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In the 8th Edition it is Chapter11–Public Health and the Role of Government in Health Care

Answer the following questions on Public Health Services:

  1. The Public Health Service originated in 1798 as the Marine Hospital Service. Identify two (2) motivating factors that prompted that development.
  2. Why, in the 1960s, were the health-related programs of Medicare, Medicaid, and Neighborhood Health Centers assigned to non-health federal agencies instead of the Public Health Service?  Please provide two (2) examples.
  3. Public health efforts and those of private medicine complement each other and together serve the spectrum of health service needs of American society. Why, then, has their relationship been sometimes contentious and have they not consistently worked together proactively to improve the health status of Americans?  Please provide two (2) examples.
  4. Contrast the population-based orientation of public health with the individual-centered focus of private health practitioners.  Provide two (2) examples.
  5. Deaths in the United States that result from preventable causes total approximately 40% of all deaths each year.  Deaths result from tobacco use, poor dietary habits and sedentary lifestyles.  What additional two (2) actions should/could the U.S. health care system use to combat the factors that contribute to preventable deaths or incentivize more healthy living lifestyles among the most at-risk populations?

Expert Solution Preview

Introduction:

The field of public health plays a crucial role in promoting and protecting the health of populations. As medical college students, it is important to understand the development of public health services, the relationship between public health and private medicine, and potential strategies to combat preventable deaths. In this response, we will address each question separately.

1. The Public Health Service originated in 1798 as the Marine Hospital Service. Identify two (2) motivating factors that prompted that development.

One motivating factor that prompted the development of the Marine Hospital Service was the need to provide healthcare to seafarers, who often faced significant health risks during their voyages. Maritime activities involved long periods at sea, increased exposure to infectious diseases, and limited access to healthcare resources. Establishing the Marine Hospital Service aimed to ensure the health and well-being of seafarers, thereby safeguarding the maritime industry.

Another motivating factor behind the creation of the Marine Hospital Service was the recognition of the economic impact of poor health on workforce productivity. Illnesses among seafarers not only affected their individual well-being but also had direct consequences for the functioning of maritime trade. By providing healthcare services, the Marine Hospital Service aimed to maintain a healthy workforce and promote economic prosperity.

2. Why, in the 1960s, were the health-related programs of Medicare, Medicaid, and Neighborhood Health Centers assigned to non-health federal agencies instead of the Public Health Service? Please provide two (2) examples.

In the 1960s, the health-related programs of Medicare, Medicaid, and Neighborhood Health Centers were assigned to non-health federal agencies for a couple of reasons. One example is that Medicare, which provides health coverage to individuals aged 65 and older, was assigned to the Social Security Administration. This decision was driven by the rationale that Social Security had existing infrastructure and administrative expertise to handle insurance programs and distribute benefits effectively.

Another example is Medicaid, a program designed to provide healthcare coverage to low-income individuals and families. This program was assigned to the Department of Health and Human Services (HHS) rather than the Public Health Service. The decision was based on the understanding that Medicaid’s focus extended beyond public health to encompass broader social and economic factors influencing healthcare access and affordability.

3. Public health efforts and those of private medicine complement each other and together serve the spectrum of health service needs of American society. Why, then, has their relationship been sometimes contentious and have they not consistently worked together proactively to improve the health status of Americans? Please provide two (2) examples.

Despite the complementary nature of public health and private medicine, their relationship has experienced contention due to various factors. One example is the difference in their goals and priorities. Public health emphasizes population-based approaches and preventive measures, whereas private medicine focuses on individual-centered care and treatment. This distinction can create tension, as resources and attention may be disproportionately allocated to one approach over the other, leading to a lack of collaboration.

Another example is the competition for funding and resources. Public health initiatives often rely on government funding, while private medicine operates within market-driven systems. Limited resources may result in competition for funding and lead to conflicting interests between public health agencies and private healthcare providers. This can hinder proactive collaboration and limit the collective efforts to improve the health status of Americans.

4. Contrast the population-based orientation of public health with the individual-centered focus of private health practitioners. Provide two (2) examples.

Public health takes a population-based approach, considering the health needs of entire communities or populations. In contrast, private health practitioners focus on individual patients. Two examples to contrast these orientations are as follows:

Firstly, public health may implement policies and interventions targeting a large population segment, such as implementing a tobacco control program to reduce smoking rates among adolescents. Private health practitioners, on the other hand, address the specific health concerns of individual patients, providing personalized smoking cessation counseling.

Secondly, public health engages in epidemiological surveillance to monitor the occurrence of diseases and identify patterns at the population level. For instance, tracking disease outbreaks and conducting contact tracing during a measles outbreak. In contrast, private health practitioners assess and diagnose individual patients, treating their specific symptoms and providing appropriate medical interventions.

5. Deaths in the United States that result from preventable causes total approximately 40% of all deaths each year. Deaths result from tobacco use, poor dietary habits, and sedentary lifestyles. What additional two (2) actions should/could the U.S. healthcare system use to combat the factors that contribute to preventable deaths or incentivize more healthy living lifestyles among the most at-risk populations?

To combat the factors contributing to preventable deaths and incentivize healthier lifestyles, the U.S. healthcare system could consider implementing the following actions:

1. Enhance preventive care and health education: By prioritizing preventive care services, such as routine screenings, immunizations, and counseling on healthy behaviors, healthcare providers can identify risks early and promote healthier lifestyles. Additionally, investing in comprehensive health education programs in schools, workplaces, and communities can empower individuals to make informed choices regarding tobacco use, nutrition, and physical activity.

2. Implement policies supporting healthy environments: The U.S. healthcare system can collaborate with local and national policymakers to create supportive environments for healthy living. This may involve implementing regulations and initiatives to reduce tobacco availability and marketing, promoting access to affordable and nutritious food options, and creating environments conducive to physical activity, such as parks and safe walking trails. Furthermore, incentivizing employers to provide workplace health programs and initiatives can positively impact the health behaviors of at-risk populations.

By adopting these additional actions, the U.S. healthcare system can actively address preventable causes of death and promote healthier living among the most vulnerable populations.

Note: It is worth mentioning that these answers are for instructional purposes and may vary based on available evidence and the specific context of public health.

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