Improving Health

Abstract

The Internet provides a ready source of patient education handouts specific to certain diseases or conditions. Patients and consumers can obtain clear, concise, and reliable information about their diseases or conditions and follow-up instructions for procedures and treatments. Patient education on the Internet can support patients or consumers in making informed health care decisions. Available day and night, patients can access this information at their convenience when they are most interested in learning. Included in this article are selected and annotated resources for locating patient education materials. Also included are Internet sites to locate materials for low literacy patient education.     

提高健康公平性的政府职责

对象 在上海市2个区内4个居委随机选择18岁及以上非学生身份的居民进行问卷调查。方法 居民的健康状况、慢性病患病状况和个人月均收入由居民自报。数据分析时，采用了描述性统计指标、X^2检验、Logistic分析法及健康或慢性病患病差别指数。结果 在调查的居民中；自认为健康状况较差或基者占10．76％，有慢性疾病者占35．10％；其中，老年居民自认为健康状况较差或差者占28．19％，有慢性疾病者占68．30％。Logistic分析显示，影响居民健康状况的主要因食是年龄和个人的月均收入(老年居民还包括性别和学历层次)；影响居民慢性病患病状况的主要因食是年龄和有无社会医疗保险。经年龄标化后，个人月均收入低者的健康状况较差或差的比例明显高于个人月均收入高者，年龄标化后的健康差别指数为15．76％；无社会医疗保险者的慢性病惠病率明显高于有社会医疗保险者，年龄标化后的慢性病患病差别指数为1．80％。讨论与建议政府应进一步加强对社区卫生服务的扶持；应促进经济发展、改善人民生活状况，适当减少人们利用卫生服务的经济障碍，提高人群受教育程度；缄小社会在享有经济财富、受教育的程度、医疗保障、卫生服务利用和使康上的差异，以利于提高人民健康，维持社会的公平性。     

社区健康教育对改善产妇健康行为的效果分析

目的:探讨社区健康教育对改善产妇健康行为的效果.方法:取我院2015年9月至2017年1月期间接收的80例产妇,分为对照组与观察组各40例,前者运用常规性社区护理,后者运用社区健康教育,分析两组护理后的健康行为与产后状况差异.结果:在早期活动、护理保健、健康饮食、合理休息等健康行为率上,观察组各项显著高于对照组,两组对比具有统计学意义(p<0.05);在3个月持续纯母乳喂养率上,观察组为62.5%,对照组为40%,两组对比具有统计学意义(p<0.05);在产后贫血、乳腺炎与意外妊娠发生率上,观察组各项显著少于对照组,两组对比具有统计学意义(p<0.05).结论:社区健康教育对改善产妇健康行为与减少产后不良问题有较好的辅助作用,有助于提升母乳喂养率.     

