Healthy People 2020 and The Patient Protection and Affordable Care Act/PHE4095 WEEK 5 DISCUSSON

PHE 4095 WEEK 5 LECTURE

Surveillance Systems

National

Disease surveillance is an epidemiological practice by which the spread of disease is monitored to establish patterns of frequency and progression. The main purpose of public health surveillance is to collect data, analyze trends, and use the analysis to target areas for public health prevention. The CDC has an extensive list of notifiable diseases that healthcare practitioners must review and then report any diagnoses of those diseases to local public health departments (CDC, 2012). Surveillance systems rely on consistent reporting by public health departments since many diseases may go untraced if mandatory reporting procedures are not carried out.

In the United States, the CDC has an extensive database of data analysis results from various surveillance systems. Examples of surveillance programs include occupational respiratory disease surveillance, adult blood lead epidemiology and surveillance, smoking and tobacco, and developmental diabetes. The CDC houses an interactive database system where you can enter the criteria for your search and the output will be displayed based on the criteria. Information can be gathered on the number of cases of cancer in your community or the number of deaths from unintentional injuries (CDC, 2012).

This information is extremely useful in identifying priority public health concerns in your community and will pave the way for public health promotion programming. This information should be used in conjunction with the data gathered from residents in the community needs assessment since this data was acquired through health professionals. In addition to the interactive database system, the CDC has resources available on the legal and ethical issues in collecting and sharing data, methods for conducting and evaluating a surveillance system, and tools and templates to administer survey questionnaires (CDC, 2012).

International

On an international level, the World Health Organization (WHO) facilitates an integrated disease surveillance program that is considered a common public service among all nations. The program recognizes that all participants are working towards a common goal to define, detect, and respond to communicable public health threats. The integration is accomplished by functions such as ensuring that surveillance is a common service among all nations and those nations are collaborating to maintain a functional approach in disease collection, disease reporting, data analysis, and other surveillance supporting systems (WHO, n.d.).

Needs Assessment

Needs assessments are essential to the success of all public health programs. Read here for more on the need for these and their use:  Assessing Community Needs and Resources

Home » Learn A Skill » Toolkits » 2. Assessing Community Needs and Resources

2. Assessing Community Needs and Resources

This toolkit provides guidance for conducting assessments of community needs and resources.

· Outline

 

· Examples

1. Describe the makeup and history of the community to provide a context within which to collect data on its current concerns.

a. Comment on the types of information that best describes the community (e.g., demographic, historical, political, civic participation, key leaders, past concerns, geographic, assets)

b. Describe the sources of information used (e.g., public records, local people, internet, maps, phone book, library, newspaper)

c. Comment on whether there are sufficient resources (e.g., time, personnel, resources) available to collect this information

d. Assess the quality of the information

e. Describe the strengths and problems you heard about   Related resources: Understanding and Describing the Community Collecting Information About the Problem Conducting Interviews Conducting Surveys Qualitative Methods to Assess Community Issues Using Public Records and Archival Data Identifying Community Assets and Resources Describe the methods (e.g., public forums, listening sessions, focus groups, interviews, surveys, observation) used to collect descriptive information SWOT Analysis: Strengths, Weaknesses, Opportunities, and Threats  

2. Describe what matters to people in the community, including a description of:

a. Issues that people in the community care about (e.g., safety, education, housing, health)

b. How important these issues are to the community (e.g., perceived importance, consequences for the community)

c. Methods the group will (did) use to listen to the community (e.g., listening sessions, public forums, interviews, concerns surveys, focus groups)   Related resources: Obtaining Feedback from Constituents: What Changes are Important and Feasible? Participatory Approaches to Planning Community Interventions Rating Community Goals The Constituent Survey of Outcomes: Ratings of Importance Conducting Public Forums and Listening Sessions Conducting Focus Groups Conducting Concerns Surveys Conducting Interviews Conducting Surveys  

