Disparities

tertiary prevention

-Aimed at the treatment of existing symptomatic disease or any condition contributing to disease complications -managing established disease

different areas where scientific evidence is evaluated

-burden of suffering -efficacy of screening tests -effectiveness of early intervention

secondary prevention

-detects a condition at its earliest stage while the disease process is asymptomatic -cure or stop progression

health disparity represents an inequality in access and quality including things like

-health literacy -access to healthcare -affordability of healthcare (underinsured, uninsured) -quality of health care providers -patient driven factors -provider driven factors -institution driven factors

what is HPDP aimed at

-infectious disease -atherosclerosis -cancer -metabolic disease -behavioral conditions

positive effects of HPDP

-prevention activities have the potential to decrease the individual and societal burden of suffering from acute and chronic diseases -effectively decreasing the overall cost of healthcare delivery

Healthy People Initiatives / research

-provides 10 year evidence based targets for the

primary prevention

-removing or modifying risk factors or causes of disease -impact health outcomes before the onset of disease of injury

why is HPDP important

-research has demonstrated BOTH economic and non-economic value in seeking the root cause of disease and the prevention of disease -Expenditures of health resources in the United States are predominately directed at late-stage disease

examples of social determinants of health

-residential neighborhoods (water quality, lead paint exposure, food choices, green spaces) -school/work environments (poor health lit., exposure to toxins/crime/trauma) -community and religious settings

HPDP classification

A. the disease has a large impact on quality/quantity of life B. the disease must have asymptomatic period during which detection and treatment reduces morbidity and mortality C. treatment in the asymptomatic phase must yield a therapeutic result superior to that obtained by delaying treatment until symptoms appear D. tests that are acceptable to patients must be available at a decent cost to detect the condition during asymptomatic period E. the incidence of the condition must be enough to justify the cost of screening

USPSTF

U.S Preventitive Services Task Force

food desert

a neighborhood where nutritional food is limited

effectiveness of early intervention

availability of clinical interventions - this can prevent or delay disorder

USPSTF Grade I

concludes that the evidence is insufficient to recommend for or against routinely providing the service

health disparity

differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups.

in the US when does most health care spending occur

end stages of life

USPSTF Grade C

makes no recommendation for or against regarding routine use of the service

healthy people 2000 (2010,2020)

goal to eliminate health disparity by 2010

2002 IOM

health disparity study

HPDP

health promotion and disease prevention

burden of suffering

incidence, prevalence, morbidity, mortality

Effective strategies to improve behaviors MUST be implemented in places where

individuals participate in their communities

disparity

lack of similarity; inequality; difference

social determinants of health

non medical conditions that affect health

community health care models (community based intervention)

proven to significantly improve outcomes

USPSTF Grade D

recommends against routine use of the service in asymptomatic patients

USPSTF Grade B

recommends routinely providing the service to eligible patients

Efficacy of screening tests

sensitivity, specificity, predictive value, and reproducibility

USPSTF Grade A

strongly recommends that these services be routinely provided to eligible patients

national institutes of health

utilizes research to identity factors related to discovery and detection of health disparity

traditional intervention is implemented from

within the clinical setting

the PA role & HPDP

▪HPDP begins during the education process of future clinicians - "The generalist curriculum...is well-suited to provide PA's entering the medical workforce with a foundation in HPDP.

what does the USPSTF do

▪Independent panel of experts in primary care and prevention that systematically reviews the available evidence and develops recommendations for clinical preventive services. ▪Works to improve the health of Americans by making evidence-based recommendations about clinical preventative services