over thousands of years. It starts off talking about the beginning of Community Health. Then it goes on to progressing through the different time periods and different health changes that occurred, for better and for worse. In the introduction it gives you the definition of health, health is a state of complete physical, mental, and social well being and not merely the absence of disease and health. Now having a good idea for what health really is it helps to further understand the issues that came up over time. It was later determined that health cannot be defined as a state because it is ever changing. The book has chose a new definition of the word health. Health is a dynamic state or condition of the human organism that is multidimensional, physical, emotional, social, intellectual, spiritual, and occupational.
Community health dates back all the way to 500 B.C. The first hospital was created during the Roman Empire. During this time the spiritual era of public health began. In that time every disease was blamed on spiritual factors, not actual health problems. As you would expect many health problems began to occur. Many epidemics lead to the death of millions in this time. Leprosy was one of the earliest epidemics to hit. The deadliest epidemic to hit during this time was the plague. The plague was also known as the black death. With all the plagues there was a total of 25 million deaths in Europe alone. In some of the most severe spots only one out of ten people survived.
The next time period was the start of an improvement in health. The Renaissance period was characterized by a rebirth of thinking about the nature of the world and humankind. One big step was that there was a growing belief that disease was caused by environmental factors not spiritual. By changing one belief that lead to the first signs of many new diseases.
When the 18th century rolled around living conditions were still very poor, cities were over crowded, and water was unsanitary, however, one big achievement was that in 1796 Dr. Edward Jenner demonstrated the process of vaccination as a protection against small pox. Later on the government started to get more and more involved in the health issues going on. Many new organizations were created to help fight the spread of disease.
In the 20th century Community Health really was starting to be taken seriously. The birth of the first national level volunteer health agencies were started. The social security act of 1935 marked the beginning of the first major government involvement in the health industry. In the 2000’s Bioterrorism became an issue, bioterrorism is the threat or release of biological agents for the purpose of influencing the conduct of government intimidating or coercing a civilian population to further political or social objectives.

Reflection: After reading chapter one I was very intrigued to find out the history behind Community Health and the many issues that affected it. People involved in any health field should be pleased with the progress made over time, which dates all the way back to 500 B.C. It is crazy to imagine that people were actually thinking about health back then. Peoples beliefs changed many times over the thousands of years, but to me that makes it more interesting, to see how each generation learned and then evolved their Health theories over prior knowledge.
Health obviously started off with little or no care. What can you really expect though. Very few people were able to get an education and I am sure health issues were not on the top of their list to learn about. When I read about how people during the middle ages thought health problems were spiritual I was kind of stunned. After thinking though the people of that time had no prior knowledge to go on, so now they don’t sound as crazy. At least they were thinking of possibilities, that’s the first step. I was pleased to see some progress made during the Renaissance period. It seemed like the people were much smarter concluding that health problems are not spiritual but environmental. That was the first big step in my opinion in understanding community health. It was nice to see the government putting a foot forward in dealing with the health problems across the country. I feel that they did a good job and made many people realize that health is important. With all the advancements most people can remain pretty healthy. Some people choose not to by choosing bad lifestyles. Many people are suffering from obesity, drug use, large consumptions of alcohol, and its sad to see people hurting their own bodies when in reality its not to hard to maintain a healthy lifestyle barring certain conditions that are not controllable. It is very pleasing to see Community Health on the rise and people are putting in a real effort to remain fit and healthy!