‘Medicalization’ in Current Health Policy

Medicalization in live strongness PolicyChanging macrocosm wellness Priorities From Medicalization to Improving create CommunitiesLaura Schultz, Brett Weed, Ashini Fernando, Carolyn Moore,Andrea Andersen, David GarciaMedicalization has greatly increased the emphasis on the delivery of clinical operate to somebodys, often at the expense of population-based solutions. We examine this phenomenon and offer an alternative that promotes universal wellness by improving neighborly, environmental, and animal(prenominal) determinants of wellnessHS1.Medicalization in Current health PolicyMedicalization is the tendency for the practice of medicine to view a great proportion of human behavior through a clinical genus Lens (Zola, 1986). Among the examples of wellness checkization is the direct-to-consumer solicitation of prescription drugs for an arguably ever-increasing repertoire of conditions and afflictions (Frosch, Krueger, Hornik, Cronbolm, Barg, 2007) and increasing assenti ng to medical c are as is evident through the initiatives implemented by the ACAHS2. ever increasing amounts of money are organism invested in treatment of degenerative diseases, while a comparatively much sm in aller proportion is invested in preventing the same conditions (HHS, 2003). The United States spends much than 17% of their GDP on wellnesscareHS3. This per capita wellness expenditure is more than twice the average of countries of the Organization of Economic Cooperation and breeding (Balding, 2014HS4), to that extent these numbers ache translated non into better wellness only when instead, a worsenedning trend in chronic diseases. US citizens besides maintain fundamentally lower life expectancy in comparison (Woolf Aron, 2013).Despite these considerable investments in health care delivery, the costs associated with treating the manifestations of curt health continue to rise unabated. Over the last five days in north Carolina alone, near USD 80 million of the federal work out for populace health was appropriated for primary care for the underserved populations (Trust for Americas health, 2014HS5).reality wellness SpendingIn contrast, public health only receives approximately 3% of the government budget and is underfunded (Balding, 2014). Nationally, 95% of health expending is for the apportioning of clinical services, while only 5% is invested in population-based solutions (Lantz, Licthenstein, Pollack, 2007). In trade union Carolina this division is even more extreme, with less than 1% of health spending dedicated to public health operations (Table 1HS6).Table 1. northernmost Carolina Public Health Appropriations as a Percentage of Public Health contend Spending (Trust for Americas Health, 2014 Chantrill, n.d.)It is worthCDL7 noning that the leading ca function of mortality in the US, cardiovascular disease, accounts for annual healthcare costs that exceed USD $312.6 billion (HHS n.d.), yet when diagnosed early, disease pr ogression can be addressed with non-pharmacological interventionsHS8. In North Carolina, a mere 0.81% ( USD 15 million, 2013) of the federal budget for public health was appropriated for prevention measures of all chronic diseases (Trust for Americas Health, 2014). These living trends pop to support medicalization of health instead of prevention through public health efforts. Rather than continue to invest in a stopgap dodge of mitigating the impact of illness, we propose to instead invest in the prevention of illnessHS9.Addressing hearty Determinants state health investments within corporate environments go through shown considerable fiscal success and value beyond return on investment (ROI). i corporate wellness program saw a ROI of close to ccc% another company saved an estimated $224 per employee in 2003 dollars from promoting health rather than treating a lack of it (HHS, 2003HS10). Applying this same per capita savings rate to North Carolina, shifting funding to preventio n and health promotion could yield savings of $2.2 billion annually3, more than offsetting the annual increases in health services expenditures. Value beyond ROI includes physical and mental health, quality of life, perceived health position and functional capacity. employment well-being also promotes other intangibles such(prenominal) as increased genial cohesion (Pronk, 2014).There is an established correlation between positive mixer relationships and health. As Robert Putnam wrote in 2000 in Bowling only when, hearty capital conveys the necessary health promoting value of communitiesHS11. It is defined as the social networks and interactions that inspire hope and reciprocity among citizens (as cited in Leyden, 2003). Social isolation, independent of other life style factors, is cerebrate to premature death and decreased resistance to disease (Cohen, 2001). Beyond individual health, social capital is associated with semipolitical engagement, volunteerism, decreased cri me rates and sparing development (Leyden, 2003). Research has shown that when we design our communities to encourage social engagement at that place is a positive effect on the psychological and physical health of the residents (Leyden, 2003HS12).Since the advent of the automobile, the design of our communities has included limited transportation choices. Most individuals guide to travel by car because urban design has made well-nigh options for pedestrians unsafe (Vandergrift, 2004). The US, compared to other high income European countries with better health measures, have at least 25% more automobiles per 1000 people (Woolf Aron, 2013). European Countries also have policies which limit sprawl and prioritize urban centralization. Though difficult to quantify, these environmental factors are likely to contribute