Ch. 11 Health and Healthcare
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What are the stages of the demographic transition to the epidemiologic transition?
- stage 1: pestilence(epidemics) and famine (starvation)
- stage 2: infectious (acute) disease (the flu, pneumonia)
- stage 3: chronic disease (cancers, heart disease)
What does the compression of morbidity thesis say?
- human life span is fixed and finite
- improvements in health care and prevention will compress the years that an individual will be disabled into the last few years of the life span (assumes everyone has equal access to disease prevention)
What does expansion of morbidity say?
new diseases are always being developed or discovered
What is the health lifestyle?
a pattern of behavior based on choices and options that are available to people according to their life situations
How does smoking affect our health?
- reduces life expectancy by 7-10 years
- major cause of COPD and asthma
- we have choice to smoke or quit smoking
- being exposed to second-hand smoke is not under our control
How does exercise affect our health?
- more ability to control weight, have fewer backaches and joint problems
- exercise improves cardiovascular function, better long and short term memory, and less disability
How does alcohol consumption affect our health?
- heavy consumption leads to more likely suffering from cirrhosis to the liver, cancer and hypertension
- moderate consumption protects against heart disease.
How does diet affect our health?
obesity leads to risk of heart disease, diabetes, and joint problems, less physical strength and less upper-body mobility (poor diet)
How does social support improve health in later life?
- positive effect on cardiovascular, endocrine, and immune systems
- emotional support is associated with better physical functioning and reduced risk of mortality
What does the theory of cumulative disadvantage say?
- people who begin life with greater resources continue to have opportunities to accumulate more of them while those who begin with few resources fall further behind
- this theory would predict that the gap in health between rich and poor increases with age
What does the convergence theory say?
- old age is a great leveler, reducing inequality that was evident at earlier stages of the life course
- this theory would predict that the gap in health between rich and poor narrows with age
Why do physicians provide the elderly with over treatment?
Few elderly being concerned about the treatment they are being given and just relinquish the responsibility of care to the doctor trusting him to do whatever is needed and potentially leading to receiving more treatment than necessary
Why do physicians provide the elderly with under treatment?
- Due to fears doctors have that elderly patients will not be able to survive or handle strenuous and demanding treatments they choose not to communicate the availability of the treatments (also a result of physician biases and poor communication)
- being that the elderly have a limited period of time left to live physicians see little reason to provide some treatments and rehabilitative services
What is managed care/health maintenance organization?
health insurance plans run by financial officers who monitor the services offered by physicians that are members of the health maintenance organization to achieve efficiency and control costs
What do diagnostic related groupings assist with?
containing medical costs by setting reimbursement rates in advance based on the diagnosis a hospital patient receives thus expecting them to stay for a specific length of time and consume a fixed amount of resources
What benefits does the Affordable Care Act provide?
- Attempts to make healthcare more available, affordable, and sustainable for older adults
- Covers children to age 26
- Medicaid money follows the person and community first choice
- National long term care insurance
- eliminating the max amount medicare will cover for prescription drugs (the "donut hole")
- Nursing home transparency that provides federal access to information on all nursing homes
- Federal criminal background checks for direct care workers
- Education and incentives for geriatric specialties
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