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Evidence based Practice

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Evidence based Practice

  1. 1. By: Kelly & Suyash
  2. 2. <ul><li>Life expectancy would grow by leaps and bounds if green vegetables smelled as good as bacon.  </li></ul><ul><li>~Doug Larson </li></ul><ul><li>IMA: Infant Mortality Awareness </li></ul>
  3. 3. A Systematic Approach to Health Improvement: <ul><li>Healthy People 2010 is about improving health of individual, communities, and of the Nation. </li></ul><ul><li>The Healthy People 2010 goals and objectives cannot by themselves improve the health status of the Nation. </li></ul><ul><li>Instead, they need to be recognized as part of a larger, systematic approach to health improvement. </li></ul>
  4. 4. This systematic approach to health improvement is composed of four key elements: <ul><li>Goals </li></ul><ul><li>Objectives </li></ul><ul><li>Determinants of Health </li></ul><ul><li>Health aspects </li></ul>
  5. 5. Healthy People 2010 Goals Goal 1: <ul><li>Increase Quality and Years of Healthy Life </li></ul><ul><li>Life Expectancy </li></ul><ul><li>Quality of Life </li></ul><ul><li>Achieving a Longer and Healthier Life—the Healthy People Perspective </li></ul>
  6. 6. Goal 2: Eliminate Health Disparities <ul><li>  Gender </li></ul><ul><li>Race and Ethnicity </li></ul><ul><li>Income and Education </li></ul><ul><li>Disability </li></ul><ul><li>  Geographic Location </li></ul><ul><li>   Sexual Orientation </li></ul>
  7. 7. <ul><li>  Healthy People 2010 is firmly dedicated to the principle that—regardless of age, gender, race or ethnicity, income, education, geographic location, disability, and sexual orientation—every person in every community across the Nation deserves equal access to comprehensive, culturally competent, community-based health care systems that are committed to serving the needs of the individual and promoting community health. </li></ul>
  8. 8. Objectives <ul><li>The Nation’s progress in achieving the two goals of Healthy People 2010 will be monitored through 467 objectives in 28 focus areas. </li></ul><ul><li>Many objectives focus on interventions designed to reduce or eliminate illness, disability, and premature death among individuals and communities. </li></ul><ul><li>Others focus on broader issues, such as improving access to quality health care, strengthening public health services, and improving the availability and dissemination of health-related information. </li></ul><ul><li>Each objective has a target for specific improvements to be achieved by the year 2010 </li></ul>
  9. 9. Healthy People 2010 Focus Areas <ul><li>1.   Access to Quality Health Services. </li></ul><ul><li>2.   Arthritis, Osteoporosis, and Chronic Back Conditions </li></ul><ul><li>3.   Cancer </li></ul><ul><li>4.   Chronic Kidney Disease </li></ul><ul><li>5.   Diabetes </li></ul><ul><li>6.   Disability and Secondary Conditions </li></ul><ul><li>7.   Educational and Community-Based Programs </li></ul>
  10. 10. Healthy People 2010 Focus Areas <ul><li>8. Environmental Health </li></ul><ul><li>9.   Family Planning </li></ul><ul><li>10. Food Safety </li></ul><ul><li>11. Health Communication </li></ul><ul><li>12. Heart Disease and Stroke </li></ul><ul><li>13. HIV </li></ul>
  11. 11. Healthy People 2010 Focus Areas <ul><li>14. Immunization and Infectious Diseases </li></ul><ul><li>15. Injury and Violence Prevention </li></ul><ul><li>16. Maternal, Infant, and Child Health </li></ul><ul><li>17.   Medical Product Safety </li></ul><ul><li>18.   Mental Health and Mental Disorders </li></ul><ul><li>19.   Nutrition and Overweight </li></ul><ul><li>20.   Occupational Safety and Health </li></ul><ul><li>21.   Oral Health </li></ul>
  12. 12. Healthy People 2010 Focus Areas <ul><li>22.   Physical Activity and Fitness </li></ul><ul><li>23.   Public Health Infrastructure </li></ul><ul><li>24.   Respiratory Diseases </li></ul><ul><li>25.   Sexually Transmitted Diseases </li></ul><ul><li>26.   Substance Abuse </li></ul><ul><li>27.   Tobacco Use </li></ul><ul><li>28.   Vision and Hearing </li></ul>
  13. 13. Determinants of Health <ul><li>Individual biology and behaviors influence health through their interaction with each other and with the individual’s social and physical environments. </li></ul><ul><li>Policies and interventions can improve health by targeting factors related to individuals and their environments, including access to quality health care. </li></ul><ul><li>Access to quality health care . Expanding access to quality health care is important to eliminate health disparities and to increase the quality and years of healthy life for all people living in the United States. </li></ul>