to the health disparities and disadvantages in the US (Woolf Aron, 2013).Political and social conditions and constructs, racism for example, also results in poor urba n design that compound health disparities including limited access to businesses and markets, exposure to environmental toxins, and lack of opportunities for social participation. Specifically, infra building investment decisions, such as libraries, parks, public safety and maintenance are likely to be allocated to geographic areas populated by citizens with greater socioeconomic status and political power, which further marginalize disadvantaged socioeconomic groups (Schulz Northridge, 2004).Alternatively, mixed use, pedestrian hearty communities are based on thoughtful design and include whole town centers, multiple income residences and well linked streets that are designed for people, not automobiles (Walkable Communities, n.d.). Prioritized determinants of health, which we expect to improve because of innovative planning include increased social engagement, improved economic status and increased physical bodily function (Walkable Communities, n.d.). As of 2012, approximatel y 50% of the US adult population has been shown to suffer from chronic diseases. However, adequate physical activity has been scientifically proven to prevent or improve these chronic disease conditionsHS13. Yet, according to a 2011 statistic from the CDC, 76% of adults did not meet the recommendation for muscle-strengthening physical activity which is a known find for heart disease (CDC, 2014).There are put ups where the built environment is viewed as worthy of significant investment to improve population health. Specifically, in mom there are two examples of lower than average socioeconomic status communities where health impact assessments indicate that built environmental improvements would improve social factors and likely decrease expenses in medical intervention. In Somerville, there is a community driven planned change to a bisecting interstate. This plan, made with stipulation for social health determinants of the residents includes multi use bike and walking paths with increased access to all areas of the communityHS14. Community-wide access leave behind provide opportunities for social interaction, physical activity and increased choices for employment (MassDOT, 2013). A community with similar demographics, Fall River, has proposed putting green drag ins for recreation and pedestrian and bicycle travel that connect residents to businesses. This is predicted to improve all health determinant the HIA evaluated (MAPC, 2013).Based on a review of state sponsored health impact assessments in other communities, there is a significant relationship between communities with walkable pathways and health ( path to Trails Conservancy, 2013). We propose that thoughtful environmental structure enhancements such as multi-use walking and biking paths will connect neighborhoods and businesses. In turn, we reckon these changes will positively affect social cohesion, economic viability and physical activity, which are all key determinants of health that can im prove with innovative public insurance implementationHS15.Conclusion and RecommendationsEvidence from state sponsored health impact assessments in other communities, indicates that there is a positive correlation between communities with walkable pathways and health ( racecourses to Trails Conservancy, 2013). environmental structure enhancements such as multi-use walking and biking paths that connect neighborhoods and businesses could positively influence population health in North Carolina. We believe these changes will positively affect social cohesion, economic viability and physical activity, which are all key determinants of health that can improve with innovative public policy implementation.In North Carolina there are 31 accurate Rails to Trails programs (NC Rails-Trails, 2014). This national program improves the built environment by converting former line routes to pedestrian and bike friendly paths. However, only 2 of the 31 completed trails are located in counties with the poorest health scores (RWJF 2014 NC Rails to Trails, 2014). easterly North Carolina, where 9 out of 10 of the most poorly rated counties for health outcomes are located, also have the fewest trail initiatives (NC Rails-Trails, 2014). This skewed diffusion of environmental improvements further demonstrates the way in which populations within poor socioeconomic communities are financially neglected, and thus likely to continue to suffer from worse health outcomes. Using Massachusetts as an example, the states plane air division of Health and Human go has initiated a program to identify communities with the final socioeconomic status and assist them to build policies, systems and environments that promote wellness and rose-cheeked living (MassDOT, 2013).In partnership with state and county planning officials, public health leaders, and state demographers, our plan is to target lower socioeconomic communities, initially commission on a county with the poorest health indicator s, to plan and build multi-use trails. We request precedence funding allocated through the US surgical incision of Transportation via the Moving ahead for Progress in the 21st Century ACT (MAP-21), as well as private foundation grants that prioritize state population health improvements like the Annie E. Casey and Doris Duke foundations. Our plan for advocacy is to engage community members in the trail project as stakeholders. Specifically we will encourage our members to influence policy decisions through community informational meetings, including letter writing assistance intended to sustain pressure on local politicians. We intend to host community or