3. Describe what matters to key stakeholders, including:

a. Who else cares about the issue (the stakeholders) and what do they care about?

b. What stakeholders want to know about the situation (e.g., who is affected, how many, what factors contribute to the problem)

c. Prioritized populations and subgroups that stakeholders intend to benefit from the effort

d. Methods you will (did) use to gather information (e.g., surveys, interviews)   Related resources: Developing a Plan for Identifying Local Needs and Resources Conducting Needs Assessment Surveys Determining Service Utilization Identifying Targets and Agents of Change: Who Can Benefit and Who Can Help? Conducting Interviews Conducting Surveys  

4. (For each candidate problem/goal) Describe the evidence indicating whether the problem/goal should be a priority issue, including:

a. The community-level indicators (e.g., rate of infant deaths or vehicle crashes) related to the issue

b. How frequently the problem (or related behavior) occurs (e.g., number of youth reporting alcohol use in the past 30 days)

c. How many people are affected by the problem and the severity of its effects

d. How feasible it is to address the issue

e. Possible impact and/or consequences of addressing the problem/goal   Related resources: Collecting Information About the Problem Developing Baseline Measures of Behavior Obtaining Feedback from Constituents: What Changes are Important and Feasible? Gathering and Using Community-Level Indicators  

5. Describe the barriers and resources for addressing the identified issue(s), including:

a. Barriers or resistance to solving the problem or achieving the goal (e.g., denial or discounting of the problem) and how they can be minimized (e.g., reframing the issue)

b. What resources and assets are available and how the group can tap into those resources to address the issue

c. Community context or situation that might make it easier or more difficult to address this issue   Related resources: Developing a Plan for Identifying Local Needs and Resources Identifying Community Assets and Resources Identifying Opponents Overview of Opposition Tactics: Recognizing the Ten D's How to Respond to Counterattacks  

6. (Based on the assessment) Select and state the priority issue (or issues) to be addressed by the group.  

7. Healthy People 2020

8. View a PDF Transcript for  Healthy People 2020 

9. Make a Child’s Smile Program

10. View a PDF Transcript for Make a Child's Smile 

11. Evidence-Based Research in Public Health

12. Evidence-based research has proven itself to be an invaluable tool in healthcare in the development of best practices and policy revision and development. The application of evidence-based research in public health will also be a priority based on the report published by the Institute of Medicine (IOM). Ensuring that members of society are healthy is a responsibility of both healthcare providers and public health officials. Therefore, the CDC and the Health Resources and Services Administration (HRSA) made a request to the IOM to gather a group of experts to discuss recommendations for the integration of healthcare and public health. (Institute of Medicine [IOM], 2012).

13. One of the recommendations that resulted from the findings of the committee was the following:

14. To create common research and learning networks that foster and support the integration of primary care and public health of the population, HRSA and CDC should convene stakeholders at the national and regional levels to share best practices in the integration of primary care and public health (IOM, 2012, p. 146).

15. Barriers to Evidence-Based Research

16. Robeson, Dobbins, DeCorby, and Tirilis (2010) also support the use of evidence-based information in public health, describing the facilitation of access to preprocessed research evidence in public health. Even though the field of public health is incorporating the process of evidence-informed decision making, there are still barriers to accessing the resources, results, and data. Time is the first barrier to accessing evidence. It may take too much time to obtain permission for results if there is another priority that needs to be addressed more urgently. Another barrier is not having sufficient staff able to interpret study findings and their implications.

17. In conclusion, it is apparent that the use of evidence-informed decision making would enhance public health initiatives. There are still barriers that remain in accessing the data and results of research studies and other data collection processes. Based on the recommendation made by the committee established by the IOM, it would be ideal to provide a platform where both public health and healthcare professionals could convene to discuss best practices and demonstrate how each discipline can work together to promote the health of the population.

