IHP600FEQ2
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Southern New Hampshire University *
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600
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Health Science
Date
Feb 20, 2024
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2. List the four health determinant categories and provide an example of how the government is supporting improvement in each determinant.
According to Shi and Singh, the four determinant categories of health include environmental, behavior and lifestyle, heredity, and medical care.
Environmental
o
According to the World Health Organization, “environmental determinants of health are the full set of social and physical conditions in which people live and work, including socioeconomic, demographic, environmental and cultural factors,
along with the health system.” This essentially encompasses all physical, chemical, and biological factors external to a person.
o
For example, the Environmental Protection Agency has set the maximum contaminant level goal for lead in drinking water at zero. This was illustrated recently in Flint, Michigan, where the amount of lead in the local water became toxic and caused residents to fall ill with various symptoms and conditions. o
In response, the state of Michigan provided over $350 million and the federal government provided an additional $100 million to Flint, with an overall goal of improving water quality.
Behavior and Lifestyle
o
These include individual behaviors such as diet, physical activity, smoking status, alcohol or drug use, etc. o
Focusing on smoking status specifically, the government has made significant improvements on helping reduce the number of people smoking. According to Sandford, this includes “a total ban on tobacco advertising and promotion; restrictions on smoking in public places and in the workplace; sustained increases in tobacco taxation combined with measures to curb smuggling; large, bold health
warnings on tobacco products; smoking cessation and health education campaigns; and the regulation of tobacco to standards agreed by the health community rather than those set by the tobacco industry.”
o
In terms of healthcare, providers are also reimbursed for offering smoking cessation counseling to their patients.
Heredity
o
According to Physioplus, “some biological and genetic factors affect specific populations more than others. Examples of biological and genetic determinants of
health include age, sex, inherited conditions and genetic make-up.”
o
Since heredity relates to one genetics, and we continue to make efforts to treat many genetic conditions, much of the government assistance has been with preventing discrimination against those with such conditions. For example, in 2008, President Bush enacted the Genetic Information Nondiscrimination Act (GINA), which prohibits insurance companies and employers from discriminating
based on information based on genetic tests. “It forbids insurance companies from
discriminating through reduced coverage or pricing and prohibits employers from making adverse employment decisions based on a person’s genetic code. In addition, insurers and employers are not allowed under the law to request or demand a genetic test” (Human Genome Project Information Archive, N.D.)
Medical care
o
Arguably the most influential determinant, the overall access to healthcare.
o
In a study performed by the National Association of Community Health Centers found that over 55 million Americans have inadequate access to primary care physicians and considered “medically disenfranchised.” However, the federal government is working to combat some of these inequalities in access to healthcare. According to The Commonwealth Fund, “The American Recovery and Reinvestment Act, also known as the stimulus plan, signed into law February 17, 2009, provides significant funds to supplement prior efforts to combat barriers
to health care access, generate new health care jobs, and meet the primary care needs of the growing uninsured and Medicaid populations.” o
Additional government programs include:
Health Center Program – administers grants and technical assistance to health centers serving primarily uninsured and low-income, publicly insured patients.
Rural Health Clinic Program – provides cost-based reimbursement from Medicare and Medicaid to rural health clinics.
Medicare HPSA Bonus Payment – offers extra payments to physicians who serve in primary care HPSAs and to psychiatrists serving in mental health HPSAs.
Works Cited
Human Genome Project Information Archive, N.D. “Genetics Legislation.” Retrieved from https://web.ornl.gov/sci/techresources/Human_Genome/elsi/legislat.shtml
Physioplus. N.D. “Determinants of Health.” Retrieved from https://www.physio-pedia.com/Determinants_of_Health
Sandford, A. 2003, March 8
th
. “Government action to reduce smoking.” Retrieved from https://pubmed.ncbi.nlm.nih.gov/12856736
The Commonwealth Fund. N.D. “State and Federal Efforts to Enhance Access to Basic Health Care.” Retrieved from https://www.commonwealthfund.org/publications/newsletter-
article/state-and-federal-efforts-enhance-access-basic-health-care
The World Health Organization. N.D. “Social and environmental determinants of health and health inequalities in Europe: fact sheet.” Retrieved from https://www.euro.who.int/__data/assets/pdf_file/0006/185217/Social-and-environmental-
determinants-Fact-Sheet.pdf
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