health center coffees with opportunities to meet county commissioners and planners. Media coverage in the local publisher is another part of our advocacy plan. Specifically, we will engage local media in an effort to frame the problem of poor environmental design and how it impacts health by profiling one citizen with health ri sks and limited transportation options who lives on a pedestrian unsafe street, visually depicting the social isolation inherent in this environment though a photo layoutHS16.By engaging our most vulnerable North Carolina citizens to take part in improving their quality of life and ultimately their health and longevity, we will have the best chance at community environmental improvement as a long term effort. The time is now to refocus our priorities on health investment through prevention and promotion of public health efforts rather than treatment of diseases.ReferencesBlanding, M. (2012). Public Health and the U.S. Economy. Retrieved from http//www.hsph.harvard.edu/news/magazine/public-health-economy-election/.Chantrill, C. (n.d.). North Carolina Government Spending Chart. Retrieved from http//www.usgovernmentspending.com/spending_chart_2003_2019NCb_16s1li111mcn_13l14tCenters for disease Control and Prevention (2014, October). Chronic Disease Prevention and Health Promotion. Retr ieved from http//www.cdc.gov/chronicdisease/overview/index.htm.Cohen, S (2001). Social relationships and health Berkman syme (1979). Advances in mind-body medicine. 17(1)5-7.Frosch, D. L., Krueger, P. M., Hornik, R. C., Cronbolm, P. F., Barg, F. K. (2007). Creating film for Prescription Drugs A Content Analysis of Television Direct-to-Consumer Advertising. Annals of Family Medicine, 5(1), 6-13.Lantz, P. M., Licthenstein R. L., Pollack, H. A. (2007). Health policy approaches to population health The Limits of medicalization. Health Affairs, 26(5), 1253-1257.Leyden, K. (2003). Social Capital and the build Environment The Importance of Walkable Neighborhoods. American Journal of Public Health, 93(9), 1546-1551.Massachusetts Department of Transportation. (2013). Health Impact Assessment of the Massachusetts Department of Transportation (MassDOT) McGrath cornerstone Study. 2013. Retrieved from http//www.massdot.state.ma.us/groundingmcgrath/HealthImpactAssessment.aspx.Metropolitan Ar ea Planning Council (MAPC) (2013). Health Impact Assessment Quequechan River Rail Trail Phase 2. Retrieved from http//www.mapc.org/quequechan-river-rail-trail-hia.NC Rails-Trails (2014, September). Resources. Retrieved from http//www.ncrailtrails.org/web/resources.Pronk, N. P. (2014). Placing Workplace wellness in decent Context Value Beyond Money. Preventing Chronic Disease 11, 1-4. http//dx.doi.org/10.5888/pcd11.140128Putnam, R. (2000). Bowling Alone The collapse and revival of American community. New York Simon Schuster.Rails to Trails Conservancy. Health and Wellness Benefits. (n.d.). Retrieved from http//www.railstotrails.org/ourWork/trailBasics/benefits.html.Robert Wood Johnson Foundation (2014). County Health Rankings and Roadmaps, Building a Culture of Health County by County 2014 Rankings North Carolina. Retrieved from http//www.countyhealthrankings.org/sites/default/files/state/downloads/CHR2014_NC_v2.pdfSchulz, A., Northridge, M. E. (2004). Social determinants of healt h Implications for Environmental Health Promotion. Health Education and Behavior, 31(4), 455-471.Trust for Americas Health (2014). Key Health Data about North Carolina. Retrieved from http//healthyamericans.org/states/?stateid=NC arm=3,year=2009,code=undefinedUS nose count Bureau (2014, July 8). NC quick facts. Retrieved from http//quickfacts.census.gov/qfd/states/37000.htmlUS Department of Health and Human Services (HHS) (2003, September). Prevention makes common cents. Retrieved from http//aspe.hhs.gov/health/prevention/.US Department of Health and Human Services (HHS) (n.d.). About Heart Disease Stroke. Retrieved from http//millionhearts.hhs.gov/abouthds/cost-consequences.htmlcost.Vandergrift, D., Yoked, T. V. (2004). Obesity rates, income, and suburban sprawl an analysis of US states. Health Place, 10, 221-229.Walkable Communities, Inc. (n.d.).Walkable Communities FAQ. Retrieved from http//walkable.org/faqs.html.Woolf, S. H., Aron, L. Y. (Eds.). (2013). U.S. Health in extern al Perspective Shorter Lives, Poorer Health. Washington DC National Academies Press.Zola, I. K. (1986). Medicine as an initiation of social control. In P. Conrad R. Kern (Eds.), The sociology of health and illness. New York St. Martins Press.1 Rounded to nearby million2 Rounded to nearest ten million represents NC state and vicinity public health care spending3 Based on 2013 NC Population Estimate of 9,848,060 (US Census Bureau 2014).HS1Nice introduction to your paperHS2Good examplesHS3Is this from your Balding summon? This statement needs to be referenced.HS4This is listed as Blanding on your reference list.HS5Very keen section, your reader will have a good understanding of medicalization subsequently reading this sectionHS6Great reference and statistics that support your premiseCDL7Do not use this construct in this class, it is, there are, etc.HS8Such as implementing lifestyle changes with diet exercise.HS9Very goodHS10ImpressiveHS11Very interesting, I will be reading this .HS12Great examples and points being made, excellent references.HS13You need a reference hereHS14This entire section isnt referenced. Unless this information is considered to be common knowledge e.g. it came from your own consciousness or was information you were aware of prior to writing this paper, it needs to have a citation. Please review when to cite from UNC library http//www2.lib.unc.edu/instruct/citations/index.html?section=why_we_citeHS15Great ideasHS16Great ideas and plan of action