Public Health Options for Improving Cardiovascular Health Among Older Americans

Life expectancy at birth has increased from 74 years in 1980 to 78 years in 2006. Older adults (aged 65 years and older) are living longer with cardiovascular conditions, which are leading causes of death and disability and thus an important public health concern. We describe several major issues, including the impact of comorbidities, the role of cognitive health, prevention and intervention approaches, and opportunities for collaboration to strengthen the public health system. Prevention can be effective at any age, including for older adults. Public health models focusing on policy, systems, and environmental change approaches have the goal of providing social and physical environments and promoting healthy choices.Public health and medical advances continue to beneficially affect the health of Americans. Life expectancy at birth increased from 74 years in 1980 to 78 years in 2006.1 In 2006, people at age 65 could expect to live an average of 17 to 20 additional years, an increase of about 1 year since 2000.1 The percentage of the US population older than 65 years is expected to grow from about 12% in 2007 to about 20% by 2050, with a doubling of the population older than 75 years.1 Furthermore, the older adult population is becoming more ethnically and racially diverse through changing demographics and increased life expectancy for all Americans.Despite significant improvements in treatment and prevention, heart diseases and stroke have been leading causes of death in the United States for almost a century.2 They also are leading causes of disability and poor health-related quality of life,3,4 and cost an estimated $273 billion in direct medical costs per year.5 The majority of those who die from heart disease and stroke are 65 years old or older.6 Furthermore, as life expectancy increases, greater numbers of older adults are living with cardiovascular (CV) conditions,7 which are frequently experienced with comorbid physical and mental conditions as well as social challenges. In their efforts to prevent and control CV conditions among older Americans, public health workers must consider these additional factors.Although the prevalence of CV disease in the US population increases with age, it is not a normal process of aging. For those who survive to older adult years, health status is the result of cumulative exposures and health conditions throughout one’s life. The associations between risk factors and health and illness may be different for older versus younger cohorts because of the effects of survivor biases or comorbid conditions. These elements suggest that a lifespan approach is useful to investigating and improving CV health and reducing disease burden, since prevention can occur at all ages.As increasing numbers of older adults live with CV disease and other chronic conditions, their physical, mental, and social functioning, as well as quality of life, are affected. For older adults in particular, a goal of public health has been to postpone and reduce years of ill health into fewer years before death, a “compression of morbidity.”8,9 Factors affecting successful aging that intersect with promoting and maintaining CV health include disability and comorbidity, independence and functional ability, and cognitive health. Challenges associated with the prevention and treatment of CV conditions in older adults include attitudes about the value of medical expenditures for people with limited life years remaining, decisions about extending life versus maintaining optimum quality of life, competing risks, greater medication use leading to potential drug interactions, changes in the risk-to-benefit ratio of interventions for older vs younger adults, and insufficient evidence of the effectiveness of particular interventions in older populations.We discuss several issues of health and healthy aging for older adults. Although we focus on those aged 65 years and older, we also discuss some issues for those at younger ages, since health in earlier years affects outcomes in later years of life. We focus on heart diseases and stroke as major CV conditions. Although peripheral vascular conditions are included as CV diseases, we do not discuss them. CV health is more difficult to define from a public health perspective. Recent American Heart Association health goals refer to CV health as optimal risk factor levels and the absence of CV conditions.10 Public health approaches for improving CV health and healthy aging will benefit from a multilevel, multisectoral approach at the state and local public health level that includes consideration of these multiple issues.     

Using Health Conditions for Laughs and Health Policy Support: The Case of Food Allergies

Health conditions are sometimes included in entertainment media comedies as a context for and as a source of humor. Food allergies are a typical case in point: They are potentially life-threatening yet may be used in humorous contexts. We conducted a content analysis of food allergies in entertainment media and tested the effects of humorous portrayals from an exemplar entertainment program. The content analysis confirmed that when food allergies were portrayed in television and the movies, it was most frequently in a humorous context and often contained inaccurate information. A follow-up experiment showed viewing a humorous portrayal of food allergies had an indirect negative effect on related health policy support via decreased perceived seriousness of food allergies. Inclusion of an educational video eliminated this effect on reduced policy support, with cognitive dissonance as a mediator. Findings support the hypothesis that portraying a health condition in a humorous context may reduce perceptions of seriousness and willingness to support public health policies to address risks associated with the condition, supporting and extending prior research findings.     

加强保健科工作的管理实践

本文结合保健科工作管理实践，着重阐述了加强军队干部保健服务的八点做法，即：更新理念，加强领导，规范管理，优化流程，简化手续，拓展功能，改善环境及健康干预。     

The Role of Primary Care in Improving Population Health

Policy Points

• Systems based on primary care have better population health, health equity, and health care quality, and lower health care expenditure.
• Primary care can be a boundary-spanning force to integrate and personalize the many factors from which population health emerges.
• Equitably advancing population health requires understanding and supporting the complexly interacting mechanisms by which primary care influences health, equity, and health costs.

     

Improving Children's Access to Oral Health Services: The Oral Health Initiative

Although major improvements have been made in oral health during the 20th century, many children in minority groups, from families with low-income, and with special health care needs still do not receive the oral health services that they need. To address the problem, the Health Resources and Services Administration (HRSA), working with the Health Care Financing Administration (HCFA), has launched the Oral Health Initiative. The initiative seeks to strengthen oral health service-delivery systems, enhance collaboration among federal agencies, and provide states with the resources needed to improve the oral health of hard-to-reach children. HRSA's activities include enhancing programs, services, and training, such as expanding the number of direct-service dental programs; establishing or enhancing graduate training programs in pediatric and general dentistry and in dental public health; and funding training programs in dentistry to train dental public health leaders.