broad determinants of health
-policy making
-health services
-individual behaviors
-biology and genetics
-social factors
social factors
-non medical factors that influence health outcomes
-conditions in the environment where people are born, grow, work, live, and age, and the wider set of forces and systems shaping condition of daily life
social determinants of health
-education access and quality
-health care and quality
-neighborhood and built enviroment
-social and community context
-economic stability
health disparity
-type of health difference that is closely linked with social, economic, and/ or environmental disadvantages often driven by SDOH
-just promoting health choices wont eliminate these and other health disparities
-not biological
Office of Minority Health Mission
-dedicated to improving the health of racial and ethic minority populations through development of health policies and programs that will help eliminate health disparities
health disparities
disability
education
income
location
race and ethnicity
sex
health equity
-notion that everyone should have a fair opportunity to attain their full health potential
-absence of unfair and avoidable or remediable differences in health among population groups defined socially, economically, demographically, or geographically
vulnerable at risk populations
-economically disadvantaged
-low income children
-elderly
-racial and ethnic underrepresented populations
-uninsured
-homeless
-mental illness
-HIV and chronic health conditions
vulnerable populations categories
1. physical
2. psychological
3. social
trauma
an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual's functioning and mental, physical, social, emotional, or spiritual well being
acute trauma
results from a single event
complex trauma
exposure to varied and multiple traumatic events, often of an invasive and interpersonal nature
secondary trauma
repeated exposure to the stories and experiences of trauma by others
kinds of trauma
-abuse or neglect
-serious accident, illness, or medical procedure
-withnessing home violence
-natural diasters
-traumatic grief and separation
effects of untreated trauma
-sense of time distorted
-unable to accurately read social cues
-memory impairments
-brain growth is stifled and underdeveloped
-unable to sense internal state
-numbness or overly focused pain
positive stress
brief increase in heart rate, mild elevations in stress hormone levels
tolerable stress
serious, temporary stress response, buffered by supportive relationships
toxic stress
prolonged activation of stress response systems in the absence of protective relationships
epigenetics
study of how environment and behavior influence gene expression
-ACE exposure= DNA methylation activity on stress response genes
-changes passed from mother to child
-reversible
resilence
ability to overcome hardship
function of WHO
direct and coordinate international health within the united nations
health
state of complete physical, mental, and social well being and not merely the absence of disease or infirmity
population health
health outcomes of a group of individuals, including the distribution of such outcomes within the group
-3 components = health outcomes, health determinants, and policies
-health outcomes are the product of mulitple inputs or determinants of health and the distribution in the population
population based medicine
an approach that allows one to access the health status and health needs of a target population, implement and evaluate interventions that are designed to improve the health of the population, efficiently and effectively provide care for members of that population in a way that is consistent with the community's cultural, policy, and health resource value
population health management
systemic approach that enables all people in a defined population to maintain and improve their health and is a practical approach of population health within medical system
patient centered medical home
-team based model of care led by a personal physician who provides continuous and coordinated care throughout a patient's lifetime to maximize health outcomes
comprehensive care
physical and mental health care needs, inclduing prevention and wellness, acute care, and chronic care
patient centered
partnering with patients and their families as core members of the care team requires understanding and respecting each patient's unique needs, culture, values, and preferences
coordinated care
primary care medical home coordinates care across all elements of the broader health care system
accessible services
primary care medical home delivers accessible services with shorter waiting times for urgent needs, enhanced in person hours, around the clock telephone or electronic access to a member of the care team, and alternative methods of communication
quality and safety
using evidence based medicine and clinical decision support tools to guide shared decision making with patients and families, engaging in performance measurements and improvement
triple aim of population medicine
-improve the healthcare experience
-improve health of population
-reduce per capitia costs of health care
public health
-all organized measures that prevent disease, promote health, and prolong life among the population as a whole
-assess and monitor the health of communities and at risk populations, formulate public policies, and assure access
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