18. Prevention and Public Health Fund

19. The Affordable Care Act, the healthcare law of 2010, created a Prevention and Public Health Fund. The fund is an unprecedented investment in promoting wellness, preventing disease, and protecting against public health emergencies. Under the law, the fund will appropriate $15 billion for an expanded and sustained national investment over the next ten years. The recipients of the funds will focus on disease prevention, modifying unhealthy risk behaviors, and placing particular emphasis on low-income and underserved communities. The allocation of the Prevention and Public Health Fund was $750 million for the financial year of 2011 (“Public health,” 2010).

20. Much of this work is done in partnership with states and communities, which are already using prevention fund dollars to help control the obesity epidemic, fight health disparities, detect and quickly respond to health threats, reduce tobacco use, train the nation's public health workforce, modernize vaccine systems, prevent the spread of HIV/AIDS, increase the effectiveness and efficiency of public health programs, and improve access to behavioral health services (Healthcare.gov, 2012). The following activities or programs are just a few recipients of the allocation of funds in 2012 (U.S. Department of Health and Human Services [HHS], 2012):

21. American Osteopathic Association (AoA): Chronic Disease Self-Management Program

22. This program provides education and tools to older Americans in the management of chronic disease. These individuals participate in an evidence-based, chronic disease self-management program. This program was allocated $10 million dollars.

23. Agency for Healthcare Research and Quality (AHRQ): Clinical Preventive Services Research

24. This activity will establish a national prevention strategy by developing evidence so best practices can be used to deliver clinical preventive services. This activity was allocated $5 million dollars.

25. CDC: Prevention Research Centers

26. The CDC will establish prevention research centers throughout the United States to help change individual behaviors and environmental factors that put people at risk for diseases such as heart disease, cancer, and diabetes. The establishment of prevention research centers was allocated $10 million dollars.

27. CDC

28. View a PDF Transcript for CDC 

29. Healthy Living

30. View a PDF Transcript for Healthy Living 

31. American Red Cross

32. Even though the American Red Cross is not a governmental agency or funded by the government, the Red Cross is chartered by Congress. The charter mandates that the Red Cross maintain a system of domestic and international disaster relief and entrusts the organization to serve as a medium of communication between members of the military and their families (American Red Cross, 2011). When you think of the American Red Cross, you think of blood donations, disaster relief, and cardiopulmonary resuscitation (CPR) classes, but they provide so much more. The Red Cross is primarily run by volunteers and is a tax-exempt 501 (c) (3) organization (American Red Cross, 2012).

33. Areas of Service

34. The Red Cross has five major areas of service. These are as follows:

35. Helping disaster victims: At the local, state, and national levels, the American Red Cross responds to disasters to provide food, clothing, and shelter to those affected. Volunteers are also available to assist with the mental health and the physical health needs for those that need assistance. An example of a disaster service is the establishment of shelters for residents evacuated due to an impending hurricane or raging wildfire (“Red Cross,” 2012). The Red Cross provides immediate support to first responders, works with local emergency services, and participates in disaster drills, thus, playing an important function in disaster response.

36. Connecting the armed forces with their families: In the event of an emergency notification, such as a family death or the birth of a child, the Red Cross facilitates communication between the family member and their loved one serving in the armed forces.

37. Teaching lifesaving skills: The Red Cross offers numerous courses in CPR, the use of an automated external defibrillator (AED), first aid, and lifeguarding. There are also numerous educational materials in health and safety and disaster preparedness to empower members of the community to respond to life-threatening emergencies.

38. Collecting, testing, and supplying blood across the nation: The American Red Cross is the largest, single blood supplier in the United States. Through rigorous testing, the Red Cross is committed to supplying safe blood and blood products.

39. Partnering in international services: The Red Cross is part of more than 180 Red Cross and Red Crescent Societies in the world devoted to alleviating human suffering (American Red Cross, 2011). The American Red Cross supports global Red Cross disaster response and works to reconnect family members during an international disaster.