  14. 14. Health Status <ul><li>To understand the health status of a population, it is essential to monitor and evaluate the consequences of the determinants of health. </li></ul><ul><li>description of the health of the total population, using information representative of most people living in this country. </li></ul><ul><li>Health status can be measured by birth and death rates, life expectancy, quality of life, morbidity from specific diseases, risk factors, use of ambulatory care and inpatient care, accessibility of health personnel and facilities, financing of health care, health insurance coverage, and many other factors. </li></ul>
  15. 15. Determinants of health
  16. 16. Health status <ul><li>Health status can be measured by: </li></ul><ul><li>birth and death rates, </li></ul><ul><li>life expectancy, </li></ul><ul><li>quality of life, </li></ul><ul><li>morbidity from specific diseases, </li></ul><ul><li>risk factors, </li></ul>
  17. 17. Health Status <ul><li>use of ambulatory care and inpatient care, </li></ul><ul><li>accessibility of health personnel and facilities, </li></ul><ul><li>financing of health care, </li></ul><ul><li>health insurance coverage, </li></ul><ul><li>and many other factors. </li></ul>
  18. 18. Health Status <ul><li>The information used to report health status comes from a variety of sources, including birth and death records; hospital discharge data; and health information collected from health care records, personal interviews, physical examinations, and telephone surveys. </li></ul><ul><li>These measures are monitored on an annual basis in the United States and are reported in a variety of publications, including Health, United States and Healthy People Reviews </li></ul>
  19. 19. Health Status: <ul><li>These measures are monitored on an annual basis in the United States and are reported in a variety of publications, including Health, United States and Healthy People Reviews </li></ul><ul><li>The leading causes of death are used frequently to describe the health status of the Nation. </li></ul>
  20. 20. Leading Causes of Death, <ul><li>1997 </li></ul><ul><li>1900 </li></ul>
  21. 22. Application of Healthy People 2010 <ul><li>“ The public health approach to eliminating disparities in health”, American Journal of Public Health, David Satcher, MD, PhD , and Eve J. Higginbotham, MD 2008(march) </li></ul><ul><li>Reducing & Eliminating Disparities in health </li></ul><ul><li>Two successful programs </li></ul><ul><li>Public health approach </li></ul>
  22. 23. The issue of disparities <ul><li>Disparities in health among different racial, ethnic, and socioeconomic groups in the U.S. : A serious threat </li></ul><ul><li>Access to quality health care : Accounts for only 15-20 % of the variation in morbidity and mortality </li></ul><ul><li>Other determinants of health : Environment, biology, genetics, and human behavior </li></ul><ul><li>Health promotion & Disease prevention: Cost effective, more humane </li></ul><ul><li>A public health-oriented strategy : Successful in the long term </li></ul>
  23. 24. Problems and Goals <ul><li>Health disparities among minorities : Higher infant mortality, premature death rates & disease burden, lower quality of health care </li></ul><ul><li>A goal of Healthy People 2010 : </li></ul><ul><li>The president and surgeon general first announced a national goal of eliminating disparities in health (1998). </li></ul><ul><li>The goal remained a national concern </li></ul><ul><li>The Institute of Medicine report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care </li></ul>
  24. 25. A public health framework for health disparities <ul><li>Physical and social environments </li></ul><ul><li>20-25 % of the variations in morbidity and mortality </li></ul><ul><li>Exposed to severe violence, toxic waste </li></ul><ul><li>Nature & human-made disasters </li></ul><ul><li>Biology and genetics </li></ul><ul><li>Genetics : 20-25% of variations in morbidity and mortality </li></ul><ul><li>Human behavior : </li></ul><ul><li>Lifestyle practices : More than 40% of variations in health outcomes </li></ul>
  25. 26. The Action for Healthy Kids Program <ul><li>Former surgeon General David Satcher and First lady Laura Bush started the Action for Healthy Kids program in 2002. </li></ul><ul><li>The goal of the initial conference: Follow on The Surgeon General’s Call to Action in Prevent and Reduce Overweight and Obesity (2001) </li></ul><ul><li>A nationwide program to fight obesity : Potential role of schools in combating obesity </li></ul><ul><li>All 50 states and the District of Columbia had Action for Healthy Kids programs </li></ul>
