Process of Identification & Definition~~~~~ 4 double spaced pages 1 cover sheet and 1 reference sheet
Review the World Health Organization’s (WHO) definition of health in Chapter 7 of your textbook. Then, write a research paper fulfilling the following requirements.
Assessing the Impact of a Health Policy
A World Health Organization (1999) report, the Gothenberg Consensus Paper, defines a health impact assessment as, “A combination ofprocedures, methods and tools by which a policy, programme or project may be judged as to its potential effects on the health of apopulation and the distribution of those effects within the population.” As we shall see later, the distributional effects may take these studieswell beyond the population at immediate risk, especially in a market system like the United States.
• Why is the definition of health important to health policy?
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• Define the term “target population” as it relates to health policy.
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• How do societal influences impact the identification and definition process of policy?
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• Research a healthcare organization and highlight how their policies align or misalign with the WHO’s definition of health.
Four to Five pages additions to the cover page and reference page
Must include at least 4 sources
Defining Health
Table 7-1 presents the view of health and health care espoused in the constitution of the World Health Organization. Although the UnitedStates is a U.N. member state, one would be hard put to find consensus in the United States on a number of the points that it cites as basicprinciples.
Asking people in the United States if health is more than the absence of illness or infirmity could produce a host of different responses.Some respondents might come down on the side of physical and mental well-being but have a problem with trying to address social well-being under the heading of health. Indeed, the fact that we have millions of uninsured and do not provide mental health care to a largeproportion of the population would seem to indicate a lack of commitment to physical and mental well-being.
Those analyzing or deciding on a policy need to understand the differences in the operational definitions of health that are representedaround the table. In the best of all possible worlds, those seated at the table would agree on that definition and move on, but sometimes theart of politics depends, in part, on knowing when to try to agree on principles, or on actions, or on both, and whether to use limited politicalcapital to try to bring them into alignment publicly.
Defining the Target Population
Just what population are we talking about? The history of community mental health centers illustrates how difficult—and critical—it can beto answer this question. A system designed to help the developmentally disabled and severely and persistently mentally ill morphed into ageneral mental health treatment system in which many practitioners avoided the original target group and concentrated on the morerewarding (professionally and financially) cases (Torrey, 1997). As more and more states now focus more intently on the original targetpopulation, many of those previously served must rely more on private payment or insurance or go without.
An analyst in charge of developing a maternal health program policy who wanted to determine the health status of the target populationmight start by looking at the health of all females of childbearing age. But what constitutes childbearing age when 8-year-old girls andwomen in their 50s can give birth? An analyst would have to put both an upper and a lower limit on the age range in order to get a count ofthe target population.
Identifying the Health Status of the Target Population
The next step after defining the target population is to assess its health status. Many data sources are available for this task, but sometimesthey do not match up exactly with the target population that has been identified. The CDC demonstrated the complex connection betweendefining the target population and assessing its health status using available data in 2000 when it reported on changes in serum foliatelevels in noninstitutionalized women ages 15–44 who participated in the National Health and Nutrition Examination Surveys from 1991 to1994 and in 1999 (CDC, 2000). It did not conduct a special study of pregnant women or women of childbearing age, the recommendedtarget group. Instead, it segmented the data in the existing surveys and analyzed that. There certainly are women bearing children after age44, before age 15, and in institutions; however, the age range covered most of the potential recipients, and the differences in outcomes wereso great that the analysts did not feel the need for further refinements.
Looking at the health status of the target population in the aggregate can often obscure differences between subgroups. One frequentlyhears about the millions of people in the United States who lack health insurance. Does their health status suffer because they lackinsurance? Sometimes and sometimes not. Historically, many of the uninsured have been young people who have made a calculated trade-off between the cost of health insurance and the fact that they are young and healthy (a group sometimes referred to as “the youngimmortals”). Yes, they are more likely to have severe auto accidents than an older population, but until one happens they are not part of the20% of the population that accounts for 80% of health care costs. They are transferring the risk of low-probability events to the public atlarge because they would probably receive care anyway. Others may want insurance and need it, but are simply unable to afford it. Thepoint is that there is plenty of room to talk at each other rather than solve problems. One can talk about the issue by discussing theuninsured as a bloc or about the needs of specific segments. The important thing is that analysts define clearly whom they are talking about.
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