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.