  26. 27. The Action for Healthy Kids Program <ul><li>Schools: Appropriate settings </li></ul><ul><li>53 million children attend school each day </li></ul><ul><li>Provide opportunities for children to improve their lives and futures </li></ul><ul><li>Provide the opportunity for children to adopt healthy lifestyles of nutrition and fitness </li></ul><ul><li>Children who ate breakfast and were physically fit : Performed better on standardized exams, attended school more regularly, and concentrated on their work better </li></ul><ul><li>Children who were overweight and obese: Higher prevalence of depression and school absenteeism </li></ul>
  27. 28. The Action for Healthy Kids Program <ul><li>Schools & Districts: </li></ul><ul><li>Enhancing the content, frequency, and quality of their physical education programs </li></ul><ul><li>Developing model nutrition programs : Changing the content of vending machines & altering school meals </li></ul><ul><li>A major boost : Congress passed the Wellness Act of 2004 </li></ul><ul><li>Reaching out to parents and communities </li></ul><ul><li>Action for Healthy Kids reports: </li></ul><ul><li>More than 70 % of school districts: Developed policies </li></ul><ul><li>Minority and lower socio-economic-status children in public schools </li></ul>
  28. 29. The 100 Black Men Health Challenge <ul><li>Started in 2002 with the Atlanta chapter of 100 Black Men </li></ul><ul><li>African American men: Being ill and dying before the age of 70 even in higher socioeconomic groups </li></ul><ul><li>The 100 Black Men America Inc: </li></ul><ul><li>Organization of professional men who are of higher socioeconomic status </li></ul><ul><li>Committed to mentoring, tutoring, and supporting children & their families in lower socio-economic communities </li></ul><ul><li>Encouraging children to succeed academically </li></ul><ul><li>Guaranteeing scholarships for college </li></ul>
  29. 30. The 100 Black Men Health Challenge <ul><li>The success of this program is documented in Project Success: Doing the Right Thing for the Right Reason </li></ul><ul><li>Widely touted in the media </li></ul><ul><li>Concern was first with the members of 100 Black Men themselves </li></ul><ul><li>Suffered highly from health disparities, especially in cardiovascular disease, diabetes, and cancer </li></ul>
  30. 31. The 100 Black Men Health Challenge <ul><li>Three Major personal health goals: </li></ul><ul><li>Regular physical activity and good nutrition </li></ul><ul><li>Smoking cessation program </li></ul><ul><li>Regularly visiting a primary care provider: screened quarterly for weight, nutrition, physical activity, and prostate health </li></ul><ul><li>Successful program : </li></ul><ul><li>Interventions targeting African American men </li></ul><ul><li>Incorporating healthy lifestyle modeling and education for their mentees </li></ul><ul><li>Improve their community environments and support opportunities for healthy lifestyles </li></ul>
  31. 32. Healthy Kids & The 100 Black Men health Challenge <ul><li>Reduce disparities and risk factors & improve learning among children </li></ul><ul><li>The Action for Healthy Kids program: Implemented nationally </li></ul><ul><li>The 100 Black Men health Challenge: </li></ul><ul><li>Ultimately, to the more than 100 chapters nationwide </li></ul><ul><li>Strong support and funding for the national leadership of 100 Black Men </li></ul>
  32. 33. Population-Based Prevention <ul><li>Effective in reducing disparities </li></ul><ul><li>Population-based prevention: Less than 3% of health budget </li></ul><ul><li>Treating diseases & complications: More than 90% </li></ul><ul><li>Available to all populations </li></ul><ul><li>Leaders who care enough, know enough, will do enough, and are persistent enough </li></ul>
  33. 34. Reference: <ul><li>www.healthypeople.gov </li></ul><ul><li>www.actionforhealthykids.org </li></ul><ul><li>www.100blackmen.org </li></ul><ul><li>David Satcher, EveJ. Higginbotham. (2008). The public Health Approach to Eliminating Disparities in Health. American Journal of Public Health. 98(3), 400-404. </li></ul>
  34. 35. Activities: <ul><li>What are the goals of systematic approach to health improvement? </li></ul>
  35. 36. <ul><li>Goal 1: Increase Quality and Years of Healthy Life </li></ul><ul><li>Goal 2: Eliminate Health Disparities </li></ul>
  36. 37. <ul><li>How many focus areas and objectives are there in Healthy People 2010 ? </li></ul>
  37. 38. <ul><li>467 objectives in 28 focus areas. </li></ul>