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How does a health management organization (HMO) type of insurance lower healthcare costs? You have to see a provider within the HMO's network. The network is made up of providers that have agreed to lower their rates for plan members and also meet quality standards. If you opt to see a doctor o...

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  • 15 augustus 2022
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pubh 6127 final exam essay and short questions and answers 2022


How does a health management organization (HMO) type of insurance lower healthcare
costs?
You have to see a provider within the HMO's network. The network is made up of
providers that have agreed to lower their rates for plan members and also meet quality
standards. If you opt to see a doctor outside of HMO, you will have to pay the entire
cost of medical services. You may need a primary care physician (PCP) referral to be
covered when seeing a specialist

What did the Affordable Care Act mandate?

(Obamacare), requires most Americans to have a basic level of health insurance
coverage. This requirement is commonly referred to as the law's "individual mandate."

What is medical malpractice?
This occurs when a hospital, doctor, or health care professional, through a negligent act
or omission, causes injury to a patient. The negligence might be the result of errors in
diagnosis treatment, aftercare, or health management

What are the top 10 health issues in the US?
1. Alcohol-related harms
2. Food safety
3. Health-care associated infections
4. Heart diseases and stroke
5. HIV
6. Motor Vehicle Injury
7. Nutrition, physical activity, and obesity
8. Prescription drug abuse
9. Teen pregnancy
10. Tobacco use

What is the social determinants of health? Describe the types of SDH?
Definition:
Determinants of health are factors that contribute to a person’s current state of health.
These could be biological factors, psychological factors, behavioral factors, and social
factors.
Social determinants of health are social conditions into which people are born and that
affect their daily lives and overall well being as they move through the various stages of
life.
Social determinants include factors that may have led to an individual’s disadvantaged
state to begin with- institutional racism, exposure to crime and violence, a lack of

,available community-based resources, and many other factors that can all be health-
harming.
Types:
- Access to high-quality educational opportunities
Individuals with access to consistent, high-quality educational opportunities are more
likely to obtain higher-income jobs. With low-quality education, low paying options will
be availed which might not offer health insurance as a jib benefit making it difficult for
individuals to access routine and specialty physician services.
Educational attainment and corresponding income levels tend to be strong predictors of
individual and population health.
- Access to medical care services
Individuals who do not live close to medical care providers are less likely to see a
physician regularly and will often seek care only in emergencies,eschewing to
preventing care ultimately leading toa decreases quality of life.
- Access to social media and other technologies
The internet and cell phones are becoming increasingly useful in individual and
population health, from reminders of appointments to learning about symptoms of
diseases and to buying of insurance through state exchanges under ACA.
- Availability of community-based resources and opportunities for recreational
activities
Community-based resources can connect residents to local health providers and
recreational/ physical activities increasing the likelihood of people leading healthier lives
overall
- Availability of resources tp meet daily needs
Individuals living in food deserts are more likely to consume fast foods or other relatively
unhealthier options contributing to a poor diet and high levels of obesity and other diet-
related diseases like diabetes and heart disease
- culture
While traditions can have important positive effects in treating illness, cultural norms can
also impact health in unseen ways.
- language/ literacy
If adequate translation and interpretation services are not in place in health care
facilities, foreign-language speaking patients may be discouraged from seeking care.
- Public safety
Individuals who live in dangerous neighborhoods tend to remain indoors, which closes
off opportunities for exercise and social interaction. People who have less access to
public transportation will miss doctors’ appointments. Also, alcohol, drugs, violence, and
adverse health outcomes are more relevant in unsafe neighborhoods.
- Residential segregation

, Physicians may prefer to set up their practice in locations dominated by certain
demographics. As a result, low income and minorities suffer from a lack of healthcare
facilities.
- Social norms and attitudes
Discriminatory attitudes remain a cause of health disparities. Bias in physicians and
other healthcare professionals plays a significant role in how patients of certain races,
gender, ethnicities, social status, age, and education levels are treated. Patient attitudes
about medical professions can also affect health.
- Socioeconomic conditions
Concentrated poverty and the stressful conditions that accompany it can have a
jeopardizing effect on health. Greater wealth correlates with lower rates of morbidity
and longer life spans.
- Transportation options
Many individuals miss medical appointments because they cannot afford private
transportation and live long distances from reliable public transportation.

How to SDH affect health outcomes

Relationship between SDH and health outcomes
Links can be drawn between social determinants and both physical and mental health.
Half of the deaths in the united states involve behavioral causes.
Health-related behaviors are strongly shaped by three important social factors:
employment, education level, and income.
Lower socioeconomic status is associated with increased prevalence of disease,
morbidity, and mortality.
Access to safe, quality, affordable housing represents one of the most influential SDH.
Regardless of income or housing cost, living in a predominantly minority neighborhood
increases the likelihood of having poor access to healthy food choices.
SDH play a significant role in mental health outcomes as well
Emotional stressors such as neighborhood violence, poverty, or familial abuse can lead
to severe consequences in life.

How is law a SDH ?
- Law can be used to design and perpetuate social conditions that can have
terrible physical, mental and emotional effects on individuals and populations.
- Law can be used as a mechanism through which behaviors and prejudices are
transformed into distributions of well being among populations.
- Law can be determinative of health through their under enforcement
- Law can be determinative of health through their interpretation

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