Public Health: What It Is and How It Works, Fourth Edition Chapter-by-Chapter Power Point Slides Links to Internet-based resources

Chapter 3 Public Health and the Health System

Chapter 3 Will Help You To: describe 3 or more major issues that make the health system a public health concern identify 5 intervention strategies directed toward health and illness identify and describe 3 levels of preventive interventions describe the approximate level of national expenditures for all health and medical services and for the population-based and clinical preventive service components of this total cite important economic, demographic, and utilization dimensions of the health sector access and utilize current data and information resources available through the Internet's World Wide Web characterize the roles and interests of key stakeholders in the health sector

Prevention and Health Services Health strategies –Health promotion –Specific protection –Early case finding –Disability limitation –Rehabilitation Levels of prevention (primary, secondary, tertiary) Medical or public health practice? Target populations and locations Medicine and public health collaborations

Exercise Select an important health problem (disease or condition) related to maternal and child health from the "Healthier Mothers and Babies" and "Family Planning" reports in the "Century of Progress in Public Health" case study. Describe interventions for this problem across the 5 strategies of health and illness related interventions (health promotion, specific protection, early detection, disability limitation, rehabilitation) presented in Chapter 3.Healthier Mothers and BabiesFamily PlanningCentury of Progress in Public Health

Exercise Select an important health problem (disease or condition) related to maternal and child health from the "Healthier Mothers and Babies" and "Family Planning" reports in the "Century of Progress in Public Health" case study. Describe interventions for this problem across the 3 levels of preventive interventions (primary, secondary, tertiary) presented in Chapter 3.Healthier Mothers and BabiesFamily PlanningCentury of Progress in Public Health

The Health System in the U.S. Economic dimensions –$ 2 trillion and rising, >16% GDP Demographic and utilization trends –Aging population –Ethnic and racial diversity growing Resources for health and health care –Health United States (report and web site)

National Health Expenditures, U.S.,

Percent of National Gross Domestic Expenditures Spent for Health-Related Purposes, U.S., Selected Years,

Total Expenditures of Governmental Health Agencies (including personal services) and Adjusted Total Governmental Public Health Spending (population based services), U.S.,

Adjusted total public health spending as a percent of total health spending US,

Per capita public health expenditures US, ($62 per person per year in 2000 = ~17 cents per person per day!)

Discussion From a public health perspective, identify the three most important health issues facing the U.S. in Briefly explain your rationale for each of these issues.

Discussion Examine the web sites of these major health organizations: American Medical Association, American Hospital Association, American Nurses Association, and the American Association of Medical Colleges. Do your selections in the previous exercise differ from the priority issues of these organizations? How do you explain or account for any differences between the two lists?American Medical AssociationAmerican Hospital AssociationAmerican Nurses AssociationAmerican Association of Medical Colleges

Persons Under Age 65 Not Covered by Health Insurance by Selected Characteristics, U.S., 2000

Current and Projected Racial and Ethnic Composition of U.S. Population: 2000, 2025, 2050

Access to Health Care, U.S., 1997 and Year 2010 Targets

Selected Causes of Death in the U.S., 1998

Changing Roles, Themes, and Paradigms Stakeholders Interests Issues Alliances

Discussion Of the major stakeholders in the health system, which ones are most influential? Which have the least influence?

Managed Care and Public Health Strange bedfellows? Managed care at the turn of the century Opportunities for improving public health

Discussion Examine two recent editorials appearing in the American Journal of Public Health: Managed Care and Public Health (Levi) and Not-So-Strange Bedfellows: Public Health and Managed Care (Koplin and Harris). If you were the editor of this journal and could publish only one of these two editorials, which one would you select for publication? Why? Managed Care and Public HealthNot-So-Strange Bedfellows: Public Health and Managed Care

Discussion Examine the data on health and the health system in Illinois that is available through the Illinois Department of Public Health, including the IPLAN data set. Then review similar date available from any other state health department using the link to State health agency web sites provided at the Association of State and Territorial Health Officials web site (this may take some exploring). Which state provides the most useful data for the purpose of assessing and improving community health? Explain your choice (justify your conclusion). Illinois Department of Public HealthIPLAN data setState health agency web sites

Discussion This discussion examines contributors to improvements in health status for mothers and infants in the U.S. since Review the "Healthier Mothers and Babies" and "Family Planning" reports in the "Century of Progress in Public Health" case study. There are 2 positions to be considered:Healthier Mothers and BabiesFamily PlanningCentury of Progress in Public Health –Position A: public health interventions are primarily responsible for these improvements. –Position B: medical care interventions are primarily responsible for these improvements.

Additional Resources Health United States 2005 Web Site. National Center for Health Statistics. Washington DC; DHHS-PHS-CDC-NCHS; Includes access to Health United States 2005 (with Trends in the Health of Americans Chart Book).Health United States 2005 Web Site Healthy People 2000 web site for information on both Healthy People 2000 and Healthy People Office of Disease Prevention and Health Promotion, USDHHS; 2001.Healthy People 2000 Managed Care and Public Health. Levi J. AJPH 2000;90(12): Managed Care and Public Health Not-So-Strange Bedfellows; Public Health and Managed Care. Koplan JP and Harris JR. AJPH 2000;90(12): Not-So-Strange Bedfellows; Public Health and Managed Care Medicine & Public Health: the Power of Collaboration (PDF format). Lasker RD. New York Academy of Medicine; 1997Medicine & Public Health: the Power of Collaboration Public Health Expenditures Trends in public health expenditures; Public Health Expenditures Trends and Indicators in the Changing Health Care Marketplace, 2002 (PDF format). Kizer Foundation; 2002Trends and Indicators in the Changing Health Care Marketplace, 2002